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CLB Agenda 09/18/2019COLLIER COUNTY Board of County Commissioners Contractor Licensing Board AGENDA Board of County Commission Chambers Collier County Government Center 3299 Tamiami Trail East, 3rd Floor Naples, FL 34112 September 18, 2019 9:00 AM Kyle E. Lantz, Chair Matthew Nolton, Vice-Chair Robert P. Meister, III Patrick G. White Michael E. Boyd Terry Jerulle Richard E. Joslin, Jr. Jeffrey Williams NOTICE: All persons wishing to speak on Agenda items must register prior to presentation of the Agenda item to be addressed. All registered speakers will receive up to three (3) minutes unless the time is adjusted by the chairman. Any person who decides to appeal a decision of this Board will need a record of the proceeding pertaining thereto, and therefore may need to ensure that a verbatim record of the proceedings is made, which record includes the testimony and evidence upon which the appeal is to be based. If you are a person with a disability who needs any accommodation in order to participate in this proceeding, you are entitled, at no cost to you, the provision of certain assistance. Please contact the Collier County Facilities Management Division located at 3335 East Tamiami Trail, Suite 1, Naples, Florida, 34112 -5356, (239) 252-8380; assisted listening devices for the hearing impaired are available in the Facilities Management Division. 1. ROLL CALL 2. ADDITIONS OR DELETIONS 3. APPROVAL OF AGENDA 4. APPROVAL OF MINUTES 4.A. APPROVAL OF MINUTES - JULY 17, 2019 5. PUBLIC COMMENTS 6. DISCUSSION 7. REPORTS 8. NEW BUSINESS 8.A. ORDERS OF THE BOARD 8.B. DAVID WAINSCOTT - REINSTATEMENT WITH WAIVER OF EXAMS 8.C. LARRY BRUELLMAN - REINSTATEMENT WITH WAIVER OF EXAMS 9. OLD BUSINESS 10. PUBLIC HEARINGS 11. NEXT MEETING DATE 11.A. WEDNESDAY, OCTOBER 16, 2019 Inquiries concerning changes to the Board’s Agenda should be made to the County Manager’s Office at 252-8383. Co et COLLIER COUNTY CONTRACTORS' LICENSING BOARD SEPTEMBER 18,2019 9:00 A.M. DAVID WAINSCOTT - REINSTATEMENT WITH WAIVER OF EXAIVS DAVID WAINSCOTT is coming before the board today asking for a Reinstatement of his REGISTERED GENERAL CONTRACTOR (restricted to Residential Properties Only) license under company NAPLES BUILDING GROUP, which was SUSPENDED in 2O11 lor failure to comply with probation. Mr. WAINSCOTT was originally before the board on 311612011for review of his credit During that meeting, the Board approved his license to be restricted to Residential Properties Only and a 1-year probationary period, in which he needed to submit his credit in 6 months for review. He is back before you today, asking for a reinstalement of his license and that the exams he took with Collier Counly Sponsorship in 2009 can be used in the application. General contractor requires 48 months experience with a passing grade on an approved test and a business and law test and means a contractor whose services are unlimited as to the type of work which he/she may do, except as provided in this article or in the Florida Stalutes. Collier County Ordinance 2006-46 (1 .6.1.1). Residential contructor requies 48 months experience with a passing grade on an approved test and a business and law test and means a conlractor whose services are limited to construction, remodeling, repair, or improvement of oneJamily, two-family, or three-family residences not exceeding two stories in height and accessory use structures in connection therewith. Collier County Ordinance 2006-46 (1.6.1.3). Qovmty Mr. WAINSCOTT was scheduled tor lhe 91211201 1 meeting to review his credit. At that time, he did not submit his credit reports for review by the Board. His license was suspended for not complying with his probation. Gontents Letter to go in Front of the Board Application Exam Scores from 2009 lndividual Credit Report Company Credit Report Sunbiz documents State of Florida/lRS Documents Statement of Ownership Verification of Experience Letters Affidavit of lntegrity & Good Character DBPR License Registration General Liability & Exemption Business Tax Application ftllarch 16, 201 1 Agenda, lvlinutes, & Finding of Facts sep tember 21,2011 Minutes & Finding of Facts Board Hearing lnformation APLE-q I,-ILDING ROLTP *+ August 5,2019 Re: David Wairscott reinstatement of General Contractor license Licensing Board, I am before you to ask that my General Contractors license be reinstated. I was before you in 2011 and was granted my G.C. License conditionally upon improving my credit which had been damaged in the recession and had not recovered. Due to circumstances, I was not able to be present for the follow up meeting before the board and my license was suspended. After that, Ijust focused on my design business. Once I was ready to return in front of the Board in 2013, I was struck with MRSA. It kept me in the hospital for over a month and recuperated for the next 6 months. When I retumed to work I maintained my design firm and also partnered with Bob Hine and activated Naples Building Group. We have been building homes in Collier County and Marco Island since under Bob 's license. Delaying my attempt to come back before the Board again was n late 2017 I had a quad bipass heart surgery. Only in the last 3 or 4 months have I recovered firlly and I am now attempting to stand before you again to ask this reinstatement. Thank you, Dave Wainscott Page I of I Naples Building Group, LLC, PO Box 990115, Naples, Florida 341 l6 C,RP", Cott*A MT.TT]XTD Contractor Licensing 2800 N. Horseshoe Dr. Naples. FL 34104 Phone - 239-252-2431 Fax - 239-252 2469 Gr1},r/lfr Managernent Oepartrnent n*--]P* r APPTICATION FOR COI"LIER COUNTY CERTIFICATE OF COMPETENCY FULT REINSTATEMENT APPLICATION FOR COLLIER COUNTY CERTIFICATE OF COMPETENCY Q 3zzzt a ?052s 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 lo: Collier County Board ol County Commissioners. For lurther information, consult Collier County Ordinance No. 2006-46, as amended. TYPE OF CERTIFICATE OF COMPETENCY: fo,n",",t ,r,,o,nn i-' Residential I Mechanical tr Rooling tr Electrician n Plumber C Air Conditioner E Swimming Pool D Specialty $230.00 $230.00 $230.00 $230.00 $20s.00 Uqv.rt G nTrade: I. APPLICANTPERSONALINFORMATION: Name Dktto b, Urhil?rt Mrddle lnrtal Business Name I..lK'?lr?, WtWtrX 60 o0? Addrcss Tb,L( h?-r*+(Lvpt lre- ilW Ac 4\4 Sveet City State Zp Emait: DhtL a iAoveo na. LDA .SS # (Last 4 digits only)o144 Date ol Birth o Driver's License # (Last 4 digits only)41o-o 'Pursuant to Chapterl-19, Floride Statut.s and Collier County Contrador Licensing Ordinance 2006.05 Section 2.1.1., all.pplic.nts ar€ requ;red to submit their socialsecurity number (SSN) forthetollowing purpoies: alAssess applicant's abilityto satlsfy creditors by reviewingthek credil hirtory. blVerifletion olapplicant's test scores and information. Our orflce wlllonly use yourSSN noted above for lhose reasons pur5uant to Chapter l-19, Flo da 5tatut6, a nd as may other$rise be a uthorized by law, W€ are fully com mitted to safe-gu.d ing and prot€ctin8 your SSN and once collected, will be maintained as conridentialand exempt under Chapt€r l-19, Florlda Statute., Registered Full Reinstatement $230 - Reinstatement $41i5 - Ronewal (ll back years) FULL REINSTATEMENT APPLICATION REV 411211 $180 - penalty fee (3 back years) ,3 of 15 $1li . 2019/2020 Renewal $991 - total due $230.00 $230.00 $230.00 $230.00 $230.00 Tetepnone:'2,24,tr12-' 4-l 14 Co Cor.tttt3l Contractor Licensing 2800 N. Horseshoe Dr. Naples, FL 34104 Phone - 239 252-2431 Fax - 239-252-2469 APPLICATION FOR COLLIER COUNIY CERTIFICATE OF COMPETENCY Provide the names and telephone numbers ot two persons who will always know your whereabouts Telephone a4.q1L.4n* II. NAME OF APPLICANT'S BUSINESS: Name boo *r Business Address Ao hht| waL ar&q.{*ea fu- 4,tt4 t I Crty Sl3ie Telephone t'?h4 1 q1'7-.?l?4 Federal lD Tax No /n. nr?.bu,l III. FINANCIAL RESPONSIBILITY NOTE. lf you have answer yES to any of the questions below, you must attach a written explanation including the nature of the charges, dates, and outcomes, sentences of conditions imposed. You must also attach proof of payment, satisfaction ot lien or judgement, bankruptcy discharge, or agreements for payment. 'lf you have had a felony conviction, proof that your civil rights have been restored will be required prior to licensure. YES NO ALL APPLICANTS MUST ANSWER THE QUESTIONS BELOW: )(Filed lor or been discharged in bankruptcy within the past 5 years? r L Undertaken construction contracts or work that resulted in liens, suits, or judgments being liled? *Undertaken construction contracts or work that a third party, such as a bonding or surety company, completed or made financial statements on? Made an assignment of assets in settlement of construction obligations for less than the debts outstanding? /-Been convicted or lound guilty of, or entered a plea of nolo contendere to, regardless ol adjudication, a crime in any jurisdiction within the past 10 years?' t-Had claims or lawsuits filed for unpaid or past due accounts by your creditors as a result of construction experience? Y Been charged wilh or convicted of acting as a contractor without a license, or if licensed as a contractor in this or any other state, been "subjecl to' disciplinary action by a state, county. or municipality? FULL REINSTATEMENT APPLICATION REV 4/12118 Page 4 of 15 Grovvtr) Managernent Departrnenl *^^"AtvN V)knttud Business Name: rcteenone, L7.7-*. U7'1 h Street Had a lien liled against you by the lnternal Revenue Service or Flolida Corporate Tax Division? /- C,Rff.,Cor*r,t!Contractor Licensing 2800 N. Horseshoe Dr. Naples. FL 34104 Phone - 239-252-243'! Fax - 239-252-2469 G.o,vth Managernent OepartrEnt APPLICATION FOR COLTIER COUNIY CERTIFICATE OF COMPETENCY IV. EXPERIENCE VERIFICATION EDUCATION: List below and provide transcripts lor any lormal education you have obtained in the area of competency for which this application is being made: lYoNt List below non formal education (on the job training) you have obtained in the area ol competency for which this application is being made ?wttt4t rtj ,6 ?AL' II,ITH oA {&t ,-J CURRENT/PREVIOUS LICENSE: ?,oW Foa UWA?5 Acfive List below and attach copies any other certificates ol competency/licenses you hold/have held in Collier County or any other jurisdiction. lnclude the license #, Type, and county you hold it in. 6,.C.Dll l.J ,-)tttvE- lrJ Co Under the penalties of perjury, ldeclare that I have read the foregoing application and the facts stated in it are tru e DavrP lt*rhcr{ Applicanl (please print)Signalure ol Applicanl State ol w ?Lo,w County of Caruva The foregoing instrument as acknowledged before me this Auawr <1o14 by ,-l> Date 2x'Jrpf).atz"{_ who has produced l-lhtW name oi person acknowledging (applicanll type ol identilicaliofi or known identification and did not take an oath as .:.ffiffiffi NOTARY'S SEAL 1rtl h,6 FULL REINSTATEMENT APPLICATION REV 4/12118 (SIGNATURE OF NOTARY) Page 5 ol 15 Dve To ftuntttpu t5S0€5 uloA Z€coul^4 u AFFIDAVIT c,&ff",Cor,t*tty Contractor Licensing 2800 N. Horseshoe Dr. Naples, FL 34104 Phone - 239-252-2431 Fax - 239-252-2469 Grci.dh Managernent Deparf nefit APPLICATION FOR COLLIER COUNTY CERTIFICATE OF COMPETENCY CERTIFICATION OF APPLICATION The undersigned hereby makes application for Certificate of Competency under the provisions ol 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 certilies that he is legally qualified to act on behall ot the business organization sought to be licensed in all matters connected with ils contracting business and that he has tull aulhority 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 lor any and all activities involving his license. Any willful lalsification ol any intormation contained herein is grounds lor disqualilication. ant (pr nt {xa.es Name ol Company vU2 ld*t,urt( Signalure ol Applicant Leoaoy County of Co"r-ttrz The foregoing instrument as acknowledged betore me this D,Ar,p lu*r,qt{who has produced name ol person acknowledging (applicant) and did not lake an oath. wlv4zt L[q^taL as identitication by dale (SIGNATURE.;ffi ONE {EA F,TIER lfl cotff,sslox, tf Sea{2 EXPIFES: Odcb.. 5, 2020 t'arnilLrliarrSrb NOTARY'S SEAL FULL REINSTATEMENT APPLICATION REV 4/12i 18 Page 6 of 15 State of: A*-,pi' {.4.0t4 1 lype of iderllilicalion or known NOTARY) C,Rft,Cott:ttt!Coniractor Licensing 2800 N. Horseshoe Dr. Naples, FL 34'104 Phone 239-252-2431 Fax - 239 -252-2469 Grc)\,vth lvtanag€rnent Departrnent APPLICATION FOR COLLIER COUNTY CERTIFICATE OF COMPETENCY WORKMEN'S COMPENSATION AFFIDAVIT It is understood and acknowledged by the Collier County Contractors' Licensing Board and mysell that if I fail to acquire, or maintain at all limes elfective Workmen's Compensation lnsurance it will result in the possible revocation of my Certificate of Competency. Applicant (please prinl ;J46gr burusr",, 6aue Name ol Company sig Applica V DXr'fi- who aff irms and Applicanl (please prinl) 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 lnsurance. {+ortv* County ol 0a,ufuz- The foregoing instrument as acknowledged belore me this b- ,-aon by date DNtv ll*,,gr{who has produced as identilication name of person acknowiedging (applicant) and did not take an oath. Iype ol identificalion or known u4./a__ p^f:.'.Sa 'rWJ $RSNEAtrIIER w coNn*l$oil I FF 9rar2 EIHiE& oc&Drt m &ddrhr Bl4.tEr8.*. (SIGNATURE OF NOTARY) NOTARY'S SEAL FLILL REINSTATEMENT APPLICATION REV 4/12118 Page 7 of 15 QAuto Wn,*"d BEFORE ME this day personally appeared State of w.i,r-r* L,u*ue Search tor Oualifier By ilame tm(ounl QllAtlflB tIBR Jn ? 32i81 OATT OI BIRTH €r JD 0Avl0 w. illArNscorT 1o/to/r961 &dfalht 1frr0 - GEiltNA. C0 TX.{!GSrIR[D (iet Contractor by Cert l{umhr Addren 588r pAtNTiD LIAF tN. NAptlS FL 141]G NAPitS MOTTE wln011 DriYeR llmbr 1.s15 DR-3904 e ffiIfl8R 163ll $ults -(USm 0t[ NAPtts SUIIONG GROUP tI( ldres 5881 PAIIT$ tIrAt tlIE tlIPtIS [ 3{11t REINSTAIE DATE DGHPT EXPIRE DAIE IXEY 24085 240$1 EXA OETAILS GAElA . GENERAL CONTR . A AAF?A - BUSINESS PROCEDURES EXAM SCORE 75 00 76.00 EXAtt t (xaTtoI ocAr-A (GrTs) OCALA (GITS) EXAH DATE 12117D009 1?,17t2o0g sPor{soR COLLIER COUNTY COLLIER COUNTY Oualifier Exam per Oualafier ID 5earcn Lerttltcates by IJBA COUNfl OL gP DATT $30/1999 RENEWAL OAITCEff N8R 1r32r 2t6al 15067 26t06 27551 35335 36,ll 29129 STAIIS crric8. clt'lcIt CANCA CAXGT clilcE IliACITvt IIIACI]v€ 084 MIXI |{APIIS BUII'DR5, INC. r4rc N ptts tultDas. hlc Ntpus sutt tNG co, tr./c NAfl.:S SUTID|NG COMpANI INC MP[:S SUrtOrNG CoMpANt INC NAPttS gurt r,16 6R0r,P frc t{rnrs E lns6ctorp ltc oRrG lssD OAIE 2r91991 9r2!ru00 931991 10/1/2001 7mn$5 t7u2!11 ulml1 6,92006OI.D NAPIIS 8UILDTRS, INC. D(PIRE DATE CNCT DATE 9n0x 999 ?nM0t2 830/1997 88r2008 &412008 9802013 9l0n0t1 8n112012 9m20t3 gmrMl 9Mn012 v21D@t a21D001 1D3t2011 011201'l GDPlus lnformation on David Wainscott t{Arr! GreenbergJoann From: Sent: To: Subject: gitsllc@gitsllc.net Thursday, December 17, 2009 4:46 PM greenbergj; BlancoJennifer; wright_m Mr. David Wainscott Good Afternoon, Ladies, Mr. Wainscott tested in our Ocala office today, December 17th, and achieved the following scores: General Contractor GAEgA - 75% Business Procedurcs AAE2A - 76Yo Please feel free to call our office if you need any additional information - thanksl Margharita Gainesville lndependent Testing Services, LLC. PO Box 831127 Ocala, FL 34483-1127 Toll Free: t-8OO-997 -2L29 Faxi 352-387 -2443 website: www.gitsllc.org The information contained in this e-mail and any attached documents may contain information that is confidential or otherwise protected from disclosure. lf you are not the intended recipient of this message, or if this message has been sent to you in error, please immediately alert the sender by reply e-mail and then delete this message, including any attachments. Any dissemination, distribution or other use of the contents of this message by anyone other than the intended recipient is strictly prohibited. I Lt€Eh* 8E6 uofr Ave. N. Suite 16, Naples, Ft 34108 Phone: 239,777.1028 Fa'c 877 -275-?593 PERSONAL CREUT FEFCRr (Compiled From National Records) <FOR> <SUB NAME> (r) P NP7771028 LTCENSES ETC <SUB.'ECT> WAINSCOTT, DAVID W. <ALSO KNOWN AS> WAINSCOTT, DAVE, W <CURRENT ADDRESS> 20791 GROVELTNE CT.. ESTERO FL. 33928 < FORMER ADDRESS> 5881 PAINTED LEAE TN., NAPIES FL. 34116 990381 pO BOX 990381, NAPLES EL. 34116 <MKT SUB> <INTILE> <DATE> 16 NP 6/85 03/1-8/t9 <SSN> <TIME> 10:16CT <BIRTH DATE>'143 LO/64 <DATE RPTD> 3/15 9/0t <POSITION> <CURRENT EMPLOYER AND ADDRESS> NAPLES BUILDING GROUP NAP],ES FL . <FORMER EMPLOYER AND ADDRESS> SOUTH FLORIDA ARCHITRCTURAL AS <VERE> <RPTD> PRES 2/07 MODEL PROEILE i**FICO SCOBE 8 SCORE +826 : TOO FEw ACCOUNTS CURRENTLY PAID AS AGREED;TOO * * *I{ANY ACCOUNTS WITH BALANCES;LACK OF RECENT REVOLVING ACCOUNT ***JNFORMi\TJON;LACK OP RECENT BANK REVOLVING INPORI{ATION* * * PUEUC RECORDS HAVE BEE]I SEARCHED AT THE C(ruilTY, STATE A'ID ET'ERAI. I.EVEI,S . IIOflE FOU'ID L2/72 12/12 TRADES SUBNAME SUBCODE OPENED HIGHCRED TERMS ACCOUNT# VERFIED CREDLIM PASTDUE ECOA COLLATRL/LOANTYPE CLSD/PD BALANCE REMARKS TARGET/rD D 647 600'1 8/10 s544 3/L9A $1000 $0 A CREDIT CARD 3/19 $O s0 MIN25 $0 048M1003 $0 PAYPAT 1- 12 MOP PAYPAT 13-2 4 vto 30/60/90 11111111E1lE R01 111111111lE1 82 0/ 0/ 0 l 1EEEEEEEEEE RO1 1EE11E 18 0/ 0/ 0 11 1 11 111111 1 R01 11111111111 23 0/ 0/ 0 111L11111111 r01 1111111 L9 0/ 0/ 0 }{AXDELO AMT-MOP WELTS EARGO B 908N664 8/L'1 3/19A A CREDIT CARD 2/79 CAPITAL ONE B 1DTVOO1 3/L7 3/tgA A ELEX SPND CRT CRD TOYOTA MTR Q 4L7 6102 C AUTO LEASE WFHE B 908N737 6/t1 2/t9A $t441 s8200 s0 $ss46 $30.0K $L206 s47.9K $27.1K s0 $500K EEEEEEEEEEEE CO1 EEEEEEEEEEEE 2/t6 2/79A $0 Page 1of 2 www.LicensesEtc.comffi C HOME EQUITY TOAN CAPITAL ONE B 1DTVOO1 6/07 3/18A A FLEX SPND CRT CRD 2/1-8C UNIT COMM B 2583028 L2/O'I t2 / r0A C HOI4E EQUITY LOAN !O/7OC E88111111111 R01 s0 111111111111 ACCT CI,SD BY CONSI'MER 28 O/ O/ O $0 $ 96s0 $72 . 6K s0 s500K $500K s0 35 0/ O/ 0 $o CLOSED 111111111111 C01 111111111111 3s o/ 0/ 0 INQUIRIES DATE SUBCODE 3/78/L9 PNP777102 8 (FLA) 6 / 30 / t'l ACHA672226 (CHr') 6/21 /L7 ACH2877925 (CHr) SUBNAME LICENSES ETC GERMAIN LEXU GERMAIN TOYO TYPE AMOUNT END OF REPORT Page 2 of 2 885 11Ot Ave. .suite 116, Naples, FL 34108 Phone: 219 .777 .LO28 Fax: 877,275,1593 wwB.LicensesEtc-com Address: Experian EII!r 948124367 Agent:Wainscott David 3825 Beck BLVD Naples, FL 34114-1274 United States 3825 Beck BLVD Naples. FL Naples Building Group LLC 3825 Beck BLVD Naples, FL Naples Building Group LLC 20791 Groveline CT Estero, FL United States Business Type:Corporation Expedan Ejlg Established: May 2011 Experian Yea6 on File: 8 Years Years in Business:More than 8 Years Filing Data Provided by: Florida Date of Incorpo6taon: 02l0U2011 Agent Address: Famlly Linkage: Naples Building Group LLC BUSIT{ESS CREDIT REPORT Key Personnel: as of: (}3 18 19 11:22 ET Fed Tax lO# 27-4723391 Manager: Hine Robert Manager: Wainscott David Ultimate Parent Branches / Alternative Locations PUBLIC RECORDS HAVE BEEN SEARCHED AT THE COUI{W, STATE AND FEDERAL LEVELS. 'r Bankruptcies: Liens: ' ,udgments Filed: " Collections: 0 2 0 0 Page 1 of 2 LI€E}IG Public Records Tax Lien Filings Date: lt/OBl2OL3 Owner: State Of Florida Filing Location: Collier County Circuit Court Legal Type: State Tax Legal Action: Lien Document Number: 4911313 Liability Amount: $349 Description: Other Tax Date 09/19/2OL3 Owner State Of Florida Filing Location: Collier County Circuit Court Legal Type: Legal Action: State Tax Lien Document Number: 4892254 Liability Amount: $300 Description:Other Tax END OF REPORT Page 2 of 2 Detail by Entity Name Page I of2 Fio.da Deoarrme.r of Srare Otvs,oN oF CoRPoRArroNs t, ( ) it i) () | ;\' t' t( ) \ [:) ---'1* in i$l. kn Sknr ,'l tini,!,t *',,h' peparhentorStare/Ql!]!r.9!_9rc-SlpglClrp!-C/SearchRecords/OelailBvDocumentNumber/ Detail by Entity Name Florida Limited Liability Company NAPLES BUILDING GROUP LLC Filinq lnfo.mation DocumentNumber L11000013200 FEUEIN Number 274723391 Data Filed O2lO1l2O11 State FL Status ACTIVE Last Eveot LC AMENDMENT Event Date Filed 1012612012 Event Effective Date NONE PrincioalAddress 3825 Beck Blvd Unit #702 Naples, FL 34114 Changed: 0212312015 Mailino Address P O. BOX 990115 NAPLES, FL 34116 Reqistored Aoent Name & Add.ess WAINSCOTT. DAVID 3825 Beck Blvd Unil #702 Naples, FL 34114 Address Changed AZ23/2O15 Authori2ed Person(sl Detail Name & Address T tle MGRM WAINSCOTT, DAVID 3825 Beck Blvd Unit #702 Naples, FL 34114 Title lvlcRM http://search.sunbiz.orflnquiry/CorporationSearch/SearchResultDetail?inquirytype=Enriq... 9/1012019 Detail by Entity Name Page 2 of 2 HINE. ROBERT 1167 BREAKWATER CT MARCO ISLAND, FL 34145 Annual Rqports Repo.t Year 2017 2018 2019 Filed Date 03t15/2017 03t12,2018 ozoat2019 @!mg4lttgSgg O2l08I2019 - ANNUAL REPORf O3/I52017 -ANNUAL REPORf O4/19/2010 _ ANNUAL REPORT OZ23l2015 -. ANNUAL REPORT O3/19/2014 - ANNUA{. REPORT 04/06/2013 _ ANNUAL REPORT 1026/2012 - LC Amendmonl 0{27,2012 _ ANNUAL REPORI 03162011 - LC Amendm€nt 02,01 /201 1 - Flo.ida Limiled Liabiliiv Vrew rmage in PDF lormal a3/1212418 UAL REPORT view image in POF lormal View image in PDF tormai View imaqe in POF romal View rmage in PDF lo.mat View mage rn POF format VEw mage in POF format view rmage in PDF rormal View rmage in PDF lormal vi* image in PoF formai View image in PDF tomal http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity...9/10/2019 2019 FLORIDA LIMITED LIABILITY COMPANY ANNUAL REPORT DOCUMENT# L1 I 0000'l 3200 Entity Name: NAPLES BUILDING GROUP LLC Current Principal Place of Business: 3825 BECK BLVO uNtT #702 NAPLES, FL 34114 Current Mailing Address: P.O. BOX 9901 15 NAPLES, FL 34116 US FEI Number: 27 4723391 Name and Address of Current Registered Agent: Certificate of Status Desired: No FILED Feb 08, 2019 Secretary of State 2269550404CC WAINSCOTT, DAVID 3825 SECK BLVO uNrT #702 NAPLES, FL 34114 US The above nemed antily submits this stetement lot tha pupo* ol changing hs /egiste/€d ofrce ot registerccl agent, or both, in the State ol Fbrida- SIGNATU RE: Electronic Signature of Registered Agent Oate Authorized Person(s) Detail : Title MGRM Name WAINSCOTT. DAVID Address 3825 EECK BLVD uNtT #702 City-State-Zip: NAPLES FL 34114 Tl{e Name Address City-State-Zip: MGRM HINE, ROBERT 1167 BREAKWATER CT MARCO ISLANO FL 34145 Electronic Signature of Signing Authorized Person(s) Detail Date he@by cstity thet the inlnmlion iodi@led on this 7€Potl ot su$enenlal tupd is nvo aocl a@@te and thet my abct'onb si;/Etutu shall haw the ffi leg€l efred as il tbda n rer th1l dy nne a.fEaB abow. q I an zltacnne wi/, al o$.t tike atutwaa<J. STGNATURE: DAVTD WAINSCOTT PARTNER O2lOBl2019 Electronic Ar{icles of OrganizationFor Florida Limited Liability Company Article I The name of the Limited Liability Company is: NAPLES BI,,ILDING GROUP LLC Article II The street address of the principal office of the Limited Liability Company is: 21560 BELHAVEN WAY ESTERO, FL. US 33928 The mailing address of the Limited Liability Company is P.O. BOX 990115 NAPLES, FL. US 34I16 Article III The purpose for which this Limited Liability Company is organized is: ANY.{\D ALL LAWFIJ'I- BUSINESS. Article IV The name and Florida street address of the registered agent is: DAVID WAINSCOTT 2I560 BELHAVEN WAY ESTERO, FL. 33928 L11000013200 FILED 8:00 AM Februarv 01.20,,11 Sec. Of Stat6 kasaly Having been named as registered agent and to accept service of process for the above stated limited liability company at flre place designated in this certificate, I hereby accept dre appointrnent as registered agent and agree to act in this capacity. I further agree to comply with $e provisions of all statutes relating to *re^ proper and complete performance of my duties, and I am familiar with and accept the obligafrons of my position as registered agent. Registered Agent Signature: DAVID WAINSCOTT Article V The name and address of managing members/managers are: Title: MGRM DAVID WAINSCOTT 21560 BELHA\,T,N WAY ESTERO, FL, 33928 US Signature of member or an authorized representative of a member Electronic Signature: DAVID WAINSCOTT L1 100001 3200 FILED 8:OO AM Februarv 01.2011 Sec. Of Stat6 kasaly I am the mcmber or authorized reorescntativc submitting drese Articles of Organization and afllrm that the facts stated herein are true. I am iware flrat false infoniation submitted in a ilocumenl to the Department of State constitutes a third degree felony as provided for in s.817.15 5, F.S. I understand the requirement to file an annual report betweenlanuary lit an<l \{ay 1st in the calendar year following formation ofthe LLC and every year thereafler to maintain "active" status. fS r ns 3g351;"hi;,ff .ffi H., CINCINNATI OlI 45999- OO23 Date of thi6 nocice: 02 0l-2017 Etnployer Ideneif ication Nunicer : 27 -4't23391. Form: SS-4 Nulrber of this notice: CP 5?5 c For aasiglance you may call us atl 1-800- 829 -4 933 IF YOU IIRITE, ATTACH Il{E SIUB AT THE END OF 1'I{IS NOTICE. WE ASS]CNED YOU AN EMPIOYER IDENAIFICATION NUI,EER Thank you for appl.ying for an E$ployer Identification Nunber (EIN). we asslgned you EIN 27-4'12339\- ThiE EfN will idenlify you, your business accounls, tax returns, ard docunent.s, even if you have no empLoyees. Plea6e keep this notlce ln your pernranent. recorda . when filing tax documents, paymente, ard related correspondence, it is very important Lhat you uae your BIN and complete name and addreag exactly as Eho\.rn above. Any variation fi\ay cause a delay in processing, result in incorrect information in your account., o! even cause you to be assigred more bhan one EIN. If the informat.lon ls not correct as shown above, please nake the correct.ion using the attached bear off etub and return ic to u6. A llmited Iiabillty company (LLC) mai file Form 8832, Enticy c.lassjfication ETection, and elqct to be cLassified as an associaLion taxable as a corporation. If the tLC is eligibl.e lo be treated as a corporation that meets.certain teata and iU e,i1l be electing S corporation stiatu€, 1t mrst Linely file Forn 2553, ElectTon W a S1rall Busjness Co4toratTon. The L,I,C vi1l be treated as a corporatian a6 of Che effective dabe of the S corporaLion election and doeg nog need to file Form 8832. To obtaln tax forms and publicatione, lncluding EhoEe referenced in this notj.ce, v1s1t our web sice at www.irs.gov. If you do not have accesa Eo Lhe Internet, call 1-800-829-35?6 (rrY/IDD 1-800-829-4059) or vi6ir your 1ocal rRS office. IMPORIANT REMINDBR9: IGep a copy of this notice in your permanent records. Thls notlcE la lssuod only one tine and bh€ IRS wlIl nol be 8b1a to gensrate a dup11cal6 colry for you. Use this EIN and your name exactLy as they appear at the top of thia notice on aIlyour federal tax forrns. NAPLES BUILDING GROUP LLC DAVID WAINSCIf,TT SOI,E MBR PO BOX 990115 NAPLES, FI, 34115 * Refer to thi6 EIN on your tax-relaEed corleapondence and docu[ents. If you have questlonE about your EIN, you can call us at the phone numller or write co us at the addrees ghoivn at the top of, this notice. If you vffite, please Eear off Che stubat the boltom of this nolice and send iE along with your letter, If you do not need CowriLe !is, do not complete and return the etub, Thank you for your cooperation. ( C,Rff.,Cor,tttt3t Contractor Licensing 2800 N. Horseshoe Dr. Naples, FL 34104 Phone - 239-252-2431 Fax - 239-252-2469 Gro\ nh Managernent Departrnent APPLICATION FOR COLLIER COUNTY CERTIFICATE OF COMPETENCY STATEMENT OF OWNERSHIP This certilies that l.@vtD lDktt)/?L6d am a member or managing APPLICANT'S NAME (please prinl) mernber of ILA41B 6utwnlt, G,Q@P, 4L. town Do % of the unils issued by the Limited Liability Company listed above Aflidavit of Applicant: I certify under penalty ol periury that lhe intormation contained is a lrue and correct slatemenl to the best ol my knowledge. QPTJ\D wA4tvz.dTi Applicanl (please prinl) Name ot CompanyJ Signature ol Applicanl State ol County of Ca.utu The foregoing inslrument as acknowledged belore me this f-r-1-A by ?ww lLtaML"L whohas produced dale wtw>l,tar* lype of identilication or known (SIGNATUR F NOIARY) CHRISTINEA R'fiER MY COt SS|ONI I FF 999a42 EXPTRES: ocbDr i !p0 Br0.{ lt,, t4.r tE, S.tt- NOTARY'S SEAL -o'-..-.,rwJ FULL REINSTATEMENT APPLICATION REV 4/12118 Page 9 ol 15 l-lq?Gs gut@t&4 G:%oe .(tot rn name oi person acknowledginq (applicant) as identification and did not take an oath. c,&ff.,Cov**1t Contractor Licensing 2800 N. Horseshoe Dr. Naples. FL 34104 Phone - 239-252-2431 Fax - 239 -252-2469 Grolvh Manaqenrent Departrnent APPLICATION FOR COLLIER COUNTY CERTIFICAIE OF CO,TAPETENCY RESOTUTION OF AUTHORIZATION Complete this form if multiple people own part of the company the license will be attached to ll there is only 1 owner, then this form is not required for the application. ln accordance with Collier County Ordinance 2006-46, as amended, Company Name to engage in contracting as 'fur*til.9 in Collier County where roposes t Company It is hereby agreed upon that we the undersigned Qa ot {ftF6 fi;ttDr,;!. 6bW Otficers/Owners/Pad.ers Company resolve and represent to the Collier County Contractor's Licensing Board that the proposed qualifying agent, 'bno lun J , is active in all matters connected with the company named Aoolicant Name il*AgWUzX 6Oorfnuelurtherresorveandrep.ssslq tnar Dfrvhr(y'*(F.?:ali rsresary Otf icers/Owners/Padners proposes to qualily lor a Certificate of Competency with company Applicanl Name Applicanl Name all matters connected with its contractang ness lype of identification or known \W.GSOutcA;x 6,ednh Company busi s and has the authority to supervise construction undertaken by Company4e4-fr C\oaa'w.ll Ofiicers'OwnerYP arl Ollicers,Owne Oijice6/Owners/Partne6 Wilness Ollicers/Owners/Partners of the above menlioned company need lo sign on the LEFT and a wilness to the signalure signs on the RIGHT. State ol {\-oAPk County ol Lov<lfu2 e loregoing i trume as ack nowledoed beto [ue,,5a7;n roduced 1/Itl*-rlt Ltr*r'<rS b-{- qTh by re me this ohasp name ol peason ack ing (Orficers/Owners) as identification and did not take an oath ...fl,igt'rw, C}SISI EA N'TIER rY coNf,flssor{ , fr l9ga2 ETPnEsi o.bart m&,r-Iltrfrg.trrSrb o,- b- NOTARY'S SEAL FULL REINSTATEMENT APPLICATION REV 4'12,'18 (SIGNATURE OF NOTARY) Page I oi 15 W Company empowered to act on behall of tJftfts gwca* O*n" C,otaaW GroUft i,'anaement Deparkn€nt Contractor Licensing 2800 N Horseshoe Dr Naples, FL 34104 239-252-2400 APPTICATION FOR COLLIER COUNTY CERTIFICATE OF COMPETENCY VERIFICATION OF CONSTRUCTION EXPERIENCE Applicant's Name VI Ce(ifi cate Category Requested Ge*ztbt- Connzaq',x 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 hiVher experience within this trade. You aIe 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.9., as a worker commanding the wage of mechanic or better in the trade). Time served solely rn 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 for the above-named applicant must provade the following information Name Title Business Name tJlq*s btqnsa 6oste Phone 44'eb<-bTb License No. (if applicable)w-wry|,uS Business Address qL L. Slale zip to Applicant's tiUe &ettw The applicant's scope of work (specific duties) included e?Aplt"e tN I tDl Additional comments )L\Atr3 Fos AsUzP. &arg,\ *uawxY** NOTE TO LICENSED CONTRACTORS Falsitying any infomation provided herein may subject your license to revocation (',-at ok Signature of pe on providing lhe statemenl State of County of Cz*ve- The foregoing instrument as acknowledged before me this h8- t4 by date ?"oar INL who has produced fitrt&l> k*pz type of identificalion or known as identification name of person acknowledging and did not take an oath. ffi CI{RISI!{EA RMER w corlssroN I rF !99{42 EPIRES 0d0b.,5, 20?O Bdraa llnJ Brt.l lersttb. NOTARY'S SEAL SIGNATUR OF NOTARY Page 10 of 15 Skeet City The applic€nt was employed by me ftom 42142-4ot4 Under penalty of perjury, I declare that the facts stated here are true. FIRM APPLICATION RCV 4112/18 Roberts Bay Custom Homes Inc. Marco Island. lrl. 341 4.5 239-970-2715 Of11cc 239-642-5766 l:ax cGCl5042l3' May I 1,2010 'l'o Whom It May Corrceln: I have known and have worked wilh Dave Wainscotl for over l5 yeals. In my dealings with Mr,Wainscott in the construction of bolh residenlial and commercial projects, he has shown exemplary knowledge in llre constnrction field. Mr. Wairrscott has always been a gentleman rvhen working with customers and has always been very tnrthfirl. I believe that Dave would be a great general contractor, and would highly recommend him to anyone. '[hartk you, o-<t zZ Zatct Hayden Warten Hoy "l < a (,t) tvi NOTARY PUIIlCSTA{B O8 TMIITDA .':""'? Chrisdne A ltittcr i..Witrffi'btt?glif,li BOrDm IrRU Arlr}ffl cBO DIT{o m,8{c- pdac-l,oq (- fuoto11 S, p /+ kjfr"^ c\/fer\ 'l' "ts I ^.. {<7q t({.r }O ah r(s +I t^-C J4 'Q6 ( I { Steven A. Henell I n.. !:: Crqft,snrun Sl8ven A. H€no[.80 Debrook Wsy ' irarco lshid. FL 3,{145 ,Phooe/Far (239} 394-3349 ' Lrc f CGC1510125. stovehenell@gmail.com Colliel Constmction Licensing Boald, This lettet is in testimony and witrress of the experience of David Wainscolt. Since 2001 I have had in-depth interaction with Dave on dozens of constt'uction projects. These projects have ranged in scope fiour new residential honies, residential, comntercial, and multi-farnily remodeling as well as new corttrnercial buildings, Dave's experience is complete fionr design and concept, knowledge ofengineeling practices, stluctural components, material estimating, cost estinrating, scheduling, and site supervision. He has worked in office and onsite as supervision with my firnr on a tegulat basis over the past nine yeats. Dave's knowledge arrd yeals ofexperience in the above referenced ateas should serve to satisfy all required work history to obtain a General Contractors License. :t--a-r\-. r. \ Steven A. Henell as President 3rz-r,:-"-r F\ s-^,: t-\ \ Printed nante Q.LL,Flx'4,*, County of befole nre this ay of known t Ile prodLrced ^r/ A e,\..^9\.(--'. Siqnature ofNotary Public r-B';;Uil- A-J*'") 44.-"- Sworn lo a Who is 20t0, by U qvl en as identification OARBARA AIOERSO'I Y CoWlSSto I 00 ldr, E€rdc!. Printed Nanle of Nolary Public iIPtSts: Nrdid ll$, (SE ( March I2, 2010 State of +'Tlh'w c,fift,Cotttttll Contractor Licensing 2800 N. Horseshoe Dr. Naples. FL 34'104 Phone - 239-252-2431 Fax - 239-252-2469 Grcrwth lvtanagernent Oeparf rEnt APPLICATION FOR COTLIER COUNTY CERTIFICATE OF COMPETENCY AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER n r-lSTATE OF o/-\D \- COUNTY OF I am a resident ol Col\ ie r County,lLo,o^- L-, more than five (5) years bK,q- \t]rnu=rrs. (State) and have resided here lor 190 z+ NR- During the last live (5) years I have known (applicant). I have had the opporlunity to observe his or her business and personal dealings and find him or her to be a person of honesty, integrity and good character Signalure Printed Name Address Street (srG TURE OF NOTARY) t7 ztpSi3te The foregoing insirument as acknowledged before me this ba ta dale q3Telephone227 '-ffi\+ who has produced frtr*rtv Uq$L as identilication lype o{ idenlification by A"n^ l*r* name ol peason acknowledging and did not take an oath. ffi CMSlIEA MIER rY @m{ssr(I{ , FF g9L1' EIPnEs: odot , 5. 2020lctdi f..rlErsn't.. 0t-+=- NOTARY S SEAL FULL REINSTATEMENT APPLICATION REV 4112118 Page 13 ol 15 f ^tl ie,v" having been first duly sworn. state and affirm: Couttt! Grol ,lfr Managernent Oeparfnent Contractor Licensing 2800 N. Horseshoe Dr. Naples, FL 34104 Phone 239 252 2431 Fax - 239-252-2469 APPLICATION FOR COLLIER COUNTY CERTIFICATE OF COMPETENCY AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER STATE OF ?r couNrYoF Co-,\tr.g 5..=t* (Lo/e,utd having been first duly sworn, state and alfirm I am a resident of L. e{:-County,ftoers*(State) and have resided here for During the last live (5) years I have known (applicant). I have had the opportunity to observe his or her business and personal dealings and Iind him or her to be a person of honesty, integrity and good character t , S,gnarrre --t / 'bo=i,cir (J uraltntl Pnnled Name Address: / o 2 t1l 5 Lt J Du,- rt 't Ar,l Street L<ruo-,;>I L 39>',d ctv State zip Telephone 3 The foregoing instrument as acknowledged before me this b -5- t4 dale flame ol person acknowledging and did not take an oath. lype ol identification or known 7,1- 7-12-'Ll t ? ov J,czrk A?,eep.^eu- who has produced @lu€15 Llut tY as identification ;ffi, C}RISTNE A RTTTER tlY COuX6Sl0l{ I FF gg!{42 EXPIRES: oob.. 3, 1020 9cd lltll l#lffr8rti.. (SIGNATURE NOTARY) NOTARY'S SEAL FULL REINSTATEMENT APPLICATION REV 4/12118 Page 14 ol 15 t, more than live (5) years. 'l)Ai p L i,*lu.., *,-..-tr1- Ad//// STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 WAINSCOTT, DAVID NAPLES BUILDING GROUP LLC PO BOX 990115NAPLES FL 34116 RICK SCOTT, GOVERNOR Congralulations! 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, fiom boxers lo barbeque restaurants, and lhey keep Florida's economy strong. Every day we work to improve the way we do business in ords, to s€rve you better. For information about our servi@s, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations lhat impacl you, subscribe to departrnent newsletters and leam more about the Oepartmenf s initiatives. Our mission at the Department is: License EfiiciEntly, Regqlate Fairly. We constantly strive to serve you better so that you can serve your custorneis. Thank you for doing business in Flo.ida, and congralulations on your nevtr license! (850) 487-1395 JONATHAN ZACHEM, SECRETARY DETACH HERE RG2911 #P STATE OF FLORIDA ot2017 INESS AND LATION STATE OF FLORIDA DEPAR TMENT OF GENERAL '*'- HAS FS. ,F"..7 w'v--'*EI ts sEo# 11709100002829 V' ISSUED: 09/10/2017 DISPLAYAS REOUIRED BY LAW I l .l .-t{ .A *---+ ._. 'd )l fi r-l rl\]\!\1 LICENSE NUMBER RG291103822 DBPR - WAINSCOTT, DAVID; Doing Business As: NAPLES BUILDING GROUP LL... Page 1 of 1 1140:55AM9/102019 Licensee Details Licensee Information Na me:WAINSCOTT, DAVID (Primary Name) NAPLES BUILDING GROUP LLC (DBA Name) PO BOX 990115 NAPLES Florida 34116 COLLIER l4a in Add ress: County: License Mailing: LicenseLocation:3825 BECK BLVD 702 NAPLES FL 34114 COLLIERCounty: License Information License Type: Ran k: License Number: Status: Licensure Date: Expires: Special Qualifications construction Business Registered General Contractor Reg General RG291103822 Current,Active 04/ 06/ 2OLL oa/3t/2o2L Qualification Effective 04 /06/ zOLt Alternate Names View Related License Information view License comolaint 2601 Blair Stone Road. Tallahassee FL 32399 :: Emaili glslgllcI]illllagLlgedlg :: custorner contact center: 850.487 1395 rhe state of Frorida rs an aa/EEo employer. C.cDyriglhLz0llzjlllll0-jltiltsi!.Eigrille1 elivrsslelr!treol Under Flonda taw, email addresses are public records. If you do not want your email address released in response to a public_records request, do not send electronic mait to thrs entity. lnstead, contaat the office by phone or by traditional m6il If You have any que;tion;, pEase contact 850.487.1395. *Pursuant to Section 455.275(1), Florida Statutes, effective Octbber 1, 2012, licensees tic;nsed Lrn;er Chapter 455, F.S. must p.ovide the Department with an email address if they have one. The emails provrded may be used for official communication with lhe licensee. How€ver email addr€sses are public record, If you do not wish to supply a personal address, Olease provrde the Department with an email address which can be made avarlable !o the public. https://www.myfloridaiicense.com/LicenseDetail.asp?SID:&id=6C 12B3F2548E5 5CE279...9t1012019 Client#:70350 NAPBU.I ACORD* CERTIFICATE OF LIABILITY INSURANCE OATE (IEDD'YYYY) 2J27 t2019 THIS CERTIFICATE IS ISSUED AS A ATTER OF INFORIANON ONLY AND CONFERS I{O RIG'{TS UX)N YHE CERNFrcATE HOLDER. THIS CERTIFICATE OOES ]tOT AFFIR ATIVELY OR NEGATIVELY A END, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TH|S CERTTFTCATE OF TNSURANCE OOES t{OT CONSTTTUTE A CONTRACT BETWEEN THE |SSUTNG NSURER(S), AUTHORTZED REPRESENTATIVE OR PROOUCER, ANO THE CERTIFICATE HOLDER. IIIPORTANT: lf tha certificate holder is an AODITIOI{AL I]ISURED, ths policy(i$) m€t be endoE€d" It SUBROGATIOII lS WAIVED, suti€ct to the te.ms and cooditionr of Ere pollcy, certain pollcies may fsquirc an endoraoment. A atatem€nt on thla c€rtiflcate do€6 not confqr rlghts to the certificate holdor in li6u of such endorsemgoqs). I'ISURER F Lu lYallace INSUREO o): 239 213-2803 INSURER E tNsuRER A. cr'.rMisF.ary I{sURER C II{SURER O IXSURE&S} AFFOf, t'I'G COI'ER GE Naples Building Group, LLC P.O. Box 990115 Napl6, FL 3al 15 COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: L THIS IS TO CERIIFY TTIAT THE POLICIES OF IIISI,RANCE LISTED BELOW rtAVE BEEN ISST,EO TO IHE I}ISI,REO NAMED ABOVE FOR THE POTICY PER'OO INDICATED NOT\MTHSTANDING ANY REOUIREITEHT. TERiI OR CONOITION Of ANY COMrRACT OR OTHER DOCUMEIIT WTH RESPECT TO \ illlcH THIS CERTIFICATE MAY BE ISSUEO OR MAY PERTAII{. TH€ INSURANCE AFFORDEO BY THE POLICIES T)ESCRIBEO HEREIN IS SUSJECT TO ALL TH€ TERMS, EXCLUSIONS ANO CONDITIO}IS OF SUCH POLICIES, LIMITS SHO!,/\AI MAY HAVE BEEN REDUCEO SY PA]D CLAIMS. TYPE OF IllSURANCE POTICY NUMBER UTTS A GEI.IERA! LTABILITY csu0045042 312019 oa1 x CON'\'ERCIAT G€NERAI TIABLIry c x OCCUR $0 x B UPD Oed 1,0 00 PERSOXAI A ADV INJURY - t I,000,000 GEN'L AC,GREGATE LIMiTAPPLIES PER ielrqlxlilL -t!ssAAUTOIIOBLE LIAB]UTY csu0M5042 3t2019 02J1Um20 ALI OWNED AUTOS HIREO AUTqS EOOtrY rl,LJURY (P€. p€.sd!)$ x SCHEDULED AUTOS NON{!/lJt{EO AUTOS BOoLY TiUURY lPa acodflr)5 x PROPERTY OA'IAGE t s U{BRELIA UAA EXCESS UAa occt R CLAIIS.I|AOE s 4!qs"s^rE__$ RETET{TION ' $ $,ORKER5 COIPENS IIO|I ANO EIPLOYERS' UASUTY ANY PROPRIETOR/PARTNER/EXECUIIVE OFFICERllii|EMSER EXCTUOEO? (titaddory in Nli) oTll E L DISEASE . EA EMPT oEscRrPfloN oF oPElt TtoNts !db,Er- DTSEASE - POtrcY trafi OESCRIPnON OF OPERAIONS / LOCATENS / VEHICIES lAtecft ACORO l0l, A{l(ilind R..n t. Sclr.dule, (nlo ! rp.co i. r6q!i@d) Collier County Contractors Licensing 2E00 N. Horaeshoe Dr Naples, FL 34104 S}IOI'U) AI'Y OF THE AAOVE T'ESCRIBED POUCIES BE CA}ICELLM BEFOflE T}E EXPIRATIOI{ DA]E THER€OF, i{()IICE wlLL 8E DELIVERED II{ ACCOROANCE ITITH I}IE POUCY PROVISO S. AUTHORIZEO REPRESENTAT]VE .aJt.#*, H R CAI{CELLATION @ ,988-2010 ACORO CORPORATION. All rlghE rr$rved. Tho ACORD namo and logo 3rs iigMrsd matt8 of AcoRD LHU'I6 ACORD 25 (m10/05) I of 1 #S138970rUM1389699 PROOUCER Gulfshore lnsurance, lnc SWFL 4100 Goodlette Road N Naples, FL 34103 239 261-3646 239 261 -35.15 . lGqll| (!'v!!E!!1!9!l GENEiAL AGGREGATE PROOUCIS . COMP/OP AC'G $ $1,firo,0o0 Elcfl occuRaEflcE l-v\rc srATtr- I TORY L ITS I E L EACH rcCI'EXT JIMMY PATRONIS CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTf,ENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSANOfl ., CERNFICATE OF ELECTION TO BE EXETPT FROM FLORIDA WORKERS'COilIPENSANON LAW - I CONSTRUCTION INDUSTRY EXEMPTIOT{ This certifies that the iMividual listed below has elected to be exempt from Florida Workers' Compensation law EFFECTIVE DATE: 111412019 EXPIRATION OATE: U1312021 PERSON: ROBERTJ HINE EilAlL: BOB@NAPLESBG-COM FEIN: 274723391 BUSINESS NA E AND ADDRESS: NAPLES BUILDING GROUP, LLC 3825 BECK BLVD NAPLES, FL 34114 SCOPE OF BUSINESS ORTRADE: Licensed Blrilding Conlraclor IMPORTATIT: Pursl€.tt to Chapbr,l,ao.(E{t 4), F.S.. an offcer of a corpo.alion who eleds exemption fro.n this dlapfe. by fli E a certificate ol election urxbr thi! Sectioi may not reco!€, beoetts o{ compensation tEdea this dlapter- Puaarar{ to Chapter,t aO.05{12), F.S., Ceat'ficabs oI eledion to be exempt... agply only within the scope of th€ bt6irt€ss or t ade listed on th€ notice of ebdion lo be exempt. Pursuant to Chapter,(,t0.05(13), F.S,, l.lotices of €bdion to b€ exempt aM cedmcates ot eledjon to be exempt shall be subiect to Errocalion . at any lirne after the filing of the rdice or OE issuance oI lhe certifcale, lhe pe6on narned on the notice oa cenifcate oo longea meets tE Gqrrieriefits ol hh sedion for issuance of a cedificab. The deparhent shall revoke a cedifcate at any tinrs tor feilurG ot the person nam€d on ttl€ cerlifuat€ to rrEet the requirements of this sedion. DFS-F2-DV\rc-252 CERT!FICATE OF ELECTION TO AE EXEMPT REVISED 08.13 ouEST|oNS? (850),1111609 JIMMY PATRONIS CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTTENT OF FINANCIAL SERVICES DtvlSION OF WORKERS'CO PENSATIOI{ ' . CERTIFICATE OF ELECNON TO BE EXEMPT FROM FLORIDA WORKERS' COIUPENSATION LAYI' - ' COT{STRUCTION INDUSTRY EXE PTION This certifies that the individual listed bebw has elected to be exempt ftom Fbrida Workers' Compensation law EFFECTIVE DATEi 1012512018 EXPIRATION DATE: 1OD5I202O PERSON: DAVID WWAINSCOTT EilAlL: DAVE@WAINSCOTTDESIGNS.COM FEIN: 274723391 BUSINESS NA E AND ADDRESS: NAPLES BUILDING GROUP LLC DFS.F2O\A'C-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED O&13 QUESTTONS? (850X111609 3825 BECK BLVD NAPLES, FL 34114 SCOPE OF BUSINESS OR TRADE: Licens€d Brrlding Cont'actor IMPORTANT: Pursuant lo Chapter 4,40.05(1,i), F.S., an ofice. o, a c..pgratk n whg eleds exernplirn frorn $rs cfiapter by fli.tg a ertifcale ot ebdbn under this sedion may not reco!€r beoefb o. cornpersation urder this dBpter. Purauant to Chapter,a40.05(12), F.S., Cortficat€8 oI eledion to be exempt... appty only within ttle scope of ttle businesE or lrad€ listed on the notice of eledion to be exempl. Pursuant to Chapter 440.05(13), F-S., tlotkes o, eledion to be exempt and certifcates of eledion to be exempt shall be sutrlbct to revocalion if, at any time der he fling d the mtice o.lhe isauance ot the cedificate, the person narned on the mlke d ceatifie e no longer meets the requiienEnts ol this sedion fur issuaoe of a certificale. The departrEil shall evoke a certificate at any 0nie fo{ faihrre of ttle p€6on namod on tlB cortifcat6 to meot the requir€nEnts ot ris sediott. G'trWJi COLLIER COUNTY BUSINESS TAX RECEIPT APPLICATION 280{, }1. Horsesho€ DriYe. Naples. FL3tl04 \lNkc Check Payrblc to: Collirr Coun$ Trr Collector Phone: 239-252-2J77 Far: 239-6.$-l7EE \l'ebsite: ri'$*.collicrtar.com CHECKLIST Cop,- ,)f,\nicl.s of li.srpcration .nd-or Ficliu(\lr lener aflno $c Shle shinS la! ,ou, business namc i! lln 6le (,{J0-:15-605: or 6058) raar.sunbiz-.'rg _ Y.llos Fir. Compli$ce (li$ oi 6r€ di{ricl phonc number _ Cony ol -(l'te lii:.r!1. froa Dcp.rlmeor of Busi,r6s .nd t\oiessional (lJ0-187-l 3r5l or Dsfanmcnl of ll.allh (8J0--1SS-059!) _ Copy ollqarco Zo ng C.difcste. (:-'19-389-5000) _ Compl€red Zoning lpFlicarion '!\ith .ppropriate lc. mrde pslabl€ ro: lro$d ol Cclrnrr" Conunisstuasr. (1-39-152-5603) CorrplljGd Busincs. T&r Rlc€its rppli.{io' t i& .ppro}rial. f€ fidd. t ryrbl€ to: Coli.r Colnty T&\ Collccror. _. Clty ot cir) Burincss Ta.( Recopl. (:-19-:l-r-t80|1, _ Clrpj- ol !i(olo. \thrclc Repair RegislBlion Ccrtiic.(. hoG! Dcr'grEc of^:ricukutc. {$q35--']J:}xCor oi lle3lii inspecrioa fror$ Dcpalllt,enl ofHotels an., Ren uBnts (8Jo-{87-1395) or DeF.ren nt ofAericultur€. (800-4.rJ-r35:) Pl.asBcoalrcr Oe PmlsD',\pprai*'r: oltrce 31 2.39.2J2-8t{5 i.glrding l|logihl. r.ri. CHECK ONE: _ Original Application _ Transfer of License # Renewal of License # Date Classification Code Number License Amount 1) la) rb) 2) CORPORATE,/LL C NA]\TE ha-6 DBA (TICTITIOUS) NAME BI,:SI\ESS O\\'\-ER OR Q I.].{LIFIER'S NATIE - PII\'SICAL ADDRESS . t\o PO. Bo\ allo!\cdi 2a) 3) IS RESIDENCE USED AS A\ OFTICE - \'ES \o BT]SI\ESS \TAILI\G .{DDRESS - Strccl City zip O\1\ER OR Q UALIFIER'S RESI DE\'TIAL ADDRESS - -I 4 TEI-EPHO\E - Business:Home-L4. 26{.(z7lb LEGAL FOR\I OF BUSI\ESS: - soic Prop'.,o*hp - Plrh.rship -(rc-.tOPE\I\G DATE OF BI.SI\ESS OR D.{TE ASST'\TED -ol Ycs,il-v License No. SOCI.{L SECURITY IO.}.EDER.{L ETIPLO}'ER IDE\TTTIC.{TIO\ \O. 4) s) 6) 7) 8) e)oa 2L- +1?-r?Lt 'e. b.(l o, .rpti.,.io. lor trplrdrto. 9a) t0) ) TYPE OF BUSI\ESS CO\DT'CTED: \U\IBER OF EMPLOYEES - lncluding number of owners:2 ,2) WILL TIIE BUSINESS STORE, HANI}LE USE, OR GNERATE ANY AMOUNT OF IIAZARDOUS SUBSTANCFS OR HAZARDOUS ITASTES? (fuck/oi\ paintq solvenb' chemicilq ett.) - Ycs tsxo FILL T\ TTIE APPROPRIATE AREAS . a) Renlal units (rnolcl'}lolcL'apls.) \umbcr of units b) Sesring Capacir-v (rest..:cafes. etc) Number of sq.tr5 l-t ) c) Nunber ofco'io-ope.atcd rnachilcs o\\'oed by busincss ot indi] idrEl STATE LlCfr-SE OR CERTIFICATTON NL;]IBER - Must h!r'e photo cop! of strte license if state ticensed and certified I'\DER PE\ALTIIS OF Pf RJIJR}" I DECL{R.f, TIL{T I IL{\'E RE.{D THE TORIGOI)'G DOCT }If IT A\D TH,{T TIII FACTS STATED I\ IT.{RE TRIE TO TIIE BEST OF }TY I(\O11'I.EDGE. TTTAPPLICA,'\T'S SIGX.{TL Rf: D.{IE: (Oqrcr u:d or represenudve ofbusitcss) TITLf: E IS \O\-RI] FL\D.IBLE FOR BUSI\ESS SI',\TED AB o'h.'r oFFrcE I'ITI N C|TI' LllflTS OF \APLES - _ \rs _)!_ No Drpanment Supenisor_ Datc SECTIOT- .{. B. A\D C FOR OFFICE trSE O\LY THIS SICTIO\ TO BE FILLID OUT BY CO\TRACTORS/BCC LICE\SING BOARD SECT IO\ A Cirssillccdon of Coltractor:Count_v CeniGcatiol \Lrmbcr: THIS SECTIO\ TO BE CO}IPLETED BY PLAN\I\G SER\:ICES SECTIO\ B - Business is aD i!-home occupatioo rud the applicant bas asreed lo adhere ro the requiremerrs as set lonh iD the Collier Coutrry Zoning Ordinance. PROPERTI' _ Busincss DOf,S CO\IPLY wirh rhe Collier Counry Zoning Ordinarce. ZO\ED Siglcd Title :Dale; Commcnts THIS SECTIO\ TO BE CO\TPLETtrD BY THE HEALTH Df P,{RT\IE\T SE(]T ONC _ Business DOES CO\IPL)' rvith tlte local a!d, or Srate requirenrenls Sigued:Tirle:Dale * In accordance with florida Statute 205.0535(5). we require ]'ou ro pro!ide us $i& either a Federal Employer ldentifcation liumber (FEI\ or e Social Securiq' number. c,RffitQovtnty& COLLIER COUNTY CONTRACTORS' LICENSING BOARD AGENDA March 16,20{1 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 TI.IE 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. APPROVALOFAGENDA: IV. APPROVAL OF MINUTES: DATE: February 16,2011 V. DISCUSSION: VI, NEW BUSINESS: (A) Piotr Banski - Qualify 2d Entity Approved. (B) Thomas C. Gibbs - Waiver Of Testing To Reinstate License Approved, must pay back fees. (c) Tony C. Kirkland - Qualify 2nd Entity Approved placed on 6 months probation must return to clb Sept. 2011 meeting. (D) David W. Wainscott - Review of Credit Report(s) Approved with restrictions; residential properlies only. Probation for 6 months must return to clb Sept. 201 1 with new credit VII. OLD BUSINESS: (A) Orders of the Board VIII. PUBLIC HEARINGS: (A) Case # 201 1-06 Stephen J. Scott removed D/B/A- Keystone Conlractors of SWFL LLC Daniel M. Kimball D/B/A - Dan Kimball Floor Installation lnc. Guilty of 4.1.3 6 months probation must pay full (B) Case # 2011-07 r\vSutuuvt I tv rv DU vv|Ull J tU \ 5 \.JU E t,/IUI (( (D) March 16, 201 I Sands have been financially irresponsible. He deferred lo Michael Ossorio's recommerrdation and supported approving the application for a second entity. Tcrrl'Jerutle stated institrting thc probationary period wotrlcl allorv the Board to review its decision itr six nrottths. Michael Ossorio confirmed that, as a Qualifier, Tony Kirkland rvill be responsible for the day+o-day operation of Mr. Sands' comparry. He continued the Qualifier for a company is responsible for any misconduct. The Licensing Board is to determine the amount of the Qualifier's responsibility. Chairman Lantz asked Jon Walker, as the maker of the Motion, to consider revising his rnotion to add a six month probationary period in order to answer the Board's questions regarding the finances (large checks) and credit. lon Wdker antended his Moliort: he moved to (tpprcve TonJ,Kirkland's application lo quafirtr a second enlity, "George T, Sonls, htc,," ott tt probcttionory basis. Mr, Sonls rmd Mn Kbklarrd ore lo return belore lhe Boanl in si.t months to provide ou explanation concerning the large checks nnd on updoted cretlil report, respectivelJ,. Second by Robert Meisler, Carrled mtanintorcly, I - 0, George Sands stated money (checks) is deposited into his cornpany's payloll account and employees' paychecks and payroll tax (payment) checks at'e rvritteu from that accormt. He verified he will comply with the Board's order to provide proof. David W. \{ainscott - Review of Credit Renort(s) Michnel Ossorio provided backgrnund infotmation: e David Wainscott applied to become a registered General Contractor . When a Tier I License is applied for, ctedit is revielved o Mr. Wainscott lvill answel the Board's questions concemirrg his credit issues 6 David \il. Wainscott stated: o He rvould like to expand his design business into a design/build construction business . He has been designing various types ofresidential projects in Collier County since 1985 r A few years ago, his busiuess pafiner had sonre life issues and the pafirlership was dissolved o After the dissolution of the company, Mr. Wainscott found his partner had left the company rvith cledit problerns . Due to the economic dorvntorvn, there lvere late paynlents (See letter of explanation submitted by the applicant) r Prior to and after this period of tirne, Mr. Wainscott's credit raling rvas good March 16,20ll He has pelsonal experience in conshuction - he built trvo honres as an orvncr/builder He continue be involved only in residential projects if he obtains his General Contl'actor's License "The Contractors' Licensing Superisor, ol designee, tnay issue a Restricted Cettificate ofCompetensy to an Applicant for a cerlificate in a particular trade, rvhich Certificate is restricted to certain aspects of that trade where the Applicant has satisfactorily dernonstrated that he/she is qualified undel this article in cerlain aspects ofthat trade, but lacks tlre required experience in other aspect(s) ofthat trade. For exarnple, an Applicant for a Certificate as a Floor Covering Installatior: Coutractor may have the required experience in laying carpets and./or tiles, but not wood flooring. Each stafflevel decision to restrict a Certificate shall be final turless reversed or modified by the Contractors' Licensing Board upon appeal by the certificate holder." Michael Ossorio asked the applicant if he had any formal education or training. Mr. Wainscott obtained a degree in Architecture fi'om the University of lr,fiami. He elaborated he is not a licensed Architect, he is a designer. His patlner rvas a licensed Architect. His firm, "Dave Wainscott Designs," ploduces design work and rvorking drawings for residential projects. Tom Lykos noted there are two issues under consideration: (1) The level of experience and which [icense is most appropriate, and (2) Credit. He stated there is a vast difference betweetr residential attd cotntnercial 7 In response to a Board member's question, Michael Ossorio noted to obtain a registered General Contractor's License, experience is required in all phases of construction, i.e., residential, conrmercial and condominium. He asked Mr. Wainscott why he didn't apply to the Board previously since he took lhe exam in 2009. Mr. Wainscott replied rvith no business to pulsue, there was no ueed to obtain the license and the expense was also a considetation. Mr. Ossorio stated the trade exam has not changed siuce Mr. Wainscott took it in 2009 aud once he becomes registered, lre will be required to complete CE hours. Mr. lVainscott stated even though he took and passed the exam for a registered General Contractor's License, his intention is lo work only in the lesidential arena. Michacl Ossorio stated the Code allows the Board to restrict the license to a particular trade or area. Attorney Neal referred Section 22-189 ofthe Code, "Reslricted Cerlrficotes o.f Conrpetency, " as follolvs: construction, and lo approve a General Contractor's Licetrse for someone rvith only linrited conrmercial experiencc is not a good idea. DnYe Wlinscott stated the business relationship with his former partner was ending, he realized his partner could not palticipate in the day+o-day operation of the company. The recession hit at the same time and business slou,ecl dolvn. He began to re-organize his company, took control of the books, and realized his partner had left him rvith a great deal of credit-card debt. [{e contacted the trvo major debtors (American Express and Snncoast Fedelal Credit Union) and made arrangements to pay off the debts. The settlernent payment to Americarr Express was made, and he made trvo payments to Suncoast rvhich he rvill continue to pay on a monthly basis as agreed. Michael Ossorio reiterated David Wainscott took and passed the Genetal Con(ractor's Licensing exam. If the Board approves his application, he rvill be issued a General Contractor's Restricted License - rcstricted to "residential" only as defined in the Code, i.e., one, two, or three-fatnily and no nrore tbarl t11'o stolies. In order to'tpgrade" the license in the ttture, Mr. Wainscott ivill be required to petition the Board. Currently, he rvill be restricted to Collier County, the City ofNaples, and the City of Marco Island. YII. OLDBUSINESS: A. Orders of the Board BREAI(: 10:25 AM RECONVENED: 10:37 AM Daniel IV[. Kirnball d/b/a - Dan Kitnball Floor lnstallation, Inc, Thonns LJ'kos tnoved lo approve llrc sigttittg o/the Orders of the Bourd by lhe Choirnnn. Second by Robert Meisler. Caried unanintorcly, I - 0, 8 March 16, 201 I Thonns Lykos ntoved lo opprove Dovitl llrainscott's opplicatiotrfor Generd Contructors'Lice se, restricled to residenlid constutcliort ortlst,for t one- yeur probationary period wilh o six-ntontlt review, After six ntonths, lhe Applicant will appeu before the Boord ond procluce an updated credit rcporl, At the end of tlte one-year probtrtionuy period, lhe Applicml will ogain appeu belore the Boord ond produce an updoted credit reporl, The Boarl rvill decide vlrcther to exteud or concel the probulionary period, or to revoke lhe license. Secoutl by Terry lerulle, Cotied wruninrottsll,, I - 0. VIII. PIJBLICHEARINGS: B. Case#2011-07: I (I Findings of Fact, Gonctusions of Law and Decision of the Board Collier County Contractors, Licensing Board For Applications Submitted to the Board for Review Type of Application: _ Credit Report ReviewX Waiver of Testing Requirements_ Reinstatement of License _ Request to Qualify Second Entity_ Other (specify) _ THls CAUSE came on for public hearing before the contractors' Licensing Board (hereafter Board) on March 16. 201 1 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 respective lo all appropriate matters, thereupon issues its Findings of Fact, conclusions of Law and Order of the Board as follows: FtNptNGS gF FACT 't. That David Wainscott has submitted an application to the Collier County contractor Licensing supervisor or his designee for waiver of testing requirements for reinstatement of a general contractor's license. 2. That pursuant to section 22-184 (b) of the Collier County Contractors, Licensing ordinance (ordinance g0-105, as amended) applications which do not appear on lheir face to be sufficient require referral to the Board for a decision regarding approval or denial of said application. 3. That the Board has jurisdiction over this matter and that David wainscott was present at the public hearing and was not represented by counsel at the hearing on March 16,2011. 4. All nolices required by Collier County Ordinance No. 90_10S, as amended, have been properly issued. 5. The facts in this case are found to be: a Applicant has demonskated through testimony and evidence presented at this hearing that he has adequate knowledge of the contracting specialty to make testing in the kade superfluous. Applicant has certain deficiencies in his performance of his hade and management of financial affairs that are of concern to the Board. The deficiencies in performance are such that any waiver of testing will require restrictions to be put upon the license. b c. CONCLUSIO NS OF LAW 1. Based upon the foregoing facts the Board concludes that the applicant has met the standard set out in Ordinance 90-105, as amended, and that the testing requirement may be waived subject to certain conditions imposed by the Board. ORDER OF THE BOARD Based upon the foregoing Findings of Fact and Conclusions of Law, and pursuant to the authority granted in Chapter 489, Florida Statutes, and Collier County Ordinance No. 90-105, as amended, by a vote of 8 in favor and 0 I opposed, a majority vote of the Board members present, reinstatement of his license is granted under the following condilions. 1. The license shall be restricted to a residentlal contracting license for the full term of the license. 2. The applicant shall contract under a probationary period of one year. During which period, the probation may be revoked for cause by the Board at a hearing noticed for such purpose. 3. At the board meeting nearest in time to six months from the date of this meeting, the applicant shall provide full credit reports to the Board for review. The board shall determine from a review of the credit reports and other operational and financial informalion whether to continue probation, extend probation or end probation and allow license to be used without probation. ORDERED by the Contractors Licensing Board, effective the 16 day of March,201'1. l?t/27 Kyle Lantz, Cdman Conlractors Licensing Board I HEREBY CERTIFY that a true and correct copy of the above and foregoing Findings of Fact, Conclusions of Law, and Order of the Board has been furnished the_AppllgAd, and Michael Ossorio, Licensing Compliance Supervisor, 2800 North Horseshoe Drive, Naples, FL 34103 onthis /51, day ot4bal2011. '7-- , ry / Conlractors Licensing Board ,'4,oo, %-*rY- (Janie French arrived al 9:27 AnI.) Chairman Lantz snggested that Mr. Sands atterrd the October meeting. Richard Joslin asked the Respondent if he were aware ofany ongoing contlacts for current projects. Tony Kirkland stated there were contracts for maitrtenance work, but not for ne'w installations. Lee Horn noted if the Board agreed to continue the matter, the probation should be extended. Palfick ll/hite antended his nrotion to opprove esclending lhe probotiortoty period until the Oclober meeling. Second by Roberl Meisler. Lee Horn asked the Respondent if he understood exactly what the Board had said and what documents to bring to the October meeting, i.e., an updated personal Credit Report, a Credit Report for the Second Entity, and a clear explanation of why so many checks were issued in such large amounts. He also recommended that Mr. Sands attend the October meeting. Mr. Kirkland stated he understood. The Choinnon called for a vote on lhe Molion, as nmended. Carfied unuintously, S - 0, Reconntendatiol.' Suspend Mr. Wainscott's Certificate. Michael Ossorio will contact the State of Florida to rcquest a suspension of Mr. Wainscott's registration until he appears befote the Contractor's Licensing Board. Lee Hont rnoved to approte suspending David lL lYainscott's Cerliticote of Contpetency unlil further uolice, nd lo uolify ,e State of Florido lo request a suspension of his regislrolion. Second by Palrick lYhite, Corried unonimously, I - 0. 5 Septeurber 21, 201 I C. Drvid W. Wainscott - Review of Credit Report Michael Ossorio refemed to Page 3 of the "Findings of Fact:" . Mr. Wainscott required was appear and provide full credit reports to the Board for review o The Board was to determine whether to continue probation, extend it, or end probation and allow the license to be used without probation. o The Board previously lestlicted his Certificate ("Residential Contractirg Only") due to his lack of experience as a Geneml Contractor Mr. Ossorio verified that a copy of the Board's Order was seut to David Wainscott and stated he spoke with him on several occasions concerning providing the required infomation. Mr. Wainscott did not comply. ( Findings of Fact, Conclusions of Law and Decision of the Board Collier County Contractors' Licensing Board For Applications Submitted to the Board for Review Type of Application: _ Credit Report ReviewX Waiver of Testing Requirements _ Reinstatement of License _ Request to Qualifo Second Entity _ Other (specify) _/ 1 THIS CAUSE came on for public hearing before the Contractors' Licensing Board (hereafter Board) on September 21. 201 1 for consideration of the application submitted to the Board for review on March 16,2011. The type of application is set out above. The Board having heard testimony under oath, received evidence, and heard arguments respective to all appropriate matters, thereupon issues its Findings of Fact, Conclusions of Law and Order of the Board as follows: FINDINGS OF FACT '1. That David Wainscott has submitted an application to the Collier County Contractor Licensing Supervisor or his designee for waiver of testing requirements for reinstatement of a general contractor's license. 2. That pursuant to seclion 22-184 (b) of the Collier County Contractors' Licensing ordinance (Ordinance 90-105, as amended) applications which do not appear on their face to be sufficient require referral to the Board for a decision regarding approval or denial of said application. 3. That the Board has jurisdiction over this matter and that David Wainscott was present at the public hearing and was not represented by counsel at the hearing on March 16.201 1. { 4. All notices required by Collier County Ordinance No. 90-105, as amended, have been properly issued. 5. The facts in this case are found to be: a b Applicant has demonstrated through testimony and evidence presented at this hearing that he has adequate knowledge of the contracting specialty to make testing in the trade superfluous. Applicant was directed by the Board at its March 16, 201 1 meeting to provide updated credit reports for the Board to determine whether the fiscal management deficiencies the Board noted at the March 16, 2011 meeting were beginning to be addressed. Applicant failed to appear at the September 21,2011 meetlng after being provided notice of the meeting in a manner exceeding the requirements of the Collier County Ordinance. The failure of the Applicant to provide the updated credit reports and explanatory testimony thereon gives the Board no credible evidence that there has been any change or improvement in the fiscal management record of lhe Applicant. d ( C ONC LUS to NS OF LAW 1 . Based upon the foregoing facts the Board concludes that the applicant has NOT met the standard set out in Ordinance 90-105, as amended, and thal the testing requirement may NOT be waived due to the failure of the Applicant to comply with certain conditions imposed by the Board at the March 16,2011 hearing. ORDER OF THE BOARD Based upon the foregoing Findings of Fact and Conclusions of Law, and pursuant to the authority granted in Chapter 489, Florida Statutes, and Collier County Ordinance No. 90-'105, as amended, by a vote of 8 in favor and 0 opposed, a majority vote of the Board members present, the applicant's request to waive testing in the trade for reinstatement of his license is granted under the following conditions. 1 . The Applicqnt's Collier County license to practice contracting shall be suspended until the Applicant fully complies with the conditions set forth in the March 16,2011 order and appears before the Board with evidence of such compliance. 2. A copy of th's Order will be sent to the State of Florida Construction lndustry Licensing Board. 3 ORDERED by the Contractors Licensing Board effective the September, 201 1. nh1 Kyle La Chairman Contractors Licensing Board 2 day of I HEREBY CERTIFY lhat a true and correct copy of the above and foregoing Findings of Fact, Conclusions of Law, and Order of the Board has been furnished thel5ppleqn:1, 2800 North Horseshoe ,2010. and Michael Ossorio, Licensing Drive, Naples, FL 34103 on this iance Su day of Licensing BoardSecretary 4 l ev Covrtt3t Gro*th Management Department Planning & Regulation Operations Division Licensing Section September 4,2019 NAPLES BUILDING GROUP DAVID WAINSCOTT 3825 BECK BLVD #702 NAPLES, FL34114 RE: REINSTATEMENT WITH WAIVER OF EXAMS Mr. WAINSCOTT, You have been added to the agenda for the Contraclor Licensing Board meeting on Wednesday, SEPTEMBER 18, 2019. Please attend the meeting so the board may review your submitted application and ask you questions regarding your previous exams you have taken as well as why you let your license lapse with Collier. The meeting is held at 9:00am at the W. Harmon Turner Building (Bldg. F, Admin. Bldg.), 3299 Tamiami Trail. E., Naples, FL34112 in the Commissioner's Meeting Room on the 3'd floor. There is a security checkpoint you will need to go through, so please allow enough time to make it to the meeting. lf you have any questions or concerns, please call (239) 252-2431 or you may email me at contractorslicensing@colliercountyf l.gov. Sincerely, Lilla Davis Administrative Supervisor Contractor Licensing Collier County Growth Management Department 2800 North Horseshoe Drive Naples, FL 34104 Growlh Managemenl Depa(ment'conlractor Licensing'2800 Norlh Holseshoe Drive'Naptes, Ftorida 34104.23g-252-24oo.www.coIierqov.net .Rftrcoun w COLLIER COUNTY CONTRACTORS' LICENSING BOARD LARRY BRUELLMAN _ REINSTATEMENT WITH WAIVER OF EXAIVS Swimming pool/spa servicing/repair contructor tequires 24 months experience with a passing grade on an approved test and a passing grade on a business and law test and means a contractor whose scope of work involves, but is not limited to, the repair and servicing of any swimming pool, or hot tub or spa, whether public or private, or otherwise, regardless of use. The scope of work includes the repair or replacement of existing equipment, any cleaning or equipment sanitizing which requires at least a partial disassembling, excluding filter changes, and the installation of new pool/spa equipment, interior refinishing, the reinstallation or addition of pool heaters, the repair or replacement of all perimeter piping and filter piping, the repair of equipment rooms or housing for pool/spa equipment, and the substantial or complete draining of a swimming pool, or hot tub or spa, for the purpose of any repair or renovation. The scope of such work does not include direct connections to a sanitary sewer system or to potable water lines. The installation, construction, modification, substantial or complete disassembly, or replacement of equipment permanently attached to and associated with the pool or spa for the purpose of water treatment or cleaning of the pool or spa requires licensure; however, the usage of such equipment for the purposes of water trealment or cleaning shall not require licensure unless the usage involves construction, modification, substantial or complete disassembly, or replacement ol such equipment. Waler treatment that does nol require such equipment does not require a license. ln addition, a license shall not be required for the cleaning of the pool or spa in any way that does not affect the structural integrity o{ the pool or spa or its associated equipment. Collier County Ordinance 2006-46 (1.6.2.9). SEPTEMBER 18, 2019 9:00 A.M. LARRY BRUELLMAN is coming before the board today asking for a Reinstatement of his SWIMMING POOL MAINT. & REPAIR-REGISTERED license, which was CANCELLED in 2012 for nonrenewal. He rs also doing a Change of Status (Dormant to Active) and a Name Change, to company LEAVE lT TO LARRY, LLC from AIUERICAN POOL & FOUNTAIN, LLC. He is asking the exams he took with Collier County Sponsorship in 2007 & 2010 can be used in this application. He did keep his registration with the state current during this inactive timeframe. Gontents Letter to go in Front of the Board Application Exam Scores from 2009 lndividual Credit Report Previous Company Credit Report Sunbiz documents State of Florida/lRS Documents Statement of Ownership Verification of Experience Letters Affidavit of lntegrity & Good Character DBPR License Registration Board Hearing lnformation letter of intent to senvice pools August '1,6, 201,9 To: Licensing Board I am currently wonking to neinstate my swimming pool Class C license. I have previously worked extensively in the pool, spa and fountain business. I have owned a PooI Company in the past. I am intenested in servicing pools and spas once again. I appreciate the opportunity to once again senve clients in this anea. Larry Bruellman leaveittolarny@gmai I . com #239-290-5855 Page 1 Cov*tt! GrE\ rtt ltranagernent DepartrBnt Contractor Licensing 2800 N. Horseshoe Dr Naples. FL 34104 Phone - 239-252-2431 Fax - 239-252-2469 APPLICATION FOR COLLIER COUNTY CERTIFICATE OF COMPEIENCY l REINSTATEMENT APPLICATION FOR COTLIE CERTIFICATE OF COMPETENCY OUNTY QBears C-Lbl?- tst.t( 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 lo.. Collier Coutity Board of County Conrr?lssioDers. For further information, consult Collier County Ordinance No. 2006-46, as amended. ryPE OF CERTIFICATE OF COMPETENCY: I General f Building I Residential ! l\ilechanical J Roofing $230.00 $230.00 $230.00 $230.00 $230 00 o Lcr L E[ Swimming Poolc\ds5- c tr Specialty $230.00 $230.00 $230.00 $230.00 $205.00 -doss- CSpecialty Trade eove il t I. APPLICANT PERSONAL INFORMATION Natne Slreel M ddle ln tral Address 5?J U\-E/a bl 3r/ Crty ?tp 0 @ /. Telephone e3?- e?o ftrtt-'SS # (Last 4 digits only) Date of Birth J-7 Y3S-t- Driver's License # (Last 4 digits only)^/3 0 $205 - Reinstatement $205 - Name Change $390 - Renewal 3 years $180 - Late fees $125 - 20'19/2020 renewal S10 - Stratus Chanoe $1,115 - Total Due f-3- 'Purtuant to chapter l_19, Florid. statut€t and collier County conkactor Liceniing Ordinance 2006-46 section 2.1.1., aI appticants are required tolubmittheir social5€curitY numb€r (5sN)ror the following purpos€sra)asr€ss applicant's ebility to iatisly cr€ditors by reviewin8 their credit history. b) verifi.alion of applicant's test scores and information. our office will only use your ssN noted above for those reasone pursuant to chept€r t-19,Florida statutes, and as mey olherwis€ be authorized by law. we are fully committ€d to 5.le,8uarding and protecting your ssN and once .o ected, witlbe maintained ae .onfidential .nd exempt under Chapt€r t-19, Florida Statuter. u('a-)rffc vfeWfidatgt'qf ir.) ih,)NSTATEMENT APPLICATION REV 4/12l1 8 N D.r'a", f P ftc{ffi= E Electrician n Plumber n Air Conditioner b$s Lor* D Ern.l/* ^^tYl Email 1e'r Qov*rx! Grorvth Managernent Departnent Contractor Licensrng 2800 N. Horseshoe Dr. Naples. FL 34'104 Phone - 239-252-2431 Fax - 239-252-2469 APPTICATION FOR COLLIER COUNTY CERTIFICATE OF COMPETENCY Provide the names and telephone numbers of two persons who will always know your whereabouts N^ .Ttt "ta 0, n,ll, ^^ 2:t { Name: J lqa ,)tt74 Telephone .5 II. FICTITIOUS NAME OF APPLICANT'S BUSINESS: Business Name L E+t) F ITro L /tKK/, 7 t-c Business Address llfno company name wllbe used, wrlte "lndrvrdual") /o /U"l:/ 3i: 5trre 7 Crty Telephone: ,?'3 7 I e?0 dr5 Y? -J6i FSTJFederal lD Tax No III. FINANCIAL RESPONSIBILITY YES NO ALL APPLICANTS MUST ANSWER THE QUESTIONS BELOW: Undertaken construction contracts or work that a third party, such as a bonding or surety company, completed or made financial statements on? Had claims or lawsuits filed for unpaid or pasl due accounts by your creditors as a result of /construction experience? Undertaken construclion contracts or work that resulted in liens, suits, or judgments being filed? Had a lien filed against you by the lnternal Revenue Service or Florida Corporate Tax Division? Made an assignment of assets in settlement of construction obligations for less than the debts outstanding? Been charged with or convicted of acting as a contractor without a license, or if licensed as a contractor in this or any other state, been "subject to" disciplinary aclion by a state, county, or municipality? Filed for or been discharged in bankruptcy within the past 5 years? t/Been convicted or found guilty of, or entered a plea of nolo contendere to, regardless of adjudication, a crime in any jurisdiclion within the past 10 years?. NOTE. lf you have answer yES to any of the questions below, you must attach a writlen explanation including the nature of the charges, dates, and outcomes, sentences of conditions imposed. You must also attach proof of payment, satisfaction of lien or judgement, bankruptcy discharge, or agreements for payment.-lf you have had a felony conviction, proof that your civil rights have been restored will be required prior to licensure. Page 4 of 11 r.t"phon", Ll/f - 7FF^1'9-at/ -z-C,JfE.,Cott*tty Contractor Licensing 2800 N. Horseshoe Dr, Naples, FL 34104 Pno^e - 239-252-2431 Fax - 239-252-2469 Growh Management Departrnefl t IV. EXPERIENCEVERIFICATION EOUCATION: List below and provide transcripts Ior any formal education you have obtained in the area of competency Ior which this application is bein made // A.EJc List below non formal educalion (on the iob training) you have obtained in the area of competency for which this applica tion is being made o l,e t /o L CURRENT/PREVIOUS LICENSE: List below and attach copies any other certilicates of competency/licenses you hold/have held in Collier County or any other jurisdiclion. lnclude the license #, Type, and county you hold it in. l)oo .- AFFIDAVIT Under the penalties of perjury, I declare that I have read the foregoing application and the facts stated in it are true. L 4y t Applicant (please print)Signature of Applicant State of F/",,J County of Co//r.n The Ioregoing inslrument as acknowledged before me this who has p na of pe on acknowledging (applicant) NOTARY'S SEAL 2ot by Dat roaucea fL.o /L$a 1 at xels Qcr,)te^" ,pe;r d;illr'rcaxo" "r. L'""*. IGNATURE OF NOTARY) FULL REINSTATMENT APPLICATION REV 4112118 Page 5 ol 15 APPLICAT]ON FOR COLLIER COUNTY CERTIFICATE OF COMPETENCY identification and did not take an oath. OF B ro.- v.l C let Cov*tW Groi/lh Managernent Departrnent APPTICATION FOR COTLIER COUNTY CERTIFICATE OF COMPETENCY CERTIFICATION OF APPLICATION 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 organizalion. 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. '/4q an Applicant pnnl) L tr/+il E 2 T T d L/tK4f, ttc State of D* rurl 1r- Name of Company gnatu Applrcanl who has produced 0a-Drt,ueer /tct'fi c hr by name of acknowledging (applicanl) as identification and did not take an oath ale lype of denlificalion or known (s TURE OF NOTARY) I E I G oulo NOTARY'S SEAL Page6ofl'1 Contractor Licensing 2800 N. Horseshoe Dr. Naples, FL 34104 Phone - 239-252-2431 Fax - 239-252-2469 LO" countyor, C4 c-c-t?Z- The foregoing instrument as acknowledged before me this CouttW Gro^ih lranagenrent Deparrnent Contractor Licensing 2800 N. Horseshoe Dr. Naples, FL 34104 Phone - 239-252-2431 F ax - 239-252-2469 APPLICATION FOR COLLIER COUNTY CERTIFICATE OF COMPETENCY WORKMEN'S COMPENSATION AFFIDAVIT It is understood and acknowledged by the Collier County Contractors' Licensing Board and myself that if I fail io acquire, or maintain at all times effective Workmen's Compensation lnsurance it will result in the possible revocation of my Certificate of Competency. y'tLo lha- Applicant (le e print) /.TfTO L {, Lt-c Name of Company n ature 'plicanl L t" BEFORE ME this day personally appeared who affirms and plicant (please print) 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 lnsurance. State of $.n.//o, County of The foregoing instrument as acknowledged before me this by rha who has produced name of acknowledging (applicant) as identification and did not take an oath L 2ar 1 ale type of ideniirlcation koown (SIGNA Ll cxlt? ( OF NOT Page7of11 NOTARY'S SEAL rE GDPlus lnformation on LARRY BRUELLMAN Search lor 0ualifier By l{ame 0riven llmM Lmt 5fudreilEm (ounl NIUflR }l8t I 2$i3 IKEY ilAi{t OAI OT BIRTli 7fin$7 50{9 p05r 0A( i.ft, Nrlus FL340t mftls Qualifier Exam per Qualifier lD :xAM I.oCATtoN EXAM OAIE LRr,l!il AAEIA. BUSINESS PROCEDURES TAElA - BUSINESS PROCEDURES scElA - POOL MATNT & REPATR {C) EXAX SCORE 6,t 00 76 00 81.00 Get Contractor by Gert Numbcr SPOilSOR 504) PosT oAx Lil MP|ESA34l0t NAPLES {GIT9 NAPTES (GrTS) ocalA (GrTs) 12r2n006 1/6,2007 2n2nat COLLIER COUNTY COLTIER COUNTY COLLIER COUNTY cfft Ist It{16 STATUS DORM car'rcEl O.d6€tor ,I,t! -E On STONE CONTf, I620-SWIMMINGP@LMA1NI & REPA i RtosllNEO r 620 - sw[aillNc pcol MAINT & RIpA F R!6I5IERED 08r cLrs!rc coNcRE t SEsuRfAcrNG, LLc. LAR8Ys ELTE POOI A FOUNTAIN, LIC- EIP DAII 9,t02011 9rl0r,l]11 Addro.! soai posl oex rerr NAPTEsFL3{iot 5OA} POSI OAK LN NIPTES FL 3410' 16:52 Search Certificates by DBA cout{TY 0r EXP OA1T 9j{a012 -,::1.,-']., 9,302011 REII]SIATE DAIT E}EMPI EXPNE OATE 1D,2113 CER'NBR 21296 12424 xlla 13896 t620!, t8l8l 36264 251n 1!794 21095 1220/ EXPIRI DAIE E3,r2012 grllyr996 9mr201'l 930/1997 ci1a012 ti1n012 grazotr 91212003 9r2E/2007 9/]02003 980,20t2 CNCL DATE5lATUS tNACTIVI CTIICEL 5U5PD CANCEL tNACT|Vf tNlanvt DOiU CA'ICEL <IXCEL clNclL tNACTIV€ 08A AU AI\TETCAN P&NIING Of NA'IIS, INC ar! AuESrcaN pRtssuRt ctlANrNo A}IFfu'AN P^llrTIN6 LLC AM€&ICAN AUI$G & FOUNOATION AMERICAN PIUMBING & SEYVES,INC A ERICAX 'TUM8ING OT SANASOTA INC- AlIm ,l Poot a fouNIAI'( uc AMERICAX 'OOT CINSTiUC'IION, INc. AMERICAI{ 'OOT CONSIRLKNON, INc. AMER(aN pOOt StRvlcts, rNC. AMERICAN PRISSUR! CUANING & SIALJNG, tNc. DAVE5 AMTRIC N POOI SERMCIS ORIG ISSO OAIT *2012105 &2E/l992 5,212009 323/1993 7l:}ln996 1/27/1998 mono11 9/12003 m0/2007 10nD002 &30/1994 :Br20l1 !tri0200. 93,n001 94302003 9?I,nO12 9/92011 2J&2012 18:14 CANCEL 913012006 191998 9/10/2006 ?!24,200! E-XATI OETAILS 20328 20858 24272 RE}lEWIL DATE 3txno11 SM CREDIT CHECK Individual Credit Report Vame...: BRUELLMAN LARRY D. Address : 542 AVEI-,LINO ISLES CIRCLE #10301 NAPLES FL 34119 iocial#: Applicant:-8355 ordered By :67 17 Received ':07 / Cust.omer :9998 24/L9 Completed:24/7907/ }REDIT SCORE: \PPLICANT FICO SCORE:768 (scores range from 300 to 850) ,UBLIC RECORDS: ,UBLIC RECORDS HAVE BEEN CHECKED AT THE LOCAL, STATE AND FEDERAL LEVELS WITH 'HE FOLLOWING RESULTS AS OF 07/24119: CLEAR iOURCE(S): EXPERTAN rRAMUrvIOi, 30 60 90RePolted op@ed \MEX 3 4999167 a4689243 DU\=0sl15 WEX 3 499923L08L6697 3 DLr\=07 / 1,9 \I,iIEX DSNB 377 487'7 5L84 DU\=05/19 ]ANKAMERICA 8310 DLA=03/l-5 ]RCLYSBANKDE 00010402918 DLA=06 /l-5 o5/16 o4/03 4Ls7 o7 /t9 ot/15 sos4 03/l-s Lt/L3 1818 o7 /79 09/Lt 06/L9 09/1"6 9367 9367 o5/16 03/09 7 907 AS AGREED0000000R01 487 AS AGREED0000000R01 40A AS AGREED0 000000R01 48 r AS AGREED0 000000R01 L6 r AS AGREED 0000000R01 48r AS AGREED0 000000R01 32 I AS AGREED 0 00 00 00 R01 48r 0 2r45 06/79 oa/14 ))A 0 00 0 )rdered by:APPLTCANT SEE NAIVIE ABOVE leporting Agency: Credit Check, lnc. - 3017 Exchange Court, Suite H, West Palm Beach,FL 33409 . (561) 616-5556 CONFIDENTIAL CREDIT RECORD (Credit historv has been checked for a period of seven ECCA lBY,/CBNA 7 007r9a97 37 0 DLA=ot / t9 ]K OF AJVIER 1111) DU\=06/19 CREDIT CHECK CONFIDENTIAL NAMC: BRUELLMAN, LARRY D. CAPl /BSTBY 7001,79197370 DLA= 0 9,/ 13 CAPl/SAKS 755538 DtA=0sl19 CBlBERGNERS 271700000245 DLA= 04 / 18 CBl P]ER1 778830203431, Dr.A=07 / L9 CBNA 426938007 304 Dr,A=07 / 79 CBNA 5].2106523233 Dr"A=07 /19 CENTRAL LOAN 3000066999012 DLA=01,/16 CENTRAL LOAN 3000077323475 DLA=02 / 78 CENTRAL LOAN 3000057380735 DLA=0sl15 CIT] 414729 DI,A=08 / L2 CITI 549143002010 DLA=03/17 CNH IND CAP 53785r.36061045001 DLA=10/09 Cust.omer; 9998 Paget2 AS AGREED0 00 00 00 R01 t4os/73 oe/L1 os/).9 tt/12 267 04/1,8 09/12 124 07 /te os/te ].96 07/19 09/1,8 529 0 0 0 0 I 0 AS AGREED0000000R01 48 I AS AGREED0000000R01 48r AS AGREED0000000R01 01 r AS AGREED0000000R01 09r AS AGREED0000000R01 37r AS AGREED0 000000M01 07 r AS AGREED0 000000u01 09 r AS AGREED0 000000R01 48 r AS AGREED0000000r01 13r AS AGREED0 000000R01 42 I AS AGREED0 00 00 00 R01 48 c 01 /1,9 Os/t5 3297 0 0 0 0 oL/L5 Os/1"s 4o8ooo os/Ls 04/74 4r.7000 08/L2 al/Ot 1310 8 0 0 03/L7 03/97 10623 0 L0 / 09 o8l08 r-r-s17s 0 CRDT FIRST 67803 DLA=06/19 DISCOVERBANK 60LL4994s621, DLA=07 /t9 06/79 t2/Ls r-s88 0 o7 /L9 03/89 74024 L4024 OTdETEd bY: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, lnc. - 30'17 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616-5556 02/L8 01,/L6 3s0000 AS AGREED0 000000u01 27 I AS AGREED0000000R01 48 I CREDIT CHECR"CONFIDENTIAL NamC: BRUELLMAN, LARRY D. FCS AMERICA 93091151001 DLA=09/09 FCS AMERICA 93091152001 DI'A=01, / 1,2 FCS AIVIERICA 9309103098615001 Dr"A= 07 / 19 JPMCB CARD 4t47 20279].87 DI;A=10 / 17 QUICKENLOANS 8573395009043 Dr,A=07 / 79 QUICKENLOANS 8673351000548 DLA=0sl15 SEARS/CBNA s12r072L0836 DLA=07 /79 SYNCB/BAERS 603467020823 Dr,A=05/19 SYNCB/CCTUFY 550159083809 DLA=07 / L9 sYNCB/LOW 7 9819261OO06 DLA=07 / 19 THD/CBNA 503532085433 DLA=05/19 THD/CBNA 603532083128 DI,A=07 / L9 THD/CBNA 50353208s149 Dr,A=05l19 WFDILLARDS 37 7'11,7 0007 6L Dr,A=03/18 o9 /09 06/08 3ooooo 07 /1,2 07/tO 2s0000 o7 /L9 08/17 2s0000 24L273 to / 1"7 07 / t2 2037 2 07 /19 02/L8 400000 390746 os/a6 07/76 3soooo Customer: 9998 Page:3 AS AGREED 0 00 00 00 r01 15 c AS AGREED0000000r01 23c AS AGREED0 000000u01 22 c AS AGREED0 000000R01 48 r AS AGREED0 00 00 00 il01 r-6 c AS AGREED0 000000u01 03 r AS AGREED0 000000R01 48 r AS AGREED0000000R01 23r AS AGREED0 000000R01 04 r AS AGREED0 000000R01 48 r AS AGREED0000000R01 23r AS AGREED0000000R01 36r AS AGREED0 000000R01 72 r AS AGREED0 000000R01 48 A 0 0 0 o7 /19 04/Ls 2045 05 /1,9 O7 /17 3376 07/19 03/19 1-176 o7 /1-9 01,/t2 7624 05/L9 06/L8 8319 06/a9 o7 /L7 18 07 /L9 06/16 50 0 0 0 0 0 0 03/1"8 03/07 709 0 OTdETCd bY: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, lnc. - 3017 Exchange Court, Suite H, West Palm Beach, FL33409. (561) 616-5556 0 0 swCREDITCHECK Name: BRUELLMAN LARRY D Customer: 9998 Total trade lines on this report.: 35 Page:4 INQUIRIES: 03/06/te by SYNCB CREDCO CREDCO CREDCO CREDCO #].263 431- #427 9853 #427 9853 #427 9 853 #427 98s3 02 / 01, 01, / 26 0]-/08ot/02 /18/tB/tg/tg by by by by RESIDENCE HISTORY: s42 AVELLTNO rSLES Cr, APT 10301 NAPLES FL 34119 (05/05/15) s089 posT oAK LN, NAPLES FL 3410s (Os/]..9/O8l 4100 coRPoRATE SQ, APT 150 NAPLES FL 34104 FRAUD RECORDS HAVE BEEN SYSTEMATICAILY CHECKED BY THE ACCESSED BUREAUS. CHECKS FOR IDENTITY THEFT, FAKE SSN, DECEASED SSN AND OFAC DATABASE PERFORMED. CREDITOR PHONE DIRECTORY: QUICKENLOANS FF13X.JOO1 1O5O WOODWARD AVE DETROIT MT, 48226 BK OF AIIIER BCI597 029 PO BOX 982238 EL PASO TX. 79998 CNH IND CAP FZ1SBBOO 8 PO BOX 35OO LANCASTER PA. 17604CAPI/BSTBY DC1DTVO57 PO BOX 30253 SALT I.,AKE CITY UT. 84130cBlPrERl HF1NZ8183 PO BOX t827 89 COLWBUS OH . 4 3 2 1 8CB/BERGNERS DC1NZ82 05 PO BOX L82789 COLUMBUS OH. 43218BRCLYSBANKDE BZIZZBOO)-P.O. BOX 8803 WTLMTNGTON DE. 19899WFDILI,ARDS BC21GJ611 CREDIT BUREAU DISP DES MOINES IA. 50306AMEX BC21WBOO1P.O. BOX 981537 EL PASO TX. 79998SyNCB/LOW LH2 3 5 041J PO BOX 955005 oRLANDO FL. 32896THD/CBNA BZ26H30O5 PO BOX 5497 SIOIIX FAILS SD. s7r-17 JPMCB CARD BC25QKOO1 PO BOX 15359 WTLMINGTON DE. 19850CITI BC282EOO1 CREDIT BUREAU DISP SIOLIX FAIJLS SD. 57117BBY/CBNA HE292FO21- (800) (800) (800) (8oo) 508-0944 421- 211,0 501-571-1 695- 6950 232 - O7 80 642 - 47 20 874-27t7 444 - t4 08 (888) (800) (800) (800) (800 ) (800) 945-2000 533-s500 OTdeTed by: APPLICANT - sEE NAME ABoVE Reporting Agency: Credit Check, lnc. - 3017 Exchange Court, SuiteH,WestPalm Beach, FL33409. (561) 616-5556 CONFIDENTIAL (TU) (TU) (ru) (TU) (ru) COMMENTS: ***oFAC NAME SCREEN ALERT - CLEAR*** OFAC (OFFICE OF FOREIGN ASSET CONTROL ) IS A FEDERAL AGENCY WHICH MAINTAINSA DATABASE OF TERRORISTS, DRUG TRAFFICKERS AND CRIMINAL ORGANIZATIONS. CREDIT CHECK CONFIDENTIAL Name: BRUELLMAN LARRY D. CREDITOR PHONE DIRECTORY . continued: PO BOX 6497 STOITX FALLS SD. 57117 CBNA BB2 92F03 ]. PO BOX 6497 SIOIIX FALLS SD. 57117 AMEX DSNB BC2A5TO 06 PO BOX 8218 MASON OH. 45040 FCS AMERICA FZ2A6COOI POB 2409 OMAHA NE. 68103cAPr/sAKs DC2DQ3 o 01 3455 HWY 80 WEST ,fACKSON MS. 39209 CRDT FIRST AZ3835OO3 POB 81315 CLEVELAND OH. 44181 CENTRAL LOAN BM5 O4TO O 1 PO BOX 77404 EWrNG NJ. 08528 SEARS/CBNA BC5256458 PO BOX 5217 STOITX FALLS SD. s7117 CBNA 8C5255492 PO BOX 6217 SrOUX FALLS SD. 57117 BANKAMERICA BC6331059 PO BOX 98223A EL PASO TX. 79998 CITI BC8213 03 O CREDTT BUREAU DISP SIOUX FALLS SD. 57117 'ISCOVERBANK 8C9516 O 03 POB 15316 WII,MINGTON DE. 19850 SYNCB/CCTUFY FF9992T9Fc/o Po Box 96s035 oRLANDo FL. 32895SYNCB/BAERS 829992408c/o Po Box 955036 ORTANDO FL. 32896CREDCO Z 427 9853 10277 SCRIPPS SAN DIEGO CA. 92131 CREDIT CHECK Z 0530273 3017 EXCIIANGE COUR WEST PALM BEAC FL. 33409SYNCB N 1263431 c,/o Po Box 965037 oRLANDo FL. 32896 Customer: 9998 Page ;5 (888 ) s74-1301 l4o2\ (800) l2t6) (800) 3 48 - 3239 221_ - 8340 352-5000 223 - 6527 815-9053 42L - 21]-0 950-5114 347 -2683 657 - O37 5 396 - 8254 637 - 2422 516-5556 41"9 - 4096 (877], (800) (800) (800) (855) (866) (800) (877), (855 ) *** EIJD OF REPORT r** TrE hiormdfi E dlfdont land 6 nor lo bs d[lo€d ereol4 llquBd br rho Far CBdt Ropo.tm Acl ' Trr @,i., or $m. rroe,6!ar: G m no wa, gusr€nts€d Ay ,M E6d*a rd usa d tns iEp.(, yar sp€oicalty ry.€ lo hdd Crsdl Ch.cr, lm hml63 fm -, l€hl|ly *h.lsc OTdeTed by: APPLICANT _ SEE NAME ABOVE Reporting Agency: Credit Check, lnc. - 3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616-5556 SM CREDIT CHECK Commercial Credit Report company: ELrrE poor, & FouNTATN rNC. Qreoio.,^S CO. Address: 542 AVELLTNo rsLEs CTRCLE #10301 CONFIDENTIAL Date: Cust. No: oa/08/19 9999 NAPLES, FLORIDA 3 4119 felephone: (239], 290-585s ]RINCIPALS: Ordered By: Page: r (X) Corporation EIN:454834585 PRES I DENT Address: Social Security Number: Stock Ownership: BRUELLMAN, I,ARRY D. 542 AVELLINO ISLES CIRCLE #10301 NAPLES, FLORIDA 3 4119 -835s' 100? Address: Social Security Number: Stock Ownership: Address: Social Security Number: Stock Ownership: Address: Social Security Number: Stock Ownership: lISK SCORE: :!1.!'Experian Financial Stability Risk Score !l 0 CREDIT RISK SCORE The score uses tradeline and collectsions informatsion, public filings as well as other variables to predict future risk. Higher scores indicate lower risk. FACTORS LOWERING THE SCORE : CREDIT LIMIT RECOMMENDATION Not available. A credit limiL recommendation is not available for this business. leported for leported by: APPLICANT - SEE NAME ABOVE Credit Check, lnc. - 3017 Exchange Court, Suite H, West Palm Beach, FL 33409. (561) 616-5556 I.,Lorr Risk Low to Med 3 .l Medium Risk Med to Hish 5 Hieh Risk Risk Class CREDIT CHECK CONFIOENTIAL Commercial Credit Report Company: ELrrE PooL & FoUNTATN rNC. Address:542 AVELLTNo lsl,Es CTRCLE #10301 NAPLES, FLORIDA 3 4119 Date Cust. No Ordered By Page os/oB/t9 9999 2 RISK SCORE - continued: Your ri"sk score is zero due to insufficient credit history can do to address this: Here's what you l-. Establish credit. lines with banks and vendors using your business name' After opening an account be aware it may take a few months to be rePorted to the credit bureaus.2. Make sure your bank or vendors rePort to Experian. virtually- all major banks and credit unions report to Experian as well as national chains like Lowes, Home Depot, and StaPles. 3. Pay your biils in a timely manner to achj-ve the best possible score. ELITE POOL & FOUNTAIN INC. was INCORPORATED in the county of COLLIER, staEe of FLORIDA, on 03/19, 2OI2. The charter number is P12000026856. The regj-stered agent is BRIIELLMAN, LARRY D. of 5089 POST OAK LANE, NAPLES, FLORIDA 34105. oifices are LEASED from N/A at N/A per month. The company employs N/A. NETWORTH: ON FILE WITH STATE The company maintains banking relations with wELLs FARGo The officer handling the account is N/A - NAPLES, FLoRTDA PUBLIC RECORDS WERE CHECKED FOR COLLIER COUNTY, FLORIDA. A SEARCH OF LOCAL, STATE, AND FEDERAL RECORDS HAS BEEN CONDUGTED wlTH THE FOLLOWING RESULTS: CLEARAS OF 08/08/19 - SEVEN YEAR SEARCH. *** Credit Profile *** REMARKS: N/A = NOT APPLICABLE/NOT AVAII,ABI,E iTHIS CORPORATION IS I,ISTED AS INACTIVE WITH THE FLORIDA DEPT OF STATE AS OF 09/25/Ls REPORT WORKED BY KELLY END OF REPORT . Th'. @dmrod Egdr 6 t t.tr.d 5dy.r 5 td h d.r.nn he rh. oldit d.lr.bfiy ol rr.pprdn(3i. t i. bsd lro hto.m.lid.atn d in !@d Litrr by nx. t6ocr tqr !..t6 d..rd Eltbk Tts @,.&1 ot m, hds, a h m ft $sf,rr..d ay yd 6tl,D ad !- olth'! EF.t, yo rrci..lr.!@ lo hob C.{xIr Ch.d( le h.mh!! 6ff rt L!*i, *r.lsq. t'.' CoranW Groruth Managernent Departrnent Contractor Licensing 2800 N. Horseshoe Dr. Naples, FL 34104 Phone - 239-252-2431 Fax - 239-252-2469 APPLICATION FOR COTLIER COUNTY CERT]FICATE OF COMPETENCY COLLECTION OF SOCIAL SECURITY NUMBERS Date: APRIL 12, 2018 To: Applicants for Certificate ol Competency From: Everildo Ybaceta, Contractor Licensing Supervisor Pursuant to Chapter l-'19, Florida Statutes and Collier County Contracto, Licensing Ordinance 2006-46 Section 2.1 .1 ., all applicants are required to submit thei. social security number (SSN) for the following purposes: a) Assess applicant's ability to satisfy creditors by reviewing their credit history. b) Verification of applicant's test scores and informaiion. Our office will only use your SSN noted above for those reasons pursuant to Chapter l-19, Florida Statutes, and as may otherwise be authorized by law. We are fully committed to safe-guarding and protecting your SSN and once collected, will be maintained as confidential and exempt under Chapter l-19, Florida Statutes. Page 11 of 1 1 Detail by Entity Name Fldida Depa.h6ni ol Srate Page 1 of2 DrvsroN oF CoiFoiaroNs *>t( urtur-a;,t1 *lrg i.- r-t i2 rL !:y! y.t t t :) ---'1*, u tltu! :;k 'qth'r"t dtt't ' tleoadm6nr or state , 9l!19p4-d-Q9@9[4@9 , S@r$-89994! r q9!al-gt!9sJo9(!r4!9! , Detail by Entity Name Florida Limited Liability Company LEAVE IT TO LARRY. LLC. Filino lnlomation Documont Numbar L'19000188729 FEUEI t{umbor NONE Drto Flfod OTlZil2O1g Ellocdve Dale O7mnO19 St t! FL St tur ACTIVE P ncipal Addre3s 542 AVELLINO ISLES CIRCLE *10301 NAPLES, FL 34,I19 !tsilils-Aggrels 542 AVELLINO ISLES CIRCLE #10301 NAPLES, FL 34,I19 Rooirtered Aoent Namo & Address BRUELLMAN, LARRY 542 AVELLINO ISLES CIRCLE *10301 NAPLES, FL 34119 Authoaized Peraon(3) Ootall Nam. t Addrt r Title MGR BRUELLMAN, LARRY 542 AVELLINO ISLES CIRCLE #'IO3O1 NAPLES, FL 34,I19 AnnualReoort8 No Annual Report! Fllod Oocument lmaoes 07 Vl€w mago ln PDF lo.mal fuD*lrot,slft,6YEsdc@fu httpy'/search.sunbiz.orgllnquirylCorporationSearch/SearchResultDetail?inquirytype=EntitY... 811612019 I certifu from the records of this office that LEAVE lT TO LARRY, LLC., is a limited liability company organized under the laws ofthe State ofFlorida, filed electronically on July 23,2019, effective July 23, 2019. The document number of this company is L19000188729. I further certifu that said company has paid all fees due this offrce through December 31,2019, and its status is active. I further certifu that this is an electronically transmitted certificate authorized by section 15.16, Florida Statutes, and authenticated by the code noted below. Authentication Code: I 9080508490 I -200332330302#l Given under my hand and the Great Seal ofthe State of Florida at Tallahassee, the Capital, this the Fifth day ofAugust,20l9 State of Florida Department of State wfifr,- Aaural /fr. Tcc Satmtary of Statr ffi IRS ?ffi3*ffi '1"9[,H,1ffi3H"" CINCINNATI OH 45999_0023 Date of this not.ice: 08-05-2019 ftnployer Identification Nulber: B4-2618292 Formi SS-4 Number of this notice: CP 5?5 c LEAVE IT TO I,ARRY ILC I"ARRY BRUELLMAN SOLE MBR 542 AVELLINO ISLES CIR APT 10301 NAPLES, FL 34119 For assistance you may call us at: 1-800-829-4 933 IE YOU ISRITE, ATTACH THE STUB AT THE END OE THTS NOTICE. WE ASS]GNED YOU AN EMPLOYER IDENTIFICATION NU},IBER Thank you for appLying for an Employer Identlfication Nunlcer (EIN) . We assigned you EIN 84-2678292. This EIN wiII identify you. your business accounts, tax returns. and docwnents, even if you have no enployees. Please keep this notice in your permanent records . Keep a copy of this notice j,n your permanent records. Itlis notice is issued only ono ti-E ard t}te IRS r.iU not b€ ab].€ to g€nerata a d4)].icat€ e4)y for f'otr. you may give a copy of this document to anyone asking for proof of your EIN. Use this EIN and your nane exactly as they appear at the top of this notice on alfyour federal tax forms. Refer to this EIN on your tax-related correspondence and docrments. If you have questions about your EIN. you can call. us at the phone nr.nnber or w.rite tous at the address shown at the top of this notice. If you write. please tear off the stubat the bottom of this notice and send it along with your letter. ff you do not need towrite us. do not colplete and return the stub. Your name control associated $rith this EIN is LEAV. You will need to provide thisinfornation, along with your EIN, if you file your returns electronically. Thank you for your cooperation. When filinq Lax docunents, payments, and related correspondence, it is very lmportantthat you use your EIN and co(plete name and add-ress exactly as shown above. Any varlatj.on may cause a delay in processing, result in incorrect infonnation in your account, or even cause you to be assigmed more than one EIN. If the inforrnation is not correct as shown above. please make the correction using the attached tear off stub and return it to us. A limited liabitity company (Lrc) may fife Form 8832, Entity Cfassification Efection, and elect to be classified as an association taxable as a corporation. If the LLC iseligible to be treated as a corporation that meets certain tests and it will- be electing S corporatlon status. it must timely flle Form 2553, ETection by a Snaff BusinessCorporation. The LLC will be treated as a corporation as of the effective date of the Scorporation election aIld does not need to file Form 8832. To obtain tax forms and publications, including those referenced in this notice,vislt our Web site at www.irs.gov. If you do not have access to lhe Internet, ca.Il 1-800-829-3676 (TTY/TDD 1-800-829-4059) or vj-sit your local lRS office. IUPCRIENT FEMIIIERS: (IRS USE ONLY) 575G 08-05-2019 LEAV O 9999999999 SS-4 Keep this part for your records.CP 575 c (Rev. 7-2007) Return this part with any correspondence so we nay identify your account. Please correct any errors in your name or add-ress. Your Telephone Nudcer Best Time to CaIlt) INTERNA], REVENUE SERVICE CINCINNATI OH 4 5999_0023 1t,,t,t,t,t,t,,t,1,,t,t,,il,,,il,,,,,t,t,,il,t,t,,t CP 575 G 9999999999 DATE OE THIS NOTICE: 08-05-2019 EMPIOYER IDENTIFTCATION NUMBER: 84-2618292 IORM: SS-4 NOBOD LEAVE IT TO IARRY LLC I,ARRY BRUELLMAN SOLE MBR 542 AVEI,],INO ISLES ClR APT 10301 NAPI,ES, EL 34119 C,RF",CoranX! Contractor Licensing 2800 N. Horseshoe Dr. Naples, FL 34104 Phone - 239-252-2431 F ax - 239-252-2469 Gro\ /th Manag€rnent Oeparfnent APPLICAIION FOR COLLIER COUNTY CERTIFICAIE OF COMPETENCY This certifies that l. member of STATEMENT OF OWNIRSHIP L o,,Bru.PTau LICANT S NAME (please Pr nl) rTOL )<LLC GtMrrED LrABtLtrY coMPANY am a member or managing E) I own /no % of the units issued by the Limited Liability Company lasted above Affidavit of Applicant: I certify undel penalty of perlury that the information contained is a true and correct statement to the best of my knowledge. icant (please print) L Frt T70 The foregoing instrument as acknowledged before me this (,// Name of C Signalure of APplicanl Lt c. hceust ale t2/)by fvc name of pe 'on acknowledging (aPPlicanl) as identification and did not take an oath ,t who has p roduced o type of identrllcation or known OTARY)L {SIGNATURE OF REINSTATMENT APPLICATION REV 4112118 Page 9 of 1'l st t or F/ OelL * countyor /lAr d-r t*- NOTARY'S SEAL C,frF.,Cor,t*tt1l Contractor Licensing 2800 N. Horseshoe Dr. Naples, FL 34'104 Phone - 239-252-2431 Fax - 239-252'2469 Growth lvlanag€rnent Depart'neflt APPLICATION FOR COLLIER COUNTY CERTIFICATE OF COMPETENCY VERlFICATION OF CONSTRUCTION EXPERIENCE l-nr.y' u- a-fn The applicant is seeking a Collier County Certificale ol Competency in the trade indicaled above. As part of the application lor this certilicate, the applicant must verily his/her experience within this trade. You are being requested to provide inlormation that will aid the applicanl in meeting this requirement. You should verify time ol active experience working as an apprentice or a skilled worker (e.g., as a worker commanding the wage ol mechanic or bener in the trade). Time served solely in a supervisory or administrative role should be described, but may or may not be considered sutficient to demonstrate required trade expe nce. The n verilying trade experience for lhe above-named applicant must provide the following information Applicant's Name Name Business Name Phone l/ t)Title ?r,<t),4 WrL License No. (if applicable) Business Address fols I +|h o-o' St-, lh<il.-t I L ?c/ti( State zip to Jo lr. The applicant's scope of work (speciiic dulies) included Additional comments NOTE TO Lf CENSED CONTRACTORS: Falsifying any intormation provided Under penalty ol perjury, I declare that the facts stated here are true. ./^-Si State ol County of G(L* o+-lr< I ?.la date Do",J N. /A *ckt who has produced 0L' t your license to revocation oviding the statement by LZ.tl --D as identilication name ol person acknowiedging and did not take an oalh. type of identitication or known A. ur*,$",-- NOTARY'S SEAL syf,r.reru ne br r.rornnv Page 10 of 15 Certiricate Category Requested : Street CitY The appticant was erproy"o 8flhe rro, A O I I Applicant's title: The foregoing instrumenl as acknowledged before me this ANA OF Coolrn, FULL REINSTATMENT APPLICATION REV 411218 -z-C,fiff.,Cot*rL!Conlractor Licensinq 2800 N. Horseshoe Dr. Naples, FL 34'104 Phone - 239'252-2431 Fax - 239-252-2469 Grclr/th Management Deparhent APPLICAT1ON FOR COLLIER COUNTY CERTIFICATE OF COMPETENCY Applicant's Name VERIFICATION OF CONSTRUCTION EXPERIENCE G"L 5 Jc (/ Ti e The applicant is seeking a Collier County Certificate of Competency in the lrade indicated above. As part of the appllcation for this certilicate, the applicant must verity his/her experience within this trade. You are being requested lo provide informalion that wilt aid the applicant in meeting this requirement. You should verily 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 sutlicient to demonstrate required trade experience. The person veritying trade experience lor the above-named applicant must provide the following information Certilicate Category Requested oo Name -l- Business Name 0 I Pho ne ? Street The applicant was employed by me trom Applicant's title The applicant s scope of work (specilic duties) included License No. (il applicable) City State zlp 3q to )o ll o (l State of d";L 6rL;t oa lz-c I -o,,by date d^o"t wno nas produceo 0L P . 'IL?O as identification name ol person ackno\,viedging and did not take an oath. type of idenlification or known A rt-,&.^- NOTARY'S SEAL FULL REINSTATI\4ENT APPLICATION REV 4112i18 ;fGr.rerune'or Nornnv Page 11 ol 15 L( Business Address: )- Additional comments: NOTE TO LICENSED CONTRACTORS i Falsitying any infomation ptovided herein may subject your license to revocalion. Under penalty of perjury, I declare that the facts stated here are true. Signature ol pe6on providing the statement County of The loregoing instrument as acknowiedged before me this OF Co(lxn. -z-C,frH.,Couttt!Contractor Licensing 2800 N. Horseshoe Dr. Naples, FL 34104 Phone - 239-252-2431 Fax - 239-252-2469 Grov/h lManagernent Deparknent APPLICATION FOR COLLIER COUNTY CERTIFICATE OF COMPETENCY (La AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER riJrSTATE OF COUNTY OF G ti, tt G,.&rq*s" t1t, I am a resident of G \QT County, *i[r having been first duly sworn, state and aflirm ri Ja-(State) and have resided here for Signatg"J st1 A (t €Q, more than five (5) years During the last five (5) years I have known Lq Ll.yvra,r,r (applicant). I have had the opportunityBru to observe his or her business and personal dealings and find him or her to be a person of honesty, lntegrity and I The foregoing instrument as acknowledged before me this ? $^, L.*. )/Y"-^^^ . ^ k A ure L Printed Name Address 5 )-A 0a" Cry t Itt-ZOl Street Nq-%o 3! ilYFU City State zip Telephone 23 -JZ sb0 7lt dn u.,,o 1e as identification NOTARyS SEAL r*'.k lWr t0N D (.) 6C c 0 lond.O qr FULL REINSTATMENT APPLICATION REV 4112/18 (srG TURE OF NOTARY) Page 13 ol 1 5 good character. ov Guln,Ld 5 l4an K whohasproduced knoonTo tfic?rrtnn.ll,t name of persor acknowteoging type ot iOentificaf.n---/- and did not take an oath. PublicNolary Commt'lon J8l6l l -2,-CfrF.,Couttt!Contractor Licensing 2800 N. Horseshoe Dr. Naples, FL 34104 Phone - 239-252-2431 Fax - 239-252-2469 Growth Management Deparfnent APPLICATION FOR COLIIER COUNTY CERTIFICATE OF COMPETENCY AFFID AVIT OF INTEGRITY AND GOOD CHARACTER STATE OF (L COUNTY OF CotLior Lo.tt*x-A. Q" A^,aving been first duly sworn, state and affirm: I am a resident ol e Llt County, more than five (5) years During the last five (5) years I have known to observe his or her business and personal deali good character. The foregoing instrument as acknowledged before me this by lt fr /rrCK who has p{od€€ed name of person acknowledging and did not take an oath. (State) and have resided here for Llu)(applicant). I have had the opportunity s and find him or her to be a person of honesty, integrity and L Signalure l.qtu*. A. Q.,) n.-'k- Printed Name Address U wl.' u \7 b1"? Street f/ 3r // ,9 City State z)p Telephone )37 ) date ot identillcat n or known as identification ?b \.) ..:.-. . :.. SAGAI TRO,IBLEY - :.-;Sl-.\\ .: Nc,,.ry pubt,i - Sini .,;:.r:! 'r irli'.i'. Lonrrssrar:UU ia -' .i .\js,,/j.'1.!, Cc,rn Er;.t5ts3.;- ;;,1.;.': ;.::.r' 3.-.ec :i,"--i \a,J..a \: r-. ii:' NOTARY'S SEAL FULL REINSTATMENT APPLICATION REV 4/12/18 IGNATURE O OTARY) Page 14 of '15 DBPR - BRUELLMAN, LARRY D, Registered PooUSpa Contractor Licensee Details Licensee Information Name: BRUELLIIIAN, I-ARRY D (Prlmary NamG) Main Address: 524 AVELLINO ISLES CIR #1O3O1 NAPLES Florada 34119 County: COLLIER License Mailing: LicenseLocation: Page 1 of2 3 01 1 1 PM A1 6r2U9 Sp€cia! Quallfication3 Pool/Spa Scrvlclng Contractor Reglstered Pool/Spa Contractor Reg Pool RP25255518s Currcntrlnactlve 04l22lzOtO oalsLl2o2t Qualification Effective 04l22lZOLO Types of work Licensee Can Perform Pool/Spa Scrvicing Contractor This contractor can repair or service any swimming pool or spa, both public or private. This contractor can repair or replace existing equipment, install new equipment, work on interior finishes, reinstall or add pool heaters, repair or replace perimeter piping and filter piping, repair equipment rooms and housing, and drain pools or spas for purposes of repalr. This contractor cannot make direct connections to water or sewer lines. Water treatment and cleaning that does not require the installation, construction, replacement. or modification of equipment does not require a llcense. Filters may be changed without a license. Alternate Names View Related License Information View Licen ComDlaint https://www.myfloridalicense.com/LicenseDetail.asp?SID--&id=954839C48C6138A7C I ... 8/1612019 lffi'! f.cicensee Can Pedorm ) License Information License Type: Rank: License Number: Status: Licensure Date: Expires: ev Covt*ti3tt Growth Management Department Planning & Regulation Operations Division Licensing Section September 4,2019 LEAVE IT TO LARRY, LLC LARRY BRUELLMAN 542 AVELLINO ISLES CIRCLE #10301 NAPLES, FL 341 19 RE: REINSTATEMENT WITH WAIVER OF EXAMS MT. BRUELLMAN, You have been added to the agenda for the Contractor Licensing Board meeting on Wednesday, SEPTEMBER 18,20.19. Please attend the meeting so the board may review your submitted application and ask you questions regarding your previous exams you have taken as well as why you let your license lapse with Collier. The meeting is held at 9:00am at the W. Harmon Turner Building (Bldg. F, Admin. Bldg.), 3299 Tamiami Trail. E., Naples, FL34112 in the Commissioner's Meeting Room on the 3rd floor. There is a security checkpoint you will need to go through, so please allow enough time to make it to the meeting. Sincerely, Lilla Davis Administrative Supervisor Contractor Licensing CoIIier County Growth Management Department 2800 North Horseshoe Drive Naples, FL 34104 GroMh Management Department'Contrador Licensing '2800 Norlh Horseshoe Orive'Naples, Florida 341 04'239-252-2400'\a.ww.coIiergov. net lf you have any questions or concerns, please call (239) 252-2431 or you may email me at contractorslicensing@colliercountyf l.gov.