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CLB Agenda 08/15/2012co ear County COLLIER COUNTY CONTRACTORS' LICENSING BOARD AGENDA AUGUST 15, 2012 9:00 A.M. COLLIER COUNTY GOVERNMENT CENTER ADMINISTRATIVE BUILDING BOARD OF COUNTY COMMISSIONERS CHAMBERS ANY PERSON WHO DECIDES TO APPEAL A DECISION OF THIS BOARD WILL NEED A RECORD OF THE PROCEEDINGS PERTAINING THERETO, AND THEREFORE MAY NEED TO ENSURE THAT A VERBATIM RECORD OF THE PROCEEDINGS IS MADE, WHICH RECORD INCLUDES THAT TESTIMONY AND EVIDENCE UPON WHICH THE APPEAL IS TO BE BASED. ROLL CALL II. ADDITIONS OR DELETIONS: III. APPROVAL OF AGENDA: IV. APPROVAL OF MINUTES: DATE: June 20, 2012 V. DISCUSSION: VI. NEW BUSINESS: (A) Doreen J. Visser — Contesting Citation(s) (B) Darleen Rowe — Credit Report(s) (C) Jeff Yingling — Review Credit Report OLD BUSINESS: (D) Nelly Nava — Review credit report (E) Orders of the Board VII. PUBLIC HEARINGS: (A) Case #2012 -09 — Lucius Blackwell d /b /a AAa Air Conditioning & Refrigeration, Inc. IX. REPORTS: X. NEXT MEETING DATE: WEDNESDAY SEPTEMBER 19, 2012 COLLIER COUNTY GOVERNMENT CENTER ADMINISTRATIVE BUILDING THIRD FLOOR IN COMMISSIONERS CHAMBERS 3299 E. TAMIAMI TRAIL NAPLES, FL 34112 June 20, 2012 MINMES OF TTY COILIFR COUNTY CONTRACTORS' LICENSING BOARD N[EEHNG June 20, 2012 Naples, Florida LET IT BE REMEMBERED that the Collier County Contractors' Licensing Board, having conducted business herein, met on this date at 9:00 AM in REGULAR SESSION in Administrative Building "F," 3rd Floor, Collier County Government Complex, Naples, Florida, with the following Members present: CHAIRMAN: Vice Chair: Excused: ALSO PRESENT: Lee Horn Richard Joslin Michael Boyd Terry Jerulle Kyle Lantz Thomas Lykos Jon Walker Patrick White Robert Meister Michael Ossorio — Supervisor, Contractors' Licensing Office James F. Morey, Esq. — Attorney for the Contractors' Licensing Board Steve Williams, Esq. — Assistant County Attorney Ian Jackson — Licensing Compliance Officer 1 June 20, 2012 NOTE: Any person who decides to appeal a decision of this Board will need a record of the proceedings and may need to ensure that a verbatim record of the proceedings is made, which record includes the testimony and evidence upon which the Appeal is to be based. I. ROLL CALL: Chairman Lee Horn called the meeting to order at 9:04 AM and read the procedures to be followed to appeal a decision. Roll call was taken and a quorum was established. Eight members were present. II. ADDITIONS OR DELETIONS: (None) III. APPROVAL OF AGENDA: Patrick White moved to approve the Agenda as presented. Second by Thomas Lykos. Carried unanimously, 8 — 0. IV. APPROVAL OF MINUTES — May 16,2012: Chanes: James F. Morey, Esq., Attorney for the Board, noted that during the May 16th meeting, Mr. Lykos stated he would abstain from voting during Case #2012 -07, Robert E. Elwell, d/bla Service Star Cooling & Heating, LLC due to a possible conflict of interest. o Mr. Lykos stated he had no direct financial connection with the Respondent's company, but the company has a history with one of his ( Lykos') clients. While the project was completed approximately two years ago, Mr. Lykos' company performs regular maintenance for his client. • Mr. Lykos signed the "Memorandum of Voting Conflict" on May 30. 2012 and circulated it to the Board members. Mr. Morey requested to include Form 8 -B, entitled "Memorandum of Voting Conflict," in the Minutes (at Page 9) and referenced it as County's Exhibit "A." Chairman Horn called for a motion to add Form 8 -B to the Minutes as the County's Exhibit "A." Vice Chairman Joslin moved to approve adding Form 8 -B to the May le Minutes. Second by Kyle Lantz. Motion carried, 6 — "Yes "12 — Abstained. Mr. Lykos abstained from voting. Mr. White could not vote because he did not attend the May 16`h meeting. 2 June 20, 2012 Thomas Lykos read the following "Disclosure of Local Officer's Interest" into the record: "A Hearing was held on an Administrative Complaint against Robert E. Elwell, d/b /a Service Star Cooling & Heating, LLC, the "Contractor "). My company had been retained by a consumer who had recent dealings with the Contractor for which we had taken, or would be taking, remedial measures. Since there may be a private gain due to my company's involvement with the Consumer, I abstained from voting in that matter." Vice Chairman Joslin moved to approve the Minutes of the May 16, 2012 meeting as amended. Second by Kyle Lantz. Motion carried, 7 — "Yes " /1— Abstention. Patrick White could not vote to approve the Minutes because he did not attend the May16`h meeting. V. DISCUSSION: Vice Chairman Joslin provided copies of a brochure on the installation of heat pumps for swimming pools and the Contractors who were allowed to do so. Michael Ossorio stated he understood mechanical contractors could install heat pumps while air - conditioning contractors cannot, but he will confirm this information with the State's Contractors' Licensing Board. Vice Chairman Joslin stated he thought the language in the Ordinance was clear, i.e., that only pool contractors may install heat pumps. VI. NEW BUSINESS: (None) VII. OLD BUSINESS: A. Orders of the Board Kyle Lantz moved to approve authorizing the Chairman to sign the Orders of the Board. Second by Thomas Lykos. Carried unanimously, 8 — 0. VIII. PUBLIC HEARINGS: (Note: In the following case, the individuals who testified were first sworn in by the Attorney for the Board.) A. Case #2012 -08: Daman Keath Sharp, d/h /a "Sharp Pools and Decking, Inc." Chairman Horn noted Mr. Sharp was not present at the Hearing. June 20, 2012 Chairman Horn outlined the general process of the Public Hearing: • The County will present an Opening Statement to set forth the charges and, in general terms, how it intends to prove the charges. • The Respondent will present his/her Opening Statement setting forth, in general terms, defenses to the charges. • The County will present its Case in Chief by calling witnesses and presenting evidence. • The Respondent may cross - examine the witnesses. • After the County has closed its Case in Chief, the Respondent may present his/her defense, i.e., to call and examine witnesses, introduce Exhibits, cross - examine witnesses to impeach any witness regardless of which party called the witness to testify, and rebut any evidence presented against the party. • After the Respondent has presented his/her case, the County will present a Rebuttal to the Respondent's presentation. • When the Rebuttal is concluded, each party is permitted to present a Closing Statement. • The County is allowed a second opportunity to rebut the Respondent's Closing Statement. • The Board will close the Public Hearing and begin deliberations. • Prior to beginning deliberations, the Board's Attorney will give a "charge" to the Board, similar to the charge given to a jury, setting out the parameters on which the decision will be based. • During deliberations, the Board can request additional information and clarification from the parties. • The Board will decide two different issues: • Whether the Respondent was guilty of the offense(s) charged in the Administrative Complaint, and a vote will be taken on the matter. • If the Respondent was found guilty, the Board must decide the sanctions to be imposed. • The Board's Attorney will advise the Board concerning the sanctions and the factors to be considered. • The Board will discuss the sanctions and vote. Vice Chairman Joslin moved to approve entering the packet for Case No. 2012 -08, Board of County Commissioners vs. Damon Keath Sharp, d/b /a "Sharp Pools and Decking, Inc., "License # C.C. #23844, into evidence. Second by Kyle Lantz. Carried unanimously, 8 — 0. • Chairman Horn entered the information packet into evidence, marked as County's Exhibit `B." Attorney Morey referred to Page 2 of the Administrative Complaint and noted the reference to the Florida's Workers' Compensation Statute 440.10(1)(a) was correct. Compensation Insurance" and not simply "compensation." June 20, 2012 Vice Chairman Joslin moved to approve including the clarification, "Workers' Compensation Insurance," in the information packet as admitted. Second by Terry Jerulle. Carried unanimously, 8 — 0. In response to Chairman Horn's question concerning proper notification, Mr. Jackson referred to Exhibit E -12, "Notice of Hearing," mailed on May 22, 2012, and to Exhibit E -13, "Certified Mail return receipt," signed by Jeanette Sharp on May 31, 2012, as proof of proper service upon the Respondent, Daman Keath Sharp. He further stated Mr. Sharp obtained a copy of the Evidence Packet on June 13, 2012 at the County's Horseshoe Drive office. Patrick White asked if Mr. Sharp had notified Mr. Jackson that he would not attend the Hearing, or if he had requested a Continuance in the matter. Mr. Jackson replied the Respondent had not contacted him. Ian Jackson, Licensing Compliance Officer, presented the County's Opening Statement: • The County will show through sworn testimony and documented facts that Daman Sharp, "Sharp Pools and Decking, Inc.," violated Collier County Ordinance 90 -105, as amended, as follows: o Section 22- 201(2): "Contracting to do any work outside of the scope of his competency " by contracting for the construction of a paving driveway which is not included within the scope of a of a Registered Residential Swimming Pool Contractor; o Section 22- 201(6): "Disregards or violates, in the performance of his contracting business in the County, any of the building, safety, health, insurance, or Workers' Compensation Laws of the State, " by not providing Workers' Compensation Insurance coverage to his employees, pursuant to Florida Statutes 440.10(1)(a); o Section 22- 201(10): "Failing to promptly correct faulty workmanship" in relation to the paving block driveway. Mr. Jackson presented the County's "Case in Chief. " Direct Examination of Complainant, David Clark, by Ian Jackson: Q. Are the payments shown on Exhibit E -15 the payments made to Daman Sharp of Sharp Pools and Decking, Inc.? (Total Amount: $45,000) A. Yes, they are. Q. Is Exhibit E -17 the bid proposal that initiated construction of your paving block driveway? A. It is, yes. (The document is an e -mail from Sharp Pools/Decking to David Clark; and the price for paver block driveway: $49,019.70) June 20, 2012 Mr. Clark stated he lives in the United Kingdom and all communication between Sharp Pools and Decking, Inc., and himself was via e -mails and phone calls. He stated he did not receive a copy of the signed "contract" nor did he receive a receipt for his tax return. Ian Jackson referred to Exhibit E -34, Florida Statues, Chapter 489.105(6), "Contracting," for the definition of a Contract: "The attempted sale of contracting services and the negotiation or bid for a contract on these services also constitutes contracting. " He continued the bid provided at $49,019.70 constitutes a contract. Patrick White stated the email was an offer and Mr. Clark testified that he accepted the offer and made payment on it, which is the consideration which made it a contract. Chairman Horn noted there was an offer and consideration. Q. Were the photos on Exhibits E -24 and E -25 taken of the construction at your property? A. They were. But they were not taken by myself. Q. Regarding Exhibit E -26, is this an email correspondence between yourself and your Leasing Agent indicating that workers other than Daman Sharp were performing construction on the pool and driveway? A. Yes, that's correct. To elaborate, the Agent went `round to check on the property for me — nothing to do with the work — she found the kitchen had been used, the toilets were rather disgusting to put it mildly. I trusted Daman with the entrance codes and, as it turned out, he had given that to the workers who were actually using and abusing the place. Consequently, she took the pictures of those workers and forwarded it to me in the UK to explain the situation." Chairman Horn asked Mr. Clark how the Respondent represented himself during their conversations — if he stated he could other jobs such as the driveways in addition to the pool and decking. How did he go from being a pool contractor to a driveway contractor? Mr. Clark replied he was not familiar with Collier County's rules and regulations. He stated one of the reasons why the job was delayed so much was because Daman Sharp stated he was studying for his full Building Contractor's [General Contractor] license, and he indicated he was also qualified to do driveway construction. Mr. Clark further stated he would not have agreed to allow Daman Sharp to do the driveway work if he had not been assured that Mr. Sharp was qualified. David Clark: "I, personally, am an engineer and I was told, consequently, of how he would fulfill that work which is, clearly, not the case." He continued, "Most of the conversations were done by phone because, quite frankly, trying to get Daman to write anything was extremely difficult." rol June 20, 2012 Direct Examination by the County was concluded. Questions from the Board: Patrick White asked Mr. Clark if he was present when the photographs (E -24 and E -25) were taken. A. Not when these photographs were taken. I subsequently, when I came back, I did see the said workers. Q. Is it your opinion that these photographs, on the date they were taken, accurately reflect the condition of the property at that time? A. Yes, it is. David Clark: "The only thing I would like to state is — you know, I know Ian, as well, has given Daman every opportunity — I don't want to see anybody in the particular work environment, as it is today, lose their ability to work. But I do — obviously, this has caused me a great inconvenience and considerable cost because there are other problems as well — but the simple fact of the matter is that I do feel until things are corrected that he doesn't have the right to do further work." He further stated, "Daman has been given every opportunity to meet and to resolve these issues." Chairman Horn stated Mr. Clark's comments were relevant. Terry Jerulle asked if the work had been resolved. David Clark: "Not only is it not resolved, I am having to resolve issues also with the pool and many other things which I'm doing myself at my own cost, and that's one of the reasons I'm back here is to resolve these issues because they can't be left." Vice Chairman Joslin asked if the work on the pool had been done and completed to Mr. Clark's satisfaction and if it had been C /O'd [received a Certificate of Occupancy]. Mr. Clark stated it was not done and he didn't have time to add it to the complaint. Michael Ossorio cautioned the Board to avoid confusion with another case to be heard at another time. Chairman Horn stated he did not want to get into the second case. He further stated the Board had not been aware of a potential second case on the project. Chairman Horn thanked Mr. Clark for his time and testimony, and he was excused. Gilbert Anuez, Jr., Collier County licensed Paving Block Contractor and qualifying agent for "Accurate Pavers" was called to the stand. Direct Examination of Mr. Anuez by Ian Jackson: Q. How many years' experience do you have in paving block construction? A. Twelve years. June 20, 2012 Q. And how long have you been licensed and a qualifier for "Accurate Pavers ?" A. Ten years. Ian Jackson asked the Board for a motion to consider Mr. Anuez as an expert witness in paving block construction. Terry Jerulle stated he knows Mr. Anuez and is a subcontractor whom he has hired. He did not think his relationship with Mr. Anuez would have any bearing on the outcome of the case — he would not be swayed by the testimony. He confirmed that Mr. Anuez is an expert at paving block construction. Chairman Horn asked the Board's Counsel if he had an objection to Mr. Jerulle's further participation. Attorney Morey stated he did not because Mr. Anuez was not the Respondent in the case and was appearing as an expert witness, Mr. Jerulle's prior relationship would not have any bearing on the case since Mr. Anuez will be providing extraneous information. Vice Chairman Joslin stated he wanted to question Mr. Anuez before he could accept him as an "expert." [Vice Chairman Joslin is a licensed Pool Contractor.] Q. A pool contractor has been hired to install a pool but has not been hired to do the pool deck. You have been hired by the General Contractor or the homeowner to do the pool deck portion of a contact. Do you pull a Permit to put in the pool deck? A. I do not. Q. Who pours the footers for the pool deck? A. The pool contractor or the General Contractor. I'm not licensed to do footers. Q. Is it your responsibility to go in and compact that pool deck if it's been dug out and a brand new pool has been put it — and the direct has been removed seven feet down? And do you put in a lift or is that the pool contractor also? A. We do. We poke around the pool and we compact. (He explained the compacting process in detail concerning the equipment used, etc.) We do not install the backfilling. It is seven feet down. We weren't there to do any kind of lifting. You should be doing lifts on a pool every three inches. A pool should be backfilled probed and compacted every three inches to get the proper lift and compaction. Unfortunately, we're not there to do that. When we come in to do a pool deck, we probe around the pool coping with water jetting and we compact what we can of the upper three to four inches. If it's very silt -y sand and you can't get the proper compaction, then we discuss about bringing in a sub -base to harden the surface for what we need to lay our pavers on. Q. Is your compaction test done so you know you don't have compaction? A. On a roadway, you do need the 97% proper density. On a pool deck, there are no guidelines — we do our own field testing as the Subcontractor. June 20, 2012 Q. After six months of sitting on a pool deck and all of a sudden the paver deck starts to settle, if you had done your job, whose fault would it be? A. Of course — that always goes to the guy who installs the deck. Unfortunately, it's not the paver guy. I am very involved with the ICPI — [The Interlocking Concrete Pavement Institute, founded in 1993, is the North American trade association that represents the interlocking concrete paving industry] — they developed the standards used for the installation of pavers. It's basically the fault of the pool contractor who did the backfilling and the compacting and the lifts of it. But it's always put on the paver guy — in good faith, I usually go back and fix the problems for the contractor just to maintain standards. Q. So, in your opinion, do you think that there should be an inspection required for a pool deck before the pavers go on — or at least a compaction test? We're not talking about a driveway because driveways aren't generally dug out to be seven foot deep and a pool is. It should be done — a compaction test — I feel. I've been in situations before where that's happened, and naturally the pool contractor has to pay to have the deck removed and a new paver deck put down because the pool contractor didn't wash it in or compact it correctly and the then paver doesn't want to do it either — and it becomes like a "Catch 22." A. Exactly. Q. Are you in agreement with that? A. As it is relative to building a pool, yes. Q. The new codes — as far as the Statutes go — there is a new code that says you have to have a Number 8 ground wire all the way around the pool if it's a paver deck. Who does that? A. The pool contractor. I don't do any bonding. It's not in my scope of licensing. I guess that would be in the structure of forming the pool. We don't connect any handrails — we don't do any of that. Q. No, I understand that, A. That has nothing to do with the paver installer. Patrick White directed a question to Ian Jackson: Q. is it the intention for the gentleman to only speak to the driveway portion of the compaction? And other issues regarding the paver blocks that were installed and not anything around the pool? Which things is he going to talk about? A. The intent of the County with Mr. Anuez is for him to comment/explain his inspection and assessment of the construction of the driveway. Q. And not the pool area? A. No. June 20, 2012 Vice Chairman Joslin stated it was the same principle and applied to the pool deck as well. Q. Does a driveway, that's permitted, have to have a compaction test done on it also? A. Not in Collier County. Vice Chairman Joslin: "Not in Collier County. That was my point." He continued questioning Mr. Anuez: Q. So there is no way for you to know, 100 %, if that driveway was compacted or not? Unless you do it yourself or get a compaction test done? A. Correct. Chairman Horn: Q. Your licenses with Collier County and the State — what are they in currently? A. Paver Block. Chairman Horn called for a motion. Patrick White moved to accept Mr. Anuez as an expert in the area of paver block installation and contracting. Second by Terry Jerulle. Carried unanimously, 8 — 0. Direct Examination of Mr. Anuez by Ian Jackson (Continued): Q. On October 31, 2011, did you perform an inspection and assessment of the driveway constructed at Mr. Clark's property with myself and Mr. Clark? A. Yes, I did. Q. Could you describe the generally accepted Standard in Collier County regarding the construction of the paver block driveway — specifically, in relation to the Standard of base rock? A. The Standard is — you to go and get a Right -of -Way Permit to do work in the right - of -way — it provides six inches of base — compacted base rock. There's not regulated, compacted test or inspection done here. But the Industry Standard is four inches of compacted base rock for the driveway after the right -of -way. Q. Four inches is the Industry's Standard. And the County's Right -of -Way requirement is six inches? A. Correct. Q. If we could look at Exhibit E -30. Mr. Anuez, could you go over your assessment shown here on E -30 regarding the driveway construction of Mr. Clark's for the Board? A. As we spoke earlier, I was invited to Mr. Clark's address at 258 Kendari Drive 10 June 20, 2012 and as we went walking over the driveway, I lifted up several — three areas in different sections of the driveway — and dug down and there was approximately an inch of bedding sand that was just for the pavers to be level and we did not find any base rock or sub -base —just natural soil. Q. The four -inch Industry Standard of base rock did not exist on Mr. Clark's driveway? A. Correct. Vice Chairman Joslin: Q. So, in your opinion, this was done improperly according to Standards? A. Correct. Patrick White: Q. What would be the proper way to fix this? A. To remove all the pavers, stack them, come back and excavate eight inches of soil — dirt — remove it — re- install four inches of compacted base, compact it, install your bedding sand, your pavers, and your concrete for extra strength, and then finish up with a final compaction. Q. Is that process essentially what you provided as an estimate on Page E -32? A. It is. Chairman Horn: Q. That applied to the entire driveway? There were no sections that were exceptions that were done properly and didn't need to be re -done? A. Not that I could find. Vice Chairman Joslin: Q. How many areas did you check? A. I would say between three and five. I'd say three as a low number and I checked in various locations. I think there were more, but we'll just go with three. Chairman Horn: Q. Have you already finished this job for the homeowner? A. Absolutely. Q. Once you re -did it and things shifted as you went down a little deeper, was there any need to purchase new materials or to add to it — to this estimate — or did everything work out? A. By new materials, do you mean the proper base rock? Q. Yes. But I was thinking of the pavers. A. We were going to purchase more brick pavers because as you lift them you lose — so you would try to match the brick pavers. 11 June 20, 2012 Q. So you don't foresee any future additional costs, then, on top of this? A. No. Direct Examination by the County was concluded. Ian Jackson requested the Board to review Exhibit E -33. i.e., a "Notice of Order to Correct" which was issued to Mr. Sharp and was signed for by Jeanette Sharp at the Horseshoe Office on January 24, 2012, explaining the steps that would be required to have the faulty work promptly corrected per the Code. He noted the steps have not been taken and the Respondent has had from January 24th to June 20th to correct the condition. Chairman Horn noted Jeanette Sharp was the same person who signed for the information packet. Patrick White asked if the nature of relationship between the Respondent and Jeanette Sharp was known. Ian Jackson stated Mr. Sharp indicated his wife would pick up the Notice from the County's Horseshoe office. Michael Ossorio stated he was present when Jeanette Sharp came in and signed for the copy of the Notice. She stated she was Daman Sharp's wife. Vice ChairmanJoslin directed his question to Ian Jackson: Q. On Pages E -7 and E -8, there is a timeline that you had written as part of the investigation. Does that accurately express the amount of times that you contacted Mr. Sharp? A. The notations on E -7 and E -8, I will testify that they do not accurately depict the correspondence that I had — there's far more correspondence than what is indicated here. Q. Is it the minimum amount of time, then? A. At a very minimum. Patrick White: Q. But what's there is accurate? A. What is there is accurate. The language in those documents is accurate. Ian Jackson: "I would also like to point out between the issuance of the "Notice of Order to Correct" on January 24, 2012 and approximately April 9th, I had extensive correspondence via telephone with Mr. Sharp explaining the process that would be required and arranging for a new Contractor to come in and provide the County with documentation on how to correct the driveway, coordinating with Mr. Clark the homeowner — possibly twice a week — I would touch base with Mr. Sharp and try to make sure that he knew what he was required to do." Jon Walker asked if Mr. Sharp was cooperative and if he wanted to resolve the issue. Ian Jackson confirmed the Respondent showed an interest in correcting the driveway. Since he was not licensed to do the work, the County was not in a 12 June 20, 2012 position to allow him to correct it. That's why an arrangement was made with a licensed Contractor. One option mentioned was for Mr. Sharp to work as an employee of a licensed General Contractor or Paving Contractor who would do the work on the driveway. The responsibility for the reconstruction would fall upon the General Contractor. Michael Ossorio explained the General Contractor or Paving Block Contractor who have a signed contract at no cost to Mr. Clark. He stated Mr. Sharp was very aware and that he communicated with him several times. He further stated Damon Sharp wanted to do the work but did not have any money. Ian Jackson confirmed the telephone conversation during which Mr. Sharp admitted he was not in a financial position to correct the faulty workmanship took place on April 9'. Vice Chairman Joslin: Q. In the contracted amount for the driveway — was that amount of money paid in full to Mr. Sharp? A. Exhibit E -15 shows the payments made by Mr. Clark of $45,000 to Mr. Sharp. David Clark was recalled to the stand. Vice Chairman Joslin: Q. Mr. Clark, all the monies that have been paid by you paid for all the work that was done on your property under contract — including the pool, the driveway — everything was included in the monies that you have paid so far? A. Correct. Thomas Lykos asked Mr. Jackson to review the three Counts contained in the Administrative Complaint and to provide all the evidence and/or documentation with regard to each Count individually. Ian Jackson: Count 1: "Contracting to do any work outside the scope of his competency as listed on his competency card and as defined by this Article or as restricted by the Contractors ' Licensing Board. " o Evidence: • Exhibit E -17 — the cmailed bid/proposal for the construction of the driveway; • Exhibit E -34 — Florida Statues, Chapter 489.105(6), "Contracting:" "The attempted sale of contracting services and the negotiation or bid for a contract on these services also constitutes contracting. " Thomas Lykos asked if the Respondent's license was as a "Registered Residential Swimming Pool Contractor" and, based on the documents provided in Exhibit E -19, 13 June 20, 2012 the construction of a paver block driveway was not included in the Scope of Work allowed for a Residential Swimming Pool Contractor (Ordinance 06 -46, Section 1.6.2.8). Ian Jackson: "Correct." Michael Ossorio referenced Exhibit E -10, "Certificate Detail Report," which is Mr. Sharp's actual License, his "d/b /a," and his Competency Card (Certificate of Competency) stating he is a Registered Residential Swimming Pool Contractor. Patrick White asked if the purpose of Exhibit E -20 was to indicate the Scope of Work that was performed, relative to the paving blocks in the driveway, and that the proper type of Contractor to perform this type of work would have been a Paving Block Contractor (under Section 1.6.3.29). Ian Jackson: "Correct." Count 2: "Disregards or violates, in the performance of his contracting business in the County, any of the building, safety, health, insurance or Workers' Compensation Laws of the State or Ordinances of this County. [Ordinance 90 -105, as amended, Section 22- 20](6)] o Evidence: ■ Exhibits E -24 and E -25 — photographs of the workers Ian Jackson stated Mr. Sharp was unable to provide payroll records showing that there was coverage for the employees and he subsequently acknowledged the fact that he was not providing coverage to them. Patrick White noted Exhibit E -10 indicated a Workers Compensation Insurance exemption was claimed for Sharp Pools and Decking, Inc. He asked if the only person who could be considered "exempt" was Mr. Sharp. Ian Jackson: "Correct." Patrick White stated the photographs showed other employees of the Corporation. Exhibit E -27 is a document from the State's Department of Financial Services and it showed, as of June 11, 2012, there was no history of coverage. Ian Jackson: "No coverage history — correct." Mr. White noted Exhibit E -10, a County document, did not contain any information concerning the expiration date of any insurance coverage. He stated his comment about not filing an Annual Report was to indicate that the Corporation would probably be administratively dissolved by the Department of State's Division of Corporations. He further stated there was only one director or officer who could fall under the Statutory exemptions allowed was Mr. Sharp as the only employee and only officer. Kyle Lantz: Q. On the Division of Finance page, if his employees were leased, would his company be listed or would the leasing company be listed? A. The leasing company and the insurance company who provided coverage to the leasing company would be listed there. But there are circumstances where that will not show up on the State's website." 14 June 20, 2012 Mr. Jackson stated it was his understand that a leasing company is not required to provide the information to the State for inclusion on the website. Kyle Lantz: Q. Did he ever mention that he hired subcontractors? Could those employees be the employees of a subcontractor? A. In the meeting at Horseshoe Drive with Mr. Sharp, Michael Ossorio and myself, we touched on subcontractors and Mr. Sharp indicated they were not subcontractors — they did not work for a subcontractor — he initially said that they were "day laborers." We asked Mr. Sharp to provide documentation or certificates from the day labor organization but he was unable to provide those. Ultimately, he acknowledged he did not have coverage for those employees. Q. In your experience, are day labor companies pretty good about keeping records? A. The day labor organizations keep their own records and also provide Contractors with individual certificates for their day -labor workers. There is a record. Patrick White: Q. Is your testimony that you requested those [records] and were told that none existed because those were his employees? A. Mr. Sharp was unable to provide the County any documentation to show that there was either daily coverage or coverage through a leasing company or a blanket -type of insurance policy covering those employees. Mr. Sharp, in acknowledging not having the coverage, took responsibility for them as his employees. Chairman Horn: Q. Did he tell you how he compensated them — cash or check? A. No. Ian Jackson continued: • Count 3: "Failing to promptly correct faulty workmanship or promptly replace faulty materials installed contrary to the provisions of the construction contract. Faulty workmanship means work that is not commenced, not continued, or not completed in accordance with all specifications of the applicable written agreement. Faulty workmanship includes any material flaw(s) in the quality and/or quantity of the unfinished work product, including any item that does not function properly as part of the entire project. If there is no written agreement provision regarding the specific faulty workmanship issue, faulty workmanship exists if the work, process, product or part thereof does not meet generally accepted standards in Collier County in relation to the entire project. Faulty workmanship does not include matters of aesthetics unless the aesthetically related item clearly violates a written contract specification directly related thereto. " [Ordinance 90 -105, as amended, Section 22- 201(10)1 o Evidence: 15 June 20, 2012 ■ Sworn testimony from Mr. Gil Anuez, an expert witness, that the construction of the driveway did not meet the generally accepted Standards for that type of construction in Collier County Patrick White stated he did not remember Mr. Anuez making a specific summary statement. He suggested Mr. Anuez could clarify his expert opinion. Gilbert Anuez was recalled to the stand. Patrick White: Q. Mr. Anuez, is it your expert opinion as a paving contractor that the work you inspected on the subject site does not meet the generally accepted Standards in Collier County for that type of work? A. Correct. Vice Chairman Joslin: Q. When you arrived at the home to do the inspection, was the work totally, 100% completed? A. It was completed. Yes. Q. When you arrived there, what defects or flaws did you see on your own? Or were you advised to remove the pavers and check the substrate? A. There were depressions in the driveway. Q. It had already begun to sink? A. Yes. Chairman Horn stated Mr. Jackson had thoroughly shown evidence on all three Counts. Michael Ossorio noted, as stated in Exhibit E -33, the Code is very specific about "failing." He stated it was not enough to perform faulty work — it was also failing to correct it. He further stated Mr. Sharp was given Notice that he needed to correct. He failed to correct and that was the basis for the Hearing. Vice Chairman Joslin: Q. Mr. Clark, what was the reason to begin with — in the very beginning — of why the driveway pavers — the original pavers — were taken up, redone, and then put back down? A. Where the garage was installed — basically, there was an original drive for the garage — this was an extension of that area to the edge of the where the pool screen and pool deck were. Q. This was a brand new add -on to an existing installation? A. Yes. Terry Jerulle: [G June 20, 2012 Q. Just to verify, Mr. Clark, you testified that you did hire Daman Sharp, Sharp Pools & Decking, Inc., to do the driveway? A. Initially, to do the pool. Then he offered to do the driveway. Q. You hired him to do the new pavers in the driveway? A. Correct. Q. And you paid him to do the pavers in the driveway? A. I most definitely did. Ian Jackson stated his Closing Statement was to be offered in support the three Counts which was done. Ian Jackson concluded the County's presentation and its case. Vice Chairman Joslin moved to close the Public Hearing. Second by Kyle Lantz. Carried unanimously, 8 — 0. Discussion: Patrick White questioned what the Respondent may have done in his own defense. He asked if anyone in the County had been asked to provide a defense packet on behalf of the Respondent. Ian Jackson spoke with Mr. Sharp on Tuesday, June 12th, and advised him that the packet to be distributed to the Board would be ready for distribution on June 13th. He stated Mr. Sharp was advised that if he had a defense packet, he was to bring it with him to the County's office at Horseshoe Drive the next day when he picked up his copy of the County's packet. Mr. Jackson further stated Mr. Sharp was aware of the fact that he had the option to provide a defense packet. Mr. White asked if anything had been provided. Mr. Jackson responded that none had been provided. Chairman Horn called for a motion. Thomas I.ykos moved to approve finding the Respondent guilty on all three Counts. Second by Jon Walker. Attorney Morey reminded the Board that he had not read the Charge to the Board and outline the Charge as follows: • The Board shall ascertain in its deliberations that fundamental fairness and due process were accorded to the Respondent • Pursuant to Section 22- 203(g) (5) of the Codified Ordinance, the formal Rules of Evidence set out in Florida Statutes do not apply. • The Board shall consider solely the evidence presented at the Hearing in its deliberation of this matter. 17 June 20, 2012 • The Board shall exclude from its deliberations irrelevant, immaterial and cumulative testimony. • The Board shall admit and consider all other evidence of a type commonly relied upon by reasonably prudent persons in the conduct of their affairs, whether or not the evidence so admitted would be admissible in a Court of Law or Equity. • Hearsay evidence may be used to explain or supplement any other evidence but hearsay, in and of itself, is not be sufficient to support a Finding, unless such hearsay would be admissible over objection in a civil action in Court. • The Standard of Proof in actions where a Respondent may lose his privileges to practice his profession is that the evidence presented by the Complainant must prove the Complainant's case in a clear and convincing manner. • The Burden of Proof on the Complainant is a larger burden than the "Preponderance of Evidence" Standard set in ordinary Civil cases. • The Standard of Evidence is to be weighed solely as to the charges set out in the Complaint. • The only charges the Board may decide upon are the ones to which the Respondent has had an opportunity to prepare a defense. • The damages awarded by the Board must be directly related to the charges. • The decision made by the Board shall be stated orally at the Hearing and is effective upon being read, unless the Board orders otherwise. • The Respondent, if found guilty, has certain appeal rights to the Contractors' Licensing Board, the Courts, and the State Construction Industry Licensing Board, pursuant to Florida Statutes and the Florida Administrative Code. • The Board shall vote upon the evidence presented in all areas and if the Respondent is found in violation, shall adopt the Administrative Complaint. • The Board shall also make Findings of Fact and Conclusions of Law in support of the charges set out in the Complaint. Chairman Horn noted a Motion was on the floor and he called for a vote. Motion carried unanimously, 8 — 0. The Respondent was found guilty. Chairman Horn asked Mr. Morey to present possible Sanctions. Attorney Morey stated if, after a Hearing has been conducted, the Contractors' Licensing Board finds there has been misconduct by the Contractor within the meaning of Section 22 -201, the Board may, but shall not be required to, impose any of the following Disciplinary Sanctions individually, or in combination: (1) Revocation of a Collier County (or City) Certificate of Competency, (2) Suspension of a Collier County (or City) Certificate of Competency, (3) Denial of the issuance or renewal of a Collier County (or City) Certificate of Competency, (4) Imposition of a period of probation of reasonable length, not to exceed two years, during which the Contractor's contracting activities shall be 18 June 20, 2012 under the supervision of the Contractor's Licensing Board, and /or participation in a duly- accredited program of continuing education directly related to the Contractor's contracting activity. Any period of probation or continuing education program ordered by the Contractors' Licensing Board may be revoked for cause by said Board at a Hearing noticed to consider said purpose. The Board may order: (5) Restitution; (6) a Fine not to exceed five thousand dollars ($5,000); (7) A public reprimand; (8) Re- examination requirement; (9) Denial of the issuance of Collier County (or City) Building permits or requiring the issuance of such permits with specific conditions; (10) Reasonable investigative and legal costs for the prosecution of the violation. Attorney Morey further advised the Board that, when imposing any of the possible Disciplinary Sanctions on a Contractor holding a Certificate of Competency or a State - certified Contractor who has been found to have violated the Ordinance, the Contractors' Licensing Board shall consider the following: (1) All of the evidence presented at the Hearing; (2) The gravity of the violation; (3) The impact of the violation on public Health/Safety or Welfare; (4) Any actions taken by the violator to correct the violation(s); (5) Any previous violations committed by the violator, and (6) Any other evidence presented at the Hearing by the parties relevant as to the Sanction which is appropriate for the case given the nature of the violation(s) or the violator. Chairman Horn posed the following questions to the County: 1. Did the gentleman have any prior complaints? 2. Were there any outstanding Permits? 3. What sanctions does the County recommend? Michael Ossorio stated: The County did not have an on -going investigation of Sharp Pools and Decking, Inc., There were no pending cases concerning Mr. Sharp; • There were no previous cases or violations concerning Mr. Sharp other than some issues with expired Building Permits (not closed out properly); • There are no active Building Permits that he is working on but there may be some expired Building Permits that have not yet been found. Mr. Ossorio stated the County incurred investigative costs of $1,024.00 (Ian Jackson's time = 32 hours x $32.00). 19 June 20, 2012 County's Recommendations: Count I — Working Outside the Scope: • Imposition of a Fine of $1,500 to be paid within thirty (30) days; • A recommendation to the State of Florida to conduct a full investigation; • Probation for a period of two years; and • Payment of investigation costs: $341.33 • Count 2: • Imposition of a Fine of $1,500 to be paid within thirty (30) days; • Re -take and pass the Business Procedures Test within six (6) months; • Payment of investigation costs: $341.33; • A recommendation to the State of Florida to conduct a full investigation; and o Probation for a period of two years. • Count 3: • An Order of Restitution requiring paying to the homeowner in the amount of $4,202 within thirty (30) days; • Payment of investigative costs: $341.33; • A recommendation to the State of Florida to conduct a full investigation; and o Probation for a period of two years. Jon Walker asked if the figure of restitution was based on the estimate for repairs by "Accurate Pavers" and Mr. Ossorio responded, "Yes." Mr. Ossorio further recommended revocation of the Respondent's license: • If payment is not made, on all three Counts, within thirty (30) days, and • If the Respondent has not taken and passed the Business Procedures Test within six months (in Count 2). Michael Ossorio will write to the State requesting a full investigation and revocation of the Respondent's license, if necessary, as well as the imposition of probation. Thomas Lykos agreed with the County's recommendation except for Count 2. He stated the amount of the fine was not sufficient — it was not a significant enough deterrent. He stated the Contractor had placed the workers and the homeowner at great risk by not providing Workers' Compensation Insurance Coverage. Mr. Ossorio responded the recommendation and the amounts were the same as were handed down to a painting contractor during a previous Board Hearing — the only difference was that the painting contractor was permitted six weeks for repayment. See: April 18, 2012 Minutes - Case #2012 -06: Walter Paesano, d/b /a Paesano's Painting, LLQ Mr. Lykos stated he did not agree with that decision, either. Aff June 20, 2012 Chairman Horn stated the total amount of money was over $8,000 which he did not think the Respondent would be able to pay. He stated an additional fine, even though it may be warranted, would probably be useless. When asked about other options available to Mr. Clark, Michael Ossorio stated he could pursue the matter in Civil court using the Findings of Fact of the Hearing as a basis for bringing suit, but it was the intention of the Contractors' Licensing Office for the Respondent to adhere to whatever decision the Board made. Vice Chairman Joslin noted the Respondent did not file an Annual Report for his Corporation and did not attend the Hearing which he thought indicated the Respondent would probably not cooperate with any decision of the Board. He further stated if the Respondent cared about his business and reputation, he would have attended the Hearing to "face the music." He stated he did not think it would matter whether or not the Board revoked the Respondent's license at the Hearing or in the future. Mr. Ossorio outlined the process: • In 30 days, the Board's Chairman will sign an Order to pay which will be attached to the Finding of Fact; • There will be a consultation with either the Board's attorney or the County Attorney's Office to determine the best avenue to take. He explained the State of Florida will impose a find for full restitution with penalties including revocation of the Certificate in the State of Florida. The revocation usually contains a caveat that the Respondent cannot obtain a license again until such time as full restitution has been made. He stated it may take up to two years to make full restitution, but typically it is made and cited a recent case that had been before the Board to restore a license. Mr. Lykos stated the Board should not decide to impose a fine based upon the Respondent's ability to pay it. He continued if the Board was to make a "statement" concerning the penalty for operating in Collier County without having Worker's Compensation Insurance coverage, the ability to pay a fine should not be relevant. Patrick White stated while he understood Mr. Lykos' argument, he also considered the other factors that the Board was required to weigh — i.e., the gravity of the violation and/or the risk involved as well as the impact of the Respondent's action. He noted no testimony concerning any type of injury was presented. He continued nothing else was presented to indicate imposing a more severe penalty than has been imposed in the past for a similar violation. Vice Chairman Joslin noted the most important responsibility of the Board is to ensure that Mr. Clark is made "whole" again by completing the repairs to his driveway in the proper manner. Kyle Lantz stated the purpose of the fines is to deter the Respondent from repeating this behavior and to prevent another Contractor from committing the same violation to another homeowner. The Board has the ability to make determinations on a case -by- case basis. There is no set formula for determining fines. Mr. Lykos stated the fine should be at least $2,500. He stated a Contractor who makes a conscious decision to not obtain Workers' Compensation Insurance weighs 21 June 20, 2012 the cost to obtain the insurance coverage versus the risk of being caught and having to pay a fine. He continued the Contractor made a business decision. If, for example, the insurance coverage costs $30,000 to obtain and the Board hands out fines of $1,500 for operating without having the insurance — it is a "no brainer" decision to make, regardless of whether or not it is an ethical business decision. If the fines are severe, a Contractor will think twice before placing his employees and the homeowner at risk. Vice Chairman Joslin concurred, stating there was no reason to take such a chance — the cost to obtain Workers' Compensation insurance coverage is approximately 16% of the dollar value of the Contractor's payroll. He further noted if the Respondent pays the amount of $4,202 within thirty days, he will not lose his license, especially if he is able to obtain an extension to pay the remaining fines. He will be able to operate because Mr. Clark has been made whole. Michael Ossorio explained as long as Mr. Sharp makes restitution to the homeowner of the $4,202 within thirty days, he could petition the Board for relief concerning payment of the other fines. David Clark: "The point I would like to make — on a Saturday morning, these workers came back with their families — I was woken up at 8:00 in the morning — and basically found their children running around a pool with no water in it. So what Mr. Lykos was saying about "injury" obviously was of great concern. Having said that, Mr. Sharp's personal circumstances — having spoken with the screening company who came back to do some repairs of their own — apparently, he has not worked on a pool since so I gather that his business finances, presumably, are not great." He asked if there was another way besides fining and inquired if the Board could order the Respondent to perform community service of some type. He further stated he knew he was not "going to see" the $4,202. Vice Chairman Joslin asked Mr. Clark if he had received any paperwork from other contractors or subcontractors about liens being placed against his property. Mr. Clark stated the screening company assured him verbally that there would be no lien against the property because they had been paid. He further stated as far as he could determine, the cost for materials had been paid. There was further discussion about prioritizing payment to the homeowner and for the County to extend the deadline for payment of its costs from thirty days to six months. It was noted the Board had the discretion to make such changes. Mr. Ossorio confirmed the County would not object to such an extension of time for repayment. Discussion continued concerning the points to be considered: • The gravity of the violation; • The impact of the violation on public Health/Safety or Welfare; • Any actions taken by the violator to correct the violation(s); and • Any previous violations committed by the violator. 22 June 20, 2012 Thomas Lykos conceded that the issue of liability insurance was no longer "on the table." He stated the evidence presented concerning the abuse of the property, the fact that the employees were not monitored, and that their families were on site were indicative of the Respondent's apathy toward professionalism and the careless method in which he operated his job sites. He continued the information supported his position that the fine for not securing Workers' Compensation Insurance coverage should be much higher as a deterrent. Mr. White stated while he supported Mr. Lykos' position, he stated the Board's goal should be to provide some restitution to the homeowner. He suggested extending the time frames for Counts 1 and 2, and for payment of the investigative costs. Mr. Lykos agreed with higher fines and an extended time period for re- payment in deference to first making restitution to the homeowner. Kyle Lantz asked why a fine was not imposed for County 3. Terry Jerulle pointed out the Board had the ability to modify the County's recommendations. Discussion continued. Jon Walker suggested raising the amount of restitution by $500 to compensate the Homeowner for the additional cleanup that he was forced to do. Attorney Morey reminded the Board that no testimony had been presented concerning additional costs incurred by the homeowner. Vice Chairman Joslin stated the homeowner, by giving his codes to the Contractor, allowed for such abuse to his property to take place and became liable. Mr. Walker stated the Board should prioritize restitution to the homeowner as the first payment to be made by the Respondent. Kyle Lantz moved to approve order the Respondent to: • Make restitution of $4,202 with in thirty days and if not made within that timeframe, the Respondent's license will be automatically revoked; • Pay a fine of $4,000 within 90 days and if the fine is not paid within the time frame, the Respondent's license will be automatically revoked; • Pay costs of $1,024 within 60 days and if the fine is not paid within the time frame, the Respondent's license will be automatically revoked; • Take and pass the Business Procedures Test within 90 days, if the test is not taken within the time frame, the Respondent's license will be automatically revoked Mr. Lantz continued his Motion: The Board will send a recommendation to the State for the maximum punishment deemed appropriate. Patrick White suggested amending the motion to include each Count separately. The option of adding a two -year probationary period was also suggested. Attorney Morey stated the County did recommend a two -year probationary period. Kyle Lantz amended his Motion to add approving a two-year probationary period. 23 June 20, 2012 Michael Ossorio began to summary by Count but was corrected by Mr. Lantz who stated the total amount of fines in his Motion was $4,000 which divided by three was $1,333.33 per Count. Mr. Lantz further stated the reimbursement to the homeowner was $4,202, and the total cost to the County was $1,024. The fines of $4,000 are to be paid within 90 days and the restitution was to be paid within 30 days. Kyle Lantz clarified his Motion as follows: • At 30 days, the restitution is to be paid; if not paid by the deadline, the Respondent's license will be revoked; • At 60 days, the County's investigative costs are to be paid; if not paid by the deadline, the Respondent's license will be revoked; • At 90 days, the fines of $4,000 are to be paid; if notpaid by the deadline, the Respondent's license will be revoked • At 90 days, the Respondent is to have taken and passed the Business Procedures Test or his license will be revoked; • A probationary period of two years, and • A recommendation to the State to conduct a full investigation and impose whatever penalties are determined to be appropriate. Mr. White confirmed that even if the Respondent met the other terms by the deadlines, he will still be under probation for two years. Patrick White offered a second in support of the Motion, as restated and clarified David Clark stated with respect to the issue of restitution, if Mr. Sharp entered into an agreement which stipulated he could only afford to pay "X" amount of money for a year or two years, he would not object. Chairman Horn stated the goal was for the Respondent to make restitution. He further stated Mr. Sharp could present such an agreement to the Board and the terms of the Order could be amended to reflect the agreement. Mr. Clark clarified when he gave Mr. Sharp the access codes to his property, it was only for Daman Sharp's use to store is equipment in the garage — the codes were absolutely not to be given to anyone. Mr. Clark continued he was not aware that Mr. Sharp's workers had access to his home. Chairman Horn restated the terms of Mr. Lantz's motion and then called for a vote. Motion carried, 7 — "Yes 71— "No. " Michael Boyd was opposed. Mr. Boyd asked if the Respondent was still able to pull Permits. Attorney Morey clarified that the Respondent's probation began immediately and his actions will be supervised by the Contractors' Licensing Office. Mr. Ossorio explained the Building Department would "red flag" any permit application submitted by the Respondent and would notify him. He stated he would also inform the homeowner of the status of the Respondent's license. 24 June 20, 2012 Chairman Horn stated: This cause came on for public hearing before the Contractors' Licensing Board on June 20, 2012 for consideration of the Administrative Complaint in Case #2012 -08 filed against Daman Keath Sharp, d/b /a "Sharp Pools and Decking, Inc.," the holder of record of Collier County Certificate 423844. Service of the Complaint was made in accordance with Collier County Ordinance 90 -105, as amended. The Board, at this Hearing, having heard testimony under oath, received evidence and heard arguments respective to all appropriate matters, therefore issued its Findings of Facts and Conclusions of Law as follows. Findin ,-s of Fact: • Daman Keath Sharp, d/b /a "Sharp Pools and Decking, Inc.," is the holder of record of Collier County Certificate #23844. • The Board of County Commissioners, Collier County, Florida, Contractors' Licensing Board is the Petitioner (Complainant) in this matter. • The Board has jurisdiction of the person of the Respondent. • Respondent, Daman Keath Sharp, was not present at the Public Hearing held on June 20, 2012, and was not represented by Counsel at the Hearing. • The Respondent had been properly noticed concerning the Hearing. • All notices required by Collier County Ordinance 90 -105, as amended, had been properly issued and were personally delivered. • The Respondent acted in a manner that is in violation of Collier County Ordinance and is the one who committed the act. • The allegations of fact as set forth in Administrative Complaint are as follows: • Count 1, under Section 22- 201(2): "Contracting to do any work outside the scope of his competency as listed on his competency card and as defined by this Article or as restricted by the Contractors' Licensing Board; " • Count 2, under Section 22- 201(6): "Disregards or violates, in the performance of his contracting business in the County, any of the building, safety, health, insurance, or Workers' Compensation Laws of the State or Ordinances of this County; " • Count 3, under Section 22- 201(10): "Failing to promptly correct faulty workmanship or promptly replace faulty materials installed contrary to the provisions of the construction contract, " have been found to be supported by the evidence presented at the Hearing Conclusions of Law: The Conclusions of Law alleged and set forth in the Administrative Complaint as to Count 1, Count 2, and Count 3 have been approved, adopted and incorporated herein, to wit: "The Respondent violated Sections 22- 201(2), 22- 201(6), and 22- 201(10) of Collier County Ordinance 90 -105, as amended, in the performance of 25 June 20, 2012 his contracting business in Collier County by acting in violation of the Sections set out in the Administrative Complaint with particularity. Order of the Board. Based upon the foregoing Findings of Fact and Conclusions of Law, and pursuant to the authority granted in Chapter 489, Florida Statutes, and in Collier County Ordinance 90 -105, as amended, by a vote of eight (8) in favor and none (0) in opposition, a majority vote of the Board members present, the Respondent has been found in violation as set out above. Further, it is hereby ordered by a vote of 7 in favor, 1 in opposition, a majority vote of the Board members present, that the following disciplinary sanctions and related Order are hereby imposed upon the holder of Collier County Certificate of Competency #23844, to wit: • Restitution in the amount of $4,202 to be paid within thirty (30) days, per Count 3; • Imposition of a fine of $4,000 to be paid within ninety (90) days, per Counts 1, 2, and 3; • Investigative costs in the amount of $1,024 to be paid within sixty (60) days; • The Business Procedures Test is to be taken and passed within ninety (90) days • His Certificate of Competency will be placed on probation for a period of two (2) years; • A recommendation will be made to the State to conduct a full investigation; • If any of the conditions are not met or if the fines are not paid in a timely manner as outlined above, the Respondent's Certificate will be immediately revoked. Chairman Horn noted the case was closed. IX. REPORTS: (None) X. MEMBER COMMENTS: • Vice Chairman Joslin suggested the County should consider instituting an inspection program for pool decks to avoid the type of problems presented during the Hearing. • Patrick White noted the Building Department holds an open meeting on the 2 °d Thursday of each month commending at 10:00 AM at the Growth Management Offices on North Horseshoe Drive. • Michael Ossorio will send an email to the members detailing the exact time, date, and location for the meeting as well as the meeting for the Fire Code Office. • It was further noted the Consumer must do his/her homework by only hiring licensed Contractors — information is available online or call the County. 26 June 20, 2012 XI. NEXT MEETING DATE: Wednesday, July 18, 2012 Board of County Commissioners' Chambers, 3`d Floor — Administrative Building "F," Government Complex, 3301 E. Tamiami Trail, Naples, FL 34112 There being no further business for the good of the County, the meeting was adjourned by the order of the Chairman at 11:10 AM. COLLIER COUNTY CONTRACTORS LICENSING BOARD Lee Horn, Chairman The Minutes were approved by the Board/Chairman on , 2012, "as submitted" [I OR "as amended" [_1. 27 Contested Citation #7165 Doreen J. Visser D /B /A — Willowood Home Design L.L.C. Table of Contents E1— Summary E2 — Citation #7165 issued for unlicensed advertising as a contractor. E3 — Letter requesting an Administrative Hearing to contest citation. E4 /E5 — Code Case Detail Report E6 — Division of Corporations listing for Willowood Home Design L.L.C. E7 — Collier County business tax receipt #900741 depicting retail sales. E8 — Internet advertisement dated 5/22/12 depicting cabinet installation services. E9 /E10 — Revised internet advertisement depicting new legal disclaimer. SUMMARY On May 22, 2012, a complaint was received by the Collier County Contractor's Licensing Office regarding the internet advertising of Willowood Home Designs L.L.C. depicting cabinet installation services. Research into databases revealed no contractor licensing information, but a Collier County business tax receipt #900741 for retail sales only. Contact was made with business owners Raymond and Doreen Visser and they were made aware of the complaint and violation. Scheduling conflicts prohibited a meeting until June 15th, 2012. At this meeting an explanation of the violation, as well as abatement measures to come into compliance were provided. In addition to this, citation #7165 was issued to Doreen J. Visser for: advertising self or business organization as available to engage in the business or act in a capacity of a contractor without being duly registered or certified. COLLIER COUNTY 71 6 BUILDING REVIEW 8, PERMITTING " lAc2fk�' i d6 '-T-t I CITATION Pursuant to section 489.127. (3)(a), Florida Statues, the,undersigned hereby certifies that upon personal investigation, he/she has reasonable and probable grounds to believe that the, person whose name appears below, as Issued To, did violate Subsection 489 127(1), Florida Statutes, and Collier county Contractor's Licensing Ordinance No. 97 -68 (as may be amended from time to time) by committing the violation stated below. ..�� r~ Month J --j Day �. Ye Tffte`I AM ((�N Issued To: J • V l 5 S F— (L Address 1 J 1 4,LAI A--(& I -> * City _N > LAS State IFL ' Zip S L416 Tel hone o. 1.0- tl" 50 W � �6 t_ocatton of vtoiatton .p OPTIONS I have been informed of the violation of which 1 have been charged and elect the following option (Check one) - �;d� . 00 ' 1) [3.11c hoose to pay the penalties of S .on the Citation. • 2) ❑ 1 ;choose not to pay the penalty and will;request in writing by certified mail or hand delivery an Administrative Hearing before the Contractor's 'Licensing Board. Description h DatR;Ygtip ,� tZ a) ❑ Falsely hold self or business organization out as a license, certificate older nr registrant; b) [3 Falsely impersonate a certificate holder or registrant; c) ❑ Piesent as his own tiro wrlifiwtii br registrntlon of another; d) ❑ Knowingly give false'or forged evidence to the Board of a member the e) ❑ Use or attempt to use a certificaie'or'registration which has been suspended or revoked; f) ❑ Engage in the business or act in the capacity of a contractor or advertise self or business organization as available to engage in the business or act in a capacity of a contractor without being duly re or certified; g) ❑ Operate a business organization engaged in contracting after (60) days following the termination of its only qualifying agent without designating another primary qualifying agent, except as provided in ss 489.119 and 489.1195, Florida Statues; h) ❑ Comtrtetice or'perform-work for which 8 buildtdg perm¢ is required pursuant "to an adopted state minimum building code without such permit bemg'iit,effect, ar i) ❑ Willfully or'Aeliberately disregard 6i violate any Collier Counfj ordinance relating to uncertified or unregistered `contractors. " A person or business organization operating on an inactive or suspended certificate or registration, or operating beyond the scope of work or geographical scope of the registration, is not duly certified or registered. SIC#NATqRE (REC ENT) GNATUR (INVESTIGATOR), ro PRINT (RECIPIENT'S NAME) PRINT (INVESTIGATOR'S NAME) Pursuant to 489.127, Florida Statues, willful refusal to sign and accept this citation constitutes a misdemeanor of the second degree, punishable as provided in section 775.082 or 775.083 Florida Statutes. (SEE REVERSE FOR INSTRUCTIONS) COLLIER COUNTY CONTRACTORS LICENSE DEPARTMENT Willowood Home Design LLC DBA — Willowood Kitchen & Bath 5201 Tamiami Trail N Suite #1 Naples FL 34103 Phone (239) 649 5880 Fax (239) 649 5886 15th June 2012 Director of the Building Review & Permitting Dept 2800 North Horseshoe Drive Naples FL 34104 CITATION No 7165 I request an Administrative Hearing before the Collier Contractor's Licensing Board. When the violation was issued to Willowood Kitchen & Bath, Willowood Kitchen & Bath was not in violation. I believe the citation was issued incorrectly and should therefore be dismissed. The investigator Mr R Ganguli was given a printed copy of the website. Yours sincerely Do ne Visser MGRM Willowood Kitchen & Bath .�.> et Report Title: Code Case Details Date: 6/2612012 8:20:41 AM Case Number: CEUL20120009253 Case Number: ICEUL20120009253 I I Case Type: Unlicensed Priority: Normal Inspector: I robinganguli Jurisdiction: I Contractor's Licensing Origin: I Complaint Status: Citation Date & Time Entered:. 6/18/2012 7:24:54 AM Entered By: RobinGanguli Case Disposition: Case Pending Detail Description:lVisser, Doreen J. $300 citation #7165 issued for unlicensed advertising for cabinet installation. Location Comments: I Internet advertisement for cabinet installation. Business Management & Budget Office 1 Code Case Details Execution Date 6/26/2012 8:20:41 AM : 7esc Assigned Requ reii Completed outcome C.cimments Preliminary Investigation robinganguli 5/22/2012 5/22/2012 Citation 5/22112. Complaint received regarding Required internet advertising for cabinet installation by Willowood Designs. Collier County business tax receipt #900741 for retail sales only. Spoke to business owner Doreen Visser to advise of complaint and violation. Difficulties in scheduling to arrange meeting. Issue Citation (Licensing) robinganguli 6/15/2012 6/15/2012 Complete 6/15/12. Meeting with Willowood Designs business owners Raymond and Doreen Visser. Complaint and violation explained as well as abatement options. $300 citation #7165 issued for unlicensed advertising. Citation Paid /Contested clements_k 7/2/2012 Pending Violation Description Status )entered 06rreote, Amount Comments Unlicensed Advertisement Open 6/18/2012 1 $300 Business Management & Budget Office 2 Www.sunbiz.org - Department of State Home Contact Us E- Filing Services Previous on List Next on List Return To List Events No Name History Detail by Entity Name Florida Limited Liabilitv Compan WILLOWOOD HOME DESIGN, LLC Filing Information Document Number L06000059242 FEI /EIN Number 205425179 Date Filed 06 /09/2006 State FL Status ACTIVE Effective Date 06/09/2006 Last Event LC AMENDMENT Event Date Filed 10/27/2006 Event Effective Date NONE Principal Address 5201 TAMIAMI TRAIL N SUITE 1 NAPLES FL 34103 Changed 01/24/2009 Mailing Address 5201 TAMIAMI TRAIL N SUITE 1 NAPLES FL 34103 hanged 01/24/2009 Registered Agent Name & Address ✓ISSER, DOREEN J 5201 TAMIAMI TRAIL N SUITE 1 NAPLES FL 34103 US Name Changed: 01/08/2008 kddress Changed: 01/24/2009 Manager /Member Detail Name & Address FiUe MGRM ✓ISSER, DOREEN J 5201 TAMIAMI TR N, STE 1 JAPLES FL 34103 Fitle MGRM !ISSER, RAYMOND R i201 TAMIAMI TRAIL N, STE 1 JAPLES FL 34103 4nnual Reports Report Year Filed Date 2010 02/16/2010 2011 02116/2011 Document Searches Forms Help Entity Name Search Page 1 of 2 http: / /Www.sunbiz.org/ scripts /cordet.exe? action = DETFIL &inl_doc_number= LO60000592... 5/22/2012 Details Collier County Tax Collector 3301 Tamiami Trail East Naples, FL 34112 -4997 Collier County Business Tax Receipt Tax Year Info: 2011 BUSINESS INFORMATION License #F9 60741 Na IWILLOWOOD DESIGNS DBA: Location: 5201 TAMIAMI TR N #1 Zon ICITY LIMITS Mail 1: 5201 TAMIAMI TR N #1 Mail 2: City, State, Zip: NAPLES , FL 34103 Phone: 649 -5880 Code: 03900001 Description: RETAIL SALES State Lic: Class; RETAIL O SALES County Lic:11 11 Category:11 STORE City Lic: Freq: FRONT ONLY Page I of 1 Next 11e+cord I OWNER INFORMATION Name 1: W C LOWOOD HOME DESIGNS, —Name 2: Address 1: 112655 BISCAYNE CT Address 2: City, State, Zip: NAPLES, FL 34105 Phone: 223 -9997 ** LICENSE IS PAID ** ** LICENSE IS OPEN ** Next ltarri 2005 Tax 2006 Tax 2007 "Tax 2008 '1'ax 2009 Tax 2010 Tax Information Information Information. Information. Information Information http:// colliertax .com/search/ols_details.php ?ID= 28093701 &page = &year =2011 5/22/2012 Willowood Kitchen and Bath, Kitchen Design, Bathroom Remodeling Naples, FL Page 1 of 1 Working With Willowood We encourage appointments to ensure that we're available to discuss your project with you in depth. After introducing our product to you, we explore species and finish preferences. Before we proceed with design, we take in -home measurements to verify your exact space. We encourage our clients to plan their project with us, whether they're interested in a new kitchen, bathroom, library, home office, media center or bar. We prefer to have clients heavily involved in the design phase —your ideas form the basis of your design. The possibilities are endless. Once you approve the design, turnaround time is generally 4 -6 weeks from order to completion, to addition to providing the professional installation of cabinets and countertops, We are able to arrange for plumbing, electrical work, or major structural jobs. Whatever your need, we'll guide you through from start to finish. Willowood Kitchen and Bath, Kitchen Design 5201 North Tamiami Trail, Suite #1 Naples, FL 34103 P (239) 649 -5880 F (239) 649 -5886 Email Us Home Custom Cabinetry Working With Willowood Photo Gallery Testimonials Planning Guides Showroom Contact http:// www .willowooddesign.com/kitchen- designs /working- with - willowood.htm 5/22/2012 Willowood Kitchen and Bath, Kitchen Design, Kitchen Remodeling Naples, FL c w Testimonials Pagel of 2 See what just a few of our satisfied clients have to say about a job done by Willowood Kitchen and Bath In Naples, Florida: "A note of many thanks for the terrific job done by Willowood Designs! It has been a real pleasure to do business with you. Your professionalism; good judgment; courtesy; attention to detail; flawless execution & personal integrity have been greatly appreciated. I am happy to provide a reference to any future customers & to report that a job was well done by you and your team!" Nancy Carlson • Naples, Florida "Now that our kitchen renovation is completed, we felt compelled to let you know how pleased we are with the finished product and we want to thank your entire team for their extraordinary efforts. We are extremely impressed with the close follow -up during all phases of the installation which gave us a high degree of comfort that all was going well throughout the entire project. Our trust & confidence in your team was rewarded with a kitchen that we will enjoy for years to come." Bob & Bonnie Caster - Naples, Florida `Bill & I wanted to thank you for our beautiful new kitchen & baths. It turned out even beyond our expectations. Our contractor had told us about your exacting standards for the fit of cabinets, http:// www .willowooddesign.com/kitchen- designs /testimonials.htm 6/26/2012 ` Willowood Kitchen and Bath, Kitchen Design, Kitchen Remodeling Naples, FL Page 2 of 2 corners & moldings plus getting perfect finish on the panels. You made sure the job was flawless. I would highly recommend your firm to anyone contemplating putting in new kitchens or baths." Bill & Sue Brock - Naples, Florida LEGAL NOTICE: Local permitting, licensing and codes apply. Willowood Kitchen and Bath, Kitchen Design 5201 North Tamiami Trail, Suite #1 Naples, Ft.. 34103 P (239) 649 -5880 F (239) 649 -5886 Email Us Horne Custom Cabinetry Working With Willowood Photo Gallery Testimonials Planning Guides Showroom Contact http:// www .willowooddesign.com/kitchen- designs /testimonials.htm 6/26/2012 a NOTE: ✓= DO X= DO NOT DO COLLIER COUNTY/CITY OF NAPLES /CITY OF MARCO CHECKLIST FOR CONTRACTORS LICENSING MAILING ADDRESS Collier County Contractors' Licensing oann Greenberg (239) 252 -2431 2800 N. Horseshoe Dr, g Board Jennifer Blanco (239) 252 -2908 Naples, FL 34104 Michael Ossorio (239) 252 -5706 FAX #: (239) 252 -2469 L:J I. Complete the application PP station with all signatures notarized. U 2. Verification of 75% passing score on examination(s) required for your approved and recognized throughout the State of Florida, as provided for tin Sec.2 6 of the Contractor Licensing Board Ordinance If you were not sponsored by Collier County to take the exam (s), need a letter from the county who sponsored you. t:LJ 3. Credit report on the individual (license holder) and firm (if more than I year old). The credit report MUST come from one of the credit bureaus from the enclosed list. There can be no liens or judgments that have not been satisfied; the report must show public records have been checked and the credit report can not be over 60 days old. (See enclosed list of credit bureaus) LYJ 4. Certificate of Incorporation or Limited Liability have been filed with the State of Florida. NOTE Can be done online t show they WWW.SLTNBIZ.ORG. Also, provide a copy of stock certificate showing the qualifier is a 50% owner of the Corporation/LLC, if they are not, then the officers /directors and/or managing members of the Corporation or LLC must fill out the enclosed Resolution of Authorization appointing him/her as the qualifier for the company. ❑ 5. Fictitious name - Copy of the letter showing he n (f applicable, i.e: sole proprietor or a corporation with d/Wa.) a been filed with the state of Florida 6• Certificate of Contractor's General Liability Insurance (minimum $100,000 Bodily Injury, minimum $25,000 Property Damage). NOTE: Collier 0--i-v Contractors' Licensina Board must be listed as a Certificate Holder see mailin address above . (NOTE: If registered with the state, must carry the amounts required by DBPR.) t.=f 7. Workmen's Compensation insurance certificate if applicable. NOTE: Collier County Contractors' Licensing Board must be listed as a Certificate Holder (see mailing address at top of checklist) If there is 1 or more employee(s) you must have workmen's compensation insurance. For the Workers Compensation Construction Exemption: If already exempt, need a copy of the exemption card; if not yet exempt, You must file a Construction exemption farm with the State of Florida. DO NOT MAIL, THIS FORM UNTIL WE TELL YOU TO. We need a copy of this form filled out and a copy of the money order before you send it to Ft Myers We will give a 30 day grace period to get the exemption filed Note: If you are a "sole proprietor" (an individual or with a fictitious name), you MUST carry Workers Comp. insurance. ❑ 8. State Registration number. The following must be registered with the State Dept of Business & Professional Regulation before the competency card is considered active for business. DO NOT MAIL THE FORM TO DBPR UNTIL WE TELL YOU TO. General Contractor Building Contractor Residential Contractor Swimming Pool Class -A,B,C Mechanical Contractor Master Plumber Roofing H.A.R.V. - Class A & B • Master Electrician's • Burglar and /or Burglar/Fire Alarm NOTE: If you are already registered with DBPR, please submit copy to Collier County Contractor's Licensing Section. L.1 9. Federal Tax Number (IRS Form SS -4, Revised 2 -06, Department of Treasury or you can file online- IRS.GOV) if Incorporated or have more than .1 managing /member of the LLC. If you are the PD-iv-managing/member of an LLC, use your S.S. #. 10. (A) Three (3) affidavit's for Verification of Experience MUST BE SIGNED AND NOTARIZED BY 3 DIFFERENT PEOPLE; the two (2) Affidavits for Integrity & Good Character can be signed by any 2 of the 3 people you have chosen. NOTE: The affidavits must state the type of work done, the persons knowledge of the trade, length of time in the trade, etc. (B) For Major Trades, three (3) NOTARIZED ORIGINAL letters on their company letterhead stating years of experience in that trade, types of work done, the persons knowledge of the trade and Integrity & Good Character. ❑11. Certificate of Competency fee (contact Contractor's Licensing office for correct amount before forwarding check). Make Check payable to "Board of Collier County Commissioners ". The certificate of Competency is renewed every Sept. Q12. Planning Approval fee for Home Occupation or Business location if in Collier County. Make Check payable to "Collier County Tax Collector.) $50.40 - Horne Occupation $125.00 - Commercial Location 13. Submit a recent photograph (2 X 2) of Qualifier, taped on application. (Note: A clear copy of your Driver's License is OK.) ly 14. Collier County Business Tax License (formally Occupational License ), if your office is located in Collier County. Submit form & check for fee. Make Check payable to "Collier County Tax Collector ". Contact Occupational License at (239) 403 -2477 for fee amount. NOTE: IF YOUR OFFICE IS NOT LOCATED IN COLLIER COUNTY NEED COPY OF CURRENT OCCUPATIONAL LICENSE WHERE YOUR OFFICE IS LOCATED.' PROOF OF EXPERIENCE 1.8.1 When determining if the applicant possesses the required experience, the Contractor Licensing Board Supervisor or his/her designee shall accept the following as proof of experience: A. Affidavits /notarized letters from former employers with specifics as to the number of years experience, work performed and any other relevant information. R. Copiefi of other certificates of competency, if any, held in other counties, cities; C. Affidavits from any building director in locations where the applicant has worked; D. Affidavits from any union organization of which the applicant has been a member, relative to the trade for which the applicant has made application; E. Affidavits from any other reasonable source as approved by the Contractor Licensing Supervisor within the trade applied for. 1.8.2 Education at an accredited school may be utilized to satisfy a portion of the experience requirements of this section. Specifically, each full year of school level work in the field for which application is made shall be credited to the applicant as .75 years experience, but such credit shall be for no more than one -half of the total experience required. C _ gut. CDES Operations & Regulatory Management Licensing Section 2800 North Horseshoe Drive Naples, FL 34104 APPLICATION FOR COLLIER COUNTYXITY OF NAPLES /CITY OF MARCO FIRM INSTRUCTIONS: This application must be typewritten or legibly printed. The application fee must accompany this application. The fee is not refundable after the application has been accepted and entered on the records. All checks should be made payable to the Board of Collier County Commissioners. For further information, consult Collier County Ordinance No. 90 -105, as amended. NAME OF COMPANY: �n Exact Corporate /Business Name: Wes Fiction Name /DBA: Qualifier Name: Physical 3320 (Number & Street) Mailing Address:_ (Number &(Nuber & Street) Telephone: C�3 '7— J�70-- a �Z TYPE OF LICENSE: ❑ General ❑ Building ❑ Residential ❑ Mechanical ❑ Roofing Specialty trade: _ (State) (Zip Code) k_1 (Cii (State)/C ode) E -Mail: 2Z �'� S�Q (?1'Y) X . C �r $230.00 ❑ Electrician $230.00 ❑ Plumber $230.00 ❑ Air Cond. $230.00 ❑ Swimming Pool $230.00 0" Specialty CHANGE OF STATUS: ( ) Reinstatement ( ) From One Business to Another Page 1 of 4 $230.00 $230.00 $230.00 $230.00 $205.00 ( ) Dormant License to Active 1. The names, titles, home address and phone numbers of all Officers/Managing Members of the Firm. U Yqr( `('.P.r) Ui fCJ �2 ice- S YO, 4 Ian 2. List all businesses, firms, entities or contracting businesses you have been associated with during the last ten years (ex. Held a license for or been a partner). Attach extra pages if needed. -Alk 3. List all debts you or any company(s) associated with you refused to pay and the reasons for the refusal to pay. Attach extra pages if needed, Cj AFFIDAVIT certify that the foregoi nd correct to t est y knowledge. Authorized Officer of the Firm STATE OF FLORIDA COUNTY OF CoWE& The foregoing instrument as acknowledged before me this S �'ULY 201IL (Date) By _ DA110EFN NRet'_r,y QDVIF ofVA- 22. 1-1rvC, Ir7tmS tntC_ (Name of officer, titletagent) (Name of Corporation) a Ro( U A Corporation on behalf of the corporation. (State or Place of Corporation) He/She has produced uayywF ucajs E identification and did not take an oath. (Type of identification) NOTARY'S SEAL Lawrence Saunders NOTARY PUBLIC STATE OF FLORIDA Comm# EE112W5 Expires 7/13/2015 Page 2 of 4 a�11-' (SIGNATURE OF NOTARY) QUALIFIER INFORMATION• Name: Address: �3 �1 <�j CLYICQ (Number & Strcet) Telephone: C935_ ��loli— /SSZ i (State) (Zip C d Date of Birth: (— (s i 9 S.S. M 000 -00- B -Mail: UQ2,2IIn� ' axs c Qimx. COM Driver's License: 1. Type of Certificate of Competency for which application is made. 2. The names and telephone numbers of two persons who will know your whereabouts. 39& - 140C/ 45, e 1 (�ywe. �So• -,� a3�- Slo U - /9-5- o 3. Have you ever been convicted of a crime related to Contracting? A10 (If yes attach extra sheet with explanation) 7. Have you or any firms you have been associated with ever filed bankruptcy? z 8. List all debts you or any company(s) associated with you refused or failed to pay and reasons why. Y'�Lq t2e � deki is Irene fe sy l+ ni (z, 1►n� anc 'f c eceyn00�114 - 9. List your business or work experience during the past ten years. 10. Statement of any formal training you have had in the area for which the application is made. Page 3 of 4 AFFIDAVIT The undersigned hereby makes application for Certificate of Competency under the provisions of Collier County Ordinance No. 2006 -46, as amended, and vouches for the truth and accuracy of all statements and answers herein contained. The undersigned hereby certifies that he is legally qualified to act on behalf of the business organization sought to be licensed in all matters connected with its contracting business and that he has full authority to supervise construction undertaken by himself or such business or organization and that he will continue during this registration to be able to so bind said business organization. The qualified license holder understands that in all contracting matters, he will be held strictly accountable for any and all activities involving his license. Any willful falsification of any information contained herein is grounds for disqualification. b `lee- -1 �I)Wf APPLICANT (PLEASE PRINT) za I �'►�► 4�:1 o rs . -1--hr NAME OF COMPANY SIGNATURE OF APPLICANT STATE OF FLORIDA COUNTY OF C 11 C(L The foregoing instrument as acknowledged before me this .5 bk 1' ay 2y12 , (Date) By _Q6a FW mtdceu w amn/ E who has produced DQtV1r19 C F_N _ (Name of person acknowledging) (Type of identification) as identification and did not take an oath. NOTARY'S SEAL Lawrence Saunders NOTARY PUBLIC STATE OF FLORIDA . Comm# EE112006 E)Vrres 7/13/2015 (SIGNATURE OF NOTARY) Page 4 of 4 AFFIDAVIT It is understood and acknowledged by the Collier County Contractors' Licensing Board and myself that if l fail to acquire, or maintain at all times effective Workmen's Compensation insurance it will result in the possible revocation of my Certificate of Competency. SIGNATURE OF APPLICANT BUSINESS N/ E DATE BEFORE ME this day personally appeared PAIUEN 94wr- who affirms and says that he has less than one employee and does not require Workmen's Compensation and understands that at any time he employs one or more persons he must obtain said Workmen's Compensation insurance. STATE OF FLORIDA COUNTY OF _ CQ t(j (' 2 . The foregoing instrument was acknowledged before me this _ S a yt)Ly 2u c? (Date) .by VA&LE EN V_LW E - who has produced ©gtVI"F - L,t c6r4 SE (name of person acknowledging) (Type of identification) as identification and who did not take an oath. NOTARY SEA LWMIA" o t &e § NOTARY PUBLIC STATE OF FLORIDA . Comm# EE112005 Expires 7/13/2015 SIGNATURE OF NOTARY NOTARY PUBLIC Judgment - Destin Floors A Builder /homeowner hired Destin Floors to install tile in a new home that was being built as the personal residence of he and his wife. Destin Floors subbed the job to Dazzling Floors -- Destin Floors supplied Dazzling Floors with approximately 1500 square feet of tile and requested it be set on the diagonal. The Builder /homeowner /husband was present during delivery of the tile and most of the time throughout the tile install. During the installation, the Builder /homeowner /wife came to the job site to check the construction progress. The Builder /homeowner /husband was not present when she was there. The wife stated she didn't like the color of the tile. She did not ask us to stop installing or say it was the wrong the just that she did not like the color. We did stop installing the job and took lunch so I could verify the tile provided to me was what the correct tile. I spoke with Destin Floors over the phone and they assured me that the tile brand and color was correct. Since the Builder /homeowner /husband had been present throughout most of the time my crew was there installing, and he never complained of the tile being incorrect, my crew and 1 continued installing the tile as we were already being pressed to complete the job on time by the builder /homeowner /husband and Destin Floors. The Builder /homeowner /husband came to the jobsite the following morning and he was informed of his wife's concerns about the color and he dismissed her complaint and agreed that the the was correct and advised us to absolutely complete the install as they were under time constraints. The Builder even praised the fast progress and how beautiful the job looked. Upon completion of the job, the Builder /homeowner /husband inspected the job and told my crew again, the job looked beautiful. Dazzling Floors submitted a bill to Destin Floors for approximately $4000 for the install and approximately two weeks after completion of the job, Dazzling Floors received payment for the install. Approximately three -to -four months after Dazzling Floors was paid for the job, Destin Floors called Dazzling Floors and asked that we install a different color tile at our expense to keep the builder's wife happy. I refused because the complaint involved the tile color and had nothing to do with poorly installed tile. Destin Floors filed suit against Dazzling Floors. I hired the attorney that incorporated Dazzling Floors and the day before the court date, his office informed me that he had a conflict of interest. I tried to hire another attorney and could not. Destin Floors was awarded a Judgment. The economy was very poor at the time and 3 of the 6 carpet stores in town closed down —work was extremely scarce. There were so many unemployed subs and installers and we were treated very poorly and our piece work pay was reduced. We were expected to do some work for free and the rest at a reduced rate, if we wanted to continue working. Because the homeowner is a Builder, Destin Floors desperately wanted to keep him happy to secure his future business in a very poor economy, and agreed to replace the the with a color the wife approved of. I've worked installing commercial and residential flooring in New York, New Jersey and Florida for over 20 years and this is the only lawsuit that was ever filed. Darleen Rowe GiTS, LLC Examination Operations Division Providing the services and products to assist Government Agencies to make informed educated decisions. Official Examination Score Report Official Score Report: Candidate Information: Name — Darleen Rowe Candidate #: 7366915OR Testing Site: Panama City, FL Final Score Result: April 18, 2012 Business Procedures Score: 86% These results represent the grade that has been achieved on the Business Procedures examination(s) administered by Gainesville Independent Testing Service for Collier County, Florida on April 18, 2012. If you have any further questions, please do not hesitate to contact us. Sincerely, Jay E. Bowermeister President PO Box 831127 Ocala, Florida 34483 -1127 — Voice (352) 369 -GITS – Fax (352) 387 -2443 800 997 2129 EXPERIAN BUSINESS REPORT PAGE RPT DATE TIME PORT 1 06/11/2012 14:03:30 -AN3 ------------------------------------ DAZZLING FLOORS INC 337 TEQUESTA DR DESTIN FL 32541 -3747 TYPE REPORT 404 --------------- -- - - -- BIN: 739397657 PHONE: 850- 650 -8007 COMPANY DESCRIPTION THE PRIMARY BUSINESS FOR DAZZLING FLOORS INC IS Legislative Bodies (SIC 91210000) WITH A SECONDARY BUSINESS CATEGORY OF Floor Laying & Other Floor Work, Nee (SIC 17520000). THE BUSINESS WAS INCORPORATED ON JANUARY 14, 2002 IN FLORIDA SIGNIFICANT DEROGATORY DATA 05 -09 -06 $11,269 ACCOUNT PLACED FOR COLLECTION WITH STERLING AND KING (TELEPHONE NUMBER 407- 339 -9033) IN 10/09 DUE TO UNPAID BALANCE OF $12,051. LAST REPORTED IN 6/12, ACCOUNT REMAINS OPEN WITH THE AGENCY. PUBLIC RECORD INFORMATION PUBLIC RECORD REPORT JUDG -FILED 05 -09 -06 $11,269, 05CC1222, OKALOOSA COUNTY CIR PLAINTIFF: DESTIN FLOORING INC COPYRIGHT 2012 EXPERIAN INFORMATION SOLUTIONS, INC. ALL RIGHTS RESERVED. * *CONTINUED ** Created with Print2PDF. To remove this line, buy a license at: nttp: / /www.software602.com/ EXPERIAN BUSINESS REPORT -------------------------------------------------------------------------------- PAGE 2 06/11/2012 DAZZLING FLOORS INC BIN: 739397657 -------------------------------------------------------------------------------- COMPANY BACKGROUND INFORMATION THE FOLLOWING WAS PROVIDED BY THE STATE OF FLORIDA. HISTORY BUSINESS INCORPORATED ON JANUARY 14, 2002 AS A FOR- PROFIT CORPORATION. FEDERAL TAX ID IS 412025049. CHARTER NUMBER IS P020000047. CURRENT STATUS ACTIVE BUSINESS. AGENT IS DARLEEN ROWE LOCATED AT 337 TEQUESTA DRIVE, DESTIN, FL. PRIMARY PRODUCT/ SERVICE: FLOOR LAYING AND FLOOR WORK, NEC SIC: 1752 ADDL PRODUCT /SERVICES : FLOOR COVERING STORES SIC: 5713 PRINCIPAL(S) : DARLEEN ROWE TITLE: DIRECTOR THE INFORMATION HEREIN IS FURNISHED IN CONFIDENCE FOR YOUR EXCLUSIVE USE FOR LEGITIMATE BUSINESS PURPOSES AND SHALL NOT BE REPRODUCED. NEITHER EXPERIAN INFORMATION SOLUTIONS, INC., NOR ITS SOURCES OR DISTRIBUTORS WARRANT SUCH INFORMATION NOR SHALL THEY BE LIABLE FOR YOUR USE OR RELIANCE UPON IT. COPYRIGHT 2012 EXPERIAN INFORMATION SOLUTIONS, INC. ALL RIGHTS RESERVED. * *END REPORT ** MERIT CREDIT HAS RETRIEVED THE ABOVE BUSINESS REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER /PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY (INCLUDING PINELLAS), STATE AND FEDERAL LEVELS. PUBLIC RECORDS LEARNED: 1 SOURCES OF INFORMATION: EXPERIAN BUSINESS INFORMATION SERVICES IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1- 800 - 371 -3348 OR 239 - 277 -3202. Created with Print2PDF. To remove this line, buy a license at: http: / /wt"Al.soft�vare602.corn/ Prepared By: Merit Credit (239) 277 -3202 (800) 371 -3348 TRANSUNION CREDIT REPORT [FOR] [SUB NAME] [MKT SUB] [INFILE] [DATE] [TIME] (I) Z NP6284423 MERIT CREDIT 15 MO 12/84 06/11/12 13:59CT [SUBJECT] [SSN] [BIRTH DATE] ROWE, DARLEEN MACKLIN 11/66 [ALSO KNOWN AS] MACKLIN,DARLEEN,MACKLIN MACKLIN,DARLENE [CURRENT ADDRESS] [DATE RPTD] 5835 PO BOX 5835, DESTIN FL. 32540 4/08 [FORMER ADDRESS] 337 TEQUESTA DR., DESTIN FL. 32541 11/06 1632 TOWN PARK DR., PORT ORANGE FL. 32129 [CURRENT EMPLOYER AND ADDRESS] [RPTD] DAZZLING FLOORS 5/04 [FORMER EMPLOYER AND ADDRESS] LAW OFFICE OF GAIONO DUNA 12/96 ---------------------------------------------------------------------------- S P E C I A L M E S S A G E S ** *ADDRESS ALERT: CURRENT INPUT ADDRESS DOES NOT MATCH FILE ADDRESSES) * ** ---------------------------------------------------------------------------- M 0 D E L P R O F I L E * * * A L E R T * ** * * *FICO CLASSIC 04 ALERT: SCORE +474 : 038, 013, 018, 016 * ** IN ADDITION * * *TO THE FACTORS LISTED ABOVE, THE NUMBER OF INQUIRIES ON THE CONSUMER'S ** *CREDIT FILE HAS ADVERSELY AFFECTED THE CREDIT SCORE. ---------------------------------------------------------------------------- C R E D I T S U M M A R Y * ** T 0 T A L F I L E H I S T O R Y PR =O COL =13 NEG =11 HSTNEG =4 -21 TRD =20 RVL =8 INST =5 MTG =4 OPN =3 INQ =5 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE INSTALLMENT: $32.2K $ $2955 $0 $578 OPEN: $2886 $ $3951 $3951 $ 0% CLOSED W /BAL: $512K $15.4K $2387 TOTALS: $35.1K $ $518K $19.3K $2965 ---------------------------------------------------------------------------- C O L L E C T I O N S SUBNAME SUBCODE ECOA OPENED CLOSED $PLACED CREDITOR MOP ACCOUNT# VERIFIED BALANCE REMARKS ASSET ACCEPT Y 1FJ3001 I 8/11 $6027 01 BANK OF AMERICA 09B 113070788 6/12A $6303 PLACED FOR COLLECTIO ASSET ACCEPT Y 1FJ3001 I 6/11 $7843 01 GE CAPITAL CARE 09B 112715922 6/12A $8305 PLACED FOR COLLECTIO NCA Y 9883003 I 6/11 $6835 01 CHASE 09B 5401683030998519 6/12A $6835 PLACED FOR COLLECTIO RJM ACQ LLC Y 1M7S003 I 12/11 $376 08 BANK OF AMERICA 09B 89BROO1516255 5/12A $376 PLACED FOR COLLECTIO Created with Print2PDF. To remove this line, buy a license at: littp: /hWNv.sottware6O2.com/ MIDLAND FUND Y 36ET009 I 6/11 $3916 CHASE BANK USA N A 09B 8540000195 5/12A $5195 PLACED FOR COLLECTIO CSI Y 2667001 I 7/11 $4118 MEDICAL 09B 2447590 5/12A $4118 PLACED FOR COLLECTIO CSI Y 2667001 I 9/11 $1494 MEDICAL 09B 2475309 5/12A $1494 PLACED FOR COLLECTIO CSI Y 2667001 I 2/12 $381 MEDICAL 09B 2571112 5/12A $389 PLACED FOR COLLECTIO CSI Y 2667001 I 8 /11 $201 MEDICAL 09B 2464110 5/12A $201 PLACED FOR COLLECTIO CSI Y 2667001 I 9/11 $230 MEDICAL 09B 2486228 5/12A $230 PLACED FOR COLLECTIO CB SERVICES Y 51CQ005 I 1 /10 $93 10 SOUTH WALTON UT 09B 1649572 3 /10A $93 PLACED FOR COLLECTIO NCO FIN /33 Y 1EDMO15 I 2/08 $13.2K MEDICAL 09B 16206693 5/08A $13.2K PLACED FOR COLLECTIO CER STS REC Y 548NO04 I 12/06 $702 MEDICAL 09B 4051214 ---------------------------------------------------------------------------- 3/07A $702 PLACED FOR COLLECTIO T R A D E S SUBNAME SUBCODE OPENED HIGHCRED TERMS MAXDELQ PAYPAT 1 -12 MOP ACCOUNT# VERFIED CREDLIM PASTDUE AMT -MOP PAYPAT 13 -24 ECOA COLLATRL /LOANTYPE CLSD /PD BALANCE REMARKS MO 30/60/90 BK OF AMER B 1597029 2/07 $6027 R09 319 8 /11A $5000 $0 I CREDIT CARD 2/09F $0 PURCH BY OTHER LENDER CHASE B 26QK001 9/06 $4524 R09 1 /11A $3500 $0 I CREDIT CARD 6/09F $0 PURCH BY OTHER LENDER CHASE B 26QK001 11/06 $3915 R09 6/09F $0 PURCH BY OTHER LENDER BK OF AMER B 6331059 9/05 $5672 R09 5/09A $4500 $1450 I CREDIT CARD 2/09F $5672 CLOSD BY CRDT GRANTOR GECRB /CARECR F 9992742 4/07 $7843 R09 4/09A $7000 $0 I CHARGE ACCOUNT 10 /08F $0 PURCH BY OTHER LENDER CAP ONE B lDTV001 6/07 $1758 R09 3/09A $1000 $0 I SLDTO SHERMAN ORI 2/09F $0 PURCH BY OTHER LENDER HSBC /MS F 235197C 4/06 $148K 12M M09 Created with Print2PDF. To remove this line, buy a license at: http : / /wvvw.so vare6O2.cot-n/ 14284574 2/09A I CONVENTIONAL REAL 2/09F $0 CVF CAC F 2DL3001 8/11 $519 98030 5/12A I 12 WFNNB $507 LVNV FUNDING F 21T9002 3/09 $1790 5/12A I 12 CAPITAL ONE $2880 CVF CAC F 2DL3001 8/11 $577 5/12A I 12 WFNNB NEWPORT $564 AMRCN HM MTG F 1946001 1/06 $474K 30928576 6/08A I CONVENTIONAL REAL 4/08C $506K CAPITAL 1 FA F 1W2K001 10/06 $32.2K 62062158855401001 5/12A I AUTOMOBILE $2955 NEWPORT NEWS C 1NZ8090 9/06 $508 7/09A $450 I CHARGE ACCOUNT 7/09C $0 WFNNB/JSTICE C 122P002 11/06 $457 7/09A $250 I CHARGE ACCOUNT 7/09C $0 BK OF AMER B 6331205 12/05 $37.7K 10 /06A I AUTOMOBILE 10 /06C $0 HSBC AUTO F 1B6A001 5/04 $25.1K 5000010061 2/06A I AUTOMOBILE 2/06C $0 B HILL AUTO A 1UAZ001 7/04 $7835 K506 2/06A I AUTOMOBILE 2/06C $0 HOMEQ F 1B6F123 9/03 $206K 1 /06A I SECURED 1 /06C $0 NEW CNTY MTG F lYP6002 9/03 $206K 982487 12/03A I CONVENTIONAL REAL 12/03C $0 VANGUARD BK B 439YO01 8/02 $5067 8/03A I SECURED 8/03C $0 ------------------------------------- I N Q U I R I E S DATE SUBCODE SUBNAME $0 FORECLOSURE,CLTRL SLD 09B $507 PLACED FOR COLLECTION 09B $2880 PLACED FOR COLLECTION 09B $564 PLACED FOR COLLECTION 480M2387 3/08 44432111111X M04 $13.9K $7456 04 1X11X11X1111 FORECLOSURE INITIATED 25 1/ 1/ 3 72M578 111111111111 I01 $0 111111121111 48 1/ 0/ 0 4/09 555432112111 R01 $0 05 111111111111 PURCH BY OTHER LENDER 34 2/ 1/ 4 4/09 555432113211 R01 $0 $78 05 111111111111 PURCH BY OTHER LENDER 33 2/ 2/ 4 60M792 1111111111 I01 $0 CLOSED 10 0/ 0/ 0 60M595 111111111111 I01 $0 1111111 CLOSED 19 0/ 0/ 0 175M259 111111111111 I01 $0 111111 CLOSED 18 0/ 0/ 0 360M1538 111111111111 M01 111111111 CLOSED 21 0/ 0/ 0 360M1335 1111 M01 $0 TRNSFRD: OTHER LENDER 4 0/ 0/ 0 12M433 X1111XX11X11 I01 $0 CLOSED 12 0/ 0/ 0 ------------------------------ - - - - -- TYPE AMOUNT Created with Print2PDF. To remove this line, buy a license at: http: / /www.softvvare602.com/ 6/11/12 ZNP6284423(FLA) MERIT CREDIT 10/06/11 YDT4587653(MCH) ASSET ACCEPT 7/22/11 YDT4587653(MCH) ASSET ACCEPT 9/07/10 YPE5556540(IND) FIRSTSOURCE 9/02/10 RNR2691233(FLA) CRYSTAL WATE -------------------------------------------------------------------------- C R E D I T R E P O R T S E R V I C E D B Y TRANSUNION 800 - 888 -4213 2 BALDWIN PLACE, P.O.BOX 1000,CHESTER, PA. 19022 Consumer disclosures can be obtained online through TransUnion at: http: / /www.transunion.com -------------------------------------------------------------------------- CREDITOR CONTACT INFORMATION ASSET ACCEPT YClFJ3001 (800) 614 -4730 POB 1630 WARREN MI. 48090 NCA YC9883003 (866) 964 -5259 P.O. BOX 550 HUTCHINSON KS. 67504 RJM ACQ LLC YC1M7S003 (800) 268 -0623 575 UNDERHILL BLVD SYOSSET NY. 11791 MIDLAND FUND YC36ET009 (800) 825 -8131 8875 AERO DR SAN DIEGO CA. 92123 CSI YC2667001 (850) 434 -0883 POB 1431 PENSACOLA FL. 32596 CB SERVICES YC51CQ005 (850) 862 -2154 P.O. BOX 4127 FORT WALTON BE FL. 32549 NCO FIN /33 YClEDMO15 (800) 786 -9330 POB 15609 WILMINGTON DE. 19850 CER STS REC Y 548NO04 (620) 663 -8811 1314 N MAIN HUTCHINSON KS. 67501 BK OF AMER BC1597029 (800) 421 -2110 PO BOX 982238 EL PASO TX. 79998 CHASE BC26QK001 (800) 945 -2006 P.O. BOX 15298 WILMINGTON DE. 19850 BK OF AMER BC6331059 (800) 421 -2100 PO BOX 982238 EL PASO TX. 79998 GECRB /CARECR FZ9992742 (866) 396 -8254 C/O PO BOX 965036 ORLANDO FL. 32896 CAP ONE BClDTV001 (800) 955 -7070 POB 30281 SALT LAKE CITY UT. 84130 HSBC /MS FM235197C (800) 365 -0175 PO BOX 3425 BUFFALO NY. 14240 CVF CAC FY2DL3001 (866) 297 -1485 PO BOX 10525 GREENVILLE SC. 29603 LVNV FUNDING FY21T9002 (866) 464 -1183 P.O. BOX 10584 GREENVILLE SC. 29603 AMRCN HM MTG FM1946001 (410) 872 -2000 PO BOX 631730 IRVING TX. 75063 CAPITAL 1 FA FA1W2K001 (800) 946 -0332 ATTN- CREDIT BUREA PLANO TX. 75093 NEWPORT NEWS CWlNZ8090 PO BOX 182789 COLUMBUS OH. 43218 WFNNB /JSTICE CS122P002 PO BOX 182789 COLUMBUS OH. 43218 BK OF AMER BI6331205 (800) 215 -6195 9000 SOUTHSIDE BLV JACKSONVILLE FL. 32256 HSBC AUTO FA1B6A001 (214) 237 -3430 Created with Pdnt2PDF. To remove this line, buy a license at: http: / /"``m"i.sofLware6O2.com/ PO BOX 961245 FORT WORTH TX. 76161 B HILL AUTO AZlUAZO01 (850) 763 -9005 3302 W. 23RD ST PANAMA CITY FL. 32405 HOMEQ FM1B6F123 (877) 867 -7378 P.O. BOX 13716 SACRAMENTO CA. 95853 NEW CNTY MTG FMlYP6002 210 COMMERCE IRVINE CA. 92602 VANGUARD BK BZ439YO01 (904) 678-4141 23 JOHNSON PARKWAY VALPARAISO FL. 32580 ASSET ACCEPT Y 4587653 28405 VAN DYKE WARREN MI. 48090 FIRSTSOURCE Y 5556540 (716) 564 -4400 205 BRYANT WOODS S AMHERST NY. 14228 CRYSTAL WATE R 2691233 (850) 654 -4659 137 MARIGOT BAY CI MIRAMAR BEACH FL. 32550 END OF TRANSUNION REPORT MERIT CREDIT HAS RETRIEVED THE ABOVE PERSONAL CREDIT REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER /PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY, STATE AND FEDERAL LEVELS. PUBLIC RECORDS HAVE ALSO BEEN VERIFIED FOR PINELLAS COUNTY. PUBLIC RECORDS LEARNED SOURCES OF INFORMATION: CREDIT DATA SERVICES, INC /EXPERIAN IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1- 800 - 371 -3348 OR (239) 277 -3202. Created with Print2PDF. To remove this line, buy a license at: http: / /www.sottware602.com/ State of Florida Department of State I certify from the records of this office that DAZZLING FLOORS, INC. is a corporation organized under the laws of the State of Florida, filed on January 14, 2002. The document number of this corporation is P02000004700. I further certify that said corporation has paid all fees due this office through December 31, 2012, that its most recent annual report was filed on April 24, 2012, and its status is active. I further certify that said corporation has not filed Articles of Dissolution. Given under my hand and the Great Seal of Florida, at Tallahassee, the Capital, this the Twenty Fifth day of April, 2012 Secretary of State Authentication 1D: 700231053347 -042512- P02000004700 To authenticate this certificate,visit the following site, enter this ID, and then follow the instructions displayed. https:// efile .sunbiz.org/certanthver.html Home Contact Us E- Filing Services Previous on List Next on List Return To List Events No Name History Detail by Entity C Florida Profit Corporation DAZZLING FLOORS, INC. Filing Information Document Number P02000004700 FEI /EIN Number 412025049 Date Filed 01/14/2002 State FL Status ACTIVE Last Event CANCEL ADM DISS/REV Event Date Filed 01/11/2008 Event Effective Date NONE Principal Address 337 TEQUESTA DRIVE DESTIN FL 32541 US Changed 01/11/2008 Mailing Address P.O. BOX 5835 DESTIN FL 32540 US Changed 04/22/2009 Registered Agent Name & Address DARLEEN ROWE 337 TEQUESTA DRIVE DESTIN FL 32541 US Vame Changed: 05/03/2006 Nddress Changed: 01/11/2008 officer /Director Detail game & Address title D ROWE, DARLEEN '.O. BOX 5835 )ESTIN FL 32540 4nnual Reports Report Year Filed Date 2011 01/25/2011 Document Searches Forms Help Entity Name Search 1 Submit I Wednesday, April 25, 2012 2011 08/28/2011 2012 04/24/2012 Document Images 04/24/20 � 2 ANNUAL RF--PORT View image in PDF format 06/21/20! 1, ANNUAL REPORT View image in PDF form 01/25/2101 -1 ANNUAL RPPORT View image in PDF format 09/108,20110 REPOFT View image in PDF format View image in PDF format OILIIH'2008' FEIN'STATEMENIF View image in PDF format 11 05/03/20,06 ANN.UALLEEPORT View image in PDF format View image in PDF format Gj--',!I6!2005 Arne.ndnneni View image in PDF format -j 09/1612001-7 Voluntary DissolLnion View image in PDF format Q'5/'G'3/2-GQ5- —ANNUAL RIEPORIF View image in PDF format _j OV � 40002 Dornestic Projflit View image in PDF format INote: This is not official record. See documents if question o �� on is ��o t ist e n No Name History | Home | c""tac vs | DOCUment Searches | E-Filinq Services | punns | myn | cnv,rinm-0aou Privacy Policies State of Florida, Department of State �� Entity Name Search I Submit Wednesday, April 25, 2012 i _ !1 } n. RS - j:d + .� ED rq All ,�• � � � �`" (cam �.=, o i, Z Q I rn ez i D D Zk GN \ \\ _ �I RNr .` -i .. /� r �t;i rr �c,�,. k1 �.%4'/i k�.... `}..ti ,�lr; .,..r�.r<..,�:� 1 _ '� °�cd; axe' . •r "' '� r. _�L.' _ � ..� .. - ='� CERTIFICATE OF LIABILITY INSURANCE DATH(MMIDDIYYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 03/27/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE IDES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT_ if the certificate holder Is an ADDITIONAL INSURED, the pollw f ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the term and conditions of the policy, certain policies may require an endorsemerht A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Gilmore Insurance & Bonding, Inc. P.O. Box 249 CONTACT NAME. (850) 244-3387 (FAX No): (850) 244-2610 infoonsurancefast.txxn Mary Esther, FL 32569 Phone (850) 244 -3387 Fax (850) 2442610 INSURE S AFFORDING COVERAGE NAIC # INSURER A: Bankers Insurance Company INSURED INSURER B : Dazzling Floors Inc INSURER C : S 300,000.00 INSURER D: © COMMERCIAL GENERAL UABIUTY P.O. Box 5835 INSURER E : Destin, FL 32540 (850) 502-9460 INSURER F: DAMAGE T RENTED PREMISES Ea owrnenw $ 100,000.00 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILNSRR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE S 300,000.00 © COMMERCIAL GENERAL UABIUTY DAMAGE T RENTED PREMISES Ea owrnenw $ 100,000.00 ❑ ❑ CLAIMS -MADE © OCCUR A ❑ 090005330017105 11/06/2011 11/0612012 MED ExP (Any one person) $ 5,000.00 PERSONAL& ADV INJURY $ 300,000.00 ❑ GENERAL AGGREGATE $ 600,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: 0 POLICY ❑ PRO- ❑ PRODUCTS - COMP/OP AGG $ 600,000.00 $ JE_T LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ ANY AUTO Ea acddent BODILY INJURY (Per person) S ❑ALL OWNED SCHEDULED AUTOS ❑ AUTOS BODILY INJURY (Per aoddent ) s El HIREDAUTOS ❑ AUTOS OWNED P� ERA DAMAGE $ ❑ ❑ $ ❑ UMBRELLA h AB ❑ OCCUR ❑ EXCESS LIAB ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DED ❑ RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS- LIABILITY YIN ❑ WC y UM ❑ ER R_LIMRS ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory M NH) Iye s, de�ribe wider EL. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, Y more space Is required) L`CATICId%ATC Unh nen Collier County Contractors' Licensing Board 2800 N Horseshoe Drive Naples, FL 34104 ACORD 25 (2010105) OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AllTHORRED REPRESENTATIVE v - Imu -m710 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1 08-13-2010 ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: PERSON: FEIN: BUSINESS NAME AI DAZZLING FLOORS INC P 0 BOX 5835 DESTIN 11/01/2010 ROWE 412025049 VD ADDRESS: FL 32540 SCOPES OF BUSINESS OR TRADE: 1- FLOORING EXPIRATION DATE: 10/3112012 DARLEEN imruntAwr: rursuam to chapter 440 . 05114), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05112), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. 3WC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 QUESTIONS? (850) 413 -160! PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS! COMPENSATION LAW EFFECTIVE: 11/01/2010 EXPIRATION DATE: PERSON: DARLEEN ROME FEIN: 412025049 BUSINESS NAME AND ADDRESS: DAZZLING FLOORS INC P O BOX 5835 DESTIN, FL 32540 SCOPE OF BUSINESS OR TRADE: I - FLOORING IMPORTANT Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. 10/31/2012 H Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt.. apply only within the scope of the business or trade listed on E the notice of election to be exempt R E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. CUT HERE QUESTIONS? (850) 413 -1609 * Carry bottom portion on the job, keep upper portion for your records. WC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 DEPARTMENT OF THE TREASURY INTERNAL REVENUE SERVICE OGDEN UT 84201 DAZZLING FLLORS INC PO BOX 413 DESTIN FL 32541 DATE OF THIS NOTICE: 02 -08 -2002 NUMBER OF THIS NOTICE: CP 575 A EMPLOYER IDENTIFICATION NUMBER: 41- 2025049 FORM: SS -4 0532729311 B FOR ASSISTANCE CALL US AT: 1 -900- 829 -1040 OR WRITE TO THE ADDRESS SHOWN AT THE TOP LEFT. IF YOU WRITE, ATTACH THE STUB OF THIS NOTICE. WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER (EIN) Thank you for your Form SS -4, Application for Employer Identification Number (EIN). We assigned you EIN 41- 2025049. This EIN will identify your business account, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent records. Use your complete name and EIN shown above on all federal tax forms, payments and related correspondence. If you use any variation in your name or EIN, it may cause a delay in processing and incorrect information in your account. It also could cause you to be assigned more than one EIN. Based on the information shown on your Form SS -4, you must file the following forms(s) by the date we show. Form 941 Form 1120 Form 940 04/30/2002 03/15/2003 01/31/2003 Your assigned tax classification is based on information obtained from your Form SS -4. It is not a legal determination of your tax classification and is not binding on the IRS. If you want a determination on your tax classification, you may seek a private letter ruling from the IRS under the procedures set forth in Rev. Proc. 98 -01, 1998 -1 1. B. 7 (or,, the supercedinp revenue procedure for the year at issue). If you need help in determining what your tax year is, you can get Publication 538, Accounting Periods and Methods, at your local IRS office. If you have questions about the forms shown or the date they are due, you may call us at 1 -800- 829 -1040 or write to us at the address shown above. If you're required to deposit for employment taxes (Forms 941, 943, 940, 945, CT-1, or 1042), excise taxes (Form 720),'or income taxes (Form 1120), we will send an initial supply of'Faderal Tax Deposit (FTD)-coupon books within six weeks. You can use the enclosed coupons if you need to make a deposit before you receive your supply. Applicant's Name: Certificate Categor (VERIFICATION OF CONSTRUCTION EXPERIENCER GMD Operations & Regulatory Management Department Licensing Section 2800 N. Horseshoe Drive Naples, FL 34104 The Applicant is seeking a Collier County Certificate of Competency in the trade indicated above. As part of the application for this certificate the Applicant must verify their experience within this trade. You are being requested to provide information that will aid the Applicant in meeting this requirement. You should verify time of active experience working as an apprentice or a skilled worker (e.g. as a worker commanding the wage of mechanic or better in the trade). Time served solely in a supervisory or administrative role should be described, but may or may not be considered sufficient to demonstrate required trade experience. The person verifying trade experience must provide the following information: Name, Title and license number of the person signing below and veifying Applicants relevant experience: Name: 'Zir�1.,� t�.. �11�Cy3e�� `M�'�► y�lt�- . S• Lam, Title: i2 St `+fee License Number (if applicable): IM&W 12t0 3`t I!ZSCA CSMG40 2L I-LZ z Name of Business: �t`�c.3..�,Qa�(,.L�t�lZt5c3, -S -XV---C.. Business Address: V-Jo Go O"7 _ ,\ t� 1.. 3Lam`�s�D Business Phone:692'SSS'7 L The Applicant's years of experience from 1gQ`� to Q�tiS.r`s. The applicant's scope of work (speck duties) included: tti.,S.'�.a.�..+• M��-� �ZF Additional Comments: Falsifying any information provided herein may subject your license to revocation. $+etiSthat5S7 Signature Print Nam e: 1MC 12;,T State of Florida County of Collier The foregoing instrument was acknowledged byre me-.on-this---L— day ofA u„ f..2 O i a by _Rg ©i ex ' n-' r- l,rc w who is personally known tome r produced as identification and who did not take an oath. C., If. -A Y. 0 Signaturiof Notaqy i10T.41'iYPi'IST.iC ST�t!'t: �ii'rL'J;t;3 P iyllis Jean Seaion Gmnttssion #E DD801495 %,„„,./ Ezlires: AUG. 06, 2612 aavnrorruu eTte►vnc AMINO co, Vic AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I, SMzM:3 IZ3a..� ��, am a resident of County, (State) and have' .resided here for more than five (5) years. During the last five years I have known DL�I�en "R)toe., applicant). I have had the opportunity to observe his or her business and personal dealings and find him or her to be a person of honesty, integrity and good character. (Address) % �A %Jl SV�"9�R. - •t•• Telephone) QtBs WARC STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this by (Date) �S bQ.,A in `-ri, -o who has producedl it %, (name of person acknowledging) (Type of identification) as identification and who did not take an oath. NOTARY p(j ' C-STATE OF FLOWDA ......� Phyllis Jean Seaton Commission#DD901495 SIGNATURE bF NOTARY f Expires• AUG. 06, 2012 4. N ii Bp,+►DED TFtBU AT►,ki'11C YONDD'iG CO,1t7C NOTARY'S SEAL (PR NT NAME OF NOTARY) NOTARY PUBLIC CATION OF CONSTRUCTION GMD Operations & Regulatory Management Department Licensing Section 2800 N. Horseshoe Drive Naples, FL 34104 Applicant's Name: _ -:>a t-ee F 6\k,,t- ._.JQ..ZZ 111x'1 tpj(�,1f' j S Certificate Category Requested: Cbue r,%1c, The Applicant is seeking a Collier County Certificate of Competency in the trade indicated above. As part of the application for this certificate the Applicant must verify their experience within this trade. You are being requested to provide information that will aid the Applicant in meeting this requirement. You should verify time of active experience working as an apprentice or a skilled worker (e.g. as a worker commanding the wage of mechanic or better in the trade). Time served solely in a supervisory or administrative role should be described, but may or may not be considered sufficient to demonstrate required trade experience. The person verifying trade experience must provide the following information: Name, Title and license numbe the person signing below and verfying Applicants relevant experience: Name: L-0, V, ~ Title: �'� �� License Number (if ap ble): NameofBusiness: i :5' i ( ' i- Business Address: �� tJ � C � k C -OAS+ m � p p ., Business Phone: a t -3e Applicant's years of experience from I qR l toetr� The applicant's scope of work (specific duties) included: -M S ALA,4_r I L-)l0 C5 F CG t-�'e�� AL Additional Comments: Falsifying any information provided herein may subject your license to revocatiyiil. 1 Print State of Florida County of Collier The foregoing instrument was acknowledged before me on this (n day of .) L_kn C_ =� a t -4 by Lc1.r r n, n k4 "Ne 4 r a whoonally known to ni�br produced as identification and who did not take an oath. Signatur of Not NOTARY PUBLIC -STATE OF FWMA , '" Ing " "'% Phyllis Jean Seaton IVComtaission #EDD801495 lrJt►itts: AUG-06,2012 BoYDfvA IRU ATiAW1C soNDM Co., tiro M S1 Oc_ 7 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER am a resident of County, sqr4q'k�S/A (State) and have resided here for more than five (5) years. During the last five years I have known DCW (ten j�d Lup applicant). I have had the opportunity to observe his or her business and personal dealings and find him or her to be a person of honesty, integrity and good character. (Signature)tj (Name) (Address) Telephone) l7 �y "s t�DSU STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this acs r a by (Date) who has produced ,n i, S;',.. a i k (name of person acknowledging) (Type of identification) as identification and who did not take an oath. NOTARY PUBLIC - STATE OF FLORIDA Phyll's Jean Seaton mn G 2 SIGH �1 O F NOTARY 3Zt ; i AU , 141 l Cn BCCIDED 1fiAD ATW1f1C BCNDNGOD'ac Ph�41115 Par, NOTARY'S SEAL (PRINT NAME OF NOTARY) NOTARY PUBLIC 'VERIFICATION OF CONSTRUCTION EXPERIENCE' GMD Operations & Regulatory Management Department Licensing Section 2800 N. Horseshoe Drive Naples, FL 34104 Applicant's Name: LJWie er-, � / Ooaz i 1►�► T Certificate Category Requested: ice I oor C �P- r l Y1 Ct (r1 I C- ( j The Applicant is seeking a Collier County Certificate of Competency in the trade indicated above. As part of the application for this certificate the Applicant must verify their experience within this trade. You are being requested to provide information that will aid the Applicant in meeting this requirement. You should verify time of active experience working as an apprentice or a skilled worker (e.g. as a worker commanding the wage of mechanic or better in the trade). Time served solely in a supervisory or administrative role should be described, but may or may not be considered sufficient to demonstrate required trade experience. The person verifying trade experience must provide the following information: Name, Title and license number of the person signing below and verifying Applicants relevant experience: Name: /riC -A_ f'Jc.Jc7xa& Title: �/ a&5 l�a�lt3D Ot /�l�fi7icense Number (if Name of Business: Business Address: Business Phone: j.52� 2� j •-C -315.3 The Applicant's years of experience from A l The applicant's scope of :f Additional Comments: /S 66ez) if Falsifying any information State of Florida County of Collier included: herein may subject your license to Print The foregoing instrument was acknowledged before me on this 111 day of m 4 V 0619- by 12 .1 C_\-S u *Io is personally known tome r produced ! as identification and who did not take an oath. Signatur of Notary NO.TARY PUBLIC -STATE OF FLORIDA ,�...X P64111S Jean Seaton s =CZission #DDS0149s ',..,„V Expires: AUG. oc xu AM)60 Ttutt1 ATL*A -nC smnnvo M, IIaC a�5- . 7 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I, ^ !�k Aar.:,.s- am a resident of C County, ge"sh- (State) and have resided here for more than five (5) years. During the last five years I have known teen applicant). I have had the opportunity to observe his or her business and personal dealings and find him or her to be a person of honesty, integrity and good character. (Signature) (Name) S (Address)6st. Telephone) 3 STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this _ 1(a M oL W a C-, i n by (Date) t? t C,K W (-) c s r, S who has produced L E o n o (name of person acknowledging) �Te of identification) as identification and who did not take an oath. SIGNAVUR.E `OF NOTARY �ES h NOTARY'S SEAL (PRINT NAME OF NOTARY) N. OTARY PUBLIC- STr`.': E OF FLORIDA NOTARY PUBLIC ""' _ P^ i,is .lean Seaton = Commission #DD801495 Expires: AUG. 06, 2012 aorrnsn TUU ATIA nc ROWNc CO., arc. O z i m 0 am :E y a z A w D cn a a (n -+ G) m i s s Z C3 -0 O O 0 C � m D p z D 0 m iA a N O z N r- z z K.n y � (D> - � �J � = 9 M i m p 0 c m m c O� 37 z 0 _av+ z y O D m mm zco 0 m a 0-0000 rn0>> D U10;oN N z O z Z Z -n G) G) C) -n 0 O rn 4 (n N 0 n C) a A m C.) M m n A U) a i a m r M O v 00 o0 x O y y wm m 0 z� ci CD � co y -n x r 0 CIO 0 N t m n O cu 00 to r NN O p +'' N t+ ~ 00 � N 00 0 Z -1 0 -0 Dz 0 z Krn r n U1 �c Rq O z 0 0 1 oc c c:� K K D W W O 0w S S2-0 � �0 z z O u7 ;D D --1 M -a O M 0) o X x O 0 O M O O D �n 0 c z M z v zm ado m r°- y n c y m -rj M Z r m X c D r toot- 00,C) C) 000UJ 000 000 O O O 0 r O D D n O N c O U) z F+ M r M ',n > o �r N 0c M C z M cn O a x M M n M -o rn X .�. M M m rn n N m z N O rn M rn 3 r rn �Ln w 0 o "J N N O �O N v I / MVrv"WW. urr wvrw. v awrrwvwrrwrw.r. July 30, 2012 To Whom It May Concern: During 2008 the Office Manager and another employee of Paints & Coatings had been caught embezzling several hundred thousand dollars from the company. Part of this fraud included the theft of payroll tax deposits which created significant penalties and interest from the IRS once this was discovered. The State's attorney stepped in and prosecuted both individuals involved and they are both currently in prison for this crime. The IRS is now working with us to resolve this matter and have agreed to a repayment plan to pay back the payroll taxes that were stolen. We realize the payroll taxes are still our responsibility and have put in place new office procedures and internal controls to prevent this from happening in the future. Sincerely, Jeff Yingling, VP REPRESENTING: CHARLOTTE COLLIER GLADES HENDRY LEE June 8, 2010 Carl A. LaQuidara 18450 Nalle Road North Fort Myers, FL 33917 Stephen B. Russell State Attorney IN RE: STATE OF FLORIDA vs. REBECCA FIELDS COOKSLEY Case Number: 09 -CF- 000138 WitID Number: 8641150 Dear Carl A. LaQuidara: OFFICE OF THE STATE ATTORNEY Twentieth Judicial Circuit of Florida Post Office Box 399 Fort Myers, Florida 33902 -0399 (239) 533 -1000 Fax Number Felony...... (239) 485 -1003 Website: www.sao.cjis20.org As you are aware, on Monday June 7, 2010, the Defendant in the above referenced case entered an open plea to the Court on the charge of First Degree Grand Theft. First Degree Grand Theft is a first degree felony and carries a maximum penalty of 30 years in prison. The Defendant also admitted that restitution in the case is at least $160,000 and is not contesting that amount. Sentencing has been set for Monday August 16, 2010, at 1:30 PM in courtroom 8 -B of the Lee County Justice Center. At that time, the Court will make a determination as to what sentence to impose. The Defendant's scoresheet reflects a possible sentencing range of 21 months prison up to and including 30 years prison. You are entitled to be present at this proceeding and to speak in your own behalf, but are not required to do so. You may also provide a written statement which will be filed with the Court. Any statement made or prepared should relate to the facts of the case and the extent of any harm, including social or psychological harm, as well as any financial losses, which resulted from the crime, and may also include any matter relevant to an appropriate disposition and sentence. If you have any questions or concerns, do not hesitate to contact me. Sincerely, Brenda M. Wade Assistant State Attorney Si usted necesita esta informacift en espatiol, por favor, llame a la Fiscalia al numero listado arriba. Gracias. Internal Revenue Service 4210 METRO PARKWAY SUITE 115 FORT MYERS, FL 33916 PAINTS & COATINGS INC 17660 EAST ST N FT MYERS, FL 33917 -2120 Department of the Treasury Letter Date: 02/02/2012 Taxpayer Identification Number. 65- 0754628 Telephone Number: (239)938 -7539 We have approved your request to pay your taxes in installments. Your first payment of $5,000.00 is due on 02/28/2012. You agreed to make future payments of $5,000.00 on the 28 of each following month until you have paid the full amount you owe. The amount you owe as of 02/01/2012 is $379,674.05. This amount does not include all accrued penalties and interest. We will charge penalties and interest until you pay the full amount you owe, because you didn't pay your total tax when it was due. You agreed to pay us by Direct Debit. This means that, on the same day each month, your financial institution will subtract (debit) the amount of your monthly payment from your checking /savings account and send that amount to us. By agreeing to pay by direct debit, you also authorize the financial institutions involved in the processing of your electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to your payment. Since we don't send you reminders, be sure to remember to subtract the payments from your account balance each month. If you don't have enough money in your checking /savings account for the monthly payment, we must charge a penalty of $15 or two percent of your monthly payment, whichever is larger. If your monthly payment is less than $15, the penalty amount will be the payment amount. Note: If the IRS is charging backup withholding on any of your accounts, it will continue. Having an installment agreement doesn't interrupt backup withholding. Although we have established an installment plan for you, we must protect the government's interest. Therefore, a Notice of Federal Tax Lien Has Already Been Filed A Notice of Federal Tax Lien is a public notice that the government has a claim against your property to satisfy a debt. We will release (remove) the lien when you finish paying what you owe. CONDITIONS OF THIS AGREEMENT: • We must receive each payment by the date shown above. If you have a problem, contact us immediately. • This agreement is based on your current financial condition. We may change or cancel it if our information shows that your ability to pay has changed significantly. • We may cancel this agreement if you don't give us updated financial information when we ask for it. • While this agreement is in effect, you must pay any federal taxes you owe on time. • We will apply your federal tax refunds (if any) to the amount you owe until it is fully paid. • If you don't meet the conditions of this agreement, we will cancel it, and may collect the entire amount you owe by levy on your income, bank accounts or other assets, or by seizing your property. • We may cancel the agreement at any time if we find that collection of the tax is in jeopardy. Letter 2849 (Rev. 1/2007) • There is a $52.00 installment agreement fee. • If agreement defaults, you must pay a $45.00 reinstatement fee if agreement is reinstated. • We will apply all payments on this agreement in the best interest of the United States. Additional Conditions: This installment agreement includes taxes for the following forms and tax periods: Form Tax Period Form Tax Period Form Tax Period 941 9/30/2006 941 9/30/2008 941 12/31/2008 941 3/31/2009 941 6/30/2009 941 9/30/2009 941 12/31/2009 941 3/31/2010 941 6/3012010 941 9/30/2010 941 3/31/2011 941 6/30/2011 941 9/30/2011 940 12/31/2010 1120 12/31/2010 If you need assistance or have a question concerning your agreement, please call the telephone number at the top of the first page of this letter. Sin erely yours, f RAMON FRANCO REVENUE OFFICER Employee Identification Number: 1000884981 Letter 2849 (Rev. 1/2007) Page 1 of 1 1 1 /We agree to pay the federal taxes shown above, PLUS PENALTIES AND INTEREST PROVIDED BY LAW, as follows: $5,000.00 on 02/28/2012 and $5,000.00 on the 28th of each month thereafter. I / We also agree to increase or decrease the above installment Davment as follows: Date of increase (or decrease) Amount of increase (or decrease) New installment payment amount The terms of this agreement are provided on the back of this page. Please review them thoroughly. ❑ Please Initial this box after you've reviewed all terms and any additional conditions. Additional Conditions/Terms (To be completed by IRS) Taxpayer to send additional payments as funds become available Note: Internal Revenue Service employees may contact third parties in order to process and maintain this agreement DIRECT DEBIT — Attach a voided check or complete this part only if you choose to make payments by direct debit. Read the instructions on the back of this page. a. Routing number: 1 authorize the U.S. Treasury and its designated Financial Agent to initiate a monthly ACH debit (electronic withdrawal) entry to the financial institution account indicated for payments of my Federal taxes owed, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke payment, I must contact the U.S. Treasury Financial Agent at the toll free number listed above no later than 14 business days prior to the payment (settlement) date. I also authorize the financial institution involved In the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payments. Spouse's signature pf a joint tlabtrtty) Title (!f corporate officer or partneq I Date Date Agreement examined or approved by (si trtl f cUon) Date JACQUELYN PERRON, ACTING MANA E C 02/02/2012 FOR IRS USE ONLY AGREEMENT LOCATOR NUMB R: 3 2 A NOTICE OF FEDERAL TAX LIEN (check one box Check the appropriate boxe below) 10 RSI "1" no further review ®AI "0° not a PPIA ® HAS ALREADY BEEN FILED ❑ RSI "5" PPIA IMF 2 year review ❑ At "1" Field Asset PPIA ❑ WILL BE FILED IMMEDIATELY ❑ RSI "6" PPIA BMF 2 year review Cl AI "2" - All other PPIAs ❑ WILL BE FILED WHEN TAX IS ASSESSED Agreement Review Cyde: 000000 Earliest CSED: 03/16/2019 ❑ MAY BE FILED IF THIS AGREEMENT DEFAULTS ® Check box if pre - assessed modules included Originator's ID #: 23062115 / 10 -00884981 Originator Code:20 Name: RAMON FRANCO Title: REVENUE OFFICER Part 1 - IRS Copy Catalog No. 16644M www.lrs_gov Form 433 -D (Rev. 1 -2012) +moo y C;vu.vlty CDES Operations & Regulatory Management Licensing Section 2800 North Horseshoe Drive Naples, FL 34104 APPLICATION FOR COLLIER COUNTY/CITY OF NAPLES /CITY OF MARCO FIRM INSTRUCTIONS: This application must be typewritten or legibly printed. The application fee must accompany this application. The fee is not refundable after the application has been accepted and entered on the records. All checks should be made payable to the Board of Collier County Commissioners. For further information, consult Collier County Ordinance No. 90 -105, as amended. NAME OF COMPANY; Exact Corporate/ Business Narne: b..r\ S a a Fiction Name /DBA: P ✓/A Qualifier Name: Physical 1 (Number & Street) ty) T_�� (Zip Code) Mailing Address: ,l` e. �+ \r C' c� (Number & Street) (City) (State) (Zip Code) Telephone: r `� of f - -_,`� E -Mail: 4 S �e�l�t�r��aa��Lor TYPE OF LICENSE: ❑ General $230.00 ❑ Electrician $230.00 ❑ Building $230.00 ❑ Plumber $230.00 ❑ Residential $23000 ❑ Air Cond. $230.00 ❑ Mechanical $230.00 ❑ Swimming Pool $230.00 ❑ Roofing $230.00 Specialty $205.00 Specialty trade: L CHANGE OF STATUS: ( ) Reinstatement ( ) From One Business to Another ( ) Dormant License to Active Page 1 of 4 1. The names, titles, home address and phone numbers of all Officers /Managing Members of the Firm. 3y� 1 VP -7 O� I Weil 2. List all businesses, firms, entities or contracting businesses you have been associated with during the last ten yearst (ex. Held a license for or been a partner). Attach extra pages if needed. 3. List all debts you or any company(s) associated with you refused to pay and the reasons for the refusal to pay. Attach extra pages if needed. I\j I A AFFIDAVIT certify that the foregoing is true and STATE= OF FLORIDA COUNTY OF 12 e_. of my knowledge. The foregoing instrument as acknowledged before me this , l , 2 w. E (Date) By L 4 b'E of at `!� S Lat t' n :T n C (Name of officer title /a nt) (Name of Corporatio ) a tt �/b � f C� r;� Corporation on behalf of the corporation. (State or Place of Corporation) He /She has produced 1 Le h S - identification and did not take an oath. (Type of identification) NOTARY'S SEAL NOTARY PUBLIC -STATE OF FLORIDA ell "' • Melissa Jean Giustina j . Commission # EE025046 Expires: SEP.12, 2014 BONDED THRU ATLANTTC BOA'DL;G CO., TNC. Page 2 of 4 +�- (SI A RE OF NOTARY) QUALIFIER INFORMATION: Name: �L _ �;rIIIAIr, Address: �i 3,`S 6 \ U QA` (Number & Street) Telephone: �) Y1, - q `i'? W HS S.S. #: 000 -00- (City) (State) (Zip Codi Date of Birth: E- Mail: C �`�`.XC� % }S ►�� Driver's License: Y 1. Type of Certificate of Competency for which application is made, 2. The names and telephone numbers of two persons who will know your whereabouts. 3. Have you ever been convicted of a crime related to Contracting? (If yes attach extra sheet with explanation) P�1Q 7. Have you or any firms you have been associated with ever filed bankruptcy ?. N,�k 8. List all debts you or any company(s) associated with you refused or failed to pay and reasons why. 9. List your business or work experience during the past ten years. 10. Statement of any formal training you have had in the area for which the application is made. Page 3 of 4 AFFIDAVIT The undersigned hereby makes application for Certificate of Competency under the provisions of Collier County Ordinance No. 2006 -46, as amended, and vouches for the truth and accuracy of all statements and answers herein contained. The undersigned hereby certifies that he is legally qualified to act on behalf of the business organization sought to be licensed in all matters connected with its contracting business and that he has full authority to supervise construction undertaken by himself or such business or organization and that he will continue during this registration to be able to so bind said business organization. The qualified license holder understands that in all contracting matters, he will be held strictly accountable for any and all activities involving his license. Any willful falsification of any information contained herein is grounds for disqualification. APPLICANT (PLEASE PRI ) STATE OF FLORIDA L COUNTY OF The foregoing instrument as acknowledged before me this C .V'_1 l 1 12— (Date) By rk I Vt C who (Name of perso ackn wled ng) (Type of identification) as identification and did not take an oath. NOTARY'S SEAL NOTARY PUBLIC-STATE OF FLORIDA . Melissa Jean Giustina Commission # EE025046 Expires: SEP.12, 2014 BONDED THRU ATLANTIC BONDING CO., INC i (SIGNATU OF N TARY) Page 4 of 4 RESOLUTION OF AUTHORIZATON WHEREAS Paa Af `= -i E;c �:_.,;'�;> proposes to (Name of Business Entity) engage in contracting as ,c in (Type of legs entity: core., partnership, etc. Collier County, Florida, according to Collier County Ordinance 2006 -46, as amended; and WHEREAS C— AS 4 co, ,� ,•,..,r proposes to (Name of Business Pnti qualify for a Certificate of Competency with (Name of Indivi6al)U NOW, THEREFORE, BE IT HEREBY RESOLVED THAT: We the undersigned -4 �, ; 1 of t (Officers, Owners, Partners) �� L-Cc ➢ S hereby resolve and represent to the Collier County (Name of Business Entity) rrrr Contractors' Licensing Board that the qualifying agent, Jc'i? �, - , is active (N� me QQf� In rvidu ) in all matters connected with the contracting business of 1-! ..,rZ�S C c e, , and (Name ofBus}ness Entity)t We further resolve and represent that -,� Y, - 1 z is (� (Names of In ividu ) legally empowered to act for _ 1 '�• � Y -Q)f>A, ^s in all matters connected with its (Name of Business En ) contr cting business, and has the authority to supervise construction undertaken by (Name of Business Entity)`�— DULY PASSED AND ADOPTED THIS rne _ t 1tneSS Sworn to and subscribed before me this �65 C7- ttf` Notary Public Name Printed Commission Number My Commission expires: NOTARY PUBLIC STATE OF FLORIDA "';Melissa Jean Giustina : Commission # EE025046 Expires: SEP,12, 2014 BONDED THRU ATI ANTIC BONDING, CO., D;C_ C) day of , )rpbrate Seal (if Applicable) Or Notary Public Certificate day of t L ZNryPublic 4Siture cv) P CATION OF CONSTIIUCTION GMD Operations & Regulatory Management Departtncrnt Licsensi.ng Section 2300 N. Horseshoe Drive Naples, )''L 34104 Applicant's Ct r(il amt, t'mcgoiy Requested: Pit Applicant is seelting a Collie, County (1cflificAW of [70rnh0tt-,ney fin the trade indleated above., As port n1 the Application 1'01 this certificate Oct Applicant must verify their eaperien". within this trade. You are being requested to provide inturmr'it.ion thAt will Aid the Applicant ih meeting this requirement. You should verify time of active experience woridag As An Apprentice or A skilled worker (e.g. as n worker commanding the wage of mechAnic or Imdter in the trade). Tian: served Solely In a supervisory or administrative rule should be dcscrribcd, but njay or may not }re eonsklcmd sufficient to demonstrate required trade uxporiolwo. The parson verirying trade experience must provide the following information: Name, 'l itle and licen1se number of the person signing helow anil veifyiq Appii0ants relevant experience; 11,4 .4 Ti.l.le; ( _. _.. r _.._.. License Number (if npplicably) ...,.,,.,....,.:.. ....... ...:....................�,....m Name of Business' .....\ coo Business Address: or,44 W ..,"' Business Phone: `� �" °� � ~D��.. ....'11re Applicant's ycar.5 of experience from to Tho applicant's scope of work (spucirk duties) Additional Comments: F'ulsifying any hN'orntation provided herein may subject,yotn li�K;nse;tu.r ton tgnHt�tre 1� Print Namet,., Slow Of Floridrl County of Collicr The f " f oing inslr rtient wat; ocknowledged bcfnre m a day of J Wi ( _ by (91 AA— .1 "ILSON. who is ersonaily knuwt o me ar produced_ as identification anti who did not tnkt: An oath, N� w.. RF�ECCASINKLEq Signature of Noisy y .. __._ �...._... Mr MWSM A on932tos EXPIRE$; OM* 11, 2013 9011dM TINU Wbiry PU* Underw Ws APPIDAVTT OIL INTEGRITYANA GOOD CHARACTER 1, l ? _�C�O/��..,., am Fa rosident of . 50.i'Cc St4 _ ('outaty, OIY..I_. _ ...__._..,___._.. (State) and gave re,91ded here for nwrc than five (5) years, Luring the last Ilve yes,rs I have known -Fj.A, . Jklc � (Applicant), 1 have 11Kd the opporturaity to olme.rve bi„ or her buyinczss and personfal dealings and find him or her to be a person of honesty, integrity aid good chtarooter. r (Signature) (Nance) FA4LJ �,i C Csov/ Telephone) STA'I'l✓ OF FLORIDA COO NTY OY "I'lie foregoing invtrumwit was aclnowledged beCurr• mo this l& a3, jz t !- vy (Dn.to) iA'-z _._.......,,._ who his produced L- (name of Parson crek'nuwledOng) ('l;ypr of iflpntific.;j(ian} as identification and who did not take an oath, NOTARY'S SRAL 11 ._ ON' NCl`I'A1tY (PRINT NAME OF NOTARY) NOTARY PUBLIC ' pEBECCA SINKIER My oOMglS 0 NDD 992106 ".: °+ • EXPIRES; pclaper 11, 2013 Bolyd�d /MM Ndory PuNic Undenwil� 11 ._ ON' NCl`I'A1tY (PRINT NAME OF NOTARY) NOTARY PUBLIC From:PAIMTS AND COATINGS 2399977117 07/20/2012 15:46 FMC PAINTS AND MAYiNSS 2399977117 07/2012012 14:32 GM OperWanu & � t gene �SOI 1V. �ISauiloa �lrlve Nook%hiL'M11W A~0 M nv. CIAO" CVAWMW Rvgaa" #344 P.0021002 0342 P.0011002 7% AppYn A is ad* s COW Cn* CUWArw of 0011000V to the true IWWW afros" As part yr 8W applwa" hr "ewftwo Aw Appowt "M wat* blebs "ertafwe W" sh Baia you an a pravtda irtbraa &W 909 *1 aid do AW*W to wage{ this ragrlwo" Yea dorm songs tpre a1'refha expa�a worklr� ae ar apprar•gea er r AdtinA..n>mr hd, 7a►a NaPAoel' ovlaawtir� thv Matlo etaaeiaata yr irtotler fa the Two wow low a a eapara" ar aiviabb%wo wh abeam im daamibed. but slay or am Mat be sommnN i r� tab :elsaaOMaeraa rob ub kwo upaipm0 Tu pare" vo*bi wok 60*jIM amt pnwws tlw Notre, TWO VW WOW Mlbw 9M pmMOr at ft below lad v40% A0*4 W r WU$ o0wiereo: wow. DaviA Ml � 4F? Tr l%l�': • ° P.1 r M t'<aat#pe phaa "�� •' �Th* ADY kWls yms af'.s* Aar 1413 „ lo _ � 02;50 0* The ayptlaofo wW of mark *so& &Wu) lnrludvd:. Lahm _!�r•— �� .` RA61' - soavevt m MM Ceaacy art:olliar TM Ja ova adaa�wb�ed baths. me � dais or. w �L`Stbr� ,.. wpl�i��en��) low■tonwa es fd.afN9oAdaa aad wbn dw ntt tslu ar oalb. A 12, r i 7 i I From:PAINTS AND COATINGS 2399977117 07/2012012 14:33 #342 P.002/002 AFFYDAVIT OF TNTHGRITY AND WOD CHAUCTER am a resident of i, Ze- County, �� d�!`� (State) and have resided here for more than five (5) years. During the last five years I have known l f ' �indlinA applicant), I have had the opportunity to observe his or her business and personal ea ' a and find hinn or her to be Wpersan honesty, integrity and good character. (Signature) (Name) °. (Address) -.2j'I ft -rex �a-._ �i. ss9oS melephone) �G3'%' io'�+ STATE OF FLORIDA COUNTY OF The foregoing Instrument was acknowledged before me this ,�° U Eby (Dane) _ y 6 who aa�pre CSa��.(l Kt'0vd (name of person acknowledging) (Type of iden afication) an identification and who did not take an 09th. NOTA,RY'S SEAL NOTARY PUBLIC -STATE OF FLORIDA Melissa Jean Giusdna °Commission # EE025046 Expires: SEP. 12, 2014 BOPIDID THRL' ATI.ANITC BONDLNG CO., INC. (PUNT NAML OF NOTARY) NOTARY PUBLIC 8 i VERIFICATION OF CONSTRUCTION EXPERIENCE, GMD Operations & Regulatory Management Department Licensing Section 2800 N. Horseshoe Drive Naples, FL 34104 Applicant's Name:- i ,�_ 1,4_\ C1 Certificate Category Requested: Y f t'�` The Applicant is seeking a Collier County Certificate of Competency in the trade indicated above. As part of the application for this certificate the Applicant must verify their experience within this trade. You are being requested to provide information that will aid the Applicant in meeting this requirement. You should verify time of active experience working as an apprentice or a skilled worker (e.g. as a worker commanding the wage of mechanic or better in the trade). Time served solely in a supervisory or administrative role should be described, but may or may not be considered sufficient to demonstrate required trade experience. The person verifying trade experience must provide the following information: Name, Title and license number of the person signing below and verifying Applicants relevant experience: Name: _ 1(ly / Title: H f E I C '_ // > 1hK12IA/ N111 e� Number (if applicable): Name of Business: )�`� C� r�� '✓ (C� Business Address: 1614 1:5) rlceL L T7-zf c a cs Business Phorid n _C;y;� } - 31o� J`( The Applicant's years of experience from c`Z -CSC ;r �i&f L,> f L 1'-17&75 The applicant's scope of work (specific duties) included: /� %�5�� C' V�/OOGS Additional Comments: % % Oi�%�l'f fJ%i��`f7� / ✓/1�/!t�''1 t1�i�� Falsifying any information provided herein may subject your license to revocation. Signature Print Nan vs State of Florida County of Collier The fq egoing jnstru nt w s acknowledged before me on this 0"" day of �J C.� �� G� by _ , ! who is personally known to me or produced Y l i Gtr �ti Fes) as identification and- o did not take an oath. NOTARY PUBLIC -STATE OF FLORIDA Signature of Notary Melissa Jean Giustim Commission # EE025046 +,,,,,.• Expires: SEP.12,2014 BONDED 7URU ATLA1177C BONDL�4G CO., INC. AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I AAJam`% 0 %T am a resident of County, f"C U2//�1� (State) and have resided here for more than five (5) years. During the last five years I have known JL 0-, (Applicant), I have had the opportunity to observe his or her business and personal eali and find him or her to be a person of honesty, integrity and good character. / (Signature) (Name) )& . \' D ut -E )i (Address) ��( -�fA -TE,?�xz Telephone) STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this AA `�1 by ' ` (Date) who has produced J ` (VI-) (name of person acknowledging) (Type of identification as identification and who did not take an oath. SIGNATURE OF TARY k-ssk J ( "4 I� NOTARY'S SEAL (PRINT NAME OF NOTARY) NOTARY PUBLIC NOTARY PUBLIC -STATE OF FLORIDA Melissa Jean Gius Commission # EE025046 ,.••` Expires: SEP.12, 2014 BONDED THRD ATLAN1nC BONDING Co., INC. Forn, W`9 Request for Taxpayer Give form to the (Rev. October 2007) Identification Dumber and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Servi" Name (as shown on your Income tax return) N m m a Business name, if different from above o Paints & Coatings, Inc. m Check appropriate box: ❑ Indivlduai/Sole proprietor Corporation F-1 Partnership Exempt p �.o 16 ► ❑ Limited Gabiliiy company. Enter the tax classification (O= disregarded entity, C= corporation, P= partnership) .. _... _ ❑ ` o ❑ Other (see instructions) ► payee Address (number, street, and apt. or suite no.) Requester's name and address (optional) a a 17660 East Street CD City, state, and ZIP code to North Fort Myers, FL 33917 List account number(s) here (optional) • Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid Social security number backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part 1 Instructions on page 3. For other entitles, it is your employer identification number (EIN). If you do not have a number, see Now to get a TIN on page 3. or Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose Employer identification number number to enter. 65 0754628 Certification Under penalties of perjury, I certify that: 1. The number shown on this forth is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. 1 am a U.S. citizen or other U.S. person (defined below). Certification instructions. You must cross out Rem 2 above it you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all Interest and dividends on your tax return. For real estate transactions, Rem 2 does not apply. For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. See the Instructions on page 4. $IQn Signature of / �,[ / _0 l Here U.S. person A,Z A111 Lin. I, A>A ��L Date ► �/,11i /a/iA /w 47 General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W -9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income. Note. If a requester gives you a form other than Form W -9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W -9. Definition of a U.S. per . For federt (;�c purposes, you are considered a U.S. person you are: • An Individual who is a U.S. citizen or U.S. resident alien, • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, • An estate (other than a foreign estate), or • A domestic trust (as defined In Regulations section 301.7701 -7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners' share of Income from such business. Further, in certain cases where a Form W -9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, N you are a U.S. person that is a partner In a partnership conducting a trade or business in the United States, provide Form W -9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income. The person who gives Form W -9 to the partnership for purposes of establishing its U.S, status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases: • The U.S. owner of a disregarded entity and not the entity, Cat. No. 10231X Form W -9 (Rev. 10 -2007) z i v V D rn z z r V o � rn � om � �» - cmz�' mcnG)R° Imo mCD3 n v n r z 1 V D V z n p m" O n O C z -q z c o� m 0 0 Ul Go A n A C z 4 m X V ro m N CO) m M I m m CA) 0 N O N r m rn n O C Z r O oa jr c o� j Nrn n m Z � Ul CD r � n v n m OD 1 XN Q = W "� 7 o y !� xD co N V N rh m tD Z U) o -4 z a m W c r r v o o 0 o z 0 o V p m" O n O C z -q z c o� m 0 0 Ul Go A n A C z 4 m X V ro m N CO) m M I m m CA) 0 N O N r m rn n O C Z r O oa jr c o� j Nrn n m Z � Ul CD r � n �� n m OD 05' c N Q M 41 "� 7 o y !� xD N o. m m A m U) 0 z m m G) c 0 p m" O n O C z -q z c o� m 0 0 Ul Go A n A C z 4 m X V ro m N CO) m M I m m CA) 0 N O N r m rn n O C Z r O oa jr c o� j Nrn n m Previous on List Next on List Return To List No Events No Name History Detail by Entity Name Florida Profit Corporation PAINTS & COATINGS, INC. Filing Information Document Number P97000034567 FEl /EIN Number 650754628 Date Filed 04/16/1997 State FL Status ACTIVE Principal Address 17660 EAST STREET N FT. MYERS FL 33917 Changed 04/06/2009 Mailing Address 17660 EAST STREET N FT. MYERS FL 33917 Changed 04/06/2009 Reaistered Aaent Name & Address LAQUIDARA, CARL 17660 EAST STREET N FT. MYERS FL 33917 US Address Changed: 04/06/2009 Officer /Director Detail Name & Address Title PTD LAQUIDARA, CARL 17660 EAST STREET N FT. MYERS FL 33917 Title VSD MINGLING, JEFF 17660 EAST STREET V FT. MYERS FL 33917 Annual Reports :)f 2 7/20/2012 2:59 PM Report Year Filed Date 2009 04/06/2009 2010 05/05/2010 2011 04/29/2011 Document Images 04/29/2011 --ANNUAL REPORT View image in PDF format 05/05/2010 -- ANNUAL REPORT View image in PDF format 04/06/2009 ANNUAL REPORT View image in PDF format 01/11/2008 ANNUAL REPORT View image in PDF format 01/09/2007 -- ANNUAL REPORT View image in PDF format 05/31/2006 ANNUAL REPORT View image in PDF format 05/02/2005 ANNUAL REPORT View image in PDF format 04/29/2004 -- ANNUAL REPORT View image in PDF format 01/27/2003 ANNUAL REPORT View image in PDF format 03/25/2002 -- ANNUAL REPORT View image in PDF format 04/24/2001 --ANNUAL REPORT View image in PDF format 01/19/2000 -- ANNUAL REPORT View image in PDF format 02/05/1999 ANNUAL REPORT View image in PDF format 07/14/1998 -- ANNUAL REPORT View Image in PDF format 04/16/1997 -- Domestic Profit Articles - View image in PDF format Note: This is not official record. See documents if question or conflict. Previous on List Next on List Return To List No Events No Name History I Home I Contact us I Document Searches I E- Flling Sarywres I Forms I HE1Q I Copyright ® and Privacy Policies State of Florida, Department of State Entity Name Searci Submit if 2 7/20/2012 2:59 PM I 10 m m Ol • • C-4 H Cif z z C7 ci 0 tij z 0 .40 3: m0 En > me OZ ou r o Pi ■ NNill ■ ■ ■ wa , rx rim c;; Findings of Fact, Conclusions of Law and Decision of the Board Collier County Contractors' Licensing Board For Applications Submitted to the Board for Review Type of Application: X Credit Report Review Waiver of Testing Requirements Reinstatement of License Request to Qualify Second Entity Other (specify) THIS CAUSE came on for public hearing before the Contractors' Licensing Board (hereafter Board) on May 18, 2011 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 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 Nelly A. Nava submitted an application to the Collier County Contractor Licensing Supervisor or his designee on May 18, 2011 which was deemed by the Contractor Licensing Supervisor to require review of credit report. 2. That pursuant to section 22 -184 (b) of the Collier County Contractors' licensing ordinance (Ordinance 90 -105, as amended) applications which do not appear on their face to be sufficient requires 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 Nelly A. Nava was present at the public hearing and was not represented by counsel at the hearing on Ma Y 18, 2011. 1 JUN -19 -2012 15:39 Credit Check 561 616 5553 P.02 J� CONFIDENTIAL R. T HE C Individual Credit Report ame,...: NAVA, NELLY A. Ordered By: dress s 2334 ARBOUR WALK CIRCLE #1017 Customer 9999 NAPLES, FL 34.109 Received :06/1$/12 Completed :06/16/12 3czal #! Ar�plicant 8111. Amt $60.00 CREDIT RECORD :redit history has been checked for a eriod of seven ears or from open date. Czetiieer Recount Number Date py opened Credit &alanea pDue Terms 3psto93 star 90 Etatust Rcv EcQ4 Ra rtod [ERICAN EXPRES (EFX) 05/12 09/016 11213 9531 9531 285 - cOLLECTIaN ,NX OF AMERICA (EFX) 06/09 01/07 0 FA1p 0 AS AGREED REV 00 00 00 R1 31 A ,P ONE (TU ) LA =12/02 12!02 0102 59 PAID 0 REV 0a o0 00 AS AGREED R 03 A. ASE (TU ) 4A -11/05 05106 02/03 495 'AID 0 REV 0000 00 S AGREED A rl CTB (TU y ) :,A -03/07 07/09 10/03 6143 PAID 0 REV 00 00 00 RS AGREED A ?I (TU ) 11/07 10/99 0 PAID 0 S AGREED ,A-05/07 REV 00 00 00 R A .L CONNECT (TU ) CIALTS005036201 06112 05/10 79 3.04 104 COLL COLLECTION GINAL CREDITOR: ALTERNATIVE WEB MEDIA - -- _" 09" 09" 02 A VERGENT (TU ) 564495 07/11 105/11 691 691 691 CALL - COLLECTION SINAL CREDITOR. SPRINT - -` `- 09'* 00 ,A, TERN CU (TU ) :8526201 02/09 01/04 32214 CLOSED 0 Pb WAS 30 =02/09 0 03 00 00 11-* 48 C ed'6y: APPLICANT - SEE NAME ABOVE rt[ng Agency: Credit Check. [nc. , ani 7 P;tinhanj%m r-'..,..4 6..:4 u I.,_ _..... SUN -19 -2012 15 :40 Credit Check 561 616 5553 P.013 , �I CH. oHFrar= NTr�a►L 3me....: NAVA, NELLY A. Customer! 9999 Page: 2 CREDIT RIEC4RD ,t redit history has been checked for a eriod of severs ears or from d en date. Creditor pate Date Nigh Ac =Cunt f0irtber Reported Opened Credit Unpaid east poy Balance Due UrIms Kiatoric Stat Cuzrent V&* 30 60 90 Status Rev ECOA :DORADO FRN (TU ) E77442105051 09/09 07/07 0 )LA =09/09 PAID 0 REV AS AGREED 00 00 00 Ri 02 A TERHOME MORTGA (EFX) 409000452776 10/10 07/03 152000 0 0 0 FORECLOSURE 0501 26 X-5-* 83 J :NGERHUT/METAB, (EFX) 05/12 08/07 329 0 0 REV AS AGREED 0000 00 R1 27 A ,CRB /SAMS CLUB (EFX) 06/12 06/03 543 0 0 REV AS AGREED 0000 00 R1 99 A CRB /WALMART (EFX) 06/12 09/02 1083 CLOSED 0 REV AS 0000 00 R1 AG 99D A CRB /CITY FURN (EFX) 03/10 08/05 401 401 403. 12 COLLECTION -- -- -- R9.* 55 A CRB /CARE CRED (,EFX) 07/09 11/07 0 PAID 0 REV PD COLLECT -- --- -- R9-* 20 A SC GATEWAY (EFX) ] 08/09 01/06 1817 PAID 0 REV AS 00 00 00 R1 AGR4E3 D A R INC (TU } 382122 04/12 10/08 1215*5 CGINAL CREDITOR: FIRST EQUITY 15461115460 CULL _ COLLECTION - -- -- C9-* 04 A "- Y's /DSNB (EFX) ' 05/12 04/03 0 0 0 REV CUR WAS 30 0100 00 R1 -* 99 A )ICAT4 (EFX) 44706 06/12 04/11 3912 3822 3812 0 _ - -_ COLLECTION -_ -T9-* 01 A )LAND FUND (TU ) 32841557 05/12 09/09 1175 GINAL CREDITOR: CITIBANK 1550 1559 COLL 4 COLLECTI ©N - _- __ 095-* 03 A GLAND FUND (TU ) 33297360 05/12 12/09 3906 GINAL CREDITOR: CITIBANK 4955 4955 COLL -- OL E T A O C TFOLIO RC (TU ) L9182303212841 06/12 05/09 5665 GINAL CREDITOR: GE MONEY SANK 6851 6851 COLL -- CCOL* ECTIO -- -_ A red by: APPLICANT - SEE NAME ABOVE -rting Agency: Credit Check. Inc.. 3017 Fvt-hnnem r.r%,#r4 o..u- Lj iA!__. r._,__ JON -19 -2012 15 :40 Credit Check 561 616 5553 P.04 %.-e.LvA1:LJIT SM Dr HE%., CONFIDENTIAL ame....: NAVA KELLY A. Customer; 5999 Page: 3 CREDIT RECORD '.relit history has been checked fora Period of seven years or from o en date. cxeditcr DaCe ;Mte High Unpaid rant Account Hunber Reported opened credit 8aance hue Fa kt08 Y HiBto60 $L90 Tetnd 3t1 status 50 90 5Larus Rev ECC?. iGIONS BANK (TU ) 02/04 05/03 22894 CLOSED 0 AS AGREED 0 00 00 00 21 )LA =02/04 09 P .AR$ /CBNA (TO } ►LA,xO /08 ARS /CBNA (TU ) LA =10/08 ARS /CBNA (TO } LA= 12/05 ARS /CBNA (TO 12/09 06106 3906 PAID 10/09 11/05 06/12 02/04 2234 PAID 414 CLOSED 05/12 02/04 551 CLOSED LA =12/05 4,CE COAST CRE (EFX) 128526221 04/1.2 02/05 11823 CLOSED 0 REV 0 REV -- -- 0 REV 00 00 00 0 REV 00 00 00 PD COLLECT R!�-* 04 A PD COLLECT RS-* 04 A AS AGREED R1 48 A AS AGREED Ri 48 A AS AGREED 1:1 38 M Total trade lines on this re ort:'29 SLIC RECORDS; 3LIC RECORDS HAVE BEEN CHECKED AT THE COUNTY, STATE AND FEDERAL LEVELS WITH FOLLOWING RESULTS. CLEAR AS OF 06/18/12. IRCE($): EQUiFAX TRANSUNION WRIES: 18/12 by CREDIT CHECK (TU) #00630273 20/12 by GECRB (TU) #01263431 LAMENTS: UD RECORDS HAVE BEEN SYSTEMATICALLY CHECKED BY THE ABOVE ACCESSED BUREAUS. ESCAN /EQUIFAX, HAWS; ALERT /TRANSUNION CHECKED FOR FRAUD. * SEE BUSINESS REPORT CON: J.H. COUNTERTOP INNOVATION", INC. 0RT WORKED BY RENEE DIT SCORE: 'ed by; APPLICANT - SEE NAME ABOVE rting Agency. Credit Check, Inc. - 3017 FxMannom r1jmior4 JUN -19 -2012 15:41 Credit Check 561 616 555; P.05 .I[ CHE .IQIF[i�VT�AL alne...... NAVA, NELLY A. Customer; 9999 Pager 4 REDIT SCORE: 'PLICANT FICO CORE: 603 (sores range from 300 to 850) * ** END OF REPORT * ** Yhrt pwaafM a part tt fiAr lrsd This irlamaW- Is oanAft" OM to e4 is be dlvulped w ad as rKulnw by iM Falr Credlr Raporyt Act The axuracy fa se fti4, harre Yia h ro m enan � &iI dWrabiltty of the rAAcangsj. Oil bCSad oup�enn krfamedar+ obmb�nd 1rI paptl fslh try Crle e4er1 CY Z: aaur�aae ddwoo tellable. *ay BY W aat PWsCe and un of IN* rspaL you AptoAOWV %M la Wo Cmdll Cheal4 tne. rlatnlecs llam anY Atdillly wheleoevm. red by: APPLICANT - SEE NAME ABOVE rf ng Agency., Credit Check. Inc. - 3017 ExchnnMA f"nurrf u W—..w JUN -19 -2012 15 : "41 Credit Check CREDIT CHEt1YA****"� Commercial Credit Report ompany: J.H. COUNTERTOP TNNOVATIONS, INC. Address: 2334 ARBOUR WALK CIRCLE, SUITE 1017 NAPLES, FLORIDA 34109 0ephone: niIVUIrHLZi: RESILIENT /DIRECTOR ddress: Ociail Security Number: tuck Ownership: ICE PRESIDENT /DIRECTOR ddress: acial Security Number. :ock Ownership: Jdress: 7ciall Security Number: ock Ownership: (dress: ►vial Security Number: ock Ownership: 561 616 5553 P.06 CONFIDENTIAL Date: 06/19/12 Cust. No.: 9999 Price. $9o.00 Ordered By: Page: 1 W Corporation EIN: 27- 4136909 NAVA, KELLY A. 2334 ARBOUR WALK CIRCLE, SUITE 1017 NAPLES, FLORIDA 34109 50% ALMEIDA, JORGE 2334 ARBOUR WALK CIRCLE, SUITE 1017 501 U. COUNTERTOP INNOVATIONS, INC. was INCORPORATED in the cOunty of COLLIER, state FLORIDA, ©n 02/02, 2011. The charter number is P11000011386. The registered ^nt is NAVA, WELLY of 2334 ARBOUR WALK CIRCLE, SUITE 1017, NAPLES, FLORIDA 109• Offices are OPERATED from APPLICANT'S RESIDENCE (HOME- BASED) at N/A per -1th. The company employs ONE (1). T WORTH: ON FILE W11'H STATE company maintains banking relations with SUNTRUST BANK officer handling the account i5 N/A - NAPLES, FLORIDA )orted for: APPLICANT - SEE NAME ABOVE forted by: Credit Check, Inc. - 3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 61&5656 SUN-19-2012 15:41 Credit Check 561 616 5553 P.O? T f�l E sm CH %.IJM CONFIDENTIAL Commercial Credit Report Company: J.H. COUNTERTOP INNOVATIONS, INC. Date: 06/19/12 Address: 2334 ARBOUR WALK CIRCLE, SUITE 1017 Cult. No.: 9999 Price. $90.00 NAPLES, FLORIDA 34109 Ordered By: Page: 2 PUBLIC RECORDS WERE CHECKED FOR COLLIER COUNTY, FLORIDA. A SEARCH OF COUNTY, STATE, AND FEDERAL RECOR13S HAS BEEN CONDUCTED WITH THE FOLLOWING RESULTS: CLEAR As AF 06/19112 - SEVEN YEAR SEARCH. Credit Profile rm I Creditor -�Qpened High Balance Rating FAXED 'EMARKS, 112% = NOT APPLICABLE/NOT AVAILABLE *** SEE INDIVIDUAL REPORT ON: NAVA, NELLY A. EPORT WORKED BY RENEE ND OF REPORT. MIS 0*1"Orclol 1Z w *M 41d In deWm 000K doWnouty of we Tf-,— 29r4w= M3 Gra"*M�S)' ""Ovm vok'"d w4=04noww TnT01 P M7 0 4 r 4. That Nelly A. Nava was required by the Board to appear at the next scheduled hearing six months or more after the hearing on May 18, 2011 for review of changes, if any, in his credit report. 5. All notices required by Collier County Ordinance No. 90 -105, as amended, have been properly issued. 6. The facts in this case are found to be: a. Applicant has submitted adequate documentation and testimony in support of his company's credit report in that his licensure will not result risk of economic loss resulting from the contractor's inability to pay his lawful contractual obligations, subject to her satisfaction of the terms set out herein. b. Credit report does meet the standards of Florida Rule 61G4- 15.006 for Financial Responsibility. C. It is appropriate for the Applicant to be restricted to a countertop license. CONCLUSIONS OF LAW 1. Based upon the foregoing facts the Board concludes that the applicant has met the standard set out in Ordinance 90 -105, as amended, subject to the restrictions and stipulations set out herein. 2 ORDER OF THE BOARD 1. Based upon the foregoing Findings of Fact and Conclusions of Law, and pursuant to the authority granted in Chapter 489, Florida Statutes, and Collier County Ordinance No. 90 -105, as amended, by a vote of 7 in favor and 1 opposed, a majority vote of the Board members present, the Applicant's credit report is approved so that a license may be granted subject to the following conditions: a. One year probationary license restricted to countertop only. b. Provide an updated credit report to the Contractors' Licensing supervisor six (6) months from the date of the hearing and one (1) year from the date of the hearing for review. Contractors' Licensing Supervisor may submit said reports to the Board for further review and action in his discretion. c. Applicant shall submit workers' compensation insurance documentation and reports to insure coverage that is appropriate and in compliance with all applicable laws. d. Applicant shall seek the assistance of a non - profit or not -for- profit credit counseling agency to assist in resolving credit issues. 3 ORDERED by the Contractors Licensing Board effective, the 18th day of May, 2011. 411) -72;�_ Kyle Lantz, Chairman Contractors Licensing Board I HEREBY CERTIFY that a true and correct copy of the above and foregoing Findings of Fact, Conclusions of Law, and Order of the Board has been furnished the Applicant, and Michael Ossorio, Licensing Compliance Supervisor, 2800 North Horseshoe Drive, Naples, FL 34103 on this 5th day of July, 2011. Sec etary / Contractors Licensing Board In 12/05/2011 16:50 3052310711 WORLD OF INSURANCF PAGE 03/03 ^'C.. ` DATEfMMMD"YI CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF -IN-FORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETVVEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATWE OR. PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: It the "IrtIficate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. V SUSROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does vot confer rights to the certificate hOldtf in lieu of such endarsemerot(s). PRODUCER World Of Insurance Agency 18600 NW 87 AVE Unit 105 Mlaml Lakes, FL 33015 _Phone (305} 231 -1111 Fax 231-0711 CONTACT NAMP-1 Katy FAX Celisouth.not ADORL SS, r1d0limb IN$VRER(SlAFM0iNe,1iCOvERA0q INSURER A; Ascendant Commercial Insurance, Inc INSURER 8: NAIC*.. — -. INSURED J H Countertop Innovations Inc INSURER C.- 2334 Arbour Walk Cir #1017 INSURER P Naples, FL 34109 (239) 27$-7785 INSURER E. . ... .. INSURER F;. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPtCT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAW. INSR ADD L SUBM TYPE OF INSURANCE MBER INSR iiF POLICY iv LIMITS OMMI MID -EACH OCCURRENCE 000.000,00 COMMFRrAAL GENERAL L1ARAITrY TO RENTED PREMISES (E, =j4r.mt,;p1_ I 100,0M.00 ❑ ❑ CLAIM&MADE R] OCCUR GL-373M.0 A LEXPLAfty�ovepe!nj_ $ F-1 03121/2011 0313112012 PEP.-SONAL & ADV INJURY t, 1.000,000.00 r-1 GErJERAL AGGREGATE S 1,000,OUO, 00 GEN'L AGGREGATE LIMIT APPLIES PER; PRc)- COMPIOP AGG ❑ PoLr-y ❑ Loc $ AUTOMOBILE LIABILITY COFABINED IfING�LEUMIT ANY AUTO BODILY INJURY Pm pmsson) S ❑ ALL OWNED XHEDULED AUTOS ❑ AUTOS DODILY INJURY (Per sariden[ S ❑ NON-QWNED MR ED AUTOS ❑ AU 06 .Z RAMAGIE S 7MCIPER UMBRELLA LIAR OCCUR EACH 0=RRF-NCG ❑ rixcrivs LiAB EICLAIMS -MALE AO(;REGATFm ❑ OED- ❑ RETENTION 5 Wt) `AFC STATIJ- AND EMPLOYERS LIABILITY YIN ANY PROPMOMMARTNEFIVEXECURVE OFFICERWEIVISER EXCLUDED? NfA EACH ACCIDENT (Narldste-ty in NH) L J L. DISEASE - EA EMPLOYE 6 lAdetefibe under 0 RIFMON OF OPERATIONS below DISEASE POI-ICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addiflonal ReIMMa Schedule. IF n*m space is required) TILE, STONE, MARBLE, MOSAIC OR TF-RRA70 WORK INTERIOR CONSTRUCTION. CERTIFICATE HOLDER CANCELLATION COLLIER COUNTY 2800 HORSESHOES ()RIVE NAPLES, PL ScO4 Attn: Michael Osodo or Jennifer Blanco Fax 239-252-2469 SHOULD ANY OifMDESCRICED POLICIES BE CANMLeD BEFORE iL a THE EXPIRATIO F, NOTICE WILL BE DELIVERED IN ACCMIDANGE11 PROVISIONS, ACORD 26 (2010105) OF OT&4MAWWCORPORATION, All rights reserved. The D name and top are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE 12/5/2011 Producer: Lion Insurance Company This Certificate is issued as a ratter of information only and confers no rights 2739 U.S. Highway 19 N. upon the certificate Holder. This Certificate does not amend, extend or alder Holiday, FL 34691 the coverage afforded by the policies below. (727) 938 -5562 Insurers Affording Coverage NAIC # Insured: South East Personnel Leasing, Inc. & SubsidiarieE Insurer A: Lion Insurance Company 11075 2739 U.S. Highway 19 N. Insurer 6: Holiday, FL 34691 Insurer C: Insurer D: Insurer E: Coverages The policies of insurance listed below have been issued to the insured named above for the policy penod indicated. NoNnthstanding any requremerq fern or corgition of any contract or other doament Wth respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terns, exclusions, and oorditions of such policies_ Aggregate limits shwm may have been reduced b paidclaims. Y Y INSR ADDL Policy Effective Policy Expiration Date LTR INSRD Type of Insurance Policy Number Date Limits (MM /DD/YY) (MM /DD/YY) GENERAL LIABILITY EachOcaitence Commercial General Liability Damage to rented premises (EA Claims Made Occur fence) Med Erp General aggregate limit applies per. Personal Adv Injury Policy Project ❑ LCC General Aggregate Products - CoffVOpAgg UTOMOBILE LIABILITY Combined Single Limit Any Auto (EA Accident) AM Owned Autos Bodily Iryury Schedded Autos (Per Person) Hired Autos Bodily Injury Non -Owned Auras (PerAccidert) Property Damage (Per Accident) EXCESS /UMBRELLA LIABILrrY Eachrourrence 11 Occur a ClaimoMade Aggregate L1edl.nbre A Workers Compensation and WC 71949 01/0112011 01/01/2012 X I WC Statu- OTK Employers' Liability tory Limits ER Any proprietor /padmr /executive officer/member E.L. Each Accident $1,000,000 excluded? If Yes, describe under special provisions below. E.L. Disease - Ea Employee $1,000,000 E.L. Disease - Policy Limits $1,000,000 Other Lion Insurance Company IS A.M. Best Company rated A- (Excellent). AMR # 12616 Descriptions of Operations /LocationsNehicles/Exclusions added by Endorsement/Special Provisions: Client ID: 82-65 -212 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company ": J.H. Countertop Innovations, Inc. Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s) , while working in Florida. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937 -2138 or by calling (727) 938 -5562. Project Name: ISSUE 09 -06 -11 (SD) / REISSUE 12 -05-11 (TD) Begin Date CERTIFICA7'& HOLD6t't CANCEt1A1'If)N COLLIER COUNTY CONTRACTOR 1_I7MINr. SMtki Ary amt above described policleeliecancelled boforo lire eViratien date thereof, the isaring insurer will endeavor to mail 30 days written notice to the certificate holder named to the left brit failure to do so shat impose no obfigafion or liability of any Idnd upon the insurer, its agerds or representatives. 2800 N. HORSESHOE DR NAPLES, FL 34104 - I V. rvcny rage Z or 0 2011 -12 -06 14:17:33 (GMT) 15616165553 From: Renee Lodes SM C-1-IRVEDIT ��CK CONFIDENTIAL Individual Credit Report Name....: NAVA, NELLY AMERICA Ordered By: Address : 2334 ARBOUR WALK CIRCLE Customer :9999 NAPLES, FL 34105 Received :12/06/11 Completed :12/06/11 Social #: Applicant: Bill Amt : $60.00 CREDIT RECORD (Credit history has been checked for a period of seven years or from open date.) Crcd itos Datc Da tc 3igi Unpaid east Pey 3i6toric stet Cu -'=Cnt Kos Rccoant tdum aer Repor tec C?e.iec Crerit 3sia_7ce Due Te_ms -10 50 90 Sts t-js Rev 3C0Il AMERICAN EXPRES (EFX) COLLECTION - 11/11 09/06 11213 1037210372 311 -- -- -- R9-* 24 A BANK OF AMERICA (EFX) AS AGREED OR /09 01/07 0 PAID 0 REV 0000 00 R1 31 A CAP ONE (TU ) AS AGREED 12/02 09/02 59 PAID 0 REV 0000 00 R1 03 A DLA =12/02 CHASE (TU } AS AGREED 05/06 02/03 495 PAID 0 REV 0000 00 R1 39 A DLA =11/05 CITI CTB (TU } AS AGREED CITI (TU ) AS AGREED COLL CONNECT (TU ) C OLLECTT614 TCCIALT8005036201 12111 05/10 79 100 100 COLL -- -- -- 09-* 01 A ORIGINAL CREDITOR: ALTERNATIVE WEB MEDIA CONCORD SVC (TU ) PASTDUE120 2870000 06/11 07/00 893 893 893 74 0000 02 05-* 25 C DLA =10/08 CONVERGENT (TU } COLLECTION 79564495 07/11 05/11 691 691 691 COLL -- -- -- 09-* 00 A ORIGINAL CREDITOR: SPRINT Ordered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, Inc. - 3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616 -5556 I i V. rvcny rage a or o 2011 -12 -06 14:17:33 (GMT) 15616165553 From: Renee Lodes CON FIDENTIAL CRELY) T CHE%..'JL%. Name....: NAVA, NELLY AMERICA Customer: 9999 Page: 2 CREDIT RECORD (Credit history has been checked for a period of seven years or from open date.) CYeCitO_ Accoant Nu. *er Date Reoor tel ➢r;t= O?ene., H1 :, C °ecit Uno_r;ic 3a Ia•r.:e Fast Fay Historic Due Te -3 60 Stet Current Mos go .i0 Stat75 Sec E Ol EAF LLC (TU ) COLLECTION 4312460 11/11 11/09 402 402 402 COLL -- -- -- p9-* 02 A ORIGINAL CREDITOR: GE CAPITAL CORP EASTERN CU (TU ) PD WAS 30 9528526201 02/09 01/04 32214 CLOSED 0 0 0300 00 I1 -* 48 C DLA =02/09 ELDORADO FRN (TU ) AS AGREED 577442105051 09/09 07/07 0 PAID 0 REV 0000 00 R1 02 A DLA =09/09 EVERHOME MORTGA (EFX) FORECLOSURE 1409000452776 10/10 07/03 152000 0 0 0 0501 26 M5-* 83 J FINGERHUT /METAB (EFX) AS AGREED 11/11 08/07 329 0 0 REV 0000 00 R1 21 A GECRB /WALMAR (TU ) 11 /11 09/02 1083 CLOSED 0 REV 0000 AS AGREED 00 R1 48 A DLA =07/07 GECRB /SAMS CLUB (EFX) AS AGREED 11/11 06/03 543 0 0 REV 0000 00 R1 99 A GECRB /CITY FURN (EFX) COLLECTION 601919020560 03/10 08/05 401 401 401 12 -- -- -- R9-* 55 A GECRB /CARE CRED (EFX) PD COLLECT 6019182303212841 07/09 11/07 0 PAID 0 REV -- -- -- R9-* 20 A HSBC GATEWAY (EFX) AS ACRFFD 50.1621- 0100253851 08109 01/06 1817 PAID 0 REV 0000 00 R1 43 A LHR INC (TU ) COLLECTION 2382122 10/11 10/08 12155 1509715097 COLL -- -- -- 09-* 03 A ORIGINAL CREDITOR: FIRST EQUITY MACY'S /DSNB (EFX) CUR WAS 30 11 /11 04/03 0 0 0 REV 0100 00 R1 -* 99 A MIDLAND MCM (TU ) COLLECTION 11/11 09/09 1175 1494 1494 COLL -- -- -- 09-* 02 A ORTGINAL CREDITOR: CITIBANK Ordered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, Inc. - 3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616 -5556 �� y rays r o1 0 2011 -12 -06 14:17:33 (GMT) 15616165553 From: Renee Lodes C('71-IrEEK" CONFIDENTIAL Name....: NAVA, NELLY AMERICA Customer: 9999 Page: 3 CREDIT RECORD (Credit history has been checked for a Reriod of seven years or from open date.) Crec itor Zccoant NumoeT Date Date Reportec ^pe-iec Hi =,_i C -ecit Unpeic pest Fay Historic Stet Current >fos 3a I a•icF Due T -•ns .i0 60 90 Statjs Rev FCOA MIDLAND MCM (TU } 11/11 12/09 3906 4741 4741 COLL -- -- -- COLLECTION 09-* 02 ORIGINAL CREDITOR: CITIBANK A PORTFOLIO RC (TU ) COLLECTION 6019182303212841 11/11 05/09 5665 6623 6623 COLL -- -- -- 09-* 03 A ORIGINAL CREDITOR: GE MONEY BANK REGIONS BANK (TU ) AS AGREED 02/04 05/03 22894 CLOSED 0 0 0000 00 I1 09 P DLA =02/04 SEARS /CBNA (TU ) DLA -10/08 SEARS /CBNA (TU } DLA =10/08 SEARS /CBNA (TU } DLA =12/05 SEARS /CDNA (TU ) DLA =12/05 PD COLLECT 12/09 06/06 3906 PAID 0 REV -- -- -- R9-* 04 A PD COLLECT 10/09 11/05 2234 PAID 0 REV -- -- -- R9-* 04 A AS AGREED 11 /11 02/04 551 CLOSED 0 REV 0000 00 R1 48 A 11/11 02/04 414 CLOSED 10 /11 02/09 11823 3146 AS AGREED 0 REV 0000 00 R1 48 A AS AGREED 0 387 00 00 00 I1 32 M Total trade lanes an this repQrt; ;iq PUBLIC RECORDS: PUBLIC RECORDS HAVE BEEN CHECKED AT THE COUNTY, STATE AND FEDERAL LEVELS WITH THE FOLLOWING RESULTS: CLEAR AS OF 12/06/11. SOURCE(S): EQUIFAX TRANSUNION INQUIRIES: 12/06/11 by CREDIT CHECK (TU) #00630273 COMMENTS: Ordered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, Inc. - 3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616 -5556 i u. welly rage o OT !D 2011 -12 -06 14:17:33 (GMT) 15616165553 From: Renee Lodes SM I T CHE CK CONFIDENTIAL Name....: NAVA, NELLY AMERICA Customer: 9999 Page: 4 COMMENTS: FRAUD RECORDS HAVE BEEN SYSTEMATICALLY CHECKED BY THE ABOVE ACCESSED BUREAUS. SAFESCAN /EQUIFAX, HAWK ALERT /TRANSUNION CHECKED FOR FRAUD. REPORT WORKED BY RENEE CREDIT SCORE: APPLICANT CREDIT SCORE: 570 (scores range from 300 to 850) * ** END OF REPORT * ** This information is confidential and is not to be divulged except as required by the Fair Credit Reporting Act. This personal report is furnished simply as an aid in determining the credit desirability of the appficaM�s). It is based upon information obtained in good faith by this agency from sources deemed reliable. The accuracy of same, however, is In no way guaranteed. By your acceptance and use of this report, you specifically agree to hold Credit Check, Inc. harmless from any liability whatsoever. Ordered by: APPLICANT — SEE NAME ABOVE Reporting Agency: Credit Check, Inc. - 3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616 -5556 � CHECK CONFIDENTIAL Individual Credit Report Name....: NAVA, NELLY A. Address : 2334 ARBOUR WALK CIRCLE #1017 NAPLES, FL 34109 Social #: Applicant: Ordered By: Customer :9999 Received :04/04/11 Completed :04/04/11 Bill Amt :S60.00 CREDIT RECORD (Credit history has been checked for a period of seven years or from open date.) Creditor Date Date High Unpaid Past Pay Historic Stat Current Mos Account Number Reported Opened Credit Balance Due Terms 30 60 90 Status Rev ECOi AMERICAN EXPRES (EFX) COLLECTION - 03/11 09/06 11213 11213 6929 336 -- -- -- R9-* 02 A BANK OF AMERICA (EFX) AS AGREED 6541 08/09 01/07 0 PAID 0 REV 0000 00 R1 31 A CAP ONE (TU ) AS AGREED 12/02 09/02 59 PAID 0 REV 0000 00 R1 03 A DLA =12/02 CARE CREDIT /GEM (EFX) PD COLLECT 07/09 11/07 0 PAID 0 REV -- -- -- R9-* 20 A CHASE (TU ) AS AGREED 05/06 02/03 495 PAID 0 REV 0000 00 R1 39 A DLA =11/05 CITI CTB (TU ) AS AGREED 07/09 10/03 6113 PAID 0 REV 00 00 00 R1 48 A I)LA= 03/0'/ CITI (TU ) AS AGREED 11/07 10/99 0 PAID 0 REV 0000 00 R1 48 A DLA =05/07 :=Y FURNITURE/ (EFX) COLLECTION 03/10 08/05 401 401 401 12 - - -- -- R9-* 55 A :OLL CONNECT (TU ) COLLECTION TCCIALT8005036201 03/11 05/10 79 93 93 COLL -- -- -- 09-* 01 A )RIGINAL CREDITOR: Al'H:RNATIVE WEB MEDIA )SNB MACYS (TU ) CUR WAS 30 476920300 03/11 04/03 0 0 0 REV 0100 00 R1 -* 48 A DLA =08/08 )rdered by: APPLICANT - SEE NAME ABOVE Zeporting Agency: Credit Check, Inc. - 3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616 -5556 ��ZEDIT CHECK Name....: NAVA, NELLY A. CREDIT RECORD CONFIDENTIAL Customer: 9999 Page: 2 (Credit history has been checked for a period of seven years or from open date.) Creditor Account Number Date Date Reported Opened High Unpaid Credit Balance Past Pay Historic Stat Current Mos Due Terms 30 60 90 03/11 06/03 543 Status Rev ECO; EAF LLC (TU ) DLA =02/06 COLLECTION 4312460 03/11 11/09 402 402 402 COLL -- -- -- 09-* 01 A ORIGINAL CREDITOR: GE CAPITAL CORP EASTERN CU ( TU ) 9528526201 DLA =02/09 ELDORADO FRN ( TU ) DLA =09/09 FVFRHOMF MORTGA (EFX) 02/09 01/04 32214 CLOSED 09/09 07/07 0 PAID 1409000452776 10 /10 07/03 152000 0 FINGERHUT /METAB (EFX) 03/11 08/07 329 0 GEMB /WALMART (TU ) PD WAS 30 0 0 03 00 00 I1 -* 48 C AS AGREED 0 REV 00 00 00 R1 02 A FORECLOSURE 0 0 05 01 26 M5-* 83 J AS AGREED 0 REV 00 00 00 R1 13 A AS AGREED 0 REV 00 00 00 R1 48 A GEMB /SAMS (TU ) AS AGREED 03/11 06/03 543 0 0 REV 0000 00 R1 48 A DLA =02/06 HSBC GATEWAY (EFX) AS AGREED 08/09 01/06 1817 PAID 0 REV 0000 00 R1 43 A LHR INC (TU ) COLLECTION 2382122 02/11 10/08 12155 1462114621 COLL - - -- -- 09-* 02 A ORIGINAL CREDITOR: FIRST EQUITY MIDLAND CRED (TU ) COLLECTION 03/11 09/09 1175 1406 1406 COLL - - -- -- 09-* 01 A ORIGINAL CREDITOR: CITIBANK 14IDLAND CRED (TU ) COLLECTION 03/11 12/09 3906 4445 4445 COLL - - -- -- 09-* 01 A 3RTGTNAT, CREDITOR: CITIBANK ?ORTFOLIO RC (TU ) COLLECTION 6019182303212841 01 /11 05/09 5665 6296 6296 COLL - - -- -- 09-* 02 A DRIGINAL CREDITOR: GE MONEY BANK ordered by: APPLICANT - SEE NAME ABOVE teporting Agency: Credit Check, Inc. - 3017 Exchange Court, Suite H, West Palm Beach. FL 33409 . (561) 61R -5558 CREDIT CHECK SM Name....: NAVA, NELLY A. CONFIDENTIAL Customer: 9999 Page: 3 SEARS /CBSD (TU ) DLA =12/05 12/09 06/06 3906 PAID 10/09 11/05 2234 PAID 03/11 02/04 03/11 02/04 551 CLOSED 414 CLOSED SPACE COAST CRE (EFX) 9528526221 02/11 02/09 11823 5568 PD COLLECT 0 REV -- -- -- R9-* 04 A PD COLLECT 0 REV -- -- -- R9-* 04 A AS AGREED 0 REV 0000 00 R1 48 A AS AGREED 0 REV 00 00 00 R1 48 A AS AGREED 0 387 0000 00 I1 24 M Total trade lines on this report: 28 PUBLIC RECORDS: PUBLIC RECORDS HAVE BEEN CHECKED AT THE COUNTY, STATE AND FEDERAL LEVELS WITH THE FOLLOWING RESULTS: CLEAR AS OF 04/04/11. SOURCE(S): EQUIFAX TRANSUNION INQUIRIES: 04/04/11 by CREDIT CHECK OF SOUT (EFX) 4465ZB00670 04/04/11 by CREDIT CHECK (TU) #00630273 04/04/11 by CREDIT CHECK (TU) #00630273 COMMENTS: FRAUD RECORDS HAVE BEEN SYSTEMATICALLY CHECKED BY THE ABOVE ACCESSED BUREAUS. SAFESCAN / EQUIFAX, HAWK ALERT / TRANSUNION (- HF( -KFD FOR FRAUD. REPORT WORKED BY RENEE CREDIT SCORE: Drdered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, Inc. - 3017 Exchanqe Court, Suite H. West Palm Beach, Fl IlAnq rj;F11 R1F_rrSR CREDIT CHECk M Name....: NAVA, NELLY A. CONFIDENTIAL Customer: 9999 CREDIT SCORE: APPLICANT CREDIT SCORE: 588 (scores range from 300 to 850) Page: 4 * ** END OF REPORT * ** This information is confidential and is not to be divulged except as required by the Fair Credit Reporting Act. This personal report is furnished simply as an aid in determining the credit desirability of the applicant(s). It is based upon information obtained in good faith by this agency from sources deemed reliable. The accuracy of same, however, is in no way guaranteed. By your acceptance and use of this report, you specifically agree to hold Credit Check, Inc. harmless from any liability whatsoever. a Ordered by: APPLICANT — SEE NAME ABOVE Reporting Agency: Credit Check, Inc: - 3017 Exchange Court. Suite H. West Palm Bearh FI 314ns (5611 Amss5F r BEFORE THE COLLIER COUNTY CONTRACTORS' LICENSING BOARD BOARD OF COUNTY COMMISSIONERS, COLLIER COUNTY, FLORIDA, CONTRACTORS' LICENSING BOARD Petitioner, IN Lucius B. Blackwell D /B /A — AAa Air Conditioning & Refrigeration, Inc. Respondent. Case Number: 2012 -09 License Number: CAC1816210 ADMINISTRATIVE COMPLAINT Collier County (County) files the Administrative Complaint against Lucius B. Blackwell( Respondent), a State of Florida licensed Air Conditioning Contractor ( license # CAC1816210), and states the following facts and allegations in support of the cited violations below: 1. The Respondent is currently licensed by The State of Florida as a Certified Class B Air Conditioning Contractor with License number CAC1816210. 2. Under the provisions of Florida Statute 489.113(4)(b) the Collier County Contractors' Licensing Board is authorized to impose penalties against State Certified Contractors for willfully violating Building Codes. 3. Under the provisions of Collier County Ordinance 90 -105, as amended, Section 22- 201.1, the following actions by a holder of a Certified Air Conditioning Contractors' License shall constitute misconduct and grounds for discipline pursuant to Section 22 -202. a. In June, 2012, Lucius B. Blackwell was issued a Notice of Noncompliance, for a violation of the 2010 Florida Building Code Section 105.1, for installation of an A/C system without required permitting. Collier County Building Official was notified. The State license (CAC1816210) qualifying AAa Air Conditioning & Refrigeration, Inc. has never registered with Collier County Building Department to pull permits. c. In May, 2012, a formal complaint was made against AAa Air Conditioning D& Refrigeration, Inc. by Gregg Governale for Marilyn Governale for not pulling a building permit which was installed on April 30, 2012. d. Thereafter, pursuant to Collier County Ordinance 90 -105, as amended, Section 22- 202(b) and Section 22- 202(c), the case was investigated and found sufficient cause to file formal charges. 4. Collier County brings the following charge in this formal complaint against the Respondent. COUNT 5. Collier County Ordinance 90 -105, as amended, Section 22- 201.1(2) states "Willfully violating the applicable building codes or laws of the State, City or Collier County ". WHEREFORE, the Petitioner asserts the above facts and charges are grounds for disciplinary action under Section 22 -201 of Collier County Ordinance 90 -105, as amended, and WHEREFORE, in consideration of the foregoing, the Petitioner respectfully requests the Collier County Contractors' Licensing Board to find the Respondent guilty of the violations charged. i Dated: 7� %2 Signed: Collier County Contractors' Licensing Supervisor or Designee C.L.B. Case #2012 -09 Lucius B. Blackwell d /b /a — AAa Air Conditioning & Refrigeration Inc. Table of Contents E1 /E3 — Formal Complaint E4 /E5 - Summary E6 —State D.B.P.R. Licensure Information E7 —Signed Notice of Hearing E8 — Returned Signed Registered Mail Receipt & Card E9 —Signed Notice of Noncompliance E10/E11— Invoice E12 — E -Mail to Mr. Blackwell at company e-mail E13 — E -mail to Tom DeGram, Building Official E14 — E -mail from Tom DeGram, Building Official E15 — Florida Building Code Section 105.1 Outlining Permitting Requirements E16/E17 — Collier County Ordinance 90 -105, as amended, Section 22.201.1(2) Outlining Misconduct by State Certified Contractors for "Willfully Violating the Applicable Building Codes or Laws of the State, City, or Collier County. Contractors' Licensing Board 2800 North Horseshoe Dr. Naples, Fl. 34104 Complaint Number- 2012 -09 Complainant: Any person who believes that a Contractor holding a State Certification or Certificate of competency has violated Collier County Ordinance 90 -105, as amended, may submit a sworn complaint to the Contractor Licensing supervisor, or his / her designee. The complaint shall be in substantially the form prescribed by the Contractor Licensing Supervisor. The complainant shall pay a fee of $50.00 to defray the costs of administering the complaint, at the time of filing the complaint. The complaining party shall state with particularity which section(s) of this Ordinance he or she believes has been violated by the contractor and the essential facts in support thereof. Complaint: Please print or type and return signed copies of the complaint. Date: July 30, 2012 Against: Contractor's Name: Lucius B. Blackwell Phone: 866 - 357 -5044 Office, Cell 561 - 202 -5037 Business Name: AAa Air Conditioning & Refrigeration Inc. License Number if known: CAC1816210 Collier County Competency number: Not Registered Contractor's Business Address: 1.161 Fernlea Drive, West Palm Beach, Florida 33417 Filed By: 0' Name: Collier County Contractors' Licensing Office Address: 2800 North Horseshoe Drive, Naples FL. 34104 Business Phone: 239 - 252 -2450 Address where work done: 2018 Duke Drive City: Naples County: Collier Date of contract: April, 27th, 2012 Date job started: April 27th, 2012 Date job completed or new home occupied: Unknown Were there plans and specifications? NO Is there a written contract? Yes. If yes, amount of Contract: $8,050.00 Has Contractor been paid in full? Yes. If not, what amount? Was a Building Permit obtained? NO Building Permit number if known: NONE Have you communicated by letter with the licensee? Yes Date: June 22, 2012. Do you have a reply? Yes Please attach to this form all copies of the purchase agreement, building contract, home improvement contract, copies of receipts and /or cancelled checks available and any additional evidence to substantiate your allegations. List any subsections of Section 4 of Collier County Ordinance number 90- 105, as amended, which, in your opinion, have been violated by the contractor which is the subject of this complaint, (list subsection number): Ordinance 90 -105, as amended, Section 22- 201.1(2) Willfully violating the applicable building codes or laws of the State City, or Collier County. E•Z Please state the facts which you believe substantiate your charge of misconduct against the subject contractor. List facts separately for each subsection number above: Discovery of A/C system installation by AAa Air Conditioning & Refrigeration Inc at 2018 Duke Drive Naples, Fl. 34110, without issuance of required permits and without qualifier being duly registered with the Collier County Building Department to obtain permit pulling privillleges. (Complainant's signature),,, State of: Florida County of: Collier Sworn to (olaffirmed)Xcl pbscribed before me this 30th day of July, 2012, (signature of person making statement). signature of Notary Public) rot,aY;�e�,n LINDA C.WOLFE -- MY COMMISSION # EE 144104 Print, type or stamp commissioned name of Notary Public: sW", EXPIRES: December 1,2015 BeFldad -Tiw 8txlg= LdNaq' °x Personally known or produced identification 0--3 C.L.B. Case #2012 -09 Lucius B. Blackwell D /B /A — AAa Air Conditioning & Refrigeration, Inc. SUMMARY On May 31St, 2012, 1 received a fax from Contractor Licensing Supervisor, Michael Ossorio, which contained an invoice for new Central Air Conditioning installation, installed on April 30th, 2012, by the State Certified contractor AAa Air Conditioning & Refrigeration, Inc. /CAC1816210, Qualified by Lucius B. Blackwell at the Governale Residence, 2018 Duke Drive Naples, FL. 34110. Checked for permit, no permit pulled, AAa Air Conditioning & Refrigeration, Inc. had not registered to pull permits in Collier County. Notified AAa Air Conditioning & Refrigeration, Inc. of the open Case #CECV2012008328 involving their company and asked to speak with Lucius Blackwell who was not available. I explained that we had a complaint regarding the Governale residence at 2018 Duke Drive Naples, FL. and let them know that we needed them to pull a permit and to sign a Notice of Noncompliance. June 1St, 2012- Rick Blackwell came in to register AAa Air Conditioning & Refrigeration, Inc., he filled out the paperwork and did not have his insurance with him, and he did sign the Notice of Noncompliance; Mr. Blackwell went out to his car and never came back in to register the Company. June 6th, 2012- Called Mr. Blackwell at AAA Air Conditioning & Refrigeration, Inc., a message was taken, that we need to have his company registered and that he needs to pull a permit for the installed A/C unit. He returned my call and said he needed to get the information he needed to apply. Called Greg Governale (homeowners son) and that we are waiting for the permit to be pulled by AAa Air Conditioning & Refrigeration, Inc. and that Mr. Blackwell had been in and tried to register his company but needed more information for the permitting process. June 15th, 2012- Called Mr. Blackwell and left another message on his cell phone. Called AAa Air Conditioning, they took another message for Mr. Blackwell. Received a call back from Mr. Blackwell on answering machine saying he had a death in the family and had to go to New York, but was back not and he would get the permit pulled by Friday (June 22nd). I returned his call and his phone was not taking messages. Called the Company and left another message with them for his to call me back. I -y June 21St, 2012- Called Mr. Blackwell several time this week, left messages, no response. Gave Supervisor Mike Ossorio the case and he tried to also call Mr. Blackwell, no response. July 10th, 2012- Notice of Board Hearing sent registered mail to Mr. Blackwell, received registered green card back signed, so it was received. July 16th, 2012- We have been unable to make contact with Mr. Blackwell, no return calls, to our voice messages. We will be taking Mr. Blackwell before Contractor Licensing Board in August. July 19th, 2012 — Talked to Supervisor Michael Ossorio at his suggestion I e- mailed Building Official Tom DeGram, review the case with him and he e- mailed back to say that it was determined that a willful code violation of Section 105.1 of the 2010 Florida Building Code has been violated for failure to obtain a required permit for a new air conditioning system at 2018 Duke Drive, Naples. 'C—✓ DBPR - BLACKWELL, LUCIUS B; Doing Business As: A A A AIR CONDITIONING ... Page 1 of 1 8:05:50 AM 5/31/2012 Licensee Details Licensee Information Name: BLACKWELL, LUCIUS B (Primary Name) A A A AIR CONDITIONING & REFRIGERATION INC (DBA Name) Main Address: 1161 FERNLEA DR WEST PALM BEACH Florida 33417 County: PALM BEACH License Mailing: License Location: License Information License Type: Rank: License Number: Status: Licensure Date: Expires: Special Qualifications Class B Construction Business Certified Air Conditioning Contractor Cert Air CAC1816210 Current,Active 04/15/2009 08/31/2012 Qualification Effective 04/15/2009 04/15/2009 View Relalled License Information View License Complaint 1940 North Monroe Street, Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer. Couyriaht 2007 -2010 State of Florida. Privacy Statement Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public- records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. https:// www. myfloridalicense .com/LicenseDetail .asp ?SID= &id= D6E733A I40CE456380.. E -G 5/31/2012 C,rowth Management Division Planning & Regulation Operations Department Licensing Section CERTIFIED MAIL # 7007 0710 0003 3698 4601 RETURN RECEIPT REQUESTED Date: 6/22/12 Lucius B. Blackwell D /B /A — A.A.a. Air conditioning & Refrigeration Inc. 1161 Fernlea Dr. West Palm Beach, FL. 33417 RE: Complaint filed against you by the Collier County Contractors' Licensing Office regarding a violation of Ordinance 90 -105 as amended Section 22-201.1(2) in April of 2012 Dear Mr. Blackwell: A complaint has been filed against you by the above referenced individual. A hearing of this complaint will be held by the Contractors' Licensing Board on August 15,', 2012 at 9:00 AM in the Board of County Commissioner's Room, Third Floor, Administration Building (W. Harmon Turner Bldg.), at 3301 East Tamiami Trail, Naples, Florida. Your presence before the Contractors' Licensing Board is required at this time. The packet you will receive marked composite exhibit "A" will be delivered to the members of the Contractors' Licensing Board one week prior to the hearing. If you wish to prepare a defense packet and have it delivered in conjunction with composite exhibit "A ", you must make fifteen copies and have them in our office by 8:00 AM on Wednesday, one week prior to the hearing. In your packet, you may give a summary of events. At this meeting, you may present evidence and be represented by an attorney of your choice. In the event the Contractors' Licensing Board finds you in violation of Section number(s) 22- 201.1(2) of Ordinance #90 -105, as amended, the range of disciplinary sanctions which may be imposed are from an oral reprimand to a suspension or revocation of your Collier County Certificate # (N /A) and/or suspension or revocation of your permit privileges against your state license # CAC 1816210. Rob -GYngu i_./ Licensing Compliance Officer (239) 252 -2914 Growth Management Division *Planning & Regulation "2800 North Horseshoe Drive *Naples, Florida 34104* 239- 252 - 2400 *www.colliergov. net 1 7007 I E•8 Notice of Noncompliance BE IT KNOWN THAT 1, the person whose signature appears below, do hereby formally acknowledge, agree and consent as follows: THAT a certain case, case # CECV20120008328, involving me has recently been investigated by the Collier County Contractor Licensing Department. THAT the said Department had made it known to me that, in the Department's view, I violated State (Florida Building Code section 105.1) and County (Ordinance 2006 -46, as amended, 4.1.6 & 4.1.18) licensing laws in said case by commencing work without first obtaining a Building Permit. Type of Work: _A /C Unit Installation Location of work: 2018 Duke Drive Naples FL. 34110 (Marylyn Governale) Date of work: April 27, 2012 THAT the said Department has explained to me that all contracting work, including BUT NOT LIMITED TO, home or business improvement, remodeling, renovation, addition, repair, plumbing, electrical, roofing, pool building, air conditioning, sheet metal, aluminum and alarm contractor work all require the issuance of a Building Permit prior to commencement. THEREFORE, BEING FULLY ADVISED, I DO AGREE that I will obtain all Building Permits required by Statutes and fully understand that if I commence work without obtaining necessary Building Permits in the future the Contractor Licensing Department will consider that a willful code violation, where penalties and restrictions to Building Permit privile s ma Ilow. Witness my signature (Contractor):. �° Not2o // 5i� n �ti"10 /�PPc�/ p,e.�' M G© , co b z State of County of The foregoing instrument was acknowledged before me this who has produced identification and who did not take an oath. Signature of Notary Licensing Investigator, in lieu of Notary. Date (date) by as E-9 MAY 30 -2012 01 :51 FROM:GREGG GOVERNALE 4A IA b t �s •� a: (401tifo u 5185233768 TO:2522469 P.1 •to s met (d44e yF}i✓ltww.L fers Ali, plc t Re6.�� -no pa«»� Nkc t —To —i2 Piftilt Oh Ymb)omp lots ftfto,& I" COPAI, 6OW401ndf Irw co Olin as ' � S lV (i� v q5q 1 .,rte , c'Elft 'go , . -A ow- �Yre Is � 6 +" T19- sa3 -3 7 Co8 r-/O C671 _ go2 - 5637 MAY -30 -2012 01:51 FROM:GREGG GOVERNALE 5185233768 TO:2522469 P.2 f s Phalle: $S6 357-QW A-M—C, 866 490008S AA Enl*h: - . co 00077(a ma .Cain No- S38:6'2' �. _ JobSftAft RE1bITi' "'PO I OX 129 Ell 7�.► ? k ' ]rU?�R, FL 33468 tea►' M.7 P4 Y 116 �r.' , r 7. x:�AVe ax �+ci rcom�ner�!+u.i�I:. iui snaniiima ai+o'ss ria ru►vsl t�crrni ,� Y�va TMVO;K'AM. - G'f1/1�'A6 $TA7i� A�1A� AMi , SPA Atf�l7ifi ��t�ft �A MAW B2 f A$.I+fJ! MX !iDlLtIIj�7t I?O� APIY Q�t ggIVBICAO$S. JtIiD E►7�l�TP TO AAA i8 WARS "Sm,,v �: o n • R 'ID�ffi'�7YI'dPANYRsidORBE$HA�fFw• , x ' " OW.Nffit'OFAI71R.Afs'i3ri P OtiCiudo Positim'aod t�deY .'...- ;��i�.X; 4:�iry'V'• :.1: '��1J'i� ::iiY:L� Ik= IJU> ^�- ";V ?_ F. �..�. r!� r: +`,«. ., �' s * •. i. �;�:•.� . , 'TYiS" .. , I? I' �tQVHi11Gi: 17MAI} 38P1 =D#�X57'RY1Cii1STtD'Bk1ltOVJIl &,W f' l +b•l% jif1.��sA_ .4'L P -+.r.. • :�� '""� ,� / �'YC' S^� k /.,G1 �J"%S ' �{S�• 'l�st r4�a 7.1' •�.5'�+11�"' � � BSi MAT.- R /PROffOS�A:L :A.PPRQ�/A�.: ' = ' DA18 �;,;�„ r,.,.. _ . (Vr't�i�(l+ fay;3p: iy�pb�eooirias}fa �oa[�pt�ritct w 9 ,: acccpt�ed�'•��ry.:c }} �J.'!.'. .�� N-..,,L L�,: �! 7; .�u..:�4. ^_"_7+.�-- '�- ^.Waj� +�T �� '�i' '�iir �'�.1: y • ?+(�.• �� Ch tr • D" SHOULD 'RR 4r �C.Com0mc tDa/�[1oUide 1 d - . -. .. SILLTD (AAA OlARG� iJ1VLYj t• • '' 'M TOTAL r PO _TAX AIAIiIi ON CARD T07'A1.6AIJIte�$• .INii ADS FULL• XMOinI T•P!AW. ` �,.:.. — Q a :CC. a azr�I ' 7 q as 7— HALANCEOR (IPA AVf(i �e�+►J • -� • �iICF � - _ u � (,� .�p..✓1 �•C � �rf"'iV � BY.SIC,TIIIdG 861AW I AGR$F THAT AAAHA9 QOMPLB'IM TMS CON -MACZ I ACXNOWLtDM MY RZCBIPT OF MI�AI ME Pit S)IIM PS D . YE, yr A CCIPY Oi� 72flS �dOCUMIEj4T ANN AaREB njA'iq?�'IIB.PR %eM HAVE BEI�1?.F,PI IiV GOOD FUNCrM I M.CONDrMN. ][�f�L� d� CL1�tj.91�r' X I - "' T Q�AN • '. OVINER orAUTHORI=AG@TP (w jpft o Itibn and'tlo) m!aa yar d miamficcmv wamuda oa **wpm= mt -Wh f VC -1a aaly).. ONS year m p.m. 90 labor. Not m Preca ,vi►haa ietr w. *Muir. OIWdkyfq�ronalmcw>mernnd c,I�sa NOr..�nr �r� .a.mW �Y� ow to aim o IXC tr; "," 9piloea oaf Nlucf�e filth® adlbr cbr4l Tim D as dndn ttma yt °^u�anfY btoe�o=.aaa coi,y,mor r®Imt Whias �� No ," E•il ClementsKaren From: ClementsKaren Sent: Monday, July 16, 2012 8:52 AM To: 'coldpro77 @gmail.com' Cc: OssorioMichael Subject: 2018 Duke Drive Naples, FL. Governale Hello, I have been trying to reach Mr. Blackwell and I am not getting a return call or any response. Please have him contact me regarding no permit for a/c unit installed at above address. We have sent a registered letter to Mr. Blackwell at the 1161 Fernlea Drive West Palm Beach FL., address and received the registered letter card back in the mail signed. We will be continuing the process to take Mr. Blackwell before the Collier County Contractor Licensing Board on August 15, 2012. We are in contact with the Department of Business and Regulation with the State of Florida, and we are proceeding to go after his State License. Thank you. Karen Clements Contractor Licensing Officer 239 - 252 -2450 or 239- 821- 4847 karenclementsC@colliergov.net f-12 ClementsKaren From: ClementsKaren Sent: Thursday, July 19, 2012 8:23 AM To: DeGramThomas Cc: OssorioMichael Subject: AAa Air Conditioning & Refrigeration Inc. Mr. DeGram, Received complaint against air conditioning company (AAa Air Conditioning & Refrigeration Inc.) on May 31". 2012. Work was performed at 2018 Duke Drive Naples Fl., at the Governale residence. New a/c unit installed. Company is not registered with Collier County. AAa Air Conditioning & Refrigeration Inc is located at: 1161 Fernlea Drive West Palm Beach, FL. the license holder is Lucius B. Blackwell IV, license #CAC1816210 State Certified. Contact was made with the AAa Air, and Mr. Blackwell did come to our office and signed a Cease & Desist order and received paperwork to register the company here in Collier County, however he had trouble getting his insurance over and said he was going out to his car and never came back, so his company was never registered with us. We are taking this before our board and we would like you're advice as to the code violation. Thank you Karen Clements 6 •M Building v July 19, 2012 TO: Contractor Licensing Attn: Karen Clements RE: Lucius B. Blackwell IV AAa Air Conditioning & Refrigeration Upon reading your report regarding Lucius B. Blackwell of AAa Air Conditioning & Refrigeration it is determined that a willful code violation of Section 105.1 of the 2010 Florida Building Code has been violated for failure to obtain a required permit for a new air conditioning system at 2018 Duke Drive, Naples. Respectfully submitted, Thomas L. DeGram, CBO Interim Chief Building Official Building Code Administrator BU1611 $ **V ReAew S6�. - M Norte HofseO Onve • Nao*s- FVea 34104.239- 252.2400 • ~ coshergm rwi E -IN SECTION 105 PERMITS 105 -SECTION 105 PERMITS Page 1 of 7 105.1 Required. Any owner or authorized agent who intends to construct, enlarge, alter, repair, move, demolish, or change the occupancy of a building or structure, or to erect, install, enlarge, alter, repair, remove, convert or replace any electrical, gas, mechanical or plumbing system, the installation of which is regulated by this code, or to cause any such work to be done, shall first make application to-the building official and obtain the required pen-nit. 105.1.1 Annual facility permit. In lieu of an .individual permit for each alteration to an existing electrical, gas, mechanical, plumbing or interior nonstructural office system(s), the building official is authorized to issue an annual-permit for any occupancy to facilitate routine or emergency service, repair, refurbishing, minor renovations of service systems or manufacturing equipment installations/relocations. The building official shall be notified of major changes and shall retain the right to make inspections at the facility site as deemed necessary. An annual facility permit shall be assessed with an annual-fee and shall be valid for one year from date of issuance. A separate permit shag be obtained for each facility and for each construction trade, as applicable. The permit application shall contain a general description of the parameters -of work intended to be performed during the year. 105.1.2 Annual permit records. The person to whom an annual permit is issued shall keep a detailed record of alterations made under such annual permit The building official shall have access to such records at all times or such records shall be filed with the building official as designated. 105.1.3 Food permit. As per Section 500.12, Florida Statutes, a food .permit from the Department of.Agriculture and Consumer. Services is required of any person who operates a food -establishment or retail store. 105.2 Work exempt from permit Exemptions from permit requirements of this code shall not, be deemed to grant authorization for any work to be done in any manner in violation of the provisions of this code. Permits shall not be required for the following: Gas: 1. Portable heating appliance. 2. Replacement of any minor part that does not alter approval of equipment or make. such equipment unsafe. Mechanical: . 1. Portable heating appliance. 2. Portable ventilation equipment. ARTICLE V. BUILDING TRADES* Page 30 of 36 Sec. 22 -201.1 Misconduct- -State certified contractors. The following actions by state certified contractors shall constitute misconduct and grounds for discipline pursuant to section 22 -202 of this article. (1) Failing or refusing to provide proof of public liability and property damage insurance coverage and workers compensation insurance coverage as required by Florida Statutes. (2) Willfully violating the applicable building codes or laws of the state, city or Collier County. (3) If the CLB finds through its public hearing process that the contractor was found by another county or municipality within the past 12 months, to have committed fraud or a willful building code violation and the CLB finds that such fraud or other willful violation would have been fraud or a willful violation if committed in Collier County or within the respective city. (4) Fraud. (Ord. No. 94 -34, § 4; Ord. No. 99-45, § 4.2-- 4.2.3, 6 -8 -99; Ord. No. 06-46, § 1(4.1.8.2)) Sec. 22 -202. Disciplinary proceedings, including minor violations. (a) There are three categories of violations: violations of subsection 489.132(1), F.S.; and contractor's licensing board. (i) violations of subsection 489.127(1), F.S.; (ii) (iii) other violations within the jurisdiction of the (1) Subsection 489.127(1), F.S., is incorporated herein. (Lack of required license, certificate, or registration). The following are designated to enforce subsection 487.127 (1), F.S.: Collier County Building Official, all - license compliance officers, the chief building inspector, chief electrical inspector, chief plumbing /mechanical inspector, and /or other inspectors authorized from time -to -time by the building official. Procedures specified in this section shall apply except to the extent, if any, that Section 489.127 or Section 489.132, may require different procedure(s). The penalties for each uncontested violation of subsection 489:127(1) and /or 489.132(1), F.S., are $300.00 for the first uncontested violation and $500.00 for each subsequent uncontested violation by the same individual or entity. Penalties for contested violations of subsection 489.127(1), F.S., are as now or hereafter specified in Section 489.127, F.S. Penalties for contested violations of subsection 489.132(1), F.S., are as now or hereafter specified in Section 489.132, F.S. The citation form attached hereto as Exhibit "A" is approved, which form may be amended from time -to -time by resolution of the board of county commissioners. (2) Minor violations: The contractor licensing supervisor or designee shall issue a "notice of noncompliance" as the county's first response to a minor violation of any provision of any regulatory law, including this section, when (i) it is reasonable for staff to assume that the violator, at the time of violation, was not aware of the provision that was violated or it can be assumed that it was not clear to the violator how to comply with the violated provision; and (ii) that violation has not then resulted in economic harm or physical harm to any person; and (iii) the violation has neither adversely affected the public health, safety, or welfare, nor created any significant threat of any such adverse affect. The notice of noncompliance should identify the specific provision that was violated, should provide information on how to comply with that provision and should specify a reasonably time for full compliance. The notice of noncompliance shall not be accompanied with any immediate threat of any monetary fine or any other disciplinary penalty, but may specify that failure of the violator to correct the violation within the time specified in the notice for compliance may result in disciplinary proceedings. Each ARTICLE V. BUILDING TRADES* Page 31 of 36 violation that is not a "minor" violation is a "major" violation. (3) Major violations. The contractor licensing supervisor, or his designee, may initiate disciplinary proceedings against a licensed contractor for major violations of this article by filing a sworn complaint with the clerk to the Collier County Board of County Commissioners. (4) Failure of non -state certified individual to promptly pay penalty to county. The Collier County Building Department should not issue any permit or any other required authorization to any Collier County certified individual who then has an obligation to pay a penalty to the county imposed with finality under this article for any violation of this article (including a citation that is not contested) and that individual has not paid that penalty in full by the applicable deadline date, plus reimbursement of the county's costs, such as recording fees and court costs. An appeal of uncontested citations stays all such withholdings. (5) Failure of non -state certified individual to meet permit conditions. The county's building department may withhold issuance of any further permit(s) or any other authorizations) to any individual who, or entity that, has not then complied with any condition of all county- issued permit(s) issued to that individual or entity, including every follow -up inspection or any other act then capable of being complied with, although late in time. (6) Withholding permit pulling privileges of state certified contractor. Before the CLB may withhold any permit pulling privilege(s) of a state certified contractor, the CLB, after public hearing, must find that the contractor violated a provision of section 22 -201.1 of this article. (b) Any person who believes that a contractor holding a certificate of competency has violated this article may submit a sworn complaint to the contractor licensing supervisor, or his designee. The complaint shall be in substantially the form prescribed by the contractor licensing supervisor. The complaining party shall state with particularity which section of this article he believes has been violated by the contractor and the essential facts in support thereof. (G) Upon the - submission of a sworn complaint, the contractor licensing supervisor, or his designee, shall conduct a preliminary investigation and determine whether the complaint submitted warrants the filing of formal charges. if charges are warranted, the contractor licensing supervisor, or his designee, shall file the, complaint with the clerk to the board of county commissioners and shall send; by certified mail, return receipt requested, a letter to the licensed contractor at his local address, or if applicable the local agent's address, as shown by the records of the contractors' licensing board, enclosing a copy of the complaint and indicating: (1) The name of the complainant; (2) The date of the commission of the alleged offense; (3) The section of this article alleged to have been violated; (4) The range of disciplinary sanctions which may be imposed upon any contractor, pursuant to this article by the contractors' licensing board in the event said board finds a violation of this article to have occurred; (5) The date, time and place at which the contractor shall appear before the contractors' licensing board for a hearing regarding the complaint. The date scheduled shall not be sooner than 20 days from the mailing date of the certified letter. (d) The notice of hearing required by this section may, in the alternative, be accomplished by hand delivery of said notice to the contractor by the contractor licensing supervisor, or his designee, or by leaving said notice at the contractor's business or usual place of residence with some person of his family over 15 years of age and informing such person of the contents of the notice. E•