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CLB Agenda 10/17/2012 CLB MEETING AGENDA OCTOBER 17, 2012 Co bier County aOr :,. COLLIER COUNTY CONTRACTORS' LICENSING BOARD AGENDA OCTOBER 17, 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. I. ROLL CALL II. ADDITIONS OR DELETIONS: III. APPROVAL OF AGENDA: IV. APPROVAL OF MINUTES: DATE: September 19, 2012 V. DISCUSSION: VI. NEW BUSINESS: (A) Angela W.Rogers—Waiver of Examination(s) (B) Terry Gouker—Waiver of Examination(s) (C) Jessie Carcamo—Qualify 2nd Entity (D) Gerardo Martinez—Waiver of Examination(s) VII. OLD BUSINESS: (A) Orders of the Board VIII. PUBLIC HEARINGS: (A) Case#2012-11 Karin Sacacian—d/b/a Olde Naples Tile&Marble,LLC. IX. REPORTS: X. NEXT MEETING DATE: WEDNESDAY NOVEMBER 21,2012 COLLIER COUNTY GOVERNMENT CENTER ADMINISTRATIVE BUILDING THIRD FLOOR IN COMMISSIONERS CHAMBERS 3299 E. TAMIAMI TRAIL NAPLES,FL 34112 September 19,2012 MINUTES OF THE COLLIER COUNTY CONTRACTORS' LICENSING BOARD MEETING September 19, 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: Vice Chair: Richard Joslin Terry Jerulle Kyle Lantz Thomas Lykos Robert Meister Jon Walker Patrick White Excused: Lee Horn, Chairman Michael Boyd ALSO PRESENT: Michael Ossorio — Supervisor, Contractors' Licensing Office Jeff Wright, Esq. —Assistant County Attorney James F. Morey, Esq. —Attorney for the Contractors' Licensing Board Jeff Letourneau— Code Enforcement Investigative Supervisor 1 September 19, 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. ROLL CALL: Vice Chairman Richard Joslin 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. Seven members were present. II. AGENDA—ADDITIONS OR DELETIONS: Additions: • Under Item VI, "New Business:" (B.) Angela Rogers, d/b/a"Thomas W. Rogers Painting Service"—Waiver of Examination Mr. Ossorio explained that, due to a scheduling error, Ms. Rogers traveled from Alabama to appear at this month's meeting. Since the Agenda was not full,he asked if the Board could review her paperwork and consider her application rather than requiring her to return in October. He stated he would present the information packet to the Board for their review if they agreed. Deletions: • Under Item VII, "Old Business:" (B.) Case#2012-03: Linda Curiale, d/b/a"Global Maintenance and Restoration, Inc."(The request to withdraw was made by Staff.) Discussion: Thomas Lykos restated his objection to making additions to the Agenda on the day of the meeting. While he understood the circumstances, he remained opposed to reviewing an information packet on such short notice. Vice Chairman Joslin suggested first approving the changes to the Agenda and then discussion options. III. APPROVAL OF AGENDA: Patrick White moved to approve the Agenda as amended by Staff. Second by Jon Walker. Motion carried, 6—"Yes"/1— "No." Mr. Lykos was opposed. Vice Chairman Joslin stated he understood Mr. Lykos' objection, even though the Board had allowed last minute additions to other Agendas in the past. He suggested reviewing the information packet to determine whether or not to proceed. Patrick White requested to review the materials at the conclusion of the Agenda's other business since Ms. Rogers was not present and he did not want to inconvenience the other Applicants who were present. 2 September 19, 2012 Michael Ossorio stated the County had no objection to amending the order in which the Items were heard by the Board. He concurred the Board could wait to review the packet until the Applicant appeared. If she did not, the case would be presented in October. Vice Chairman Joslin agreed to "table" Item VII-B. Patrick White moved to approve changing the order of the Agenda to allow Item VII-B to be heard as the last item of business. Second by Thomas Lykos. Carried unanimously, 7—0. IV. APPROVAL OF MINUTES—August 15,2012: Thomas Lykos moved to approve the Minutes as submitted. Second by Robert Meister. Carried unanimously, S—0. (Note: Kyle Lantz and Patrick White could not vote to approve the Minutes because they did not attend the August 15th meeting.) V. DISCUSSION: A. Repealing County Ordinance Number 82-20, as amended. Michael Ossorio stated: • The County Attorney's Office has been reviewed the Ordinances to eliminate redundancies. • He explained the old process under#82-20: a Judge would review the Citations, referred to then as a"Notice to Appear,"in Civil Court o under the codified version of Ordinance 2006-46, as amended, the Contractors' Licensing Board is the Hearing Official for Citations. • The"Notice to Appear" is one of several obsolete forms that are no longer used. • The request to repeal Ordinance 82-20, as amended, will be presented to the Board of County Commissioners for review. Mr. Ossorio reviewed the Ordinance together with Jamie French, Director of Operations &Regulatory Management, Growth Management Division, and the recommendation was to repeal Ordinance 82-20 with the exception of Section 1 (A), entitled"Designations,"and Section 2 (A), entitled"Duties." Section 1 (A)reiterates the Contractors' Licensing Office is part of the Building Department, while Section 2 (A) correlates the differences between the Building Department officers, the Zoning Department officers, and the Contractors' Licensing Board officers. He further stated Assistant County Attorney Jeff Wright concurred, agreeing the revised Ordinance will mirror the codified version of the Muni Code. 3 September 19,2012 Patrick White asked if any amendments had been made to Ordinance 82-20, noting if there were, the amendments should be identified and also repealed. Assistant Attorney Wright stated he was not aware of any amendments between #82-20 and the present Ordinance, but would verify that any amendments to Ordinance#82-20 were also repealed. Mr. White asked if Ordinance 2006-46 was a stand-alone Ordinance or an amendment to #82-20. Mr. Wright stated his understanding was the Ordinances were independent of each other; #2006-26 was free-standing while#82-20 was dormant. Michael Ossorio stated Mr. Jeff Letourneau, Code Enforcement Supervisor, was present to support the repeal of#82-20 as well as to answer questions concerning the Ordinance and Code Enforcement. Patrick White asked about the duties of a"Zoning" Investigator versus a Code Enforcement Investigator. Jeff Letourneau, Code Enforcement Investigative Supervisor, stated: • The Code Enforcement Ordinance#2010-04 covered all of the duties of the Code Enforcement Department and was more pertinent to 2012 than the Ordinance before the Board. • In 2010-04, Investigators are no longer referred to as "Zoning"Investigators but as "Code Enforcement" Investigators. Mr. White asked if the functions detailed in#82-20 were appropriate and should remain operable and, if so, did the County and Code Enforcement recognize it. Mr. Letourneau replied the duties of Code Enforcement Investigators were specifically outlined in#2010-04. Concerning duties of Code Enforcement Investigators in 2012, it was his opinion that Ordinance#82-20 was no longer relevant. He continued Ordinance#2010-04 was included in the Code of Ordinances and the duties were outlined in Sections 2-2037 through 2-2044. County Attorney Wright verified that the title to Ordinance#2006-46 did not contain any references to#82-20. Patrick White moved to approve supporting Staff's recommendation to the Board of County Commissioners to repeal Ordinance #82-20, as amended, with the exception of Section 1 (A) and Section 2 (A). Second by Thomas Lykos. Carried unanimously, 7—0. VI. NEW BUSINESS: (Note: In case heard under Section VI, the individuals who testified were first sworn in by the Attorney for the Board.) A. David Goff—Waiver of Examination (Cabinetry License) Mr. Goff stated the reason why he requested a Waiver was because he is financially unable to pay the costs to attend class and take the exam. He further stated he has 4 September 19, 2012 been self-employed since 2003. He has used a payroll company. His goal to work for other cabinet companies as an installer. Michael Ossorio provided background information: • Mr. Goff has been licensed for so many years that he was "grandfathered in," i.e., not required to take any examinations. • In 2009, his license was cancelled because he did not renew. • Mr. Goff is to explain to the Board what he has actively been doing in the trade of Cabinetry since 2009. • Mr. Goff is to state if he has maintained a license in other jurisdictions even though his license lapsed in Collier County. Mr. Goff explained: • In 2009, to reinstate his license, he was required to produce a credit report and pay a fine. • In 2008, his salary was significantly reduced("cut in half') • By 2009, he paid himself slightly more than$3,000 for the year. • Since that time, he has cleared up his debts and there are no judgments or liens filed. • He has worked as an employee for a company until it went under and closed its doors. Jon Walker asked Mr. Goff if he had worked locally since 2009. David Goff replied he had not worked in any other jurisdiction and stated he did not have any licenses in Florida other than in Collier County. Thomas Lykos asked Mr. Goff if he made and installed his own cabinets or if he simply installed cabinets for someone else. He asked him to explain the type of work he had done and why he wanted to remain in the business. David Goff responded: • He worked for 14 years for one of Naples' largest cabinet makers. • He began by installing cabinets but was promoted to constructing entertainment centers and other built-ins. • He has worked on multi-million dollar housing projects. • He further stated he enjoyed working in wood and had been in construction since he was 18 years old. • He has no other skills and did not attend college. • He has installed factory-line cabinets but most of his work has been "custom." Terry Jerulle asked Mr. Goff if he built custom entertainment centers and if he intended to resume that type of work again. The response was, "Yes." Mr. Jerulle asked if Mr. Goff had his own shop; he replied that he had"a small shop." 5 September 19,2012 When asked if he would hire employees, David Goff indicated he did not have plans to hire anyone. Vice Chairman Joslin asked Mr. Goff who he had worked for recently. David Goff stated he has constructed some built-in units and some furniture pieces. He noted, to date, he has earned approximately $5,000 in 2012. He further stated he needs to find more stable employment with a large company. Terry Jerulle asked Mr. Goff if he had asked for a Waiver because he could not afford to take a written test or if he was afraid to take the test. Mr. Goff reiterated he could not afford to pay for the course that was required to take the exam. He stated if the Business Law Exam was primarily tax-based, he has never done his own taxes. He has relied on a payroll service and a CPA to complete his tax returns. Mr. Jerulle asked Mr. Goff if he was given some time to save money for the course, did he think he could take and pass the exam. David Goff said he had no idea of what the test was like—he had never taken it. When he was initially licensed in 1990, he was required to produce proof of his experience in the trade and good character affidavits. He confirmed he would continue to utilize the services of a payroll company and a CPA for preparation of tax returns in the future. Patrick White asked for clarification concerning which tests Mr. Goff had requested to waive. Michael Ossorio noted it was the Business Procedures test. He stated there is no trade test for cabinetry. In Collier County, "cabinetry"is an entry-level construction license and only the Business Procedures test is required. For a "carpentry" license, there is a trades test in addition to the Business Procedures exam. Kyle Lantz stated he had no doubt that Mr. Goff was an expert carpenter who could construct anything in wood. He further stated he was not concerned with Mr. Goff's carpentry skills but with his ability to run a business. To obtain a license,the requirements are to pass the test, show decent credit, and produce proof of some experience in the trade. He stated the Business Law exam covers more than just payroll taxes and Workers' Compensation—it also covers the topic of construction lien law,what work you arc allowed to do under the license and what is not permitted. He recommended that Mr. Goff take the Business Procedures test. Thomas Lykos stated the State of Florida and Collier County have established minimum standards to allow an individual or an entity to operate a business or to possess a license. The standards were established to protect the public. He agreed with Kyle Lantz's recommendation. Vice Chairman Joslin asked if Mr. Goff could begin working for a contractor if his license were reinstated. 6 September 19, 2012 David Goff answered that a builder he had worked for previously had returned to Naples and indicated he would have work for him. He stated his preference was to work as an installer for a builder or a large company—not to deal directly with the public. Terry Jerulle asked if Mr. Goff s license was reinstated contingent upon his taking and passing the test within six months, would he be able to comply. David Goff stated he thought he could if he were given enough time to acquire the funds necessary to take the course and the test. Michael Ossorio explained there are two exam companies that offer the Business Procedures test: • "Pro-Metric"which offers the test on a monthly basis in Fort Myers, and • "Gainesville Independent"which offers the test on a daily basis in Gainesville. The test is also available in Bonita Springs and in Miami on a regular basis. • The cost for the exam is $80 and $130 for the course. He stated the County could recommend issuing a provisional license for a period of six months to allow Mr. Goff some time to take the course and pass the test. He confirmed that, as soon as Mr. Goff passed the Business Procedures exam, the probation would end. He stated Mr. Goff would be able to obtain employment immediately. Patrick White asked if the Board could restrict the probationary license to permit Mr. Goff to work only for general contractors or builders. Mr. Ossorio confirmed the Ordinance allows the Contractors' Licensing Board to restrict a Certificate (or license). Vice Chairman Joslin supported Mr. White's suggestion. Mr. Ossorio clarified that the license could be issued for a six-month probationary period. If Mr. Goff passed the Business Procedures exam,the restrictions would be removed. If he did not pass, his license would be cancelled. He stated Mr. Goff would also have to pay a reinstatement fee, all of his back fees, and a renewal fee as applicable. David Goff stated if he were issued a probationary license, he would be able to contact builders and contractors to obtain employment. He did not want to pursue any offers until the Board had made a decision regarding his request. He again stated his goal was to work as a subcontractor performing installations. Thomas Lykos moved to approve issuing a conditional or probationary license for a period of six months to allow Mr. Goff to take and pass the Business Procedures exam. Mr. Goff will be restricted to working for licensed builders and he must pay all back fees. At the end of the six-month period,Mr. Goff is required to appear before the Board to verify that the conditions have been met. At the time, the Board will make a determination regarding the disposition of his license. 7 September 19,2012 Vice Chairman Joslin stated if Mr. Goff met the conditions that had been imposed, he should not be required to appear before the Board because Staff could issue an unrestricted license automatically. Patrick White stated he would second the Motion but requested the restriction to working only for a licensed builder to remain. He stated it would not be necessary Mr. Goff to appear before the Board unless he were to request removal of the restriction so he could deal directly with the public. Thomas Lykos explained the intent of his Motion: to issue a six-month license to Mr. Goff and at the end of the period, he is to return before the Board to verify that he took and passed the test and paid all required fees. The Board would decide at that time what to do concerning the restriction of working solely for licensed builders. He reiterated if Mr. Goff did not meet the conditions, his license would be cancelled. Mr. Lykos stated the purpose of his Motion was to avoid grey areas. At the end of the six-month period,the Board will decide to either extend the probationary period or offer Mr. Goff a full license,but nothing will be "automatic"—the determination will be made solely by the Board. Mr. White withdrew his second in support of the Motion. Jon Walker offered to second in support of the Motion. Discussion: Kyle Lantz asked if there were other issues for the Board to discuss, i.e.,problems with Mr. Goff's credit report. Michael Ossorio stated if the application were on his desk and Mr. Goff had taken and passed the Business Procedures test and paid the required fees, an unrestricted license would be issued if his credit were in order because Mr. Goff had been working in the industry for a long time, had been licensed previously, and had provided affidavits. He confirmed that,under those circumstances, Mr. Goff would have been issued an unrestricted cabinet license. Mr. Lantz questioned when, in the process, the fees would be paid? Mr. Ossorio stated the fees must be paid before even a provisional or restricted license would be issued. Discussion ensued between Mr. Lantz and Mr. Lykos regarding the timing for payment of the fees by Mr. Goff. Michael Ossorio reminded the Board that it does not have the authority to waive fees but it can make recommendations to the BCC concerning fees. He continued, stating in the past,the Board has never made a decision concerning payment of fees because it is understood they must be paid first. Vice Chairman Joslin reiterated the matter before the Board was Mr. Goff's request 8 September 19,2012 to waive taking the examination in order to reinstate his license. He posed a question: If Mr. Goff were to amass the funds necessary to pay the County's fees and the fees for the course and the exam by next week or next month—and he was passed the exam—would he still have to wait six months for his license or would it be issued to him immediately upon his satisfying the conditions of the Motion. Patrick White stated the point of his second was to allow Mr. Goff the opportunity to have a restricted license once he passed the Business &Law exam—and he would have up to six months to pass the exam. If at the end of six months, Mr. Goff had either not applied to take the test or had not passed the test, his restricted license would be suspended. Regardless,the license would have been restricted. The only point in time, within the six-month period, that Mr. Goff would be required to return before the Board would be if he wanted to remove the restriction based upon the fact that he has passed the exam. He concluded by reminding the Board that it could choose to do whatever best fix the circumstances. Thomas Lykos concurred, stating the Motion was trying to accomplish something that the Board does not typically do. He stated he would withdraw his Motion because he didn't consider the requirement to pay the fees first. He was attempting to give Mr. Goff six months to do everything necessary to come into compliance. As a rule the back fees must be paid in advance. He suggested starting over or finding a simpler solution. Thomas Lykos moved to withdraw his previously stated Motion. Jon Walker withdrew his second in support of the Motion. Kyle Lantz moved to approve waiving the requirement to take an examination for a period of six months and issue a restricted license permitting Mr. Goff to work only for a licensed builder or company. If Mr. Goff passes the exam and submits proof to the Contractors'Licensing Office, the restriction on his license will be removed. He will become fully licensed to install cabinets. If Mr. Goff does not pass the exam within six months, his license will be suspended or become "null and void" Second by Patrick White. Thomas Lykos suggesting amending the Motion to reiterate that the fees must be paid first and then a conditional license would be issued. Mr. Lantz concurred, stating the fees must be paid, and Mr. Goff must show proof of insurance, etc. He clarified the six month period will begin running from September 18th. If it takes Mr. Goff three months to pay his fees, the time clock is not re-set. Mr. White stated he understood and agreed Vice Chairman Joslin asked Mr. Goff if he understood the conditions being imposed by the Motion. 9 September 19,2012 Mr. Goff questioned the time line. Vice Chairman Joslin explained that if he paid all the fees, and if he passed the test before the end of the six month period,provided he submitted proof to the Contractors' Licensing Office,the restriction would be removed from his license and he will be issued a full cabinet installer license. The license will be restricted until the fees are paid and he has passed the exam. Vice Chairman Joslin called for a vote on the Motion. Carried unanimously, 7—0. VII. OLD BUSINESS: A. Orders of the Board Kyle Lantz moved to approve authorizing the Vice Chairman to sign the Orders of the Board. Second by Robert Meister. Carried unanimously, 7—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#2012-10: Linda Curiale, d/b/a "Global Maintenance & Restoration,Inc." Vice Chairman Joslin noted Ms. Curiale was present and was represented by Attorney Patrick Neale. Vice Chairman Joslin outlined the general process of the Public Hearing: • Hearings will be conducted pursuant to the procedures contained in Collier County Ordinance#90-105, as amended, and Florida Statutes, Title XXXII, "Regulation of Professions and Occupations, " Chapter 489. • The Hearings are quasi-judicial in nature. • Formal "Rules of Evidence" shall not apply. • Fundamental fairness and due process shall be observed and govern the proceedings. • Irrelevant, immaterial, or cumulative evidence shall be excluded. • All other evidence of the type commonly relied upon by reasonably prudent persons in conducting their affairs shall be admissible, whether or not such evidence would be admissible in a trial in the Courts of the State of Florida. • Hearsay evidence may be used for the purpose of supplementing or explaining any evidence but shall not be deemed sufficient by itself to support a Finding, unless such hearsay would be admissible over objection in a civil action in Court. • The "Rules of Privilege" shall be effective to the same extent that such Rules are now, or hereafter may be, recognized in civil actions. 10 September 19, 2012 • Any member of the Contractors' Licensing Board may question any witness before the Board. • Each party to the proceedings shall have the right to call and examine witnesses, to introduce Exhibits, to cross-examine witnesses, to impeach any witness regardless of which party called the witness to testify, and to rebut any evidence presented against the party. • The Chairperson or, in his/her absence,the Vice Chair, shall have all powers necessary to conduct the proceedings at the Hearing in a full, fair, and impartial manner, and to preserve order and decorum. • The general process of the Hearing is for the County to present an Opening Statement to set forth the charges and, in general terms,how the County intends to prove the charges. • The Respondent will present an Opening Statement setting forth, in general terms,his/her 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: o Whether the Respondent was guilty of the offense(s) charged in the Administrative Complaint, and a vote will be taken on the matter. o 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 which may be imposed and the factors to be considered. • The Board will discuss the sanctions and vote. • After the matters are decided, the Chair/Vice Chair will read a Summary of the Order to be issued by the Board. The Summary is a basic outline of the Order and may not reflect the same language contained in the Final Order. 11 September 19,2012 • The Final Order will include complete details as required under State laws and procedures. Patrick White advised the Board that he would abstain from voting; he spoke with the Board's attorney, and completed Form 8-B entitled "Memorandum of Voting Conflict for County, Municipal and Other Local Public Officers." He read the"Disclosure of Local Officer's Interest" into the record, as follows: Mr. White stated his law firm had been retained to represent Mr. and Mrs. Patrick J. Martin in a matter involving "Global Maintenance & Restoration, Inc." He further stated there is a potential, since disciplinary action is being considered, that could inure to their special gain or loss. Mr. White confirmed he will participate in discussion but will not vote on the matter. Form 8-B will be included as part of the Minutes of the Meeting. Vice Chairman Joslin accepted Mr. White's signed declaration. Attorney Patrick Neale stated: • On behalf of his client,he entered into discussion with Michael Ossorio prior to the beginning of the Hearing. • His client has agreed to enter into a Stipulation and Agreed Order on the matter to resolve the matter. Mr. Neale stated he would distribute of the document to the Board Members for their review. He requested the Board: • confirm that his client agreed to the Stipulation, and • adopt the Stipulation and Order. Thomas Lykos moved to approve accepting Respondent's Exhibit "A"into evidence. Second by Kyle Lantz. Carried unanimously, 7—0. Michael Ossorio noted the Stipulation and the Order were from the first case, Number 2012-03, which had been heard in March, 2012. Mr.Neale stated the Stipulation was specifically designed to resolve the issues that were outstanding in both cases (2012-03 and 2012-10). He further stated the only relevant issue before the Board was to determine whether or not his client accepted the terms of the Stipulation. He read the terms of the Stipulation into the record as follows: 12 September 19,2012 " BEFORE THE COLLIER COUNTY CONTRACTORS' LICENSING BOARD BOARD OF COUNTY COMMISSIONERS. COLLIER COUNTY, FLORIDA, CONTRACTORS' LICENSING BOARD, Case#2012-03 Petitioner, License No.: vs. CGC 1508972 and LINDA CURIALE, CC #27333 d/b/a "Global Maintenance & Restoration, Inc.," Respondent. Stipulated Settlement Agreement and Agreed Order Linda Curiale and the Board of County Commissioners, Collier County, Florida, Contractor's Licensing Board (hereafter"the Board"),hereby stipulate and agree: 1) Respondent admits the allegations in the Administrative Complaint for the purpose of this Stipulation and settlement of this matter. 2) Respondent and the Board hereby agree that her permit pulling privileges in Collier County and the cities of Marco Island and Naples,Florida, will be permanently suspended. 3) Respondent and the Board further agree that this Stipulation and Order shall be forwarded to the State Construction Industry Licensing Board with a recommendation that the State Construction Licensing Board perform a full investigation of this case. 4) The Respondent agrees to voluntarily pay$500.00 investigative costs in this case within thirty(30) days of this Order. Executed this day of September, 2012. Isl Linda Curiale Is/ Michael Ossorio Linda Curiale Michael Ossorio Respondent Contractors' Licensing Supervisor 13 September 19, 2012 Order Adopting Stipulated Settlement Agreement THIS BOARD BEING FULLY ADVISED on the Stipulated Settlement Agreement, it is hereby: ADJUDGED that the foregoing Stipulated Settlement Agreement is adopted in its entirety, and the parties are ordered to comply therewith. DONE AND ORDERED at the regularly-set Contractor's Licensing Board hearing at Naples, Collier County, Florida, on this day of September, 2012. Lee Horn, Chairman, Contractors' Licensing Board " Mr. Neale asked his client if she read the Stipulation and understood the terms. Her response was, "Yes." Mr.Neale asked his client if she agreed to the terms of the Stipulation as a voluntary act. Her response was, "Yes." His client stated her name for the record, "Linda Michele Curiale." Vice Chairman Joslin asked Ms. Curiale if she was the license holder of CGC 1508972 and 27333, and her response was "Yes." Kyle Lantz noted the Stipulation was against Ms. Curiale personally—not against the business—and asked if she could hire another General Contractor to pull permits for her. Michael Ossorio stated if the Corporation petitioned the State Licensing Board to obtain a new qualifier, it would be under a totally different certificate and separate CGC license. He clarified the Stipulation and Order pertained only to Ms. Curiale. Thomas Lykos questioned the references in the Stipulation. Attorney Morey concurred and stated the case number for the Stipulation should be changed to 2012-10, not 2012-03. Attorney Neale stated the correct case number appeared on the documents presented to the Board. He agreed the Stipulation was specific to Case#2012-10. Michael Ossorio verified the correct paperwork had been submitted to the Board. Vice Chairman Joslin noted, "for the record,"that the correct Case number (2012-10) appeared on the document presented to the Board by Michael Ossorio. 14 1 September 19,2012 Patrick White explained why connecting the two cases, i.e., 2012-03 and 2012-10, was important— Stipulation 2012-03 established the Board's jurisdiction in the matter at hand because the Respondent was subject to probation. Attorney Neale stated while the Board could not order Ms. Curiale to be subject to probation since she is a State-certified contractor, she voluntarily agreed to it as she voluntarily agreed to pay the County's investigative costs of$500.00. Since she specifically agreed,the Board may incorporate the information into the terms of the Stipulation and Order. Thomas Lykos summarized: The 2012-03 Stipulation noted if an infraction occurred, certain penalties would be imposed. The 2012-10 Stipulation acknowledges the prior Agreement and permits the penalties to become effective. Mr. Lykos stated he does not approve of the Stipulation process. Mr. Neale pointed out that, under the terms of the Stipulation, the Respondent agreed to the maximum penalties that could be imposed. Mr. White clarified using a Stipulation was the most efficient way to achieve the outcome without devoting a day to hear one case. [The members debated the positive and negative aspects of the Stipulation process.] Kyle Lantz moved to approve accepting the Stipulation as presented. Second by Vice Chairman Joslin. Vice Chairman Joslin read the terms of the Stipulation into the record [See Page 13 of the Minutes] and then called for a vote on the Motion. Motion carried, 6— "Yes"/1—Abstention. Patrick White abstained from voting. Attorney Morey suggested the Vice Chair read the terms of the Order into the record [See Page 14 of the Minutes]. Vice Chairman Joslin signed the Stipulation and Order. VI. NEW BUSINESS: (B.) Angela Rogers, d/b/a"Thomas W. Rogers Painting Service"—Waiver of Examination Vice Chairman Joslin noted Angela Rogers was not present. Michael Ossorio stated the case would be added to the October Agenda. IX. REPORTS: • Attorney Morey referenced a previous hearing during which the Board heard a Petition to Contest a Citation. The Petitioner asked if the Board's 15 September 19, 2012 decision could be appealed. Assistant County Attorney Wright verified that any decision of the Board could be appealed. • There was also a discussion during the previous meeting of the possible form (and language) of a Motion when a Citation was contested. o If a Motion is made but does not carried,what is the inference. • A copy of Statute 489.127 was presented to the Members. • Mr. Morey noted 489.127is the governing Statute for Citations issued by Investigators. • Additional copies provided: o A Citation(front and back) o Several"sample"motions for consideration by the Board. • Attorney Morey explained the process to issue a Citation and referred to Section 5(a) of 489.127 as well as Section 1(a)through(h) which outlines the prohibitions and what can be cited. He stated the form of the Citation currently used by the County"tracks"the Statute. • If a Respondent elects to contest a Citation, he/she is entitled to a Hearing before the Board. • If a Respondent could prove that the issued Citation was invalid or if the violation had been corrected prior to the Hearing,the Board may dismiss the Citation. • The Board may impose a civil fine or penalty if it found that a violation did exist. • He explained if a Motion is made but does not carry, it cannot be voted on again. • The Board may make a motion to clarify the proceedings. • Findings of Fact and Conclusions of Law will be issued by the Board based on the hearing process. Examples of Sample Motions: (1) Move to dismiss the Citation on the basis that the Petitioner showed the Citation was invalid. (2) Move to dismiss the Citation because the violation had been corrected by the Petitioner prior to the Hearing. (3) Move to uphold the Citation on the basis that the violation which exists is irreversible or irreparable. (4) Move to uphold a Citation on the basis that the violation has not been corrected. X. MEMBER COMMENTS: None XI. NEXT MEETING DATE: Wednesday, October 17, 2012 Board of County Commissioners' Chambers, 3rd Floor—Administrative Building"F," Government Complex, 3301 E. Tamiami Trail,Naples, FL 34112 16 September 19,2012 There being no further business for the good of the County, the meeting was adjourned by the order of the Vice Chairman at 11:00 AM. COLLIER COUNTY CONTRACTORS LICENSING BOARD Richard Joslin, Vice Chairman The Minutes were approved by the Board/Chairman on , 2012, "as submitted" F 1 OR "as amended" ( ]. 17 /o W/o ,m j'7ay �oore�e� Y+.enzag„,� /20„,c, C' G �-� � P� .D u 'a,0 r^^9 ci4 -wtice 2l)q e-o e� aoa9 � ✓.� c,f �9 -AA/0,1 -171/Le i $O./\_- a.. W h c P f�a.t ti J f4+ . d-to GJu J krno_,) RS j Cam .e Aa_c_k yietiol fo ti/LP * wP, tiPd ( ,lam Re.° �,., .� I ) erktutA, w°'3' . P -1)001 q0-001 5 c_DQ o-2/1_ r14,4 /-71P-L&)/P■09d} i Ak File Edit View Help Iri+! a b g x. 0 Addressing/Property 1 Code Enforcement Permitting Dev.Review 1 Cash M • Qualifier Certificates Permits Inspections Cert-O cc rlii Certificate No Qualifier Name DBA Status 20105 01GELA WELCH ROGERS rob ITOM &ANGIES CUSTOM PAINTING &FAl INACTIVE zi S Detail I DBA Info I LIAB Ins I WC Ins I Bond Ins I Associated Tables I Update Info I Class Code 4270 roe PAINTING CONTR. --County Original Issue Date 412911999 Comp Card I Expiration Date Renewal Date 1 OL Exempt r Expiration Date 19/30/2010 ® OL Number 1962293 OL Expiration Date 913012010 Cancel Date �:Skate-- — { Number I Expiration Date Reinstate Date 1 ® I -Other Debit Account I nee I, OL Number Expiration Date Planning Comm. 1 'be Tuesday,Sep 18,2012 02:43 PM .. ..,-. �.1 I X Quoit fer iZ- .,i. ,P ,,. .f ` t ' res '.._ › oolitic" No First Name Middle Name Last Name Postfix 18135 VNGELA rWELCH ROGERS Detail Addresses Associated Tables I Update Info ID No_ Description Exam Date Score Location Sponsor _ e 5005 BUSINESS AND LAV/ 21711998 66 FT.MYERS COLLIER COlJ.1 5168 BUSINESS AND LAW 31711998 68 NAPLES COLLIER CO Certificates 5004 PAINTING 217/1998 75 FT. MYERS COLLIER CO 5997 BUSINESS AND LAW 11911999 76 NAPLES COLLIER CO 5404 BUSINESS AND LAW 7/1111998 68 NAPLES COLLIER CO Examinations 5 Record(s)-Examinations i E Tuesday, Sep 18,2012 02:44 PM G c;0/Peire, CDES Operations & Regulatory Management Licensing Section.. ' %' � 2800 North Horseshoe Drive _.,\` Naples, FL 34104 ti APPLICATION FOR ~. COLLIER COUNTY/CITY OF NAPLES/CITY OF MAR( 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%Busin W ess Name:"?��j l° ', `�} � } 5 A l�Oj l L Fiction Name/DBA: Qualifier Name: am 9 0,4 lay 5' Physical Address: /04/ U k'&g., 1-5 1,/i it 06 /ear J,,�j ° 311.3-0 (Number& Street) (City) State (Zip Code (City) (State) � Code) Mailing Address: I e �_' 6 # Rel 1 3' I D-4.) (Number & Street) (Ci (State) (Zip Code) 3 - 4 9 PkillieW. ` Tele hone � �g` `�S E=Mail:�j'� �� M �nqo33 LJq ti 5c TYPE OF LICENSE: P` U General $230.00 ❑ Electrician $230.00 U Building $230.00 ❑ Plumber $230.00 U Residential $230.00 U Air Cond. $230.00 U Mechanical $230.00 Q Sy.imming Pool $230.00 L Roofing $230.00 Specialty $205.00 Specialty trade: C 1., } .A". Qualifier 18135-ANGELA WELCH ROGERS . C GE OF STATUS: Reinstatement$205.00 ( Reinstatement ( ) From One Business to Another Renewal W!Late Fee$185.00 2010-2011 Renewal W/Late Fee$185.00 2011-2012 Renewal 2012-2013 125.00 Page 1 of 4 Name Change$205.00 1. T e names, titles, home address and phone numbers of all Officers/Managing Members of the Firm. 2 &a •. _ i P Alia .e 1 '(1&2.. 11 4r, r 1zi -SA 19 nci I 3 1.1-0 nr‘') R0110‘6-0- 5 0,om a 6 1 4 116,_•LoF1 Plnotire 33I 49 ` ' R ,q. 1.-143 2. List all businesses, firms,entities or contracting businesses you have been associated with during the last ten years (ex. Held a license for or been a partner). Attach extra pages if needed. 3. List all debts you or any company(s)associated with you refused to pay and the reasons for the refusal to pay. Attach extra pages if needed. AFFIDAVIT AE_l A d Scerti fy that the foregoing is true and correct to the best of my knowledge. �\ e(�.., La C I �h 0) -\\/(-U(1.. } Authorized Officer of the Firrh STATE OF FLORID COUNTY OF (4//L/ D--Thoin- fore s ac Ii/ e foregoing instrument a n knowledged before me this (Date) / �t By /4/ kZ / i dl/US W - l�o tic PQoh77 Lt (1( me of officer titl gent)9 ) Name of Colporation) a F!Qf/da Corporation on behalf of the corporation. (State or Place of Corporation) He/She has-produced -. . f l --- pi (/e/'' L . identificatio :nd did not take an oath. (Type of identification) P ��c, KAREN E Y Notary Public-State tate of of Florida � I M i Y Comm.C omm Expires Jun 8,2015 (SIGNATURE.• NOTARY) F,°P`� Commission#EE 89199 Page 2 of 4 1 QUALIFIER INFORIVIA'I'ION: Name: dh ILA t_ ' ' &.1 CAA__ f20 6_.12-� e Address: 1 C im 1 51 Ana 4. A 11. 5 V 3 Li 1 -O (Number& Street) (City) (Sta -) (Zip Code) Telephone:_ 3 15 9 Date of Birth: 10 • 0 • 103 s.s. #: 000-oo- ‘ E-Mail: tA ru,ck) -j _E rA;r1 ',a .- Driver's License: - . 1.i A v t°0 1. T e of Certificate of Competency for which application is made. R1cfil vy)1 2. The names and telephone numbers of two persons who will know your whereabouts. C s.EV.-$ D 3c1 L , " 5 5c1 ■ 3. Have you ever been convicted of a crime related to Contracting? n b (If yes attach extra sheet with explanation) 7. Have,you or any firms you have been associated with ever filed bankruptcy? 0 8. List all debts you or any company(s)associated with you refused or failed to pay and reasons why. r-An "'-- • 9. List your business or work experience during the past ten years. 6 , �. .Am • • f te 1-r k '. _ 10. , - Q'f, F; irk s le, 10. Statement of any formal training you have had in the area for which the application is made. Page3of4 AFFIDAVIT The undersigned hereby makes application for Certificate of Competency under.the provisions of Collier County Ordinance No. 2006-46, as amended, and vouches for the truth and accuracy of all statements and answers herein contained. The undersigned hereby certifies that he is legally qualified to act on behalf of the business organization sought to be licensed in all matters connected with its contracting business and that he has full authority to supervise construction undertaken by himself or such business or organization and that he will continue during this registration to be able to so bind said business organization. The qualified license holder understands that in all contracting matters, he will be held strictly accountable for any and all activities involving his license. Any willful falsification of any information contained herein is grounds for disqualification. )A .1U ?.00irsLA.S APPLICANT(PLEASE PRINT) hp 1'Vtit C:,-0 C.Q('125 R ‘Z171 NAME OF COMPANY i L r-v-P (Lb) 09,--A-A- SIGNATUliE 0 -APPLICANT STATE OF FLORID / COUNTY OFllfCy/. The foregoing instrument as acknowledged before me this qh "' (Date) �1 r` By J6: kOger5 who has produced D o Uet5 (_- ' (Nam f person acknoedging) (Type of identification) as identification and did not take an oath. NOTARY'S SEAL � • ,�nY aL'. KAREN E YAKUBEC 5r �(i ' • '\. = Notary Public-State of Florida SIGNATURE OF 1, •TARP) Comm.Expires Jun 8,2015 ?N: irr`.aQ My '�9T»op.= Commission#EE 89199 Page4of4 • AFFIDAVIT It is understood and acknowledged by the Collier County Contractors' Licensing Board and myself that if I fail to acquire, or maintain at all tunes effective - Workmen's Compensation Insurance it will result in the possible revocation of my Certificate of Competency. Piyr4_2(do orRA,DJ SIGNAT1tJRE OF APPLICANc31" --Fkrfmaz BUSINESS NAME DATE BEFORE ME this day personally appeared 'AP I& /��J ��� 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 FLORIDJ�'Q/t� o COUNTY OF (( , The foregoing instrument was acknowledged before me this 1 /l (Date) by : :/c Pd.Ver5 who has produced c j)n oer5 C.'�' - nem of erson a i y( p owl dgrr g) (Type of Identification) as identification and who did not take an oath. -_KAREN E YAKUBEC (b/Vn a_hic 0� ' Notary Public-State of Florida S GNATURE OF NO ARY NOTARY rri �'ia� My Comm.Expires Jun 8.2015 / Commission#EE 89199 NOTARY PUBLIC • RESOLUTION OF AUTHORIZATON WHEREAS 14 L/ _1 l L L-C ft5poses to • imp of Business Entity) - engage in contracting as in (Type of legal entity:corp.,partnership,etc. Collier County,Florida,according to Collier County Ordinance 2006-46, as amended;and 1110 • ' - LL c WHEREAT fib fb Li / .b i 0.414 proposes to (Name of B i ess 'ntity' qualify for a Certificate of Competency with AT AAA__ , A A Ai (N.me of Individual) NOW THEREFORE,B HEREBY RESOLVE/ THAT: We the undersigned M Crfr of 0 Offiders,Owners,Partners) /AA/. • r 4 jiy,re l e and represent to the Collier County (Name of Business E s tity) lh. (L- 11 Contractors'Licensing Board that the qualifying agent, I Li _� �J _ p1L4s)active me •f In•i idual)all matters connected with the contracting business of I/ / I ) g/!>J 1, d (Nam..f B sines ti ) We further resolve and represent that Wfl'!/ !,i„ ) A /,%, i is ► ;mes • Individual) legally empowered to act for I / A 1 A. _1 I,4_, * tterk.connected with its (Name of Business ntity) L tractin business, d has the on to supervise construction undertaken by oi'r)0S fO EL ` —f'5 �t e, (Name of Business Entity) G DULY PASSED AND ADOPTED THIS � day of ,220— (Officers,Partners,Owners—with esignation underneath e /tic -- / Witness v Witness Witness Corporate Seal(if Applicable) Or Notary Public Certificate Sworn to and subscribed before me this 'W day of Ill , 1?by 1 L 'ham i�f' ice . Li6 Notary Public Name Printed �--' stary Public Sips: f e Commission Number My Commission expires: 44-;:s Y�p►7°�% KAREN E YAKUBEC •; ,•,� Notary Public•State of Florida �:�o�= My Comm.Expires Jun 8,2015 ,,Q;; Commission#e EE 89199 COLLIER COUNTY GOVERNMENT COMMUNITY DEVELOPMENT AND ENVIRONMENTAL SERVICES DIVISION • 2800 N.Horseshoe Dr. • Naples,Florida 34104 • 239-403-2400 • FAX 239-403-2334 MEMORANDUM DATE: November 29,2007 TO: Applicant's FROM: Michael Ossorio,Contractor Licensing Supervisor. CC: Robert Dunn, Collier County Building Director. Alamar Finnegan, Collier County Permitting Supervisor. Robert Zachary, County Attorneys Office. All Contractor Licensing personnel. SUBJECT: Collection of social security numbers. Pursuant to Chapter 119, Florida Statues and Collier County Contractor Licensing Ordinance 2006-46 Sec. 2.1.1, all applicants are required to submit their social security number(SSN) for the following purposes: a) Assess applicant's ability to satisfy creditors by reviewing their credit history. b) Verification of applicant's test scores and information. Our office will only use your SSN noted above for those reasons pursuant to Chapter 119,Florida Statues and as may otherwise be authorized by law. We are fully committed to safe-guarding and protecting your SSN and once collected, will be maintained as confidential and exempt under Chapter 119,Florida Statues. Prepared By: Merit Credit (239) 277-3202 (800) 371-3348 TRANSUNION CREDIT REPORT [FOR] [SUB NAME] [MKT SUB] [INFILE] [DATE] [TIME] (I) Z NP6284423 MERIT CREDIT 16 NP 6/91 07/31/12 08:37CT [SUBJECT] r..gN1 [BIRTH DATE] ROGERS, ANGELA W. - 10/63 [ALSO KNOWN AS] GOGERS,ANGELA,W WELCHROGERS,ANGELA,G WELCH,ROGERS,ANGELA [CURRENT ADDRESS] [DATE RPTD] 1140 KERI ISLAND RD., NAPLES FL. 34120 12/06 [FORMER ADDRESS] 1073 COUNTY ROAD 109, DALEVILLE AL. 36322 7/11 1140 KERI ISLAND RD. , DALEVILLE AL. 36322 M O D E L P R O F I L E * * * A L E R T * * * ***FICO CLASSIC 04 ALERT: SCORE +481 : 038, 013, 010, 018 *** IN ADDITION ***TO THE FACTORS LISTED ABOVE, THE NUMBER OF INQUIRIES ON THE CONSUMER'S ***CREDIT FILE HAS ADVERSELY AFFECTED THE CREDIT SCORE. C R E D I T S U M M A R Y * * * T O T A L F I L E H I S T O R Y PR=0 COL=4 NEG=8 HSTNEG=4-16 TRD=29 RVL=18 INST=5 MTG=5 OPN=1 INQ=6 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $14.8K $20.2K $0 $0 100% INSTALLMENT: $172K $ $165K $4329 $1082 OPEN: $5450 $ $6346 $6346 $ 0% CLOSED W/BAL: $27.3K $17.0K $ TOTALS: $193K $20.2K $199K $27.7K $1082 C O L L E C T I O N S SUBNAME SUBCODE ECOA OPENED CLOSED $PLACED CREP 4110' MOP ACCOUNT# VERIFIED BALANCE ' ARKS GULF CST COL Y 1X5L001 I 4/10 $90 EDICAL 09B 7/12A $90 PLAC. . OR COLLECTIO MIDLAND FUND Y 36ET009 I 2/10 $608 GE MONEY BANK 09B 7/12A $831 PLACED FOR COLLECTIO MIDLAND FUND Y 36ET009 I 6/11 $10.8K CHASE BANK USA N A 09B 7/12A $11.9K PLACED FOR COLLECTIO AFNI Y 96ER007 I 11/11 $296 10 DIRECTV 09B 12/11A $296 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 DISCOVER FIN B 9616003 5/98 $10.3K R09 601100424015 7/12A $8400 $7490 I CREDIT CARD 2/10F $10.3K UNPAID BLNC CHRGD OFF BK OF AMER B 1597186 9/02 $7742 R09 7/12A $8400 $5656 I BUSINESS CREDIT C 7/09F $8307 ACCT CLSD BY CONSUMER AMEX B 21WB001 7/94 $5129 R09 6/12A $3897 I CREDIT CARD 9/09F $5129 CLOSD BY CRDT GRANTOR CHASE B 26QK001 8/06 $12.1K R09 6/11A $11.3K $0 I CREDIT CARD 12/09F $0 PURCH BY OTHER LENDER GECRB/JCP D 235058D 1/94 $340 R09 3/10A $500 $0 C CHARGE ACCOUNT 11/09F $0 PURCH BY OTHER LENDER SEARS/CBNA B 6256458 6/95 $5450 R09 12/09A $4200 $0 I CREDIT CARD 8/09F $0 PURCH BY OTHER LENDER LVNV FUNDING F 21T9002 11/09 $5450 09B 7/12A $6346 I 12 CITIBANK SEARS $6346 PLACED FOR COLLECTION WFHE B 908N737 4/08 $172K 360M1082 2/12 321111111111 I04 2/12A $4329 $4329 04 11111111 C HOME EQUITY LOAN $165K 20 1/ 1/ 0 GECRB/ACCC A 7824012 9/04 $1653 111111111111 ROl 7/12A $2500 $0 111111111111 I CHARGE ACCOUNT 9/08C $0 CLOSD BY CRDT GRANTOR 48 0/ 0/ 0 GECRB/DILLAR D 235061C 11/99 $200 111111111111 RO1 7/12A $224 $0 111111111111 I CHARGE ACCOUNT 10/08C $0 CLOSED 48 0/ 0/ 0 THD/CBNA B 26H3005 9/00 $4690 1/10 111111111111 ROl 6/12A $16.OK $0 04 111111111111 A CHARGE ACCOUNT 9/09C $0 SETTLED [ FULL BLNC 48 1/ 1/ 1 SUNTRUST BK B 423A022 10/05 $22.7K 60M434 111111111111 I01 21500002155460278 12/10A $0 111111111111 C AUTOMOBILE 12/10C $0 CLOSED 48 0/ 0/ 0 DOMSTICATION H 1NZ8108 7/05 $169 4/10 155432114321 ROl 7/10A $100 $0 $50 05 111111111111 I CHARGE ACCOUNT 10/09P $0 48 2/ 2/ 4 WF/WB B 11YD053 4/08 $172K 30M1082 111111111111 MO1 32010100146 5/10A $0 111111111111 C CONVENTIONAL REAL 5/10C $0 CLOSED DUE TO TRNSFR 24 0/ 0/ 0 TARGET N.B. D 1ZX5001 11/00 $0 111111111111 RO1 12/09A $5000 $0 111111111111 I CREDIT CARD 5/03C $0 CLOSED 48 0/ 0/ 0 1 AMEX B 21WB001 3/94 $3581 111111111111 RO1 10/09A $3200 $0 111111111111 I CREDIT CARD 9/09C $3581 CLOSD BY CRDT GRANTOR 48 0/ 0/ 0 BK OF AMER B 1597029 1/03 $0 RO1 10/09A $0 A FLEXIBLE SPENDING 10/09C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 HSBC BANK B 92WL002 12/05 $4466 111111111111 ROl 12/08A $300 $0 111111111111 I CREDIT CARD 5/07P $0 36 0/ 0/ 0 DISCOVER FIN B 9616003 8/99 $1169 111111111111 ROl 7/08A $12.OK $0 111111111111 I CREDIT CARD 7/08C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 BK OF AMER B 1597029 6/94 $6609 111111211121 RO1 6/08A $1000 $0 111111111112 I CREDIT CARD 1/08P $0 ACCT CLSD BY CONSUMER 48 3/ 0/ 0 WFHM B 82TE004 3/06 $89.OK 180M957 111111111111 MO1 5/08A $0 1111111111 C FRD341421588 5/08C $0 CLOSED 22 0/ 0/ 0 WF/WB B 11YD053 11/06 $66.2K 360M 111111111111 I01 5/08A $0 111111 C SECURED 5/08C $0 CLOSED 18 0/ 0/ 0 FIA CSNA B 1597185 9/01 $3620 XXXXXXXXXXXX RO1 5/08A $8000 $0 XXXXX1 I CREDIT CARD 1/03P $0 CLOSD BY CRDT GRANTOR 48 0/ 0/ 0 FIA CSNA B 1597185 12/03 $0 XXXXXXXXXXXX ROl 4409 11/06A $10.8K $0 XXXXXXX1 I CREDIT CARD $0 CLOSD BY CRDT GRANTOR 35 0/ 0/ 0 WFHM B 82TE004 3/03 $71. 9K 180M144 111111111111 MOl 4/06A $0 111111111111 C FRD838443966 4/06C $0 CLOSED 37 0/ 0/ 0 SUNTRUST BK B 423A021 11/03 $42.OK 60M823 111111111111 MOl 3/06A $0 111111111111 C HOME EQUITY LOAN 3/06C $0 CLOSED 29 0/ 0/ 0 SUNTRUST BK B 423A022 8/01 $31.8K 60M640 X11111111111 I01 11/03A $0 111111111111 C AUTOMOBILE 11/03C $0 CLOSED 28 0/ 0/ 0 SUNTRUST BK B 423A022 7/99 $16.OK 60M336 X11111111111 I01 11/03A $0 111111111111 C AUTOMOBILE 11/03C $0 CLOSED 43 0/ 0/ 0 WFHM B 82TE004 5/96 $86. 9K 360M827 X11111111111 MOl 9360017072091 3/03A $0 11111X1XX111 C FHA REAL ESTATE M 3/03C $0 CLOSED 35 0/ 0/ 0 I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 7/31/12 ZNP6284423 (FLA) MERIT CREDIT 9/09/11 YPE6175913(IND) LERS LLC 8/24/11 YPE5556540 (IND) FIRSTSOURCE 8/01/11 NCV1340002 (CLV) CFNA 3/30/11 YPE5556540 (IND) FIRSTSOURCE 9/03/10 YPE3050328 (IND) MERCANTILE A C R E D I T R E P O R T S E R V I C E D BY : TRANSUNION 800-888-4213 2 BALDWIN PLACE P.O. BOX 1000,CHESTER, PA. 19022 Consumer disclosures can be obtained online through TransUnion at: http: //www.transunion.com CREDITOR CONTACT INFORMATION GULF CST COL YC1X5L001 (877) 827-4820 5630 MARQUESAS CIR SARASOTA FL. 34233 MIDLAND FUND YC36ET009 (800) 825-8131 8875 AERO DR SAN DIEGO CA. 92123 AFNI YC96ER007 (800) 371-3645 PO BOX 3097 BLOOMINGTON IL. 61702 DISCOVER FIN BC9616003 POB 15316 WILMINGTON DE. 19850 BK OF AMER BC1597186 (800) 421-2110 PO BOX 982238 EL PASO TX. 79998 AMEX BC21WB001 (800) 874-2717 P.O. BOX 981537 EL PASO TX. 79998 CHASE BC26QK001 (800) 945-2006 P.O. BOX 15298 WILMINGTON DE. 19850 GECRB/JCP DC235058D (800) 542-0800 PO BOX 965005 ORLANDO FL. 32896 SEARS/CBNA BC6256458 PO BOX 6282 SIOUX FALLS SD. 57117 LVNV FUNDING FY21T9002 (866) 464-1183 P.O. BOX 10584 GREENVILLE SC. 29603 WFHE BB908N737 P 0 BOX 31557 BILLINGS MT. 59107 GECRB/ACCC AZ7824012 (866) 396-8254 C/0 PO BOX 965036 ORLANDO FL. 32896 GECRB/DILLAR DC235061C (800) 643-8278 PO BOX 965005 ORLANDO FL. 32896 THD/CBNA BZ26H3005 PO BOX 6497 SIOUX FALLS SD. 57117 SUNTRUST BK BY423A022 (877) 596-5407 PO BOX 85526 RICHMOND VA. 23285 DOMSTICATION HZ1NZ8108 PO BOX 182789 COLUMBUS OH. 43218 WF/WB BB11YD053 (336) 747-8325 POB 3117 WINSTON SALEM NC. 27102 TARGET N.B. DZ1ZX5001 PO BOX 673 MINNEAPOLIS MN. 55440 BK OF AMER BC1597029 (800) 421-2110 PO BOX 982238 EL PASO TX. 79998 HSBC BANK BC92WL002 (800) 947-1000 PO BOX 5253 CAROL STREAM IL. 60197 WFHM BM82TE004 (800) 288-3212 7255 BAYMEADOWS WA DES MOINES IA. 50306 FIA CSNA BC1597185 (800) 421-2110 PO BOX 982238 EL PASO TX. 79998 SUNTRUST BK BZ423A021 (877) 596-5407 PO BOX 85526 RICHMOND VA. 23285 LERS LLC Y 6175913 (800) 663-4707 5440 NORTH CUMBERL CHICAGO IL. 60656 FIRSTSOURCE Y 5556540 (716) 564-4400 205 BRYANT WOODS S AMHERST NY. 14228 CFNA N 1340002 PO BOX 81315 CLEVELAND OH. 44181 MERCANTILE A Y 3050328 6390 MAIN ST WILLIAMSVILLE NY. 14221 END OF TRANSUNION REPORT MERIT CREDIT HAS RETRIEVED THE ABOVE PERSONAL CREDIT REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY, STATE AND FEDERAL LEVELS. PUBLIC RECORDS HAVE ALSO BEEN VERIFIED FOR PINELLAS COUNTY. PUBLIC RECORDS LEARNED 0 SOURCES OF INFORMATION: 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. EXPERIAN BUSINESS REPORT PAGE RPT DATE TIME PORT TYPE 1 07/31/2012 08:40:26 -AN3 REPORT 404 TOM & ANGIE'S CUSTOM PAINTING & FAUX FINISHES INC BIN: 941168842 1140 KERI ISLAND RD NAPLES FL 34120-3854 PHONE: 239-352-9091 COMPANY DESCRIPTION THE PRIMARY BUSINESS FOR TOM & ANGIE'S CUSTOM PAINTING & FAUX FINISHES INC IS Painters (SIC 17210100) WITH A SECONDARY BUSINESS CATEGORY OF Painting & Paper Hanging Contractors (SIC 17210000) . THE BUSINESS WAS INCORPORATED ON AUGUST 18, 2004 IN FLORIDA. TRADE PAYMENT INFORMATION TRADE PAYMENT EXPERIENCES (TRADE LINES WITH AN {*} AFTER DATE REPORTED ARE NEWLY REPORTED) RECENT ACCOUNT STATUS HIGH -DAYS PAST DUE- BUSINESS DATE LAST PAYMENT CREDIT BALANCE 1- 31- 61- CATEGORY REPTD SALE TERMS $ $ CUR 30 60 90 91+ COMMENTS BLDG MATRL 07-12 08-05 CREDIT 0 ACCTCLOSED ADDITIONAL PAYMENT EXPERIENCES ADVERTISNG 07-09 NET 30 0 CUST 6 YR COPYRIGHT 2012 EXPERIAN INFORMATION SOLUTIONS, INC. ALL RIGHTS RESERVED. **CONTINUED** EXPERIAN BUSINESS REPORT PAGE 2 07/31/2012 TOM & ANGIE'S CUSTOM PAINTING & FAUX FINISHES INC BIN: 941168842 COMPANY BACKGROUND INFORMATION THE FOLLOWING WAS PROVIDED BY THE STATE OF FLORIDA. HISTORY : BUSINESS INCORPORATED ON AUGUST 18, 2004 AS A FOR-PROFIT CORPORATION. FEDERAL TAX ID IS 800124187. CHARTER NUMBER IS P040001197. CURRENT STATUS : INACTIVE BUSINESS. PRIMARY PRODUCT/SERVICE: CONTRACTORS-PAINTING & PAPERHANGING SIC: 1721 ADDL PRODUCT/SERVICES : CONTRACTORS-PAINTING & PAPERHANGING SIC: 1721 ADDL PRODUCT/SERVICES : MISC. PERSONAL SERVICES, NEC SIC: 7299 NO. OF EMPLOYEES : 2 ESTIMATED SALES : $222,000 PRINCIPAL(S) : ANGELA ROGERS TITLE: OWNER/PRESIDENT THOMAS ROGERS TITLE: VICE PRESIDENT 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/PROPIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY (INCLUDING PINELLAS) , STATE AND FEDERAL LEVELS. PUBLIC RECORDS LEARNED: 0 SOURCES OF INFORMATION: EXPERIAN BUSINESS INFORMATION SERVICES IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1-800-371-3348 OR 239-277-3202. www.sunbiz.org - Department of State Page 1 of 2 FLORIDA DEPARTMENT "IMF— .t. LIEPARTMENT OF STATE DIVISION Of CORPORATIONS Home Contact Us E-Filing Services Document Searches Forms Help Entity Name Search Submit Detail by Entity Name Florida Limited Liability Company THOMAS W ROGERS PAINTING LLC Filing Information Document Number L12000098647 FEI/EIN Number NONE Date Filed 07/31/2012 State FL Status ACTIVE Effective Date 09/01/2012 Last Event LC NAME CHANGE Event Date Filed 08/10/2012 Event Effective Date NONE Principal Address 1140 KERI ISLAND RD NAPLES FL 34120 US Mailing Address 1140 KERI ISLAND RD NAPLES FL 34120 US Registered Agent Name & Address ROGERS,ANGELA W OWNER 1140 KERI ISLAND ROAD NAPLES FL 34120 US Manager/Member Detail Name&Address Title OWNE ROGERS,ANGELA W OWNER 1140 KERI ISLAND ROAD NAPLES FL 34120 US Annual Reports No Annual Reports Filed Document Images I View image in PDF format View image in PDF format I http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&ing_doc_numbet=L120000986... 9/18/2012 www.sunbiz.org - Department of State Page 2 of 2 Note:This is not official record.See documents if question or conflict. "` '` Entity Name Search Submit i Home I Contact us I Document Searches I E-Filinq Services I Forms I Help Copyright©and Privacy Policies State of Florida, Department of State ........,.1.,...—T 1,1nnnACIO nn0 i1/11,1 {' • LI 2z::(1)-z)( 1g4(4-1 (Requestor's Name) III MI -111 11,1 11 111 (Address) - 300238340773 (Address) (City/State/Zip/Phone#) PICK-UP WAIT MAIL 08/10/12--x11014--III it **2.S.00 (Business Entity Name) (Document Number) Certified Copies Certificates of Status Special Instructions to Filing Officer: rAUG"3 3 2012 L. SELLERS >co rn x" m s rr' C7 . cn k C' '11 D ■ I Office Use Only rm- b-4 GD am cr, 1 COVER LETTER TO: Registration Section Division of Corporations /* SUBJECT: d A' /1,5 +�l n t 1 PDOK5 e of Limited Liability Company / The enclosed Articles of Amendment and fee(s)are submitted for filing. Please return all correspondence concerning this matter to the following: n e lrA \A le 6/25 Name of PE3snn li D 14 -� L L C Firm/Company 10 7 3 CA)141+44 PC1 1 D�'j x,41611 ; 116 /4 I t 310 . Ci fate and Zip Code �i fad l4(to used Ca tutnre6 anemia re no *cation)�O Coneki For further information concerning this matter,please call: 6`Yt A Rc at(.g7 ) • N 1— . r J 9 Name of Person Coda&Daytime Telephone Number Enclosed is a check for the following amount EiS25.00 Filing Fee 0$30.00 Filing Fee& 0S55.00 Filing Fee& [J560.00 Filing Fee, Certificate of Status Certified Copy Certificate of Status& (additional copy is enclosed) Certified Copy (additional copy is enclosed) MAILING ADDRESS: STREET/COURIER ADDRESS: Registration Section Registration Section Division of Corporations Division of Corporations P.O. Box 6327 Clifton Building Tallahassee,FL 32314 2661 Executive Center Circle Tallahassee,FL 32301 • ARTICLES OF AMENDMENT TO ARTICLES OF ORGANIZATION OF• ' UGC IrmorynA514)1 meumia ,a , rds on.. emit.• ea• ity ompany The Articles of Organization for this Limited Liability Company were filed on and assigned Florida document number I.. 1 a1 Q a OO Q ti(p Lt 7 This amendment is submitted to amend the following: A. If amending name,enter the new name of the limited lability company here: 1—kern A's t,� Ro E(zs L I. C The new name must be distinguishable and end the words"Limited Liability Comny,"the designation"LLC"or the abbreviation "L.L.C." Enter new principal offices address,if applicable: (Principal office address MUST BE A STREET ADDRESS) Enter new mailing address,if applicable: (Mailin z address MAY BEA POST OFFICE BOX) B. If amending the registered agent and/or registered office address on our records, enter the name of the new, registered agent and/or the new registered office address here: >ce r-rn N Name of New Registered Agent: `i "-�- ' New Registered Office Address: m EllFlorida street as cn . ,'Florida ?°- + City Dr/Zipiode New Registered Agent's Signature.if changing Registered Arent: I hereby accept the appointment as registered agent and agree to act in this capacity. I further agree to comply with the provisions of all statutes relative to the proper and complete performance of my duties, and!am familiar with and accept the obligations of my position as registered agent as provided for in Chapter 608, F.S. Or, if this document is being filed to merely reflect a change in the registered office address, I hereby confirm that the limited liability company has been notified in writing qf this change. If Changing Registered Agent,$ienaturc of New Resdsteral Anent Page 1 of 2 If amending the Managers or Managing Members on our records,enter the title,name,and address of each Manager or Managing Member being added or removed from our records: MGR=Manager MGRM=Managing Member Tit a Nome Address Tye of Action n Add f Remove n Add n Remove n Add o Remove Add Remove fAdd ❑Remove nAdd ['Remove D. if amending any other information,enter change(s)here: (Attach additional sheets, V.necessary) j ID -€c c (24 i) &61%. e:A c-1,1. D 0-6 , a�. nes Dated (jA (9 , ry D ) ( Ll7J igna o I' mk ?r a a onWesentative of a member PrtqF ) 4 1W5 Typ or pun e o s►gnee Page 2 of 2 Filing Fee: $25.00 STATEMENT OF OWNERSHIP This certifies that I /f IN gl_J--/)--QYI'�')�,,LL��- am a member or (APPLICANT'S NAME) if) pManaging member of BIN) I. 4. r _ t--5 1 I .1-- (LIMITED LIABILITY COMPANY NAME) I own JOO % of the units issued by the Limited Liability Company listed above. Affidavit of Applicant:.I certify that the information contained is a true and correct statement to the best of my knowledge. t(' 6-/A Cie (PRINT NAME) 1. OLL 4 (APPLICANT'S SIGNATUR 6- �---� (DATE) 1 �..,, Policy Number: Date Entered: 8/2/2012 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) • 4........---- 8/2/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Perlin Insurance Agency NAME: PHONE((A .Extl: (239)263-3141 FAX No): (239)263-8696 PO Box 366697 Bonita Springs, FL 34136 E-MAIL AI 24520 Production Cr. , #4 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Bonita Springs, FL 34135 INSURER A:NORTHPOINTE INS. Co. INSURED THOMAS W. ROGERS PAINTING, LLC INSURERB: THOMAS ROGERS INSURER C: 1140 KERI ISLAND ROAD INSURERD: NAPLES, FL 34120 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $300 r 000 A X COMMERCIAL GENERAL LIABILITY 12-0371 08/02/2012 DB/02/2013 PRTORENTED PREMISES(Ea occurrence) $100,000 CLAIMS-MADE X OCCUR MED EXP(Anyone person) $5,000 PERSONAL&ADV INJURY _ $300,000 GENERAL AGGREGATE $600,000 GENII AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $600,000 7 POLICY JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS ( ) HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) _ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) PAINTING INTERIOR AND EXTERIOR CERTIFICATE HOLDER /CANCELLATION f-- �N. COLLIER COUNTY CONTRACTORS LICENSING BOARD \SHOULD ANY OF THE,ABOVE DESCRIBED'ROLICIES BE CANCELLED BEFORE 2800 N HORSESHOE DRIVE HE EXPIRATION DATE THEREOF, NOTI E WILL BE DELIVERED IN CCORDANC�ITH TH POLICY PROVISIONS NAPLES, FL 34104 FAX: 239-252-2469 AUT O' IZED REPRESS€NTATIVE `, / FAX: 239-252-6417 �N` ---- �`\``,\/ -, ---\\I \`` ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 'reduced using Forms Boss Plus software.www.FormsBoss.com;Impressive Publishing 800-208-1977 • ' =7, http1L—uppte.fidfs.corn i'procttyl<risoto,EstariptionNil stlAst iIpLpeisorLidc0O264,377 vi a 7.1 P- file Edit Slew Fivorites loots Help -a Favorites . Google &I Proof of Cowl-ogle El Ens• Gaiety• 721A7•44- JEFF ATWATER,CHIEF FINANCIAL OFFICER FLORIDA DEPARTMENT OF FINANCIAL SERVICES t.WC Home F WC Databases t.CFO Horne Exemption Detail Page This database was last updated Tuesday,September 18,2012 2:22 AM. I Return to Previous Page Exemption Details loire Title Hitt,5.Psi- •Tel rnirtairitri Date Type Activities t-iripiciyur Nadir 111th Here to Vieve ANGELA W SP Aug 22 1696 Dec 311109 Construction Achilles Lisled on ROGERS ANGELA ROGERS EXI:1111.1.rt Nem to View ANGELA W ME 101 72012 Aug 7 2014 Construct. sLIoleotes ROGERS Eiseman Clck Nero%View SOH&ANGE ANGELA,Ve CUSTOM ROaRS PT Sep 15 2003 Dec 21 2003 Construction ictirelet 1.911,2 09 PAINTING&FAUX • Exemption EN.g.O TOM&ANGIE 1 Attr,ELA tt't CUSTOM Fr sap 152001 Sep 152005 Construction Activates Letod on ROGERS PAKONG&FAUX HtLjS. It Nem to View 7°" I ANGELA W PT Sep 3 1599 Sep 2 2001 Construction Actrcheis Lasted cm CUSTOM ROGERS pArinso a FAUX Exemoten FHTSH Click Hers to View Tfg`l ANSE1 PR ANGELA tlie Allg 7 2005 Aug 72015 Construction Activhes Lts110 on ClitSTOIE ROGERS PAINT9IG&FAX'. Excitation FaiSHES SIC TOM&ANGE'S Click Here to%Neu< ANGELA W PR Aug ZE 2006 Aug 7 21,95 Construction Activities Listed on CUSTOm ROGERS PARTTNG FAUX Exemption FIMMNES INC caai Nem Witco, 500 0459015 I &Ro&G;ELARs'Y PR eat 7 2004 Sep 102005 Construction ACIAISS Listed on CUSTOM PAWING FAUX Exempts. fNiSHESelq 'Termination Inay be through the reveLation of the exemption.or expiration of the exemptton. The exemption only applies lo the business activities listed on the exemption [ Return to Search Page I 61 Internet!Protected Mode On •`,4- *o.nrm 19anprofcryoe.+ye ,..,• w#.,Fwlperawaedby The coae C. 1-"'"77774:y. ,' fi x 66. httP -p O fldfs.corn p cc cf. ,s 2p _n pt C a ..t F 'I t I 4 tog File LdR Yew Furor tee Ionic Help Fevontes y 11 Google 5 Proof of Coverage r ©' ' -� ."`� page 5sfety. Tools- Q JEFF ATWATER,CHIEF FINANCIAL OFFICER FLORIDA DEPARTMENT OF FINANCIAL SERVICES r tVC Hc,=se r°.YC Pa:=_rz-e- ■CFO Exemption Detail Page This database was last updated Tuesday,September 18.2012 2:22 AM. [—Return to Previous Page j Exemption Details . �., r ..... r♦ .:i4.,er Here ANGELA VI III CMH -Ve'r, ROGERS Aug 221593 Dec 311999 ceesNabee H tt. sted on aGGEaS� ANGELA YY III 'RYA Here m o dc: ROGERS A0972012 Aug 72018 ..onstrucbon 4rt.:tes-clod cn MRS Exe.x;c PAN0MG LLG v.Hi 0a re m'�e: ANGER YY Sep 152003 Cec312003 Can6truGbn ru:rtes kd_�. ROGERS Fe [h.Here to' -GN3�Nf ANGELAYr Pr Sep152001 Sep 152003 Constructs. :ct.tt s Ustea ROGERS ? — Frlry ▪ l Y 4 rc 11 C „r ROGERS cep 31999 Sep 22001 Constructs. 4C1, C o xem� E2iI5M Cac 1:= Ota dite:,CS A C= GELASY © o ,. Rue 72008 Aug 72010 Construct Art sea L.st<C co ROGERS _rtnfe;n P�al3.G3 a E etc ll5H5 MC © • H fo f PG k ANGELA Aug 282000 Aug 72008 wnstuC. Lntr c t ROGERS Le AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER auc a- bespyvirckLf I, /�r�«���,41�iIG�� , am a resident of Col ` s County, 1► I ` (State) and have resided here for more than five (5) years. During the last five years I have known 4flC /L_ c applicant). I have had the opportunity to observe his or her business and personal dealings nd�m or her to be a P erson of honesty, integrity and good character. (Signature)a, (Name) r� [S (Address)a`-(7D 1/AN erI( `/ 6e 6 Aiq-�►IPS, y(07 Telephone) 2^3 S 9 7-6 a Yd STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this / Vi c b ,/ /� g y D($/Y)C'c,. 2/ 5 ate) who has produced (name of person acknowledging) (Type of identification) as identification and who did not take an oath. A t tikC GNATURE OF N(TARY NOTARY'S SEAL (PRINT NAME OF NOTARY) NOTARY PUBLIC 4 .`tPa °'o'o, KAREN E YAKUBEC = Notary Public•State of Florida. I -,n ∎ Sri . QS My Comm.Expires Jun 8,2015 Fob oars Commission#EE 89199 i COLLIER COUNTY BUSINESS TAX BUSINESS TAX NUMBER: 962293 COLLIER COUNTY TAX COLLECTOR-2800 N.HORSESHOE DRIVE-NAPLES FLORIDA 34104-(239)252-2477 VISIT OUR WEBSITE AT:www.colliertax.com THIS RECEIPT EXPIRES SEPTEMBER 30, 2013 C f - c DISPLAY AT PLACE OF BUSINESS FOR PUBLIC INSPECTION LOCATION: 1140 KERI ISLAND RD ' l FAILURE TO DO SO IS CONTRARY TO LOCAL LAWS. ,.tEtAL F0 2M , 'YN,; _ THIS TAX IS NON-REFUNDABLE ZONED: HOME OCC ,f- LLC �" i BUSINESS PHONE: 269-4589 �sj (.. °‘ l'-, p I THOMAS W ROGERS PAINTING LLC COUNTY LIC: 2012-3187 a ROGERS,ANGELA W i )1 .x" 1140 KERI ISLAND RD -..,, , - t NAPLES FL 34210-0000 NUMBER OF EMPLOYEES: 1-10 EMPLOYEES * » r,° y CLASSIFICATION:PAINTING CONTRACTOR Cr µ ui:: ',.. DATE 07/31/2012 • �� }._,c: AMOUNT 18.00 CLASSIFICATION CODE: 02101601 ` RECEIPT 2300.40 This document is a business tax only.This is not certification that licensee is qualified. It does not permit the licensee to violate any existing regulatory zoning laws of the state,county or cities 4 G �- nor does it exempt the licensee from any other taxes or permits that may be required by law. r • -._~ __._ :ems" ...# . .t 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. 90405,as amended. NAME OF COMPANY: Exact Corporate/Business Name: CSR a '\i tti"?,s (A2k ( _L O C Fiction Name/DBA: Qualifier Name: r--�R G C.3 u k 2 Physical Address: -©g. S ! 1,4 C I 4-PIE CO E 1 • (Number 85 Street) (City) (State) (Zip Code) Mailing Address:D-(11).9 - { C 0-A P�(`.c)K`rA L--- V (Number 8s Street) • (City) (State) (Zip.Code) Telephone: - - '( E-Mail. �- in 4 3 ,; c LI? f S -iz ,C a1 TYPE OF LICE ❑ General $230.00 ❑ Electrician $230.00 Building $230.00. ❑ Plumber $230.00 ❑ Residential $230.00 ❑ Air Cond. $230.00 ❑ Mechanical $230.00 ❑ Swimming Pool $230:00 LI Roofing $230:00 ❑ Specialty $205.00 Specialty trade: \ ...k 1A_R CHANGE OF STATUS: ( ) Reinstatement ( )From One Business to Another ( )Dominant License to Active Page 1 014 ; :'.Flor DRIVER LICEN' t,. " E IV G260-812 45-09t 0 TERRY LYNN GOUKER -°' 2929 SW$TH CT CAPE CORAL.FL 33914-0000 ooa0346 SEX.N ?rte` 4} '`'f+ 0 "zalt9 ..000400,000 r1 a rra-a m a.tverre . N tt-r^ns.flt vv.,.4 ,ct .'•ter a,KX _ft%;F,z. 1. The names,titles, home address and phone numbers of all Officers/Managing Members of the Firm. I"a.el Qm 29a s47 setAct cA'Pe ccer.K, 1 L 41 `t _gat. Gout kr,g, 1 P..i ALA rrrj 4, Atvt, \C't tAt c• VL 3,i4'',)%-',-- 425 -s 110 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. 3. List all debts you or any company(s).associated with you refused to pay and the reasons for the refusal to pay. Attach extra pages if needed. AFFIDAVIT 1,="(4-ZR1 Go ub k:Lk certify that the foregoing is true and correct to the best of my knowledge. Authorized Officer of the Firm STATE OF FLORID COUNTY OF k r. _-- The foregoing instrument as acknowledged before me this 541-"‘---1 ..A.-''l � k... . ;ICI - - (Date) I By t C%c -..,r. L. GuNik,i ,:= C of ktzcvl t<< ; T ;6Th T (Nacre of officer,title/agent) , 'Si (Name of Corporation) a c'r-i ok.4,°, 's Corporation on behalf of the corporation. (State or Place of Corporation) He/She has producedi>>t..i ..a ,-. cif,_ti(-- -Gfidentification and did not take an oath. (Type of identification) 34,. 3 G I r1 NOTARY'S SEAL + 4.41:17i" , NtY ic-8lt t1N [ ►r , ( s' t N----)'',N----)'',., t . :y •a as (SIGNATURE OF NOTARY) Page 2 of 4 • QUALIFIER INFORMATION: Name: 1i,(Z 4"t G 0 U. 2, Address: M.a.1. S w � C"i Cr C A,t3 Gott t 339W (Number&Street) (City) (State) (Zip Code) Telephone: ')1 "Lk.%t‘= <4<6' Date of Birth: 3 " lla — t-f S.S.#: 000-00- -- E-Mail: L-t:-lYl,Ar @ C x(15 c e (six ,C0l. Driver's License: G 1. Type of Certificate of Competency for which application is made. A-K3 - 2. The names and telephone numbers of two persons who will know your whereabouts. INC NI 1.1 ou.1 &3`t- ('t3 '-ci3 ' C-1-04-0 Gov kt _ 1 gtyS-- V-76 3. Have you ever been convicted of a crime related to Contracting? (If yes attach extra sheet with explanation) 7. Have you or any firms you have been associated with ever filed bankruptcy? y ES —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. to-Statement of any formal training you have had in the area for which the application is made. Page 3 of 4 RESOLUTION OF AUTHORIZATON WHEREAS TEA Ry Go u. ,t -%o'3 ttAk AttikA ttAi ktiproposes to (Name of Business Entity) - engage in contracting as Co wotZA-"f l t in (Type of legal entity:corp.,partnership,etc. Collier County,Florida,according to Collier County Ordinance 2006-46,as amended;and WHEREASTGRR. Gout�$�s �abs Tostkttiktar1 Tk .proposes to (Ninz of Business Entity) qualify for a Certificate of Competency with T Y1,J2 Go LtAe (Nark of Individual) NOW,THEREFORE,BE IT HEREBY RESOLVED THAT: We the undersigned CO- c I -R.S of (Officers,Owners,Partners) r-QAZ.RtiGourki SoNi.NgiaUaktalJT,srhereby resolve and represent to the Collier County (Name of Business Entity) Contractors'Licensing Board that the qualifying agent, 1� �� (Cq ,is active (Namg,ofIndividual) in all matters connected with the contracting business of I4and (Name of Business Entity) We further resolve and represent that `t rt,a- H Co tv, 1c?ITL,lZ is (Names of Individual) legally empowered to act for i; 4th Gov.tC S u-n -toitk •OC,in all matters connected with its (Name of Business Entity) contracting business,and has the authority to supervise construction undertaken by _R.Ryl pU,..kvLAI 0,tikkauLw1C (Name ofBusiness Entity) DULY PASSED AND ADOPTED THIS 754 day of , . (Officers,Partners,Owners-with t Are ,,jjJJ Witness w I MI Witness V tit. ) Corporate ► pp le Or Notary Public Certificate Sworn to and subscn'bed before me this-25- hi 5g day of,1/1 , by _.1 - _f /,� . ..2 d h & Printed `i'. Notary Pub lic N ame imbed o • he Signature Commission Number My Commission expiiesAMAGaXcalt3 OE MS O.MCDONAt • 'ROW ;4'`i; rip w. M$12 • ' :it.: IWO tt • (91 AFFTDAVTT 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. Tg_eR1 GQckklE APPLICANT(PLEASE PRINT) �ERRy Cn1OkeR.*SW *kiik 410 vi kc • NAME OF COMPANY "o f 1> SIGNATURE OF APPLICANT STATE OF FLORIDA :�� COUNTY OF � = ' The foregoing instrument as acknowledged before me this L !--c`, . r '(Date) By �� L 1 ' L L t L . t'- e who has produced ' I . (Name of person 4cknowledging) (Type of identification) , �,�i• as identification and did not take an oath. �. ��.►"�` MONIQUE A.FRANCOIS ?, ,l Notary Public-State of Florida 4 t,, S My Comm.Expires Jan 24,2015 �'!�;,a�wt�,�`, Commission#EE 52986• NOTARY'S SEAL If! -)r (SIGNATURE OF NOTARY) X115 Page4of4 • AFFIDAVIT It is understood and acknowledged by the Collier County Contractors' Licensing • Board and myself that if I fail to acquire, or maintain at all times effective Workmen's Compensation Insurance it will result in the possible revocation of my Certificate of Competency. SIGNATURE'OF APPLICANT RI ---t V.K BUSINESS NAME 1 \S• 1 DATE • BEFORE ME this day personally appeared L who . • • affirms and says that he has less than one employee and does not require Workmen's Compensation and understands that at anytime he employs one or more persons he must obtain said Workmen's Compensation Insurance. . STATE OF FLORIDA COUNTY OF (••__&5. The foregoing instrument was acknowledged before me this 27) (Date) _ - by ) t who has produced-41 - (name of person acknowledging) (Type of Identification) 17--4,-, . as identification and who did not take an oath. • - - • • • • "*. • SIGNATURE OF NOTARY - ,4„ MONIQUE A.FRANCOIS•NOTARY SEAL . AP:A. 3 Notary Public state - -of Rorida My Comm.Expires Jan 24.2015 NOTARY PUBLIC • • • ...OF Commission#kE 52986 STATEMENT OF OWNERSHIP This certifies that I, ' ERR L am a member or (APPLICA S NAME) Managing member of-RAUN of-AU G u,k .. \5 ti_x ` iu�,; �? L (LIMITED LIABILITY COMPANY NAME) I own C) % of the units issued by the Limited Liability Company listed above. Affidavit of Applicant:.I certify that the information contained is a true and correct statement to the best of my knowledge. (PRINT kL\JV'\\ (APPLICANT'S SIGNATURE) t - to_ (DATE) www.sunb iz.or g-Department of State Page 1 of 2 p FLORIDA DEPARTMENT OF +Sr 1E ) DI; €i�i;)), lei ; OR"OR_1I1O\ Home Contact Us E-Filing Services Document Searches Forms Help Previous on List Next on List Return To List Entity Name Search No Events No Name History ( Submit Detail by Entity Name Florida Profit Corporation TERRY GOUKER&SON INSTALLATION, INC. Filing Information Document Number P03000141998 FEI/EIN Number 500013451 Date Filed 11/21/2003 State FL Status ACTIVE Principal Address 2929 S.W.8TH COURT CAPE CORAL FL 33914 Changed 04/28/2011 Mailing Address 2929 S.W.8TH COURT CAPE CORAL FL 33914 Changed 09/22/2005 Registered Agent Name &Address GOUKER,TERRY L 2929 SW 8TH CT. CAPE CORAL FL 33914 US Name Changed:04/28/2011 Address Changed:04/28/2011 Officer/Director Detail Name&Address Title PD GOUKER,CHAD 2929 SW 8TH CT CAPE CORAL FL 33914 Title VD GOUKER,TERRY 2929 SW 8TH CT CAPE CORAL FL 33914 Title STD GOUKER,TERRY L 2929 SW 8TH CT http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&inq_doc_number=P030001419... 9/13/2012 www.sunbiz.org-Department of State Page 1 of 1 ,. . FLORIDA DEPARTMENT OF STATE DIVisio\ OF CORPORATIONS 5107MZ 441141$4 Aft* Att 44.4, Home Contact Us E-Filing Services Document Searches Forms Help Document Number P03000141998 Thank you for frog your Annual Report online.Your report filed date will be today's date if them are no processing errors- Your confirmation number is 900227746589. Your charge amount is$150.00. Home l Contact us j Document Searches ( E-Fifina Services f Forms Help Copyright v and Privacy Policies State of Florida,Department of State httos://fis.sunbiz.org/spus.exe 4/7/2012 07-03-'12 14:11 FROM-KS Inc 'Z -b5'L-W423 r-b14 11101/WW1 r-/52S AR� CERTIFICATE OF LIABILITY INSURANCE DAs,O,°z"" THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE GOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate to holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endvraeanent. A statement on this certificate does not confer rights to the certificate holder in Neu of such endo sement(s). PRODUCER A ui " ['7 Midden Enhanced Commercial Services.Inc. (239)652 0251 rc.Neh (239)652-0423 P.O.BOX 4728,NO.FT.MYERS,FL. ADn>B;LS ecs4 MMnk.net INSUREIESI AFFORDING COVERAGE URIC Y 33918 Ir150RERA: American Sakti Insurance Company , INSURED wouRERB: Progressive InsuranoeCompany TERRY GOUKER AND SON INSTALLATION INC. INSURER C: 2929 SWBTH CT CAPE CORAL FL. INSURER D: INSURER E: _ CAPE CORAL FL 33914 _INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LtSTYO BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDR ON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 1NHICH 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. UNITS LTR TYPE Of INSURANCE .eISR erie POUCYNUII R IIMr�01YYYV� GENERAl.UAMU.Y EACH OCCURRENCE $ 1,000.000 ILMXIXTISRERW- X COMMERCIAL GENERAL LUBIUTY PREMISES(igmnenew S 50,000 I CLAIMS-MADE © OCCUR MED EXP AAy om Darren) N 1.000 A 0L932195 02/01/2012 02101/2013 pERSONALaADVMyurr $ 1,000, GENERAL AGGREGATE $ 2,000,000 GEM.AGGREGATE LASTAPPUE�SPER PRODUCTS-COMP/OP AGG $ I,0O0,000 —1 policy 1-1 E r-t LOC CauBle O SIrGLt LAST S 300.000 AUTOMOBILE UA6LLMI /Ea accident J-- ANY AUTO WOOLY INJURY(Per pawn) $ B — oorgEO X SCHEDULED 06484040.4 06103/2012 06/03/2013 000ILYIKFJRY(PWacddw,q 1 HIRED AUTOS AIR Per Accident) ' s PIP s 10,000 UMOASLIA LIAe occuR EAOI DOL'1JRRENCE t — EXCESS LIAR CLANS-MADE AGGREGATE S OW WORKERSCOMPENBARON 1 STAR/71 H 1OFA s RETENTION S AND EMPLOYERS'LIABanY ANY PRO9NIE�TNE n N/A E.I.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? Pignoatery in nee EL DISEASE-EA EMPLOYEE DESCRIPTION OF OPERATiONS below E.L.DISEASE-POLICY UNIT $ OESCRIP°IIONOFOPERAT IONS/LOCATIONS/VEHICLES(AtbshACORD1W,AdABeaall&raeIINNSdiedule,Value wow lerequired) Tile Installation Contractor CERTIFICATE HOLDER CANCELLATION _ _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Colter County Contractors Licensing Board THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2800 N Horseshoe DrNe ACCORDANCE WITH THE POLICY PROVISIONS. Naples.Fl.34104 AUTNORQEDISPIMSENTATNE.....de,....eeooez..., I ACORD 25(2010/05) 5)19882010 ACORO CORPORATION. All rights reserved. The ACORO name and logo are registered marks of ACORO 1 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA IMPORTANT DEPARTMENT OF FINANCIAL.SERVICES .4 ..`' Pursuant to Chapter 440.05(14). F.S, an officer of a corporation who CONSTRUCTION CTIO WORKERS'DUS RY IDN ; D elects exemption from this chapter by filing a certificate of election t�NSTRUE OF ELECTION INDUSTRY YUO �CpsIPD�1T10N L�,AW EXEMPT FROM FLORIDA '� - q LD under c �q section may not recover benefits or compensation under this EFFECTIVE 09/30/2011 EXPIRATION DATE: 09/29/2013 Pursuant to Chapter 440.05(12), F.S., Certificates of election to be PERSOP&t TERRY L GOWER H exempt.. apply only within the scope of the business or trade listed on FEIN E the notice of election to be exempt 500013451 R BUSINESS NANnE AND ADDRESS: E Pursuant to Chapter 440.05(13), FS., Notices of election to be exempt TERRY GOUKER & SON IISTALLATION INC and certificates of election to be exempt shall be subject to revocation 2929 SW 8TH COURT if, at any time after the filing of the notice or the issuance of the CAPE CORAL, FL 33914 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 SCOPE OF BUSINESS OR TRADE person named on the certificate to meet the requirements of this section. 1- T QUESTIONS? (850) 413-1609 CUT HERE * Carry bottom portion on the job, keep upper portion for your records. OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA IMPORTANT DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WOE > =T' F Pursuant to Chapter 440.05(14), F.S, an officer of a corporation who COMPENSATION O elects exemption from this chapter by filing a certificate of election cERTIFICATE OF ELECTION TO CONSTRUCTION INDUSTRY ' ,P L under this section may not recover benefits or compensation under this dyp TION LAW FLORIDA D chapter. EFFECTIVE 01/30/2012. EXPIRATION DATE: 01/29/2014 Pursuant to Chapter 440.05(12), F.S, Certificates of election to be CHAD GOWER H exempt... apply only within the scope of the business or trade listed on PERSON E the notice of election to be exempt FEIN 500013451 R BUSINESS NAME AND ADDRESS: E Pursuant to Chapter 440.05(13), F.S. Notices of election to be exempt TERRY GOUKER & SON INSTALLATION INC and certificates of election to be exempt shall be subject to revocation 121 BOA AVE if, at any time after the filing of the notice or the issuance of the FORT MYERS, FL 33905 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 SCOPE OF BUSINESS OR TRADE person named on the certificate to meet the requirements of this section. 1- TILE QUESTIONS? (850) 413-1609 CUT HERE 1 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I, et}T l e r ii' • RO )•Q t- , am a resident of 1,e-e...... ounty, fh Is j 4a..._ State) and have resided here for more than five (5)years. During the last five years I have known ) err\-1 a �l o i^ applican_ t). I have had ie opportunity to observe his or her business and person dealings and find him or her to be a person of )nesty, integrity and good character. (Signature a 2,„te Z (Name) 044 P f I n .gy p 1..ti P • (Address) C' d ' i /9/(/� L #`f 4 I — /9� Telephone) 'S 7 -8(O c',/ STATE OF FLORIDA COUNTY OF The foregoinginat,ument was acknowledged before me this --z/-/Z- by -1 --' (Date) - /�1- r/ --"' t•i--'L -Q '-/ who has produced - �-- (Rate) of person acknowledging) (Type of identification) as identification and who did not take an oath. ___K__.,- 4_ ) 4-..-ii. SIGNATURE F NOTARY J NOTARY'S SEAL j >{� 1 ,r y N / (PRINT NAME OF NOTARY) NOTARY PUBLIC i°,..-?.; BEVERLY I. * * MY COMMISSION•DD 0643:i „Awl, EXPIRES:June 2,2013 'flews, Bonded Nu Budget Netaly Sees, 8 i :,--, , , . s LEE OUNTY LIC2007-02038 License Holder TERRY GOUKER Name: Firm Name: TERRY GOUKER AND SON INSTALLATION Address: 2929 SW 8TH COURT CAPE CORAL FL 33914 • Below please find your Lee County Certificate of Competency. This Certificate will need to be renewed yearly if you wish to perform work in Unincoprorated Lee County. Renewal will begin in the middle of August of each calendar year. If you choose to place your license on inactive status please notify this office as soon as possible. Please keep yourself up to date with our departments information by periodically reviewing our website at www.lee-county.com/dcd/contractorlicensing.htm In addition to this Certificate, it is your responsiblity to maintain your worker's compensation,general liability insurance and obtain a yearly business tax receipt from the Lee County n le etc performing work in Unincorporated orpor ted Lee is County. You may do so by emailing your certificates 239-53344895 Please e-mail address and/or telephone changes to ContractorLicensing@Leegov.com IMPORTANT CHANGE PLEASE READ: In an effort to reduce costs and "go green" we will no longer be mailing renewal reminders. If you wish to receive a renewal reminder via email please provide us with your email address along with your case number LIC2007-02038 to ContractorLicensing@Leegov.com. Re: "renewal by email". ta Conditions of Certificate LEE COUNTY Conditions of Certificate CERTIFICATE OF COMPETENCY (239j533-8895 Renewal due for active and inactive certificate each year in September. NAME:TERRY GOUKER Shall maintain required insurances on active D/B/A TERRY GOUKER AND SON INSTALLATION I certificates. COMP.NO.shall appear on all LICENSED FOR: Tile and Marble advertisements including vehicles reflecting a business name. Shah inform the Contractor Licensing Office of any Address or telephone#change. Shall only contract in DBIAname as it COMP.NO.: TM 000137 appears on certificate.Board of Approval NOT VALID AFTER: 012012 required on business name changes. i ot�MSE�x lair- Siinaiure rmtrioc ren2.rpt 241r.-,-'1)2 L.:' t.'2•22.'i'• .WS, .......__PPI•2 ' „ill "--. , y.. 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'-'- ----, •' - ill,- - -y- I,' 4 i.1.4--.f•--.1 , . . `-'-'- kw • - .1.,-- .- ..f' -:.';,-.--- ,w.....A.4."=•.- '•-. - 'T i";',1 i.AW§...11,.7■ FL-.1,, ,..-• .1 -.'0, ,..1,-,,,,, 0- y, ,P ---., i - AZ.r-Th V:.L.>•...--'---1‘ .., _." .,,,,.jjk ..,...-- . te...4,,,,!."."..'''-...'.:,k,,.., .?.o;r;r;',,,..:::1,._-:..f,,.L,,e. 4:11..L.:,... ‘,.,.?,,, .:,,_',,....,...,'"a•.,1.,,,,,k.t1;L:;._,J,..____:; -\z_t,,,,._.''''',,,,,,.,- A,.1..._''''. /' .---; ' ' ' '.! if.r—-__.:1 ....:-,. ••.; ,,--1 — _--...._- s.....„ ONTRJCTOR � `Ar ln1f N G . iic� Contractors F.O.Box 2122 - Marco Island,FL 34146 • (239)774-5100 - Fax:(239)774-2100 CONTRACTOR CREDIT REPORT Personal Credit Report Name of Individual; Terry L. Gouker Social Security Number: Credit Score: 554 Search Date: September 11, 2012 Searches Requested: Credit History, Liens,Judgments and Bankruptcy Bankruptcy/Judgment/Lien Search Result: LOCATION DATE AMOUNT Florida Middle, Ft Myers, FL 04/18/2012 Filed Bankruptcy Doc#: 1205831 Chapter 13 CONTRACTOR EIS,104Gi P.O.Box 2122 • Marco Island,FL 34146 - (239)774-5100 Fax: (239)7742100 SEPTEMBER 11, 2012 PERSONAL CREDIT REPORT CMAREMPROWWW044.41MOVJ [SUBJECT} (SEN] [BIRTH DATE] GOUKER, TERRY L. • 3/46 [CURRENT ADDRESS) [DATE RPM] 2929 SW. 8TH CT—, CAPE CORAL FL. 33914 8/04 (MOM ADDRESS) 2743 COLONIAL AV, #206. FORT MYERS FL. 33907 5/95 3824 SE. 2ND PL., CAPE CORAL FL. 33904 [POSITION) [CURRENT EMPLOYER AND ADDRESS] EVERT) (HIRE] T L FLOOR COVERING OWNER 8/75V 1/71 [FORMER EMPLOYER AND ADDRESS) GOLKER INSTALTIONS MODEL PROFILE * * * ALERT * * * ***PICO CLASSIC 04 ALERT: SCORE +554 : 038, 013, 016, 018 *** IN ADDITION ***TO THE FACTORS LISTED ABOVE, THE NUMBER OF INQUIRIES ON THE CONSUMER'S ***CREDIT FILE HAS ADVERSELY AFFECTED THE CREDIT SCORE. CREDIT SUMMARY * * * TOTAL FILE HISTORY PR=1 COL=0 NEG..6 RSTNEG=2-22 TRD=30 RVL=23 INST=5 HTG=2 OPN=O INQ-5 HIGH CRED CRED Lrm BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $0 $66.6K $40.9K $2967 $133 38% MORTGAGE: $165K $0 $0 TOTALS: $165E $66.6K $40.9K $2967 S133 PUBLIC RECORDS SOURCE DATE LIAB ECOA COURT ASSETS DOCKET* TYPE PLAINTIFF/ATTORNEY E 5064304 4/12R $0 I FE $0 1205831 CHAPTER 13 BANKRUPTCY FILING STEVEN K TEUBER TRADES SUBNA SUBCODE OPENED HIGHCRED TERMS MAXDELQ PAYPAT 1-12 MOP ACCOUNT. VERFIED CREDLIM PASTDUE ANT—MOP PAYPAT 13-24 ECOA COLLATRL/LOANTYPE CLSD/PD BALANCE REMARKS MO 30/60/90 WELLS FARGO B 90811664 4/96 $9248 R09 6/11A $17.5K $0 I CREDIT CARD 7/10F $0 PURCH BY OTHER LENDER CAP ONE NA B 1DTV035 3/08 $15.0K 7214 109 10/10A $0 USA CREDIT BUREAU • • • PAGE 1 OF PERSONAL CREDIT REPORT I LINE OF CREDIT 3/09C $0 ACCT CLSD BY CONSUMER 13 0/ 0/ 0 UNVL/CITI B 8194051 10/02 111111111111 RO1 3/09A $122.0K $0 1111,11111111 I CREDIT CARD 1/09P $0 48 0/ 0/ 0 • BK OF AMER B 1597029 3/01 $400 RO1 12/08A $1500 $0 I LINE OF CREDIT 12/080 $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 BEALLS/GNB D 2894002 10/05 $400 111111111111 RO1 8/08A $400 $0 111111111111 I SLDTO WWNNB 8/08C $0 PURC3 BY OTHER LENDER 33 0/ 0/ 0 EMERGE/FNBO B 24FC014 10/96 $4431 4/06 111111111111 RO1 7/08A $300 $0 $40 03 111111111111 I CREDIT CARD 7/08C $0 CLOSD BY CRDT GRANTOR 48 1/ 2/ 0 GECRB/LOW L 235041J 5/98 $938 1'11111111111 RO1 9/0Th $4200 $0 111111111111 I CHARGE ACCOUNT 9/070 $0 CLOSED DUE TO TRNSFR 48 0/ 0/ 0 MW AM CU Q 686D004 8/03 $13.4K 60M203 KM/MIKE/MX ZO1 7/06A $0 KK1XX1X11111 C AUTOMOBILE 7/06C $0 CLOSED 34 0/ 0/ 0 HSBC BANK B 2001161 11/95 $9576 111111111111 R01 6/06A $12.5K $0 111111112111 C CREDIT CARD 12/05C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 CAP ONE B 1DTV001 10/98 $3626 111111111111 RO1 6/06A $0 1X11111111:1 I CREDIT CARD 6/06c $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 REGIONS BANK B 3604047 12/01 $20.6K 72M 111111111111 I01 3/06A $0 111111111111 P AUTOMOBILE 3/06C $0 CLOSED 48 0/ 0/ 0 FLEET CC B 517R038 10/96 $4431 111111111111 RO1 6/05A 811.0K $0 111111111111 I CREDIT CARD 6/05C $0 PURCH BY OTHER LENDER 48 0/ 0/ 0 BK OF AMER B 4278002 12/98 $114K 360M975 111111 111111 M01 4/05A $0 111111111111 I CONVENTIONAL REAL 4/050 $0 CLOSED 48 0/ 0/ 0 KEYBANK N.A. B 273Q593 12/98 $8613 541205 11111111_111 101 6/03A $0 111111111111 I AUTOMOBILE 6/03C $0 CLOSED. 38 0/ 0/ 0 GMAC Q 2592672 5/99 $10.3K 60M228 111111111111 101 4/03A $0 111111111111 C AUTOMOBILE 4/030 $0 CLOSED 36 0/ 0/ 0 I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 9/11/12 2NF1034779(FLA) COLLIERCOUNT 4/01/12 PPT1924226(wA8) CRICKET DEBT 4/08/11 YPT9168205(YOU) NORTHSTAR LO 1/05/11 YA22300026(MWB) PRIMARY SVC USA CREDIT BUREAU • • • • PAGE 3 OF PERSONAL CREDIT REPORT CONTRACTOR ..ficonsino Contractors P.O.Box 2122 • Marco island,FL 34146 (239)774-5100 • Fax:(239)774-2100 SEPT' ER 11, 2012 BUSINESS CREDIT WORT TERRY GOUKER & SON INSTALLATION, INC. FED TAX ID#: 50-0013451 FILED: 11/21/2003 2929 SW 8" CT, CAPE CORAL FL 33914 CORPORATE OFFICERS OFFICE SSN CHAD GOUKER PD NONE PROVIDED TERRY GOOKER VD NONE PROVIDED TERRY COOKER STD NONE PROVIDED FINANCIAL RECORDS CREDITOR/BANK TYPE OF HIGH RET PAST ACCOUNT NUMBER ACCOUNT OPENED BALANCE LIMIT CHECKS DUE NOT PROVIDED RANKRUPTCRILIDGMINT/LIEN SEAR PUBLIC RECORDS HAVE BEEN CHECKED AT THE COUNTY, STATE AND FEDERAL LEVELS ANY RECORDS FOUND MATCH ONE OF THE ELEMENTS SEARCHED AND MAY OR MAY NOT PERTAIN TO THIS SITUATION: NO RECORDS FOUND ELEMENTS SEARCHED: TERRY GOUKER & SON INSTALLATION, INC. FED TAX 1D4: 50-0013451 2929 SW 8" CT, CAPE CORAL FL 33914 IN THE PREPBRATIOt OF THE CONTRACTOR LICENSE REPORT, USA CREDIT BUREAU BIAS USED CREDIT AND PUBLIC RECORD INFORMATION FROM ONE OR MORE OF THE NATIONALLY RECOGNIZED CREDIT AND PUBLIC RECORD INFORMATION REPOSITORIES. EACH OF THESE REPOSITORIES CERTIFIES THAT PUBLIC RECORD INPORMATXON IS SYSTEMATICALLY COLLECTED AND ENTERED INTO THEIR DATA BASE. USA CREDIT BUREAU • • • PAGE 1 OF BUSINESS CREDIT REPORT co3NITI £mot C..(intraCtOrS. •P.0.Box 2122 - Marco Island,FL 34146 - (239) 774-5100 - Fax: (239)774-2100 CONTRACTOR CREDIT REPORT Business Credit Report Name of Company: Terry Gouker &Son Installation Inc. FEI Number: 50-0013451 Reference (If necessary): Terry Gouker Search Date: September 11,2012 Searches Requested: Credit History, Liens,Judgments and Bankruptcy Bankruptcy/judgment/Lien Search Result: SEARCH FOR LIENS, JUDGEMENTS AND BANKRUPTCIES PROVED NEGATIVE 12/17/10 YDE3844518(CNM) PRIME COLLEC END OF CREDIT REPORT - USA BANKRUPTCY/JUDGMENT/LIENSE4RCH PUBLIC RECORDS RAVE BEEN CHECKED AT THE COUNTY, STATE AND FEDERAL LEVELS ANY RECORDS FOUND MATCH ONE OF THE ELEMENTS SEARCHED AND MAY OR MAY NOT PERTAIN TO THIS SITUATION: 9ANm'7PTCY RECORD DEBTOR - TERRY GOWER ADDRESS - 2929 SW 8TH CT, CAPE CORAL FL 33914-4202 SSN - POTENTIAL SSN LE,XID - 974565009 CASE NUMBER - 1205831 COURT LOCATION - FLORIDA MIDDLE - 1T MYERS DATE FILED - 04/:8/2012 FILING STATUS - INDIVIDUAL ELEMENTS SEARCHED: TERRY GOUXER 2929 SW 8"/ CT, CAPE CORAL FL 33914 SSN: IN THE PREPERATION OF THE CONTRACTOR LICENSE REPORT, USA CREDIT BUREAU HAS USED CREDIT AND PUBLIC RECORD INFORMATION FROM ONE OR MORE OF THE NATIONALLY RECOGNIZED CREDIT AND PUBLIC RECORD INFORMATION REPOSITORIES. EACH OF THESE REPOSITORIES CERTIFIES THAT PUBLIC RECORD INFORMATION IS SYSTEMATICALLY COLLECTED AND ENTERED INTO THEIR DATA BASES. USA CREDIT BUREAU • • • PAGE 4 OF PERSONAL CREDIT REPORT 1 I SLDTO ANOTHER LEN 10/10F $0 PURCH BY OTHER LENDER BK OF 4ER B 6331059 11/04 $8199 R07 9408 5/12A $7400 $0 I CREDIT CARD 12/10C $0 CHAPTER 13 BANKRUPTCY CEASE B 26QK001 6/05 $6033 R07 5/12A $6700 $0 I CREDIT CARD 1/11C $0 CHAPTER 13 BANKRUPTCY DISCOVER FIN B 9616003 9/07 $3906 R07 5/12A $6000 $0 I CREDIT CARD 12/10C $0 CHAPTER 13 BANKRUPTCY BK OF AMER B 4275002 3/06 $0 m18133 10/10 555555555555 c05 3/12A $54.6K $2967 $569 05 555554321111 I HOME EQUITY LOAN $40.9K CREDIT LINE SUSPENDED 48 1/ 1/18 T80/C8NA B 2683009 8/06 $1141 11 1111111111 R01 8/12A $4500 50 111111111111 I CREDIT CARD 11/09C $0 CLOSD BY CADT GRANTOR 48 0/ 0/ 0 GECRB/LOW L 2350413 4/98 $482 111111111111 R01 • 8/12A $224 $0 111111111111 A CHARGE ACCOUNT 9/100 $0 CLOSED 48 0/ 0/ 0 CEASE B 26QK001 9/98 $3000 111111111111 R01 8/12A $12.0K SO 111111111111 I CREDIT CARD 8/10C $0 CLOSD BY CRDT GRANTOR 48 0/ 0/ 0 EXXMBLCITI B 282E045 11/02 $1491 111X11111111 R01 8/12A 53000 $0 111111111111 X CREDIT CARD 4/12C $0 CHAPTER 13 BANKRUPTCY 48 0/ 0/ 0 CHASE B 26QK001 7/04 $6750 111111111111 RO1 8/12A $8000 $0 111 111111111 I CREDIT CARD 8/10C $0 CLOSD BY CRDT GRANTOR 48 0/ 0/ 0 CHASE- BP B 247V021 10/00 $103 111111111111 R01 8/12A $500 $0 111111111111 CHARGE ACCOUNT 8/10C $0 CLOSD BY CRDT GRANTOR 48 0/ 0/ 0 cITI-SHELL B 282E022 1/01 $293 X11111111_11 R01 7/12A $550 $0 111111111111 I CREDIT CARD 4/12C $0 CHAPTER 13 BANKRUPTCY 48 0/ 0/ 0 TED/C138A B 2683005 9/09 5388 111111111111 RO1 " 5/12A $500 $0 111111111111 I CHARGE ACCOUNT 4/12C $0 CHAPTER 13 BANKRUPTCY 31 0/ 0/ 0 BK OF AMER B 427S002 4/05 $165K 36081143 111111111111 M01 4/12A $0 111111111111 I CONVENTIONAL REAL $0 CHAPTER 13 BANKRUPTCY 48 0/ 0/ 0 GECRB/LOWESD B 235063Q 3/07 $58 111111111111 R01 7/10A $224 $0 111111111111 X CREDIT CARD 3/10C $0 CLOSD BY CRDT GRANTOR 34 0/ 0/ 0 BK OF AMER B 1597029 2/08 $0 R01 3/09A $500 $0 USA CREDIT BUREAU • • • PAGE 2 OF PERSONAL CREDIT REPORT , . n - -•.ALL, g„,_2)),,z,,,,, ,A,---6,„,,k_ fo.s,... ._ (...,,J.A __A , '\._,V.,,,-- ' Q.-&-T-YLsYrti;\ .‘) .— II. QA)\Q/1.1Sceszir.___(.14AZ, UQ..-sZ \; (- i — . .‘•,rytii_ Clz+L &L.A_C).: . LL _1,......v.3) • , 1 I ... c .4_, t- L),,} ,z,z . vkZ,----. \_._ .,(A ,,U4._ toy( ) (.) 2620 29th Ave NE Naples, FL 34120 September 27, 2012 Collier County Licensing Board 2800 N. Horseshoe Drive Naples, FL 34104 To the Collier County Licensing Board, With this letter I, Jessie Carcamo (C35923), request to qualify a second entity using my Tile and Marble license. I am currently the qualifier of SR Marble and Tile, Inc. and am seeking permission from the board to qualify Abbey Carpet of Naples, LLC as a second entity. I wish to maintain my present license with SR Marble and Tile, Inc. because it is a family-owned business and continuing my standing as qualifier will ensure that my family is provided for and able to work in Collier County where we have lived for 12 years. In qualifying Abbey Carpet of Naples, LLC, I am able to further expand my career in the construction industry. I have strong ties with Abbey Carpet of Naples, LLC and I hold the knowledge and ability to oversee all contracted work. Abbey Carpet of Naples, LLC is also in agreement of making me their qualifier and of having me as an integral part of their tile and marble operations. It is my wish that the above statement be taken into serious consideration when analyzing this request. Please be ensured that I am fully aware of my responsibilities as the qualifier of two entities should you approve my request. If you have any questions or concerns, please feel free to contact me at (239) 682-8360. S. erely, ,8 v J e Carcamo T' e and Marble C35923 Enclosures BUILDING REVIEW AND PERMITTING CONTRACTOR LICENSING SECTION COLLIER COUNTY/CITY OF NAPLES/CITY OF MARCO ISLAND Contractors Licensing Board AT _. S)A Community Development&Environmental Services Division ;TER. 2800 North Horseshoe Drive P ; 's ED, Naples,Florida 34104 � : : 3AR Telephone: (941)403-2431 JESS. �Y Facsimile: (941)403-2345 y•` APPLICATION TO QUALIFY SECOND ENTITY THIS FORM MUST BE COMPLETED IF YOU WISH 110 INITIATE OR CHANGE THE STATUS OF AN EXISTING LICENSE. . READ ALL INSTRUCTIONS AND MAKE SURE YOU HAVE SIGNED WHERE INDICATED. TYPE OR PRINT IN INK. MAKE CHECKS PAYABLE TO THE COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS. ALL CHECKS MUST CLEARLY STATE APPLICANT'S NAME AND ADRESS. PLEASE ALLOW 2-3 WEEKS FOR PROCESSING. FEE $ (05.00. 1. Applicant's Name(Licensee) )QSS1 e Cnrcam 0 LICENSE# C 35q_2 3 JNDER THE FEDERAL PRIVACY ACT, DISCLOSURE OF SOCIAL SECURITY NUMBERS IS VOLUNTARY UNLESS ;PECIFICALLY REQUIRED BY FEDERAL STATUTE. IN THIS INSTANCE, SOCIAL SECURITY NUMBERS ARE VIANDATORY PURSUANT TO TITLE 42 UNITED STATES CODE, SECTIONS 653 AND 654; AND SECTIONS 455.203(9), 109.2577,. AND 409.2598, FLORIDA STATUTES. SOCIAL SECURITY NUMBERS ARE USED TO ALLOW EFFICIENT ;CREENING OF APPLICANTS AND LICENSEES BY A TITLE IV-D CHILD SUPPORT AGENCY TO ASSURE COMPLIANCE JWITH CHILD SUPPORT OBLIGATIONS. SOCIAL SECURITY NUMBERS MUST ALSO BE RECORDED ON ALL ?ROFESSIONAL AND OCCUPATIONAL LICENSE APPLICATIONS AND WILL BE USED FOR LICENSE IDENTIFICATION 'URSUANT TO THE PER SONAL RESPONSIBILITY AND WORK OPPORTUNITY RECONCILIATION ACT OF 1996(WELFARE --- 193,SEC.317. 03/21/ Place of Birth: (City) M an a a� (State) (Nation) N i CQr U social Security Number ; Date of Birth I V ;EX: _Male X_Female ; RACE: (1)White ;(2)African-American; (3)Hispanic ;(4)Asian (5)Indian;(6)Other 2. Name of Business To Be Qualified: AAbR y Coeta<.- 6-c /1/0/9/C°J LL c Mailing Address: 25321 6 unwl'Xod Dr. Lo 1m+a Sprit FL 311135 Street or P.O.Box City --State Zip Street Address: 3250 rn c(I M'1 1 I N 1•119,p les FL 3(-1 110 Street City State Zip Business Phone Number:()1 5q( — 55q 6q Federal ID Number: 05 "V5 u 2 w 1 APPLICATION TO QUALIFY SECOND ENTITY 3. Applicant's (Licensee)Name: CAYCQmO 3esste. ✓t;.lsv dar is Last First Middle Applicant's (Licensee) Official Mailing Address of Record: 2 co 20 2C +h Fie NE N apI es �ol l i er FL 3-1Iz Street City County State Zip Street Address (if Post Office Box is listed above): Street City County State Zip Home Phone(234) 3Q 4 - 11559 Office Phone ( ) 4. VERWICATION OF GENERAL LIABILITY INSURANCE and WORKERS' COMPENSATION (or exemption from Workers Law)INSURANCE (ATTACH A CERTIFICATE OF INSURANCE OR EXEMPTION. I HEREBY AFFIRM THAT I HAVE OBTAINED GENERAL LIABILITY AND PROPERTY DAMAGE INSURANCE IN THE AMOUNTS SET FORTH BELOW and workers' compensation insurance(unless exemption has been filed with and approved by the Bureau of Workers' Compensation compliance), for the safety and welfare of the public. I further affirm that I have met all continuing education requirements. I understand that it is my responsibility to maintain all documentation supporting this affirmation of eligibility. I affirm that these statements are true and correct and I recognize that providing false information may result in a FINE,SUSPENSION or REVOCATION of my contractor's license. A ' I &GIL 1 Jessie Cosccirno q I 2-11 IC AP'APi CANT'S S 1.1 PRINT OR TYPE NAME ATE TO FILE A NOTICE OF ELECTION TO BE EXEMPT from the provisions of the FLORIDA WORKERS' COMPENSATION LAW, contact your nearest Florida Department of Labor and Employment Security, Bureau of Workers'Compensation Compliance office to obtain form#BCM-250-T. 3 APPLICATION TO QUALIFY SECOND ENTITY 5. QUESTIONNAIRE—QUALIFYING A SECOND ENTITY THIS FORM MUST BE COMPLETED BY THE APPLICANT REQUESTING TO QUALIFY A SECOND ENTITY OR REQUESTING A CHANGE TO AN EXISTING SECOND ENTITY QUALIFICATION. THE APPLICANT AND PRESIDENTS (OR PARTNERS/OWNERS) OF ALL COMPANIES INVOLVED MUST SIGN WHERE INDICATED. PLEASE USE THIS SHEET. ONLY USE ADDITIONAL SHEETS IF NECESSARY. A. Explain why you wish to maintain your present license(s)while qualifying this additional business. a bo since ss Witren+1 y qualified i S -Cam I - ouNVd an d bpinB the qualifieef for .1-4- Man -Mod- fam11y is Pa idcd -Foy: B. Has the proposed entity been previously qualified? If so, explain why the previous qualifier is no longer willing to continue to qualify this entity. T oeoSed■ eh-s-I-y sle.ply wa-.-1-s -fa VII‘a\ke- o. cLo be c ck t,s c ti C. If the proposed entity has been qualified within the last 12 months, list the last three jobs completed by the proposed entity. Include dates of completion, address, description of work, name of previous qualifier and name of owner. C ass 1 C11 1Q.eskdke.-(-e.s bj 4 4k - Uwi)ous Jobs CIUta 4-on-e5 — voalOus So�S D. List the last three jobs completed by you under your existing license. Include date of completion, address,description of work,name of previous qualifier and name of owner. SR Mar b�-e Tr le _ o-wmck bq Serge CarcQ.mo. Abbi5 Cof pk OJft or4- 'word - 'UOYioUS fobs E. Do the business(s) you presently qualify and/or wish to qualify have any outstanding liens against them or against the property of consumers as a result of construction work or a contract they had with your firm? YES NO 7 If yes,identify business and provide explanation. F. List principal suppliers for the past six months for the business you presently qualify. flMb) Cup?* Dkpoi_ loon AA &poles G. List principal suppliers for the past six months for the business you are applying to qualify. 4/4,-, M61--awL. Srokc.v*.Qke s 4 APPLICATION TO QUALIFY SECOND ENTITY H. List persons authorized(currently and in the past 6 weeks)to pull permits on your license(s). No or',. I. How are you being paid by the business(s)you presently qualify(examples: salary, %of profits,etc.)? OQ.r J. How will you be paid by the business you are applying to qualify? Gt rAo�A-Lty -ce€ K. What percentage of ownership do you have in the present business(s) you are qualifying and what percentage of ownership will you have in the business you are attempting to qualify? O°lo oW�eQs1�.., �.• .e b -. a ss we o'- .- a -e,.._t,�,J to y1-1i4 P°10 'DW i rch:Ip in - - bogint,SS I c.0 rrprl-11tr gv0.Qi 'y. L. Do you(applicant) have check writing authority for the present and proposed entity? YES NO If yes, provide a letter from the bank. t-,4)-4- kav� 0.4 0..0,t.,-kr a- -tom f Ro(ascQ M. List officers(or partners,owners)of business you are applying to qualify and give title/position held. le d VICe ea<s.��.l .- �•.- -.�� N. List officers(or partners,owners)of business you presently qualify and give title/position held. Si2f-ijo Careamo 01)3(\,u O. Do the business(s)you presently qualify and wish to qualify have any other licenses presently qualifying those businesses? YES NO . If yes,list licensee's name,license number and address. Presen-N9 cioal RR- No �,hYis 6rvnizr1 2 l,oy q l u3kSh 'ID qu i,%Fj- uses 27031 Po-e_ (Ave_ BcA S prin S, PL P. Submit notarized statements signed by an authorized agent of the entity(s) you presently qualify y and from an authorized agent of the proposed entity attesting to the fact that each is aware of what entity you presently qualify, and what entity you are requesting to qualify. 5 APPLICATION TO QUALIFY SECOND ENTITY 6. FINANCIAL RESPONSIBILITY. All applicants/licensees must answer the questions below. If you answer"yes to any of the questions,a written explanation is required. Additional documentation is also required,as indicated. If you are applying to qualify a corporation,partnership or other legal business entity, ALL OFFICERS OF THAT ENTITY MUST ALSO EXPLAIN IF ANY OF THE BELOW WOULD PERTAIN TO THEM. This would include the president,vice president,secretary,and/or partners or owner of the proprietorship. HAVE YOU,the business organi7ntion,or any of the above mentioned individuals in any capacity ever: YES NQ )( A. Undertaken construction contracts or work that a third party, such as a bonding or surety company, completed or made financial settlements? _ X B. Had claims or lawsuits filed or unpaid or past due accounts by your creditors as a result of construction operations? XC. Undertaken construction contracts or work which resulted in liens,suits or judgments being filed? X D. Had a lien filed against you by the U.S.Internal Revenue Service or Florida Corporate Tax Division? If"yes", you must attach a copy of the Notice of Lien, and any payment agreement, satisfaction, Release of Lien or other proof of payment. _ x E. Made an assignment of assets in settlement of construction obligations for less than the debts outstanding? _ X F. Been charged with or convicted of acting as a contractor without a license, or if licensed as a contractor in this or any other state, been "subject to" any disciplinary action by a state, county, or municipality? If "yes", you must attach a copy of any state, county, municipal or out-of-state disciplinary order or judgment. G. Filed for or been discharged in bankruptcy within the past five years? If"yes",you must attach a copy of the Discharge Order,Order Confirming Plan,or if a Corporate Chapter 7 case, a copy of the Notice of Commencement. — _� H. Been convicted or found guilty of,or entered a plea of nob contendere to,regardless of adjudication, a crime in any jurisdiction within the past 10 years? NOTE: IF YOU, THE APPLICANT/LICENSEE, HAVE HAD A FELONY CONVICTION, PROOF THAT YOUR CIVIL RIGHTS HAVE BEEN RESTORED WILL BE REQUIRED PRIOR TO LICENSURE. NOTE: The Board requires any applicant/licensee who answers"yes"to any question contained in the Financial Responsibility Section of the Application to supply a complete explanation of the response, and include a statement detailing the steps taken by the licensee to prevent a recurrence of the circumstances leading to the conviction,discipline,judgment,bankruptcy,or other event leading to the response. You must include any proof of payment,satisfaction of liens,judgments and bankruptcy discharge papers in your submittal,if applicable. Applicants may be required to appear before the Application Review Committee to answer questions regarding such responses. 7. CREDIT REPORT(Reports that do not include the following information will not be acceptable) Reports for the present and proposed entities must be submitted (not more than six months old) from a nationally recognized credit- reporting agency and must be submitted before an additional license can be issued. If you are applying to qualify as an individual,the credit report must be on you. If you are applying to qualify a business organization,the credit report must be on the business organization. If your business is newly established,you will ALSO need to submit credit reports on the following: the newly formed business and the majority owners holding 25%or more interest PLUS letters from three construction related suppliers indicating that an account either exists or has been opened for the entity you are applying to qualify. A credit report is also required for the entity that you are presently qualifying. 6 APPLICATION TO QUALIFY SECOND ENTITY Make sure you give written authorization to the credit agency so they can accurately check your credit references. Federal,State,County (including all counties within the State of Florida)public records pertaining to judgments,bankruptcies,and tax liens must be searched and results noted on the credit report The credit report must include a public records check of the.home counties and all other counties where 25%or more of the contractor's work has been done over the last three years. (If public records reflect unsatisfied obligations,attach written explanation and legal documentation.) The credit report must reflect officers, partners, and proprietors and FEIN and Social Security numbers. Attach a credit report(s)from a nationally recognized credit-reporting agency to this application. If you are unable to receive the credit report,you may have a credit agency send the credit report directly to: Florida Construction Industry Licensing Board,7960 Arlington Expressway,Suite 300,Jacksonville,Florida 32211-7467,and complete this statement: I have requested a credit report(s)on /V Q We-3. � LLC Date q 127 I OPOSED NPRES to be sent directly from NA. 1"r (Ygd1 (NAME OF CREDIT REPORTING AGENCY) 8. CORPORATIONS — ATTACH A COPY of the current Annual Report Form filed with the Florida Secretary of State or, if your corporation is newly established, attach a'copy of the Florida Certificate of Incorporation for the proposed and present entities, if applicable. All foreign (out of state) corporations must register with the Florida Secretary of State(850)488-9000. 9. FICTITIOUS NAME — ATTACH A COPY of the recorded Fictitious Name Registration from the Division of Corporations; also submit a copy of the filed application or newspaper article for the proposed and present entities, if applicable. (This does not apply to corporations using their registered name.) 10. ORGANIZATIONAL RELATIONSHIPS—Do you qualify any business other than the business you are applying to qualify? YES X NO (If "yes",what percentage of the business do you own(if any)? D %). Contact Board office for guidelines to qualify more than one business. Company Name: S R Nkoi b I,Q 3 T R, v n G Company Address: g(.0,90 gel RJR_R_ N E t') -eS t PL. 3L1\ 2 0 Your License Number: C 35 q as 11. PROOF OF CONTINUING EDUCATION IS REQUIRED when reactivating or reinstating a license. When reactivating or reinstating your license, you must attach a copy of your Certificate of Completion from a Board approved sponsor. You must provide proof of your continuing education hours, equal to those required of an active licensee, during the period of time your license was delinquent or inactive(beginning December of 1993). 7 AFFIDAVIT I, led 1 ./c+ees/t , A66ey, C of a F iii,k,Uc certify that the foregoing is true and correct to the best of my knowledge. -' ■1111r A VOW r'W ICER FOR THE FIRM kJ". of A..a_c STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this . e,,J'.0 .27 do/a_ (DATE) by /;d Q/4,1.4.1 e,-i 4, of 46he C �- .d i✓ jam, <(-� , (NAME OF ICER,TITLE/AGENT) Y (TAME OF CORPORATION) a �02,l� corporation,on behalf of the corporation. He/She has (STATE OR PLACE OF CORPORATION) produced Di wee A L r c.e- ie as identification and did not take an oath. (TYPE OF IDENTIFICATION) - 16 Oria---/ i/L-, ' (/ SIGNATURE ONOTARY MY ''�� p�RES:Maw t8.tots ((PRINT NAME OF NOTARY) i ea"ded NOTARY PUBLIC 1. . • $ 8 AFFIDAVIT The undersigned hereby makes application for Certificate of Competency under the provisions of Collier County Ordinance 90-105, as amended, and vouches for the truth and accuracy of all statements and answers herein contained. The undersigned hereby certifies that he/she 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/she has full authority to supervise construction undertaken by himself/herself or such business or organization and that he/she 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. . @co o�rarn iS/SaQ., APPLICANT(PLEASE PRINT)0_0■Va CW N• t,E OF COMPANY !,►A •i _ALL 1i SIG •TURE OF AP' CANT STATE OF FLORIDA COUNTY OF Lie_ The foregoing instrument was acknowledged before me this J--grftnei b Qr a 7, 2J 12_ by ecl-r (DATE) T�J S S 1 L , CCt m o who has produced K (NAME OF PERSON ACKNOWLEDGING) ('TYPE( IDENTIFICATION) as identification and who did not take an oath. a 01A stA e. SIGNATURE OF NOTARY ALICIAC.MOTw c.A Y ••. 11YCOGaSSIONfa0d3221 •_ t,- p I.48di18,2015 n,1 a_ !kilo Bonded Ito Nokirf Rik Urdemters (PRINT NAME OF NOTARY) NOTARY PUBLIC 9 RESOLUTION OF AUTHORIZATON WHEREAS /b be Covie F 4.4 (el uC proposes to (Name of Business Entity) engage in contracting as G'-c m (Type of legal entity:corp.,partnership,etc. Collier County,Florida,according to Collier County Ordinance 99-45;and WHEREAS d6hti Cr. f- .f /'4Iei proposes to (Name of B iness En�() qualify for a Certificate of Competency with ,LSS t Q, ( t ff('OtfY\ (Name of Individual) NOW,THEREFORE,BE IT HEREBY RESOLVED THAT: We the undersigned e L�i t yo K( '- of (Officers,Ofwners,Partners) A�bo C�/t of les C LL hereby resolve and represent to the Collier County (Name of usiness Entity) n Contractors'Licensing Board that the qualifying agent, 3fSSi ' l QyC'o n o ,is active (Name of Individual) in all matters connected with the contracting business of Ailey B �11e1 Entity)L C ,and We further resolve and represent that LXSSle k. ofC nine) is (Names of Individual) legally empowered to act for A66 Cvyo C (Lc in all matters connected with its (game of Business Entity) contracting business,and has the authority to supervise construction undertaken by abhtyy cam+ .'- • le, t.c.0 . (Name bf Business Entity) DULY PASSED AND ADOPTED THIS 21 day of S20+, 201Z. (O i• -. P • • —with Desi erneath) e4ik ANIN0*■1 Wi,,. ss t/,cc c.#f. • 4�r et,—'t IC FI••a••fc Witness Witness Corporate Seal(if Applicable) Or Notary Public Certificate Sworn to and subscribed before me Mad day day of`"`e" , W 1 by a c1 k o. •. (fici. a LL . N o Public Name Pri Notary Public Sign �' 0 3�9 Commission Number E E I My Commission expires: 3-I g-/s IIUCIAC.MOflICKA � .r_ MY COMMISSION 1 E 43291 EXPIRES:Match 18,2015 4j` ;hdf• Banded Diu Notary Pubic UaaeMtiea COLLIER COUNTY GOVERNMENT COMMUNITY DEVELOPMENT AND ENVIRONMENTAL SERVICES DIVISION 2800 N.Horseshoe Dr. • Naples.Florida 34104 • 239-403-2400 • FAX 239-403-2334 MEMORANDUM DATE: November 29,2007 TO: Applicant's FROM: Michael Ossorio, Contractor Licensing Supervisor. CC: Robert Dunn, Collier County Building Director. Alamar Finnegan, Collier County Permitting Supervisor. Robert Zachary, County Attorneys Office. All Contractor Licensing personnel. SUBJECT: Collection of social security numbers. Pursuant to Chapter 119, Florida Statues and Collier County Contractor Licensing Ordinance 2006-46 Sec. 2.1.1, all applicants are required to submit their social security number(SSN) for the following purposes: a) Assess applicant's ability to satisfy creditors by reviewing their credit history. b) Verification of applicant's test scores and information. Our office will only use your SSN noted above for those reasons pursuant to Chapter 119, Florida Statues and as may otherwise be authorized by law. We are fully committed to safe-guarding and protecting your SSN and once collected, will be maintained as confidential and exempt under Chapter 119,Florida Statues. SR Marble&Tile,Inc. 2620 29th Ave NE Naples,FL 34120 To whom it may concern: I,Sergio Carcamo,Owner and President of SR Marble&Tile,Inc.am aware that SR Marble&Tile, Inc.'s qualifier,Jessie D.Carcamo,is requesting to qualify a second entity,Abbey Carpet of Naples, LLC. 41410P/ Off/ r of C•mpany OVALY Title STATE OF FLORIDA COUNTY OF L Sworn to(or affirmed)and subscribed before me this c:174 day ofSPp ,2012_, by(name of person making statement). Personally Known X OR Produced Identification Type of Identification Produced '/4 °SUa. C . cAtiCje (Signature of Notary Publ c-State of Florida) A\ a_ 0-. M a- (Name of Notary Typed, Printed,or Stamped) 1 A,LyIg��AC�.�I�A CKI(►y,��� ail^^`;ff ;• M :{ 1116.2015 R**. � Baled �7Tfeu Pubicuiora la$ (NOTARY SEAL) To whom it may concern: AI lc (LC I,led ul uq.kle �P F�r��e (Title)of Abbc1 f.afc4r.F (Co. Name)am aware that Jessie D. Carcamo,who is requesting to qualify /G .a (Co. Name)is the current qualifier of SR Marble& Tile, Inc. ai ��of Company V. P. Fsrw..cc Title STATE OF FLORIDA COUNTY OF L.- 5. Sworn to(or affirmed)and subscribed before me this 7 day of ,20/ by(name of person making statement). Personally Known OR Produced Identification Type of Identification Produced //-)- ( (-- (, 1)7)6V-46(44_, (Signature of Notary Public-State of Florida) 6_ /40 y ckt (Name of Notary Typed, Printed,or Stamped) F MY COMMISSION l EE 00291 . EXPIABIt Match 18,2015 *44-7' Dom imv1.3hrilumc usionon (NOTARY SEAL) Prepared By: Merit Credit (239) 277-3202 (800) 371-3348 TRANSUNION CREDIT REPORT [FOR] [SUB NAME] [MKT SUB] [INFILE] [DATE] [TIME] (I) Z NP6284423 MERIT CREDIT 16 NP 6/06 09/06/12 09:06CT [SUBJECT] [SSN] [BIRTH DATE] 3/88 CARCAMO, JESSIE D. [DATE RPTD] [CURRENT ADDRESS] 6/06 2620 NE. 29TH AV., NAPLES FL. 34120 M O D E L P R O F I L E * * * A L E R T * *012 004 *** IN ADDITION ***FICO CLASSIC 04 ALERT: SCORE +750 : 030, 010, 012, ***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 * * * TOTAL F I L E H I S T O R Y PR=0 COL=0 NEG=0 HSTNEG=0 TRD=9 RVL=9 INST=O MTG=0 OPN=0 INQ=4 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $9512 $8150 $2605 $0 $83 68% TOTALS: $9512 $8150 $2605 $0 $8; T R A D E S SUBNAME SUBCODE „, OPEID HIGHCRED TERMS MAXDELQ PAYPAT 1-12 MOP ACCOUNT# ;' AiERI CREDLIM PASTDUE AMT-MOP PAYPAT 13-24 ECOA COLLATRL/LOANTYR CLSD/PD BALANCE REMARKS MO 30/60/90 BK OF AMER B 159709 8/07 $6 111111111111 RO1 97 MIN15 111111111111 8/12A $0 48 0/ 0/ 0 I FLEXIBLE SPEND $442 4 111111111111 RO1 WFNNB/VCTRIA C 16US00 /07 $264 12A $950 *� 111111111111 48 0/ 0/ 0 I CHARGE ACCOUNT 7�E2P $0 x . w GECRB/SAMS D 235046S 9/11 x;464 r�125 11111111111 RO1 8/12A '4fa ,i 11 0/ 0/ 0 I CHARGE ACCOUNT $3 BK OF AMER B 6331059 6/06 $2387 MIN43 111111111111 RO1 8/12A $2500 $0 111111111111 I CREDIT CARD $1825 45 0/ 0/ 0 CRDT FIRST A 3835003 4/12 $0 1 RO1 5/12A $2000 $0 1 0/ 0/ 0 I CHARGE ACCOUNT $0 BK OF AMER B 1597029 8/07 $6397 RO1 11/11A $0 I FLEXIBLE SPENDING 11/09C $0 CRDT CARD LOST/STOLEN 12 0/ 0/ 0 BK OF AMER B 6331059 6/06 $1663 111111111111 RO1 11/09A $2500 $0 11111111111 I CREDIT CARD 11/09C $0 CRDT CARD LOST/STOLEN 48 0/ 0/ 0 AMEX B 21WBOO1 8/07 $2545 111111111111 RO1 6/09A $1000 $0 11111111 Created with Print2PDF. To remove this line, buy a license at: http://www.software602.com/ I CREDIT CARD 6/09C $0 CLOSD BY CRDT GRANTOR 20 0/ 0/ 0 CAP ONE B 1DTV001 6/06 $931 111111111111 RO1 11/07A $1250 $0 11111 I CREDIT CARD 11/07C $0 ACCT CLSD BY CONSUMER 17 0/ 0/ 0 I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 9/06/12 ZNP6284423(FLA) MERIT CREDIT 4/12/12 NCV1340002(CLV) CFNA 9/03/11 NNY4215612 (EAS) GECRB/SAMS 9/28/10 ZNP3343169(FLA) MERIT CREDIT C R E D I T R E P O R T S E R V I C E D B Y : 800-888-4213 TRANSUNION 2 BALDWIN PLACE P.O. BOX 1000,CHESTER, PA. 19022 Consumer disclosures can be obtained online through TransUnion at: http: //www.transunion.com CREDITOR CONTACT INFORMATION BK OF AMER BC1597029 PO BOX 982235 EL PASO TX. 79998 WFNNB/VCTRIA CZ16US001 PO BOX 182789 COLUMBUS OH. 43218 GECRB/SAMS DV2350465 PO BOX 965005 ORLANDO FL. 32896 BK OF AMER BC6331059 PO BOX 982235 EL PASQ TX. 79998 (216) 362-5000 CRDT FIRST AZ3835003 POB 81315 CLEVELANDi • , OH. 44181 (800) 874-2717 AMEX BC21WB001 P.O. BOX 981537 ,EL PASO TX 79998 CAP ONE BC1D (800) 955-7070 I� O1 POB 30281 LT LAKE CITY 6T 4130 tts CFNA N 1340002 PO BOX 81315 CLEVELAND OH 44181 (800) 964-1917 GECRB/SAMS N 4215612. PO BOX 965005 ORLANDO FL 1 S96 (800) 371-3348 MERIT CREDIT �i 12734 KENWOOD LANE FORT MYERS • 3907 END OF TRANSUNION REPORT MERIT CREDIT HAS RETRIEVED THE ABOVE PERSONAL CREDIT REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY, STATE AND FEDERAL LEVELS. PUBLIC RECORDS HAVE ALSO BEEN VERIFIED FOR PINELLAS COUNTY. PUBLIC RECORDS LEARNED 0 SOURCES OF INFORMATION: 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.software602.com/ www.sunbiz.org- Department of State rags Vl L FLORIDA DI.PAi' 1 `` ..NT D S ._`.'I I: D it 1 iia� i�� Col,' 0R_,! ] O Home Contact Us E-Filing Services Document Searches Forms Help Previous on List Next on List Return To List Entity Name Search No Events No Name History Submit Detail by Entity Name Florida Profit Corporation SR MARBLE&TILE,INC Filing Information Document Number P09000056628 FEIIEIN Number 800436623 Date Filed 06/29/2009 State FL Status ACTIVE Principal Address 2620 29TH AVE.NE NAPLES FL 34120 US Changed 01/08/2011 Mailing Address 2620 29TH AVE.NE NAPLES FL 34120 US Changed 01/08/2011 Registered Agent Name & Address CARCAMO,SERGIO L 2620 29TH AVE.NE NAPLES FL 34120 Name Changed:01/08/2011 Officer/Director Detail Name&Address Title PRES CARCAMO,SERGIO L - 2620 29TH AVE.NE NAPLES FL 34120 US Annual Reports Report Year Filed Date 2010 02/16/2010 2011 01/08/2011 2012 01/28/2012 Document Images http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&ing_doc_numbet=P090000566... 9/27/2012 www.sunbiz.org - Department of State rage z, 01/28/2012--ANNUAL REPORT View image in PDF format 01/08/2011 —ANNUAL REPORT I View image in PDF format 02/16/2010—ANNUAL REPORT I View image in PDF format 06/29/2009--Domestic Profit I View image in PDF format INote:This is not official record.See documents if question or conflict.' Previous on List Next on List Return To List Entity Name Search Submit No Events No Name History Home I Contact us I Document Searches I E-Filing Services I Forms I Help I Copyright©and Privacy Policies State of Florida,Department of State http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&incLdoc_number=P090000566... 9/27/2012 EXPERIAN BUSINESS REPORT PAGE RPT DATE TIME PORT TYPE 1 09/06/2012 09:11:27 -AOZ REPORT 404 SR MARBLE & TILE, INC BIN: 917023314 2620 29TH AVE NE NAPLES FL 34120-7408 COMPANY DESCRIPTION THE PRIMARY BUSINESS FOR SR MARBLE & TILE, INC IS Terrazzo, Tile, Marble & Mosaic Work (SIC 17430000) WITH A SECONDARY BUSINESS CATEGORY OF Construction, Specialty Contractors (SIC 17000000) . THE BUSINESS WAS INCORPORATED ON JUNE 29, 2009 IN FLORIDA. COMPANY BACKGROUND INFORMATION THE FOLLOWING WAS PROVIDED BY THE STATE OF FLORIDA. HISTORY : BUSINESS INCORPORATED ON JUNE 29, 2009'AS A FOR-PROFIT CORPORATION. CHARTER NUMBER IS P090000566. FEDERAL ID : 80-0436623 CURRENT STATUS s ACTIVE BUSINESS. AGENT IS CARMAMO SERGIO LOCATED AT 2620 29TH AVE NE, NAPLES, FL. SIC: 1743 PRIMARY PRODUCT/SERVICE: TERRAZZO, TILE, MARBLE, MOSAIC WORK SIC: 1700 ADDL PRODUCT/SERVICES SPECIAL TRADE CONTRACTORS TITLE: PRESIDENT PRINCIPAL(S) : SERGIO CARCAMO 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 I,TS 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. MERIT CREDIT HAS RETRIEVED THE ABOVE BUSINESS REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY (INCLUDING PINELLAS) , STATE AND FEDERAL LEVELS. PUBLIC RECORDS LEARNED: _0_ SOURCES OF INFORMATION: EXPERIAN BUSINESS INFORMATION SERVICES IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1-800-371-3348 OR 239-277-3202. Created with Print2PDF. To remove this line, buy a license at: http:/lwww.software602.com/ EXPERIAN BUSINESS REPORT PAGE RPT DATE TIME PORT TYPE 1 09/27/2012 14:56:01 -AOZ REPORT 404 ABBEY CARPET OF NAPLES LLC BIN: 935478829 13230 TAMIAMI TRL N FILE ESTABLISHED: JULY 2010 NAPLES FL 34110-1629 PHONE: 239-596-5959 SIGNIFICANT DEROGATORY DATA STATE TAX LIEN - RELEASED 07-08-10 $11,068 STATE TAX LIEN 06-03-10 $11,068 TRADE PAYMENT INFORMATION TRADE PAYMENT EXPERIENCES (TRADE LINES WITH AN (*) AFTER DATE REPORTED ARE NEWLY REPORTED) RECENT ACCOUNT STATUS HIGH -DAYS PAST DUE- BUSINESS DATE LAST PAYMENT CREDIT BALANCE CUR 30 60 90 91+ COMMENTS CATEGORY REPTD SALE TERMS $ CRAFTS 07-12 07-12 NET 30 6000 2100 3% 97% PAYMENT TOTALS CONTINUOUSLY REPORTED( 1) : 6000 2100 3% 97% DBT: 15 PUBLIC RECORD INFORMATION PUBLIC RECORD REPORT STAT-TX-REL 07-08-10 $11,068, 4450563, COLLIER COUNTY CIRC COPYRIGHT 2012 EXPERIAN INFORMATION SOLUTIONS, INC. ALL RIGHTS RESERVED. **CONTINUED** Created with Print2PDF. To remove this line, buy a license at: http://www.software602.com/ EXPERIAN BUSINESS REPORT PAGE 2 09/27/2012 ABBEY CARPET OF NAPLES LLC BIN: 935478829 PUBLIC RECORD REPORT (CONTINUED) STAT-TX-LN 06-03-10 $11,068, 4437574, COLLIER COUNTY CIRC COMPANY DESCRIPTION THE FOLLOWING INFORMATION IS PROVIDED BY THE STATE OF FLORIDA: STATUS : ACTIVE DATE FILED : NOVEMBER 12, 2002 FEDERAL ID # : 05-0542678 PRINCIPALS) PHILIP GUTIERREZ TITLE: MANAGER 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 EXPERIAN INFORMATION AS O C SOLUTIONS, INC. ALL RIGHTS RESERVED. MERIT CREDIT HAS RETRIEVED THE ABOVE BUSINESS REPORT FOR LICENSING PURPOSES AS BEE CHECKED AND VERIFIED ATN THE PCOUNTY TO(INCLUDING CPINEOLLAS) , STATES REPORT ANDFEDERAL BEEN CHECKED PUBLIC RECORDS LEARNED: 2 SOURCES OF INFORMATION: EXPERIAN BUSINESS INFORMATION SERVICES IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1-800-371-3348 OR 239-277-3202. Created with Print2PDF. To remove this line, buy a license at: htt p //www software602.comJ COLLIER COUNTY CERTIFICATE OF COMPETENCY CERTIFICATION INFORMATION C35923 Certification Information Date: October 05, 2011 Collier County Board of County Commissioners DBA: SR MARBLE &TILE, INC. ADDRESS: 2620 29TH AVE. N.E. NAPLES, FL 34120- PHONE: 2393044554 CELL: 2396828360 FAX: 2393044554 LICENSEE NBR: QUALIFIER: JESSIE D. CARCAMO C35923 CLASS CODE: TYPE: TILE &MARBLE CONTR. 4420 ISSUANCE NUMBER: 35922 INSURANCE: ORIG ISSD: EXPIRES: Worker's Compensation October 28, 2010 September 30, 2012 October 11, 2011 General Liability December 02, 2011 NOTE: It is the Qualifier's responsibility to keep all business, licensing and requirements current and to provide up to date copies for Collier county files. This includes all insurance certificates and any change of address information. Collier County • City of Marco • City of Naples Contractor Licensing TILE & MARBLE CONTR. Cert Nbr: Exp: Status: C35923 09/30/2012 Active Exp:09/30/2012 SR MARBLE & TILE, INC. 2620 29TH AVE. N.E. NAPLES, FL 34120- COLLIER COUNTY CERTIFICATE OF COMPETENCY CERTIFICATION INFORMATION C35923 Certification Information Date: October 05, 2011 Collier County Board of County Commissioners DBA: SR MARBLE &TILE, INC. ADDRESS: 2620 29TH AVE. N.E. NAPLES, FL 34120- PHONE: 2393044554 CELL: 2396828360 FAX: 2393044554 LICENSEE NBR: C35923 QUALIFIER: JESSIE D. CARCAMO CLASS CODE: TYPE: FLOOR COVERING CONTR. 4170 ISSUANCE NUMBER: 35923 INSURANCE: ORIG ISSD: EXPIRES: Worker's Compensation October 28, 2010 September 30, 2012 October 11,2011 General Liability December 02, 2011 NOTE: It is the Qualifier's responsibility to keep all business, licensing and requirements current and to provide up to date copies for Collier county files. This includes all insurance certificates and any change of address information. Collier County • City of Marco * City of Naples Contractor Licensing FLOOR COVERING CONTR. Cert Nbr: Exp: Status: C35923 09/30/2012 Active Exp:09/30/2012 SR MARBLE & TILE, INC. 2620 29TH AVE. N.E. NAPLES, FL 34120- COLLIER COUNTY CERTIFICATE OF COMPETENCY CERTIFICATION INFORMATION C35923 Certification Information Date: September 13, 2012 Collier County Board of County Commissioners DBA: SR MARBLE &TILE, INC. ADDRESS: 2620 29TH AVE. N.E. NAPLES, FL 34120- PHONE: 2393044554 CELL: 2396828360 FAX: 2393044554 LICENSEE NBR: C35923 QUALIFIER: CARCAMO, Jessie D. TYPE: FLOOR COVERING CONTR. CLASS CODE: 4170 ISSUANCE NBR: 35923 INSURANCE: ORIG ISSD: EXPIRATION: Worker's Compensation October 05, 2011 September 30, 2013 October 11, 2012 General Liability October 11, 2012 Worker's Comp Exemption August 20, 2013 NOTE: It is the Qualifier's responsibility to keep all business, licensing i cludes all requirements fcates and to provide up to date copies for Collier county files. This and any change of address information. Collier County • City of Marco • City of Naples Contractor Licensing FLOOR COVERING CONTR. Cert Nbr: Exp: Status: C35923 09/30/2013 Active SR MARBLE & TILE, INC. CARCAMO, Jessie D. 2620 29TH AVE. N.E. NAPLES, FL 34120- COLLIER COUNTY CERTIFICATE OF COMPETENCY CERTIFICATION INFORMATION C35923 Certification Information Date: September 13, 2012 Collier County Board of County Commissioners DBA: SR MARBLE &TILE, INC. ADDRESS: 2620 29TH AVE. N.E. NAPLES, FL 34120- PHONE: 2393044554 CELL: 2396828360 FAX: 2393044554 LICENSEE NBR: C35923 QUALIFIER: CARCAMO, Jessie D. TYPE: TILE &MARBLE CONTR. CLASS CODE: 4420 ISSUANCE NBR: 35922 INSURANCE: ORIG ISSD: EXPIRATION: October 05,2011 September 30, 2013 Worker's Compensation October 11, 2012 General Liability October 11, 2012 Worker's Comp Exemption August 20, 2013 NOTE: It is the Qualifier's responsibility to keep all business, licensing ludes and insurance e i ments current and to provide up to date copies for Collier county files. This includes any change of address information. Collier County • City of Marco • City of Naples Contractor Licensing TILE & MARBLE CONTR. Cert Nbr: Exp: Status: C35923 09/30/2013 Active SR MARBLE & TILE, INC. CARCAMO, Jessie D. 2620 29TH AVE. N.E. •um cc GI 14120- isanKOTMmenca Page 1 of 3 Bank of America, N.A. • Statement Period P.O. Box 06/01/12 through 06/30/12 Tampa, FL L 33622-5118 E0 P PA OA 52 00726' Enclosures 0 Account Number SR MARBLE & TILE, INC 2620 29TH AVE NE NAPLES, FL 34120-7408 Our Online Banking service allows you to check balances, track account activity and more. With Online Banking you can also view up to 18 months of this statement online. Enroll at www.bankofamerica.com/smallbusiness. Sa r.i •:J.ti•::i':tii•::::Y:•'•:::ii•;•:•:•:•:tifi:::' :...i':�ii:�i:'::;i{:;f::;:i:•:•:is i:Y:'•::•�:ti :v• 4•: ti:J:•: �•i i i•J:: •f:: •:i`:•:•::::•:•}::i':i :;,;•::•:i•::•;i•:iii' '•JJ:::.Y:d 4:• •,1i •'•'1`i N ) 'nay Y:, ••l:J:�l:::•, •: :yC�• YS .J,v... V:• •:J:i r:r _:A _ "•mow ii• •-i}4?'• '? i'C?-.:z�Si'••,°;ii.. 4 7' ; .•. ?i-r_ _ •,�.<- 4�'; .;;`�S; 4=ZS'. `- :•^J��.�•`'J�J J;;''4•J,:.'{'`�:.'��:•.,%•• '*:°.`'G_''^'SC•- �i'?Ss'�{=-.:•^a,3.Z_rx-�F::-.i_:a:.':>�_f_�':�3.,:�,t:�:�:�?5f 3-:5:'x,.'._•�_- - 4._:'w,3�4 4`-j., "J s:•k•.-.y:`` S eJ x J. ..-r'• S._•2 j''J ;x r'�`4•'y,f '-Vi--•i:".�'?��-�> �' .`•'�:+=:.f:.4,--'',�.:_r-{ r � hf.!Y 3__z•4 F •.-.•i.»= :�__�_.-•u•�::�-'z:^�•...:-.u.��r�=mss:=;=�����'�:�z,��:.. .. ....... ....... • NFIB - Small Business Business Economy Checking SR MARBLE & TILE, INC Your Account at a Glance Account Number Statement Beginning Balance $2,564.49 Statement Period 06/01/12 through 06/30/12 Amount of Deposits/Credits $0.00 d $176.44 Number of Deposits/Credits 0 Amount of Withdrawals/Debits 4 Statement Ending Balance $2,388.05 Number of Withdrawals/Debits Number of Deposited Items 0 Average Ledger Balance $2,438.85 Number of Days in Cycle 30 Service Charge $0.00 I H Page 2 of 3 Statement Period 06/01/12 through 06/30/12 SR MARBLE &TILE, INC E0 P PA OA 52 Enclosures 0 Account Number Withdrawals and Debits Other Debits Bank Date Reference Posted Amount $ Descristion Card Account # 06/05 48.00 7-Eleven 06/04 #000700453 Purchase 53 9463060407004 946306060996001 06/06 20.44 67107001174 06/06 #000996001 Purchase 946306160196001 06/11 33.00 Murphy6920Atwa 06/10 #000153350 Purchase 946306100153350 06/13 75.00 Racetrac327 06/13 #000463446 Purchase Subtotal 176.44 Daily Ledger Balances Date Balance ($) Date Balance ($) Date Balance ($) 2,496.05 06/13 2,388.05 06/01 2,564.49 06/06 2,463.05 06/05 2,516.49 06/11 Ft Page 3 of 3 00726: How To Balance Your Bank of America Account FIRST,start with your Account Register/Checkbook: — -— — $ 1. List your Account Register/Checkbook Balance here 2. Subtract any service charges or other deductions not previously recorded that are listed on this statement. _ .Y----- $$ 3. Add any credits not previously recorded that are listed on this statement(for example interest) —•••-- $ 4. This is your NEW ACCOUNT REGISTER BALANCE NOW,with your Account Statement 1. List your Statement Ending Balance here.__.__—...........__.._._._.----�-•-•-�•-�-•���••_. _._.._._—. $ 2. Add any deposits not shown on this statement ._...._.._..-----•--•- SUBTOTAL ......................................_.......................... $ 3. List and total all outstanding checks,ATM,Check Card and other electronic withdrawals Checks,ATM,Check Card, Checks,ATM,Check Card, Checks,ATM,Check Card, Electronic ks,A M,Check C Electronic Withdrawals Electronic Withdrawals Amount Date/Check# Amount Date/Check# Amount Date/Check# 4. TOTAL OF OUTSTANDING CHECKS,ATM,Check Card and other electronic withdrawals 5. Subtract total outstanding checks,ATM,Check Card and other electronic withdrawals from Subtotal This Balance should match your new Account Register Balance Upon receipt of your statement, differences, if any, should be reported to the bank promptly in writing and in accordance with provisions in your deposit agreement. IMPORTANT INFORMATION FOR BANK DEPOSIT ACCOUNTS Change of Address. Please call us at the telephone number listed on the front of this statement to tell us about a change of address. Deposit Agreement. When you opened your account, you received a deposit agreement and fee schedule and agreed that your account would be governed by the terms of these documents.as we may amend them from time to time. These documents are part of the contract for your deposit account and which contain govern lthe cur ent version of the your erms and conditions of y all our accountrelationship, ay be obtained at ur bankongtcente agreement and fee schedule, If you your star ent case r a of errors wor rong questions or about need your more information transfers ATM transactions,direct deposits or If yu think your statement or receipt is wrong to if you need more information about an electronic transfer(e.g., withdrawals, point-of-sale transactions)on the statement or receipt,telephone or write us at the address and number listed on the front of this statement as soon as you can. We must hear from you no later than 60 days after we sent you the FIRST statement on which the error or problem appeared. • Tell us your name and account number. u need more • Describe the error or the transfer you are unsure about,and explain as clearly as you can why you believe there is an error or why Y information. Tell us the dollar amount of the suspected error• we will investigate your complaint and will correct any error For consumer take more used primarily s for ss personal, family or household purposes,a M promptly. If we take more than 10 business days(10 calender days if you are a Massachusetts customer) (20 business days if you are a new customer, for electronic transfers occurring during first 30 after the first deposit made to your account for the amount you i n error, you the have use of the during time takes to complete o this, For other accounts,we investigate,and if we find we have made an error,we credit your account at the conclusion of our investigation. problems or unauthorized best position within the times and specified in Reporting Other Problems. You must examine your statement carefully and promptly. You are in the best position to discover errors and unauthorized the dep isit on r yur t(which If you fail to notify than in 60 days of suspected pr the deposit agreement(which periods are no more than 60 days after we make the statement available to you and in some cases are 30 days or less),we are not liable to you for,and you agree not to make a claim against us for the problems or unauthorized transactions. Direct Deposits. If you have arranged to have direct deposits made to your account at least once every 60 days from the same person or company,you may call us at the telephone number listed on the front of this statement to find out if the deposit was made as scheduled. Bank of America,N.A.Member FDIC and A Equal Housing Lender I i ton KoTAmerica 40°- H Page 1 of 4 Bank of America, N.A. Statement Period 33622-5118 Tampa, FL P.O. Box 25118 06/01/12 through 06/30/12 E0 P PA OA 52 00721( Enclosures 0 Account Number SR MARBLE & TILE, INC 2620 29TH AVE NE NAPLES, FL 34120-7408 Our Online Banking service allows you to check balances, track account activity and more. With Online Banking you b at wwwankofameica.com/smalh this statement online. business "' r ri rr < •.J4! i:J:Y4:•f: r• r2 4r•: Jv •'.. v. ' • rJ r. •�i .4•. v ..4 J. .S V ::•:::•:: . •A•4:: ..:•'i4...• .•JJ1C. •••'•'•1h•✓11J�_uu J}%::n:•?:C4:di;{:•'J::•;{{•;:4•i•:?:iy: i•:Wi.4��.^4..•.••yr•••::•::...sm:s❖.42. f_. �---rr•sue rx� - - r- s�=--=�a-f=-'�_k�:�:: 4 z�-+ � f��:-'R'_#x; '•r r:::_=:=-=--?-rte'^r ?z ' � :_ ';_ .: << ;cs_ �_ _':r`l:r$,. ,o�, _ :`'i-'?: _ yy 4JY''x• x x :=A :-:- ::?-frx:SZ'::r:�M _i^r__ :r:::-^ ^ 1 =.8J S '$ 3. -•-Sr.x. - :? _:r2 r 4?.V'� S? :.i nr g,:: .. ,:v. :.. :._-".'-•y'_Fi x .�: __ _r:?_ _ ''4_?_:^ter' ,F.1.4::::- is> �•S??r:''a.':� .:• - .i,... ??x:�-zr �:f_ r _ _ --.-:�--�_'�r' :.:+�:�z� �?. _?z���. �a�-'_-3�,, . r:ii4= =i'r-arvn:. v ri.._Sv::r:n::..x.._..;,:xr?S==i^.-ir{2?--_'s:r:::kr...n:: :.::: "._? e:-.i:: ??:==-:- ,y.JL''�^._..�_:fir.?:-._.�a..._.r:.:r_.._..__- :..... ....................?����':-.:.__. .. v?.n:: _. .. r '�f :..._:. n::'':-x :::._. x:.? �.r:f.-2*i-"si-?i'Si='^?? =fir.???'-i"?- Fri^ Business Economy Checking SR MARBLE & TILE, INC Your Account at a Glance Account Number Statement Beginning Balance $3,570.56 Amount of Deposits/Credits $9,357.85 Statement Period 06/01/12 through 06/30/12 Amount of Withdrawals/Debits $11,841.96 Number of Withdrawals/Debits 33 Statement Ending Balance $1,086.45 Number of Withdrawals/Debits 44.17 Number of Deposited Items 3 $2,3 Average Ledger Balance $0.00 Number of Days in Cycle 30 Service Charge Your account has overdraft protection provided by Deposit Account number 2290 3219 1001. i H Page 2 of 4 Statement Period 06/01112 through 06/30/12 SR MARBLE &TILE, INC E0 P PA OA 52 Enclosures 0 Account Number Deposits and Credits Ban Reference Pe Amount $ Descriution Pose 946306010004974 06/01 648.00 BkofAmerica ATM 06/01 #000004974 Deposit Bonita/I-75 Bonita Spring FL 06/15 2,492.35 BkofAmerica ATM 06/15 #000006976 Deposit 946306150006976 946306220009172 Riverchase NAPLES FL 06/22 6,217.50 BkofAmerica ATM 06/22 #000009172 Deposit Riverchase Withdrawals and Debits Checks Check Date Bank Check Date Bank Number Amount $ Posted Reference Number Amount $ Posted Reference 1,500.00 06/20 813101782980127 623.00 06/15 813106692482507 1262 1,831.27 06/20 813207250875056 1257 994.78 06/04 813207350517864 1263 908.92 06/25 813106792402636 1258 880.00 06/04 813101782019143 1264 225.00 06/27 813207250201266 1259 1,000.00 06/07 813106692544418 1266 1261* 436.85 06/21 813106392123296 • Gap in sequential check numbers. Other Debits Bank Reference De DescriItion Pose Amount $ 902352013733846 06/01 36.00 Payroll Service go Co D1:3943345425 Ccd Indn:Carcamo, Sergio 943206220005045 06/27 1,5 S rint Bill Payment 902379007391299 06/22 129.93 IRS Des :Usataxpymt ID:270257932106966 5511.884 4 Indn:Sr Marble & Tile Inc Co ID:3387702000 Cc 946306010953237 Card Account # 946306050037801 Card 78.01 Hess 09458 06/01 #000953237 Purchase 06/05 77.97 The Home Depot 06/05 #000037801 Purchase 946306070652245 06/07 91.00 Samsclub #6364 06/07 #000652245 Purchase 946306080635701 06/08 42.23 67107001174 06/08 #000635701 Purchase 946306080635701 06/08 20.98 Shoreline Floc 06/08 #000992339 Purchase 946306180992339 06/11 85.01 Hess 09458 06/11 #000294216 Purchase 946306120294216 06/12 12.08 67107015331 06/12 #000288701 Purchase 946306120288704 06/13 75.00 Racetrac602 06/13 #000495794 Purchase 946306130561911 06/13 18.26 Racetrac602 06/13 #000561911 Purchase 946306130561911 06/13 5.23 Racetrac327 06/13 #000464262 Purchase 946306140464262 06/14 75.00 Pilot #0352 06/14 #000347365 Purchase 946306140347365 06/14 21.17 67107015331 06/14 #000000101 Purchase 946306150801823 401 06/15 8.05 Fayard Hardwar 06/15 #000801823 Purchase 946306170079432 06/18 48.00 Shell Service 06/17 #000079432 Purchase 946306170079432 06/18 20.00 Exxonmobil POS 06/16 #000640291 Purchase 946306190337598 06/19 90.00 Hess 09458 06/19 #000337598 Purchase 94630629 337598 06/25 596.78 CheckCard 0622 Fast Radios 929906221985265 06/25 89.01 Shell Service 06/25 #000686541 Purchase 946306250686241 06/25 52.00 Golden Gate BP 06/23 #000488200 Purchase 946306260833720 06/26 147.59 Samsclub #6364 06/26 #000833720 Purchase 946306280074047 06/28 71.00 Samsclub #6364 06/28 #000074047 Purchase Subtotal 1,724.37 H Page 3 of 4 Statement Period 06/01/12 through 06/30/12 007211 SR MARBLE &TILE, INC E0 P PA OA 52 Enclosures 0 Account Number Daily Ledger Balances Date Balance ($) Date Balance ($) Date Balance ($) 802.01 06/22 6,559.86 06/01 4,104.55 06/13 705.84 06/25 3,081.88 06/04 2,229.77 06/14 2,567.14 06/26 2,934.29 06/05 2, .80 06/18 2,499. 06/07 1,060.80 06/18 2,499.14 06/27 1,157.45 997.59 06/19 2,409.14 06/28 1,086.45 06/08 912.58 06/20 909.14 06/12 900.50 06/21 472.29 06/12 H Page 4 of 4 How To Balance Your Bank of America Account FIRST,start with your Account Register/Checkbook:T _ $ 1. List your Account Register/Checkbook Balance here 2. Subtract any service charges or other deductions not previously recorded that are listed on this statement._._.__._..___—___=• $$ 3. Add any credits not previously recorded that are listed on this statement(for example interest) $ 4. This is your NEW ACCOUNT REGISTER BALANCE NOW,with your Account Statement: $ 1. List your Statement Ending Balance here.._._..............._......_. $ 2. Add any deposits not shown on this statement ....._.._......_._.__._._. SUBTOTAL ............_.................................._......_........ $ 3. List and total all outstanding checks,ATM,Check Card and other electronic withdrawals Checks,ATM,Check C Checks,ATM,Check Card, Checks,ATM,Check Card, Checks,ATM,M,Check Card, Electronic Withdrawals Electronic Withdrawals Date/Check# Amount Date/Check# Amount Date/Check# Amount $ 4. TOTAL OF OUTSTANDING CHECKS,ATM,Check Card and other electronic withdrawals 5. Subtract total outstanding checks.ATM,Check Card and other electronic withdrawals from Subtotal $ This Balance should match your new Account Register Balance Upon receipt of your statement,differences, if any, should be reported to the bank promptly in writing and in accordance with provisions in your deposit agreement. IMPORTANT INFORMATION FOR BANK DEPOSIT ACCOUNTS Change of Address. Please call us at the telephone number listed on the front of this statement to tell us about a change of address. Deposit Agreement. When you opened your account, you received a deposit agreement and fee schedule and agreed that your account would be governed by the terms of these documents,as we may amend them from time to time. These documents are part of the contract for your deposit account and hicgovern ontain all transactions current relating to the your erms and conditions off y all our account relationship,may be obtained both t our banking deposit centerrsment and fee schedule, Electronic Transfers: In case of errors or questions about your electronic transfers If you think your statement or receipt is wrong or if you need more information about an electronic transfer(e.g., ATM transactions,direct deposits or withdrawals, point-of-sale transactions)on the statement or receipt,telephone or write us at the address and number listed on the front of this statement as soon as you can. We must hear from you no later than 60 days after we sent you the FIRST statement on which the error or problem appeared. • Tell us your name and account number. ou need more • Describe the error or the transfer you are unsure about,and explain as clearly as you can why you believe there is an error or why you • Tell us the dollar amount of the suspected error. your complaint and will correct any error For consumer accounts used primarily for personal, family or household purposes, we will investigate 2y business days if you are a new customer, promptly. If we take more than 10 business days(10 calender days if you are a Massachusetts customer)( Ys Y aomount you think transfers occurring error,so during w 11l have use of the money during t the time it takes us to t account)omplete our investigation.recredit your account for the you other accounts,we investigate,and if we find we have made an error,we credit your account at the conclusion our o discover errors and unauthorized Reporting o Other our account.c u. You must examine notify your in writing of suss and promptly. the deposit s greement(which periods are no more than 60 days after we make problems he statement available o you transactions a cases are 30 days or specified s s,we are not liable to you for.and you agree not to make a claim against us for the problems or unauthorized transactions. Direct Deposits. If you have arranged to have direct deposits made to your account at least once every 60 days from the same person or company,you may call us at the telephone number listed on the front of this statement to find out if the deposit was made as scheduled. Bank of America,N.A.Member FDIC and in Equal Housing Lender , nKer America 1P11" H Page I of 3 Bank of America, N.A. Ptatemef Period 336 P.O. Box 25 07/01/12 through 07/31/12 Tampa, FL 33622-5118 EO P PA OA 52 00709: Enclosures 0 Account Number SR MARBLE & TILE, INC 2620 29TH AVE NE NAPLES, FL 34120-7408 • Our Online Banking service allows you to check balances, track account activity and more. With Online Banking you can also view up to 18 months of this statement online. Enroll at www.bankofamerica.com/smallbusiness. •lJ:: 'vY.. J JJ 'J✓.: ;;;; J J., i;JJ. N J:✓�J. eA} t' i4 •:'•l:•l:::•:Y,�}...•:•:•ii:'J.;yJ::.;.1:;.}}:•ii:•:is:}•M1.. .Ri• •h• J.. f iJ. ::J''?:•:•:•: ":4•:•:.•YrJ::J:'r:'::::::•:!:•yl:ti: ................ :•:Ai :VY R'• ......J«...«u.J'u•:`�Juu'u19•..«•uu' •u `v:✓.%. ...ul�: ..y_a n_._ ,r> .'. :=^.F:::=}F4 S_i']-X,A,ss=ff Wq,.,-FN 9::i-r.9'`. :r.i yq? .s WW1:.'Mg .n; p1, :_,::zN_:-'-�Y •z: - ?_:.al _x>g.==z ``,F4,=F-.::��.x ::::::,....-42.,...22,...2..: :--.:.:._::_as:`=-z`- ..-x %x NFIB - Small Business Business Economy Checking SR MARBLE & TILE, INC Your Account at a Glance Account Number Statement Beginning Balance $2,388.05 Deposits/Credits $0.00 Statement Period 07/01/12 through 07/31/12 Amount of De p Number of Deposits/Credits 0 Amount of Withdrawals/Debits $161.17 Number of Withdrawals/Debits 3 Statement Ending Balance $2,226.88 Number of Deposited Items 0 Average Ledger Balance $2,343.87 Number of Days in Cycle 31 Service Charge H Page 2 of 3 Statement Period 07/01/12 through 07/31/12 SR MARBLE &TILE, INC E0 P PA OA 52 Enclosures 0 Account Number Withdrawals and Debits • Other Debits Bank Date Reference Posted Amount $ Descri,tion Card Account # 0 2 3601 07/16 58.03 CheckCard 0714 Inca's Kitchen 929907143620012 92990724362001 07/24 39.11 CheckCard 0723 Samsclub 6364 Gas 929907233568231 07/30 64.03 Shell Service 07/28 #000955342 Purchase Subtotal 161.17 Daily Ledger Balances Date Balance ($) Date Balance ($) 07/01 2,388.05 07/24 2,290.91 07/16 2,330.02 07/30 2,226.88 H Page 3 of 3 00709: How To Balance Your Bank of America Account FIRST,start with your Account Register/Checkbook: $ 1. List your Account Register/Checkbook Balance here $ 2. Subtract any service charges or other deductions not previously recorded that are listed on this statement. $ 3. Add any credits not previously recorded that are listed on this statement(for example interest) ----• $ 4. This is your NEW ACCOUNT REGISTER BALANCE NOW,with your Account Statement: 1. List your Statement Ending Balance here..__.___._.._-...•-• $ 2. Add any deposits not shown on this statement .-.•__._-. ..- SUBTOTAL .................................................................. $ 3. List and total all outstanding checks,ATM,Check Card and other electronic withdrawals Checks, Check Card, Electronic ksA Withdrawals Checks, ks,ATM,ATM,Check Card, ATM,Check Card, Electronic Withdrawals Electronic Withdrawals Amount Date/Check# Amount Date/Check# Amount Date/Check# ................................................................................................ $ 4. TOTAL OF OUTSTANDING CHECKS,ATM,Check Card and other electronic withdrawals 5. Subtract total outstanding checks,ATM.Check Card and other electronic withdrawals from Subtotal This Balance should match your new Account Register Balance $ Upon receipt of your statement,differences, if any,should be reported to the bank promptly in writing ACCOUNTS with provisions in your deposit agreement. IMPORTANT INFORMATION FOR BANK DEPOSIT Change of Address. Please call us at the telephone number listed on the front of this statement to tell us about a change of address. Deposit Agreement. When you opened your account• you received a deposit agreement and fee schedule and agreed that your account would be governed by the these your account, including all time. These documents withdrawals. Copies of are boh the f deposit contract for and deposit account and govern contain the current version of the terms and conditions of your account relationship,may be obtained at our banking centers. Electronic Transfers: In case of errors or questions about your electronic transfers If you think your statement or receipt is wrong or if you need more information about an electronic transfer(e.g., ATM transactions,direct deposits or withdrawals, point-of-sale transactions)on the statement or receipt.telephone or write us at the address and number listed on the front of this statement as soon as you can. We must hear from you no later than 60 days after we sent you the FIRST statement on which the error or problem appeared. • Tell us your name and account number. • Describe the error or the transfer you are unsure about,and explain as clearly as you can why you believe there is an error or why you need more information. • Tell us the dollar amount of the suspected error. ses we will investigate your complaint and will correct any error For consumer take more used primarily u for personal, family or household purposes. If we take more than 10 business days(10 calender days if you are a Massachusetts customer) (20 business days if you are a new customer. for electronic transfers occurring sn du you the 1 have0 d ys th after t y first deposit is during the time made takes your to complete account)to our investigation. we will recredit your account for the it amount other you think For other accounts,we investigate,and if we find we have made an error,we credit your account at the conclusion of our investigation. Reporting problems or unauthorized transactions within the time periods specified in Other Problems. You must examine your statement carefully and promptly. You are in the best position to discover errors and unauthorized the deposit on r your agreement(which periods If you fail to noire h in 0 days of suspected Pr _ �deposit you for, nd youragreernot no to make aaclaOm against us fortthe problems or unauthorized t(artsactdionss�e cases are 30 days or less),we are not liable Y may Direc t usoat the teleophone number listed on the front o deposits s statement your o find out least ade0asascheduled the same person or company,you Y Bank of America,N.A.Member FDIC and A Equal Housing Lender , b3nKOTAmmo H 4sAIPP' Page 1 of 4 Statement Period PBox America, N.A. 07/01/12 through 07/31/12 P.O..p. Box 25118 OA 52 00703! E0 P PA Tampa, FL 33622-5118 Enclosures 0 Account Number SR MARBLE & TILE, INC 2620 29TH AVE NE NAPLES, FL 34120-7408 Our Online Banking service allows you to check t al18 es, track oa count activity and more. With Online Banking you can also view up Enroll at www.bankofamerica.com/smallbusiness. : "Oe +J::•l::'::•;:;'::•i:M:•:iii:•:'::•f:::•:::J:•::f::.':i:}.:.i;.:.;.:•;•;•:•J•�•::• •:fJ: i{iii•. '•1J: or.< �YJ i�• VJ• t Y: .S: '•:!!• •J•}:icy: •: 4:v�:Y:::::•::{•.uul..J. .Y, :=it `•k =ti _f-` t_ ;F&2 v:�:: 4 ' � �a_f !"j..- ` 3^ Y_ .. : 4- § -_ :::: _ 2 :t",,,.'4,• ,•-;t:? Stfy: * ? z4 • 4 ::i ?- _.g '-:M z _> se4s . F r a ?.. ` ayNli . 3 . 4 ^ ^' z r= . 4 .x a A+ i z::ri�: 2_' ' x Wi : .. ... .. ... z . i .. a <: „ - y _ : :_ = Business Economy Checking SR MARBLE & TILE, INC Your Account at a Glance $1,086.45 Statement Beginning Balance $24,805.18 065 Account Number 07/01/12 through 07/31/12 Amount of Deposits/Credits $14,8 .18 Number Deposits/Credits 5 Amount of Withdrawals/Debits $11,061.17 Number of Dephdits/Credits 50 Statement Ending Balance Number of Withdrawals/Debits 5 $5,053.35 Number of Deposited Items Average Ledger Balance $0.00 Number of Days in Cycle 31 Service Charge Your account has overdraft protection provided by Deposit Account number 2290 3219 1001. H Page 2 of 4 Statement Period 07/01/12 through 07/31/12 SR MARBLE &TILE, INC E0 P PA OA 52 Enclosures 0 Account Number Deposits and Credits Ban. Reference Pose Amount $ Descri,tion Posted 946307020003254 07/02 1,882.50 BkofAmerica ATM 07/02 #000003254 Deposit 946307060005687 Riverchase NAPLES 07/06 3,831.00 BkofAmerica ATM 07/06 #000005687 Deposit 946307120006457 Bonita/I-75 Bonita Spring FL 07/12 3,250.00 BkofAmerica ATM 07/12 #000006457 Deposit 946307130008020 Riverchase NAPLES 07/13 2,945.00 BkofAmerica ATM 07/13 #000008020 Deposit 946307130008120 Bonita/I-75 Bonita Spring FL 07/27 12,896.68 BkofAmerica ATM onita Spring FL Deposit Bonita/I-75 p Withdrawals and Debits Checks Check Date Bank Check Date Bank Numer Amount $ Date Reference Number Amount $ Posted Reference 631.07 07/18 813106792917083 1265 228.79 07/02 813101782168671 1273 908.92 07/23 813207250442182 1267* 631.07 07/03 813106992142546 1274 1,908.92 07/19 3 813106992717118 1268 873.69 07/05 813105892645123 1275 228.79 07/20 813106992717118 1269 994.78 07/12 813207350985996 1276 84.79 07/30 813101782542960 1270 1,500.00 07/09 813101882510335 1277 50.00 07/12 813105892021268 1271 1,0322.339 07/19 813106992599260 5046 1272 • Gap in sequential check numbers. Other Debits Bank Reference Dse Descri stion Poosted Amount $ 902381010500889 36.00 Payroll Service Des:Fee ID:1332117 07/02 Indn:Carcamo, Sergio Co ID:3943345425 Ccd 943207180005047 Sprint Bill Payment 902313006631204 07/18 129.62 IRS Des:Usataxpymt ID:270261304534352 07/31 2,219.29 Indn:Sr Marble & Tile Inc Co ID:3387702000 Ccd 946307020632778 Card Account # 946307020682778 07/02 Card 35.49 Wal-Mart #5391 07/02 #000632778 Purchase 13.18 7-Eleven 07/03 #000782427 Purchase 946307030782427 07/03 90.00 Samsclub #6364 07/05 #000983568 Purchase 946307050983568 07/05 18.03 CheckCard 0702 7-Eleven 34148 929907052364955 07/05 290.00 CheckCard 0705 Osmany Auto Parts 929907082364955 07/09 43.03 CheckCard 0708 Chevron 002098 946307100548416 07/09 87.00 Samsclub #6364 07/10 #000548416 Purchase 929907082665269 07/10 37.05 CheckCard 0708 Paloma Blanca Restaura 946307110128670 07/11 142.05 Wal-Mart Super 07/11 #000128670 Purchase 946307110120881 07/11 57.35 Wal-Mart Super 07/11 #000120881 Purchase 946307110407501 07/11 3.81 67107015331 07/11 #000407501 Purchase 9463071/0 07504 07/11 114.22 CheckCard 0710 Office Depot #2355 929907100728354 07/12 66.62 67107015331 07/12 #000729801 Purchase 946307120721801 07/12 78.00 Hess 09460 07/13 #000121840 Purchase 946307140210393 07/16 34.50 Samsclub #6364 07/14 #000210393 Purchase 929907134236695 07/16 23.34 CheckCard 0713 Grand Buffet 946307170357401 07/16 16.39 67107001174 07/17 #000357401 Purchase 07/17 H Page 3 of 4 Statement Period 07/01/12 through 07/31/12 00703' SR MARBLE &TILE, INC E0 P PA OA 52 Enclosures 0 Account Number Withdrawals and Debits Debits Continued Other Bank Reference Date Descristion Posted Amount $ 946307190992001 07/19 67.04 67107001174 07/19 #000992001 Purchase 9463071909920 1 07/20 75.00 CheckCard 0718 7-Eleven 34148 929907182099918 07/24 58.15 Shell Service 07/23 #000325977 Purchase 929907232585610 07/25 94.01 CheckCard 0723 Hess 09466 946307260260760 07/26 78.00 Samsclub #6364 07/26 #000260760 Purchase 946307260240160 07/26 72.97 Wal-Mart #5391 07/26 #000648139 Purchase 946307260648139 07/26 52.00 CheckCard 0724 Carne Asada Tortilleria 07/26 38.50 CheckCard 0724 Carne Asada Tortilleria 929907241083665 929907241083665 07/26 35.64 Wal-Mart Super 07/26 #000150910 Purchase 929907241493952 07/26 25.00 CheckCard 0724 Signet Diagnostic Miam 946307270803853 07/27 132.48 Rack Room Shoe 07/27 #000803853 Purchase 946307270803853 07/27 90.00 CheckCard 0724 8Th Street Medical Plaz 929907261665793 07/27 6.00 CheckCard 0726 Sams Club#6364 62793 07/30 187.00 CheckCard 0726 Osmany Auto Parts 9299 929907261492825 07/30 91.00 Samsclub #6364 07/30 #000175407 Purchase 946307200275407 07/30 54.01 CheckCard 0728 Hess 09466 929907283207437 07/31 24.89 CheckCard 0729 Advance Auto Parts #924 Subtotal 2,331.75 Daily Ledger Balances Date Balance '.) Date Balance ('.) Balance (') 1 420.23 Date 07/24 1,086.45 07/12 4,737.79 07/25 1,420.22 07/01 07/13 7,604.79 07/25 1,326.22 07/02 2,668.67 07/16 6,046.95 07/27 13,024.31 07/03 2,024.42 07/17 6,030.56 07/27 13,275.64 07/05 4,583.70 07/18 5,269.87 07/31 11,275.64 07/06 4,040.67 07/19 2,691.09 07/10 2,916.62 07/20 2,387.30 07/1 1 2,713.42 07/23 1,478.38 07/11 2,713.41 Fl Page 4 of 4 How To Balance Your Bank of America Account FIRST,start with your Account Register/Checkbook: $ ______------•-- 1. List your Account Register/Checkbook Balance here — $ 2. Subtract any service charges or deductions deductio not previously recorded that are listed on this statement. _ $ 3. Add any credits not previously recorded that are listed on this statement(for example interest) y $ 4. This is your NEW ACCOUNT REGISTER BALANCE -- -- — NOW,with your Account Statement: 1. List your Statement Ending Balance here.......____ _-.._•_--•-----•-•••---_.._....__.__...._._.__..__._ $$ 2. Add any deposits not shown on this statement ...____._. _•..•-•.- SUBTOTAL ..._._.__._...__....._....__..._.___...._. $ 3. List and total all outstanding checks,ATM,Check Card and other electronic withdrawals Checks,ATM,Check Card, Checks,ATM,Check Card, Electronic ATM,M,Check C Checks,ATM,Check Card, Electronic Withdrawals Electronic Withdrawals Date/Check# Amount Date/Check# Amount Date/Check# Amount $ 4. TOTAL OF OUTSTANDING CHECKS,ATM,Check Card and other electronic withdrawals 5. Subtract total outstanding checks,ATM,Check Card and other electronic withdrawals from Subtotal $ This Balance should match your new Account Register Balance Upon receipt of your statement,differences, if any,should be reported to the bank promptly in writing and in accordanc with provisions in your deposit agreement. IMPORTANT INFORMATION FOR BANK DEPOSIT ACCOUNTS Change of Address. Please call us at the telephone number listed on the front of this statement to tell us about a change of address. Deposit Agreement. When you opened your account, you received a deposit agreement and fee schedule and agreed that your account would be governed the these tin them e to time These documents r f p at for yo ur deposit account and govern a ltra act o s relating to your accoun4 nclud including all deposi sand � ws of both the deposit agreement and fee schedule, which contain the current version of the terms and conditions of your account relationship,may be obtained at our banking centers. Electronic Transfers: In case of errors or questions about your electronic transfers If you think your statement or receipt is wrong or if you need more information about an electronic transfer(e.g., ATM transactions, direct deposits or withdrawals,point-of-sale transactions)on the statement or receipt,telephone or write us at the address and number listed on the front of this statement as soon as you can. We must hear from you no later than 60 days after we sent you the FIRST statement on which the error or problem appeared. more • Tell us your name and account number. you believe there is an error or why Y • Describe the error or the transfer you are unsure about. and explain as clearly as you can why Y information. • Tell us the dollar amount of the suspected error• we will investigate your complaint and will correct any error primarily for personal, family or household purposes, (20 business days if and are a new customer, promptly.ptly. If take more used pr Y days( promptly. If we take more than 10 business days(10 calender days if you are a Massachusetts customer) for electronic transfers occurring during the first 30 days after the first deposit is made to your account)to do this,we will recredit your account for the during the time it takes us to complete our investigation. For other accounts,we investigate,and if we find we have made an error,we credit your You are at the best position of our discover errors ors and unauthorized Reporting Other your account.u• You must examine your statement of carefully uss and promptly.y Toed in transactions e osit on Your which If you ds are no more than 60 days after weomake the statement available unauthorized transactions you andoin some cases are 30 days less),we the deposit agreement(which Po are not liable to you for,and you agree not to make a claim against us for the problems or unauthorized transactions. Direct Deposits. If you have arranged to have direct deposits made to your account at least once every 60 days from the same person or company, you may call us at the telephone number listed on the front of this statement to find out if the deposit was made as scheduled. Bank of America,N.A.Member FDIC and A Equal Housing Lender uaf1Ko1'R11Ca- H . Page I of 4 Bank of America, N.A. Ptatement Period 33622-5118 P.O. Box 25118 08/01/12 through 08/3//12 00707( Tampa, FL EO P PA OA 52 Enclosures 0 Account Number SR MARBLE & TILE, INC 2620 29TH AVE NE NAPLES, FL 34120-7408 Our Online Banking service allows you to check balances, track account activity and more. With Online Banking oll at www o view upi o. com smallhs of th s statement online. r r: q •'JJ.'•:'4 •:•r :••r4••:.!4Y.::f• fi.,•4:.:'i r •:t!V.�:r'•rJ.•:•:�r:r V:.4:{ :v:tiff: •:•:•:.•: •:•:J ''fJ:.:.V.V:J•J: :f... • • :• •4V r :r '':r •rr 'r:: J:.•.V:•r' ' ' ' r :r� :•rr: ' i'r: :C Y::::•:•i•:•r:•: ' :•rr ` 4b r. .r.•: r rr .rrr• .:S . •w ':.•f::::::•:•:•:'r::•Jr:"rrr{::::;:�r:•r::r l: ••rr: :•Jr s!: � ; :•r• :•4 .V• f ' rl••• • rr: ' .r.• rr::• ::::•:•rr.•;..• : 1 !•::'r r:' •:'r' :: •:u:•:ti'i:'i • r r' J •:r • }GG 1 : Y•.J•G 4G..G: r 1 �.• , 44•. y J,N.:.:.:.:.::::.$:::!.. : - 41.E}} fG.:r.: •r.'::•::•:}'::::;:�'ti:•.�::}::•r rr•::• •:.4:•A Y.• •:•:V....::•:•:ij�!:•::':::•:':::tir:::it:ti. ':•J:•:::•::•::.•:::•r:r J.;r:•r:.•:':rJ;•:��'::;�.•r�:: .M1. :.4 •rrr: r:•>:JM1 r:1•. r!.':rr:•r:tir:r:'Jr:'ti':i'ry:�'r::'rrr:•rrr: ..G. .4.•Ju•- };l:::::Y:l:•rr':::•::r;l:::?rl'r•:•r:•'•'•r r :.4V . ••N :: J• J:d •G Y .a. J.ti'A 4'•r:•r .4.. •r:•:•. 44S •r.r..,::G:• rJL•S•4 •r:' '•:'r .G.4.S...NJ.�:Y••.N..•• ♦L :1{•y.4:4•:l •4:':4:;�Gi,.7"'ryyi:y�y{.;J•:r��G,•:�rS.44•.•v.•.�'L�w+Tasi'--'.• .. ,.._..,._>_::__:._->.:------>:>._$:--.:>+:_:ter:..7:: ,;':=`?. _ - Business Economy Checking SR MARBLE & TILE, INC Your Account at a Glance $11 031.46 Statement Beginning Balance $11,031.46 Account Number Amount of Deposits/Credits $25,963. 0 Number of Deposits/Credits 08/01/12 through 08/31/12 Amount of Withdrawals/Debits $5,406.16 Number of Dephdits/Credits 48 Statement Ending Balance Number of Withdrawals/Debits 3 $6686.94 Number of Deposited Items Average Ledger Balance , $0,00 Number of Days in Cycle 31 Service Charge Your account has overdraft protection provided by Deposit Account number 2290 3219 1001. • H Page 2 of 4 Statement Period 08/01/I2 through 08/31/12 SR MARBLE &TILE, INC E0 P PA OA 52 Enclosures 0 Account Number Deposits and Credits Ban Reference De Amount $ Descri•tion Posted 946308130008541 08/13 5,276.30 BkofAmerica ATM 08/13 #000008541 Deposit Bonita/I-75 Bonita Spring FL 946308170006257 08/17 5,032.00 BkofAmerica ATM 08/17 #000006257 Deposit Golden Gate NAPLES 946308240009819 08/24 5,655.60 BkofAmerica ATM 08/24 #000009819 Deposit Brooks Village - NAPLES FL Withdrawals and Debits Checks Check Date Bank Check Date Bank Number Amount $ Posted Reference Number Amount $ Posted Reference 1,500.00 08/15 813101882577977 1278 18.00 08/03 813109992866501 1287 1,127.61 08/15 813106792376048 1279 18.00 08/03 813109992866500 1288 125.00 08/10 813106792376048 1280 1,349.79 08/03 813106792511359 1289 1,125.00 08/17 813206792 31774 1281 1,269.31 08/01 813106392752341 1290 2,126.48 08/27 813207350107483 1282 1,207.52 08/06 813207550236216 1291 026.23 08/20 813101782550297 1283 1,500.00 08/01 813101782741977 1292 500.00 08/21 813105892064789 1284 454.77 08/08 813106392228184 1293 1,403.97 08/24 813207250507889 1285 228.79 08/06 813101782427367 1294 53.97 08/24 813106192677400 1286 1,161.97 08/10 813207250138150 5048 • Gap in sequential check numbers. Other Debits Bank Reference De Di s tion Posted Amount $ escr 902313010864896 08/01 36.00 Payroll Service go Co D1:3943345425 Ccd Indn:Carcamo, Sergio 0 20000549 129.62 Sprint Bill Payment 943209422088200015049 08/20 IRS Des:Usataxpymt ID:270264263019693 08/29 3,575.51 Indn:Sr Marble & Tile Inc Co ID:3387702000 Cc Card Account # 08/02 93.00 Samsclub #6364 08/02 #000488945 P08020488945 urchase 946308020488945 08/06 40.20 CheckCard 0803 7 Food Mart 929908034136174 08/06 27.97 Cvs 00712 08/06 #000408754 Purchase 9463080604754 08/07 98.01 Samsclub #6364 08/07 #000622576 Purchase 946308070822897 08/07 63.60 Dillards - 021 08/07 #000822897 Purchase 08/07 13.23 067190039560 08/07 #000081394 Purchase 946308070081394 946308070081394 08/09 198.44 Sam's Club 08/09 #000578349 Purchase 929908092793312 08/13 101.01 CheckCard 0809 Hess 09458 946308110132052 08/13 93.52 Cracker Barrel 08/11 #000132052 Purchase 929908122913769 08/13 47.00 CheckCard 0812 Golden Gate Food Mar 946308130969501 08/13 35.98 67107015331 08/13 #000969501 Purchase 929908121964245 08/14 486.51 CheckCard 0812 Sprint NAPLES 929908121964245 08/14 100.00 Samsclub #6364 08/14 #000870600 Purchase 946308150216401 08/15 75.00 The Home Depot 08/15 #000216401 Purchase 946308150116401 08/15 3.16 Sunoco 0470112 08/15 #000112906 Purchase 946308160217801 08/16 59.43 The Home Depot 08/16 #000217801 Purchase 946308170292058 08/17 100.00 Samsclub #6364 08/17 #000292058 Purchase 946308210854674 08/21 181.59 Sam's Club 08/21 #000854674 Purchase 946308210854614 08/21 79.00 Samsclub #6364 08/21 #000628618 Purchase H Page 3 of 4 Statement Period 08/01/l2 through 08/31/12 00707( E0 1 PA OA 52 SR MARBLE &TILE, INC Enclosures 0 Account Number Withdrawals and U btss Continued Other Bank Reference Dse Descri s tion Posted Amount $ 946308240819477 110.00 Sam's Club 08/24 #000819477 Purchase 946308240819177 08/24 34.45 Samsclub #6364 08/24 #000853173 Purchase 946308240853173 08/24 0.94 Sam's Club 08/24 #000818286 Purchase 946308241888286 08/24 100.00 CheckCard 0824 Golden Gate BP 929908241980691 08/27 95.34 The Home Depot 08/25 #000080601 Purchase 9263082500 06 1 08/27 61.00 CheckCard 0825 Hess 09460 929908272127074 08/27 CheckCard 0827 Sunpass Operations 946308310253001 99 2 27 74 08/29 116.67 08/31 116.67 The Home Depot 08/31 #000253001 Purchase Subtotal 2,418.80 Daily Ledger Balances Date Balance ($) Date Balance ($) Date Balance ($) 08/21 5,355.23 08/10 3,077.86 08/24 5,355.23 08/02 8,226.15 08/13 8,076.65 08/27 9,205.13 08/02 6,747.36 08/14 7,490.14 08/27 9,205.83 08/06 5,242.88 08/15 5,911.98 08/31 5,625.87 08/06 5,018.04 08/16 5,852.55 08/0 8 4,563.27 08/17 9,658.07 08/08 4,364.83 08/20 6,344.61 08/09 4,364.83 • H Page 4 of 4 How To Balance Your Bank of America Account FIRST,start with your Account Register/Checkbook: 1. List your Account Register/Checkbook Balance here —"'"_ 2. Subtract any service charges or other deductions not previously recorded that are listed on this statement.___..._-----------• $$ 3. Add any credits not previously recorded that are listed on this statement(for example interest)•.--•-- _._..__._______ $ 4. This is your NEW ACCOUNT REGISTER BALANCE ____.._.____--.•-----•—-- —' NOW,with your Account Statement: $ 1. List your Statement Ending Balance here._—._._ — .---.__.— _._..._.............._. $ 2. Add any deposits not shown on this statement SUBTOTAL ._............................................._................ $ 3. List and total all outstanding checks,ATM,Check Card and other electronic withdrawals Checks,ATM,Check Card, Checks,ATM,Check Card, Electronic ATM,M,Check C Checks,ATM,Check Card, Electronic Withdrawals Electronic Withdrawals Amount Date/Check# Amount Date/Check# Amount Date/Check# $ 4. TOTAL OF OUTSTANDING CHECKS,ATM,Check Card and other electronic withdrawals 5. Subtract total outstanding checks.ATM,Check Card and other electronic withdrawals from Subtotal eg ........_....._._...........___..........._...._._._...._..__-_..._...._...................._............................................... $ This Balance should match your new Account Register Balance Upon receipt of your statement,differences, if any,should be reported to the bank promptly in writing with provisions in your deposit agreement. IMPORTANT INFORMATION FOR BANK DEPOSIT ACCOUNTS Change of Address. Please call us at the telephone number listed on the front this reement statement nd fee schedule and agreed that your account would be Deposit Ay the term When you documents,your account, you them received a deposit 9 governed nYlltransactions erelatingof your account. including al depositseand time. withdrawals. Copies of are botth hefdeposit agreement andefee schedule, and Bove which contain the current version of the terms and conditions of your account relationship,may be obtained at our banking centers. Electronic Transfers: In case of errors or questions about your electronic transfers If you think your statement or receipt is wrong or if you need more information about an electronic transfer(e.g.. ATM transactions,direct deposits or withdrawals,point-of-sale transactions)on the statement or receipt,telephone or write us at the address and number listed on the front of this statement as soon as you can. We must hear from you no later than 60 days after we sent you the FIRST statement on which the error or problem appeared. • Tell us your name and account number. believe there is an error or why you need more • Describe the error or the transfer you are unsure about.and explain as clearly as you can why you information. • Tell us the dollar amount of the suspected error. For consumer accounts used primarily for personal, family or household purposes, we will investigate your complaint and will correct any error (20 business days if and are a new any promptly. If we take more than 10 business days(10 calender days if you aar^e a Massachusetts customer) for electronic transfers during l have use days the money first deposit tis made os�l account)to do investigation.this.we recredit your account for the For oth you think is m For other accounts,we investigate,and if we find we have made an error,we credit your account an the�ilpos�on to discover and unauthorized Reporting Other your Problems. You must examine your statement of suss and promptly. transactions on Your account. If you fail to notify us in writing of suspected problems or unauthorized transactions within the time periods specified in the deposit agreement(whit periods ode notoo more e to claim against after nt us for the problems e statement cent available ut> to you and in s�cases are 30 days or less),we are not liable to you Y Direct Deposits. si the telephone number have edirect deposits statement de to your o find out if the least opt was made 60 days from the same person or company, you may call us Bank of America,N.A.Member FDIC and A Equal Housing Lender • banKoTAmerica H 41010P' Page l of 3 Bank of America, N.A. Statement Period P.O. Box 25118 08/01/12 through 08/31/12 00712 Tampa, FL 3 3 3622-5 1 1 8 E0 P PA OA 52 Enclosures 0 Account Number SR MARBLE & TILE, INC 2620 29TH AVE NE NAPLES, FL 34120-7408 Our Online allows balances, track nt activi With OineBank ng youcanalso view up to 18 months of this statement online. Enroll at www.bankofamerica.com/smallbusmess. g +c. :Cr �•JJ: 11:1 .•.VYJ•.Y::JJ:.::r:.:VJJJ•:J:•J::J•JJJ.Jr.••':J::::J:�':'::':'' i;�i';+;fi�:::;�:'t� �`-'-, i's' i:: � :'JJI:IN:•:' � ,,.•�..y s fix'':? ?'�_'_ � 3_'``••' J• '�OJL J •E'• -S,<Y�J�v;',y."-''�'��:i t. ,,X.e" sigti z.J a ,J „I� n ii*X• :, $ t, - _ y z.� x•.�✓,• °J JW __ J•,,;'';•v `._g'a 3*-= 00-::r4-.,'�-_-,��y �.Yfi' >tx..-�x ===='24� -. '2 �` --�,.'*.., ' ,�,aaF-?r ,—* .� :-__2..,.__ -c-''4`•, e:;l.'' ` ^-'f-_ ,-"`�3?x_"_lxz� :,,",'�"-_F_a_0::F : =?�:�o n - f-.a' _::-�,� "_ =;: "-;.s`-.----r.= -"__ f s?;:�,-��=_:'-_ '-'-':'�'''f'Y ��__.��:�.A-__k_-�1-,_r ,a3�<<-=-`-rte.>-_x_- NFIB - Small Business Business Economy Checking SR MARBLE & TILE, INC Your Account at a Glance $2,226 88 Statement Beginning Balance $900.00 Account Number 08/01/12 through 08/31/12 Amount of Deposits/Credits $102 86 Number Deposits/Credits 2 Amount of Withdrawals/Debits $$162.86 Number of Dephdits/Credits 4 Statement Ending Balance Number of Withdrawals/Debits 2 $2413.22 Number of Deposited Items Average Ledger Balance , $0.00 Number of Days in Cycle 31 Service Charge H Page 2 of 3 Statement Period O8/O1/12 through 08/31/12 SR MARBLE &TILE, INC E0 P PA OA 52 Enclosures 0 Account Number Deposits and Credits Ban Reference Date Amount $ Descriition Posted 946308170006259 08/17 550.00 BkofAmerica ATM 08/17 #000006259 Deposit 94630817000 259 Golden Gate NAPLES 08/31 350.00 BkofAmerica ebblebrooke ATM NAPLEs#000004161 Deposit Withdrawals and Debits Other Debits Bank Reference De Descri 1tion Pose Amount $ 929908063374731 08 0d Account # CheckCard 0806 Samsclub 6364 Gas 946308100875821 08/07 42.00 Samsclub #6364 08/10 #000875821 Purchase 946308200875821 08/10 42.00 929908231512657 36 1701 08/23 26.38 The Home Depot 08/23 #000601701 Purchase 35.00 CheckCard 0823 JT Lawn Equip 08/27 Subtotal 162.86 Daily Ledger Balances Balance ($) Date Balance ($) Date Balance ($) Date 08/31 2,964.02 08/17 2,675.40 08/07 2,226.88 08/23 2,649.02 08/07 2,167.40 08/27 2,614.02 08/10 10 0 2,125.40 H Page 3 of 3 00712: How To Balance Your Bank of America Account FIRST,start with your Account Register/Checkbook: 1. List your Account Register/Checkbook Balance here — 2. Subtract any service charges or her deductions not previously recorded that are listed on this statement.__ _.--•------ $ 3. Add any credits not previously recorded that are listed on this statement(for example interest)...._._...._.._____.._.._ -•_.._ . $ $ 4. This is your NEW ACCOUNT REGISTER BALANCE NOW,with your Account Statement: $ 1. List your Statement Ending Balance here. _.._-..____.____.__--- - $ 2. Add any deposits not shown on this statement ._.._.._..-•-•-_____. SUBTOTAL ............._.........._........................._...._..... $ 3. List and total all outstanding checks,ATM,Check Card and other electronic withdrawals Checks,ATM,Check C Checks,ATM,Check Card, Electronic A M,Check Card,Checks,ATM,Check Card, Electronic Withdrawals Electronic Withdrawals Date/Check# Amount Date/Check# Amount Date/Check# Amount 4. TOTAL OF OUTSTANDING CHECKS,ATM,Check Card and other electronic withdrawals ..................... 5. Subtract total outstanding checks,ATM,Check Card and other electronic withdrawals from Subtotal $ This Balance should match your new Account Register Balance •,_• --------- Upon receipt of your statement, differences, if any,should be reported to the bank promptly in writing and in accordance with provisions in your deposit agreement. IMPORTANT INFORMATION FOR BANK DEPOSIT ACCOUNTS Change of Address. Please call us at the telephone number listed on the front of this statement to tell us about a change of address. Deposit Agreement. When you opened your account, you received a deposit agreement and fee schedule and agreed that your account would be governed govern the ltransact transactions relattingntonyour account, including all from withdrawals. Copies of are botth the deposit agreementtua an d 1schedule, and coven al which contain the current version of the terms and conditions of your account relationship,may be obtained at our banking centers. Electronic Transfers: In case of errors or questions about your electronic transfers If you think your statement or receipt is wrong or if you need more information about an electronic transfer(e.g., ATM transactions, direct deposits or withdrawals,point-of-sale transactions)on the statement or receipt,telephone or write us at the address and number listed on the front of this statement as soon as you can We must hear from you no later than 60 days after we sent you the FIRST statement on which the error or problem appeared. • Tell us ri your name and the t transfer number. • explain as clearly as you can why you believe there is an error or why you need more Describe the error or th transfer you are unsure about.and exp information. • Tell us the dollar amount of the suspected error. I family or household purposes, we will investigate your complaint and will correct any error For consumer take more primarily personal, promptly. If we take more than 10 business days(10 calender days if you are a Massachusetts customer)(20 business days if you are a new customer, for for electronic transfers n error,so�that yo�it will have use of the money during�theit[is made to me it takes your to ccomplete oudr investigation. For your account for the amount other you a think is For other accounts.we investigate,and if we find we have made an error,we credit your You are at n the bestlposOtion our investigation.errors and unauthorized Reporting problems or unauthorized test position within the times ands unauthorized in Other Problems.account.. You must examine your statement of suss and promptly. the deposits on your account. If you fail to noire than in 60 days of suspected pr oblems or unauthorized transactions. the deposit agreement(which periods are no more than 60 days after we make the statement available to you and in some cases are 30 days or less),we are not liable to you for,and you agree not to make a claim against us for the problems Deposits. If .e telephone number listed to have the irect deposits s a statement to your r account f the least once eve made 60 days from the same person or company, you may call us A Equal Housing Lender Bank of America,N.A.Member FDIC and 0 EverBaflR Last statement May 31,2012 This statement:June 29,2012 Total days in statement period:29 Page 1 allligiiiier 220 MO 216 ##001268 (216) ABBEY CARPET OF NAPLES LLC 3471 BONITA BAY BLVD Direct inquiries to: BONITA SPRINGS FL 34134-4364 888-882-3837 EverBank 1185 Immokalee RD Naples, FL 34110 Business Analysis Checking Account number Beginning balance $262,209.05 216 Total additions 990,904.37 Enclosures Total subtractions 926,013.74 Ending balance $327,099.68 CHECKS Amount Number Date Amount Number 19677 06-04 1,634.91 21067 06-01 06-01 373 72 72..73 19678 06-04 1138.49 21068 0 04 188.38 4564 19679 06-06 721.54 21069 06-06 4 100.00 19680 06-05 1,573.72 21070 06-01 1,168.40 19681 06-01 3,247.03 21071 06-01 2,084.22 19682 06-01 1,693.53 21073* 06-12 901.15 19683 06-20 1,096.73 21074 06-07 4,267.22 19684 06-20 773.48 21075 06-07 150.00 19685 06-25 1,573.77 21076 06-01 1,227.09 19686 06-18 3,246.98 21077 06-07 80.00 20878* 06-19 250.00 21078 06.04 1,169.27 20939* 06-01 100.00 21079 06-04 1,901.13 21023* 06-08 13,616.12 21080 14,539.53 21027* 06-12 72.11 21082* 06-06-11 11 7,502.87 21030* 06-01 772.50 21083 06.01 3,142.33 21045* 06-05 6,000.00 21084 06-01 24.32 21048* 06-01 1,714.45 21085 06-05 103.71 21050* 06-01 643.77 21086 06-12 163.15 21054* 06-01 2,763.05 21088* 06-07 259.35 21056* 06-14 2,883.61 21089 005 165.00 21063* 06-05 444.40 21090 06 158.45 21064 06-04 51.68 21092* 06-01 1,052.25 21066* 06-04 325.00 21093 • • 11 Oval Drive •Suite 107 • Islandia, NY 11749-1416 ABBEY CARPET OF NAPLES LLC Page 2 �� June 29,2012 Amount Number Date 330.00 Date Amount 06-08 Number 06-04 898.96 21153 06-07 476.98 21096' 451.00 21154 06-07 1,432.46 21097 06-05 70.68 21155 422.38 21098 06 04 154.69 21156 06-05' 444.23 21101 1,088.00 21157 930.00 21101 * 06-04 510.34 21159* 06-12 21102 �'"� �� 200.00 81,10 21160 47 93 21103* 06-04 1,639.40 21161 06-12 76.75 21106 06-06 500.00 21162 06-13 21107 06-01 06-25 �0'� 21108 06-08 328.30 21163 06-05 50.00 592.33 21109 06-04 1,210.00 21164 100.00 21165 06-06 21110 21166 21111 06-11 160.40 06-11 1,517.85 21112 06-08 2,610.25 21167 06-07 7,204.12 06-11 2,402.12 21113 06-04 1,710.00 21168 06-11 100 00 21114 06-04 575.00 21169 21115 06-08 655.00 21171 * 06.14 06-12 1,148.21 855 69 21116 06-05 1,318.26 21172 06-11 895.35 21117 06-14 512.17 21173 06-11 1,000.00 21118 06-04 648.00 21174 06-11 2,050.00 21119 06-05 1,638.00 21175 06-11 4,050.50 21120 06-06 368.60 21176 06-15 3,286.43 21121 06-08 532.25 21177 06-11 843.00 21122 879.00 21178 366.00 21124* 06-07 337.26 21180* 0-11 7 550.00 21125 06-06 397.81 21181 300.00 21126 06-05 4,491.82 21182 06-12 06-12 1 1300.82 21127 06-06 310.78 21183 06-14 2,766.82 21128 06-06 2,538.25 21184 06-11 2,827.25 21129 06-06 508.53 21185 06-11 667.13 21130 41.18 21186 06-11 2,003.94 21134* 06-06 2,771.91 21187 06-13 3,609.77 21135 06-08 567.75 21188 06-13 101.47 06-05 169.39 21189 06-18 54.00 21136 06-05 25,67197 21190 110.00 21137 * 839.20 4 21140 21141 74 2.08 212.91 21142 1,016.86 21143 21144 iiiiiiuiiiiii.65 2.43 1,224.42 21147 . 98 .00 250 21148 115.00 99 250. 0 21149 222.73 21200 06-13 1,780.24 21150 06-25 116.69 21201 06-12 1,121.70 21151 06-08 1,325.94 21202 06-12 447.00 21152 06-05 887.13 21203 1268 -5188 ABBEY CARPET OF NAPLES LLC Page 3 �ge June 29,2012 Number Date Amount Number Date Amount 21204 06-13 4,295.84 21276 018 3,450.00 06-18 4,771.81 21205 06-25 35.61 21277 06-20 -1,488.35 21206 06-18 62.84 21278 06-18 2,492.35 21210* 06-28 5,776.94 21280* 06-18 1,325.40 21211 06-14 64.66 21281 06-18 911.97 21213* 06-25 250.00 21282 06-18 2,057.60 21214 06-13 464.28 21283 06-25 1,000.00 21215 06-12 1,460.28 21285* 06-27 7,759.57 79.50 21291 * 21216 06-14 06-21 2,412.63 x . 06-13 990.36 21292 06-20 5,367.00 21218* 41417 21293 21220* -12 09 6,034.00 21221 06-18 920.78 21296* 1 06-1 14,034.61 21222 06-15 1,544.66 21298* 06-25 946.90 21223 06-13 825.00 21299 06-25 246.68 21225* 06-11 8,754.40 21300 06-25 599.00 21226 06-12 251.37 21301 06-27 2,858.07 21227 06-15 412.38 21303* 06-28 328.10 21228 06-18 212.66 21304 06_26 2,944.00 21229 06-13 547.70 21305 06-25 2,527.05 21230 06-14 56.04 21306 06-26 2,527.50 21231 06-18 606.61 21307 06-27 678.16 21232 06-14 320.60 21308 06-26 3,678.76 21233 06-13 17,158.16 21309 06-25 6,217.50 21234 06-14 269.51 21311 * 06-25 1,281.50 21235 06-19 6,033.78 21312 06-25 816.82 21238* 06-21 6,821.82 21313 06-27 8 306.34 21246* 06-22 727.48 21314 06-25 10,542.34 21248* 06-26 178.50 21316* 38.87 21249 06-15 10,101.07 21317 06-206-27 7 2,815.30 21264* 06-25 18,023.17 21320* 06-26 24,493.59 21266* 06-21 5,964.37 21323* 06-25 14,811.97 137.68 21325* 21268 06- 06-29 22,335.15 21269 06-11 *8 630.83 21328 06-28 25,073.84 21270 06-19 1,577.85 21331 * 06-25 1,768.10 21271 06-19 8,544.28 21335* 06-28 482.10 21273* 06-19 853.58 21336 21274 06-18 8,862,84 *Skip in check sequence 21275 06-18 3,116.11 DEBITS Subtractions Date Description 25,770.79 06-01 ' Preauthorized Wd PAYCHEX TPS KS UITX CR 120601 45189400022317X 6,998.80 06-01 ' Preauthorized Wd PAYCHEX-HRS 401(K)120601 0000015717966 1268 -5189 ABBEY CARPET OF NAPLES LLC Page 4 June 29,2012 Subtractions Date Descri•tion 270.63 06-01 ' Preauthorized Wd PAYCHEX EIB INVOICE 120601 X45203400013152 21,272.03 06-04 ' Preauthorized Wd MOHAWK FACTORING PAYMENTS 120601 6,971.11 06-05 ' Preauthorized Wd PAYMENTECH FEE 120605 5263167 9,219.15 06-06 ' Preauthorized Wd 6,396.85 THE DIXIE GROUP CUSTOMERS SEE NOTES 06_06 ' Preauthorized Wd THE DIXIE GROUP CUSTOMERS 1844042,1845349'1 860931 4,032.92 06-06 ' Preauthorized Wd THE DIXIE GROUP CUSTOMERS 1847261,1862441 1,086.35 06-12 ' Preauthorized Wd AMERICAN EXPRESS COLLECTION 120612 1,442.28 06-13 ' Preauthorized Wd 38,571.82 THE DIXIE GROUP CUSTOMERS 1868089,1874227 06-15 ' Preauthorized Wd PAYCHEX INC.PAYROLL 120615 45412700002664X 36,291.66 06.15 Preauthorized Wd 13,016.93 MOHAWK FACTORING PAYMENTS 120614 06.18 ' Preauthorized Wd PAYCHEX TPS TAXES 120618 45413300021449X 3,708.96 06-18 Preauthorized Wd PAYCHEX-HRS 401(K)120618 0000015795215 225.01 06-18 ' Preauthorized Wd PAYCHEX EIB INVOICE 120618 X45429500004224 24,135.79 06-20 ' Preauthorized Wd FLA DEPT REVENUE CO1 120620 000000012969052 100,000.00 06.21 ' Cash Mgmt Trsfr Dr REF 1730811L FUNDS TRANSFER TO DEP 1001400967 FROM FUNDS TRANSFER 6,098.4 p6_27 ' Preauthorized Wd 4,335.76 SHAWUSD PAYMENTS 120626 06-27 Preauthorized Wd 58,710.44 SHAWUSD PAYMENTS 120626 06-29 ' Preauthorized Wd PAYCHEX INC.PAYROLL 120629 45597400036961X 1268 -5190 Page 5 ABBEY CARPET OF NAPLES LLC June 29,2012 Subtractions Date Descri. 'on 25,194.07 06-29 ' Preauthorized Wd MOHAWK FACTORING PAYMENTS 120628 CREDITS Additions Date Descri•tion 30 Add 06-01 ' Ca•ture De•• it 27,374.00 06-01 ' Ca•ture De•• it 30 27,334.00 06-01 ' Ca•ture De•• it 8,630.45 06-01 ' Preauthorized Credit PAYMENTECH DEPOSIT 120601 5263167 11,891.17 06-04 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120604 7,944.04 06-04 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120604 4,365.56 06-04 ' Preauthorized Credit PAYMENTECH DEPOSIT 120604 5263167 239.56 06-04 ' Capture Deposit 2,880.44 06-05 ' Preauthorized Credit PAYMENTECH DEPOSIT 120605 5263167 1,620.71 06-05 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120605 21.20 06-05 ' Preauthorized Credit PAYMENTECH DEPOSIT 120605 5263167 06-06 ' Preauthorized Credit PAYMENTECH DEPOSIT 120606 5263167 2,038.42 06-06 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120606 113.34 06-06 ' Ca•ture De•• it 104,707.43 06-07 ' Ca•ture De••sit 897 06-07 ' Preauthorized Credit PAYMENTECH DEPOSIT 120607 5263167 50,000.00 06-08 ' Ca•ture De•• it 185.38 06-08 ' Capture De•ssit 27,3,181.34 06-08 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120608 3,602.54 06-08 ' Deposit 1268 -5191 Page 6 ABBEY CARPET OF NAPLES LLC June 29,2012 Additions Date Descri on 1,730.99 06-08 ' Preauthorized Credit PAYMENTECH DEPOSIT 120608 5263167 28.01 06.08 ' Ca•ture De•• it 62,847.20 06-11 ' Ca•ture Des•sit 62,247.20 06-11 ' Ca•ture De•• it 46,229.00 06-11 . ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120611 9,473.56 06-11 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120611 5,432.30 06-11 ' Preauthorized Credit PAYMENTECH DEPOSIT 120611 1,027.94 06-11 ' Capture Dee',sit ,929.22 06-12 ' Capture Dee•sit 6 6,929.22 06-12 ' Ca•ture Dee•sit 5,526.23 06-12 ' Preauthorized Credit PAYMENTECH DEPOSIT 120612 5263167 2,843'88 06-12 ' Preauthorized Credit PAYMENTECH DEPOSIT 120612 5263167 14,209.66 06-13 ' Preauthorized Credit PAYMENTECH DEPOSIT 120613 5263167 2,902.22 06-13 ' Ca•ture De••sit 602.38 06-13 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120613 12,346.33 06-14 ' Ca•ture De••sit 9,074.98 06-14 ' Preauthorized Credit PAYMENTECH DEPOSIT 120614 5263167 17,444.14 06-15 ' Preauthorized Credit PAYMENTECH DEPOSIT 120615 5263167 7,428.61 06-15 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120615 6,275.05 06-15 ' Ca•ture De•• it 43,812.94 06-18 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120618 8,138.36 06_18 ' Capture Deposit 1268 -5192 ABBEY CARPET OF NAPLES LLC Page 7 June 29,2012 Additio ions Date Descri•tion 3d di 06-18 ' Preauthorized Credit PAYMENTECH DEPOSIT 120618 5263187 2,105.58 06-18 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120618 Credit PAYMENTECH DEPOSIT 120619 5263167 .00 06-19 ' Ca.ture Des'sit 2,000 , 0 .00 06-19 ' Preauthorized Credit PAYMENTECH DEPOSIT 120619 5263167 06-19 ' Ca i ture Del.sit 05 878800..05 06-19 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120619 164.25 06-19 ' Ca s ture De i•sit 11,631.09 06-20 ' Preauthorized Credit PAYMENTECH DEPOSIT 120620 5263167 2,123.03 06-20 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120620 263:94 06-20 ' Ca s ture De•osit 13207.58 06-21 ' CaIture Desosit 5,812.68 06-21 ' Preauthorized Credit PAYMENTECH DEPOSIT 120621 5263167 3,270.97 06-21 ' Ca s ture De•'sit 23,2 06-22 ' Casture Desosit 29,493.75 06-22 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120622 8,024.02 06-22 ' Preauthorized Credit PAYMENTECH DEPOSIT 120622 5263167 853.26 06-22 ' Caiture Desosit 23,853.26 06-25 ' CaIture Desosit 5,480.59 06-25 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120625 3,585.81 06-25 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120625 582.08 06-25 ' Preauthorized Credit PAYMENTECH DEPOSIT 120625 5263167 1268 -5193 ABBEY CARPET OF NAPLES LLC Page 8 ���` June 29, 2012 Additions Date Descri.tion 27 ddii 06-26 ' Preauthorized Credit PAYMENTECH DEPOSIT 120626 5263167 11,430.47 06-26 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120626 10,746.03 06-26 ' Preauthorized Credit PAYMENTECH DEPOSIT 120626 5263167 3,837.60. 06-27 ' Preauthorized Credit PAYMENTECH DEPOSIT 120627 5263167 3,019.70 06-27 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120627 96,282.00 06228 ' C ptu po are De sit 9,581.15 06-28 ' Ca•ture De••sit 3,211.04 06-28 ' Preauthorized Credit PAYMENTECH DEPOSIT 120628 5263167 72,849.55 06-29 ' Ca•ture De•osit 17,976.05 06-29 ' Preauthorized Credit PAYMENTECH DEPOSIT 120629 5263167 1,680.71 06-29 ' Capture Deposit IIMIIIIIII OVERDRAFT/RETURN ITEM FEES Total for Total this period year-to-date Total Overdraft Fees $0.00 $0.00 Total Returned Item Fees $0.00 $0.00 Thank you for banking with EverBank 1268 -5194 , / . EverE3ank Last statement:June 29,2012 This statement July 31, 2012 i Total days in statement period:32 II Page 1 220 MO 190 ##001246 ABBEY CARPET OF NAPLES LLC (190) 3471 BONITA BAY BLVD BONITA SPRINGS FL 34134-4364 Direct inquiries to: 888-882-3837 EverBank 1185 Immokalee RD Naples, FL 34110 Business Analysis Checking Account number 4011.11011.P Beginning balance $327,099.68 Enclosures 190 Total additions 972,842.20 Total subtractions 1,072,702.09 Ending balance $227,239.79 CHECKS Number Date Amount Number Date Amount 19687 07-03 584.97 21243 07-09 54.81 19688 07-03 1,114.59 21244 07-06 640.00 19689 07-03 785.38 21245 07-05 39.60 19690 07-06 946.76 21247* 07-03 158.95 19691 07-06 1,573.77 21250* 07-05 408.90 19692 07-02 3,247.03 21252* 07-19 656.13 19693 07-17 1,055.12 21253 07-03 34,994.36 19694 07-17 1,112.20 21254 07-13 5,976.27 19695 07-17 717.94 21255 07-13 300.00 19696 07-20 1,572.79 21256 07-05 220.00 19697 07-16 3,230.66 21257 07-03 373.85 20975 * 07-13 5,000.00 21258 07-18 75.00 21062* 07-09 7,908.50 21259 07-06 850.00 21158* 07-18 125.00 21260 07-09 16.87 21208* 07-24 3,833.23 21261 07-11 238.85 21209 07-03 2,925.05 21262 07-09 4,204.19 21212* 07-03 4,650.00 21263 07-05 16.66 21217* 07-05 1,500.00 21265* 07-13 604.90 21219* 07-05 2,104.29 21267* 07-05 217.02 21236* 07-18 188.00 21272* 07-09 166.00 21239* 07-19 125.00 21279* 07-03 2,057.20 21241 * 07-05 412.62 21284* 07-10 203.00 21242 07-31 1,972.35 21286* 07-25 100.00 1248 -4872 11 Oval Drive • Suite 107 • Islandia, NY 11749-1416 ! ABBEY CARPET OF NAPLES LLC Page 2 July 31,2012 Date Amount Number Date Amount Number 07-09 3,677.51 21287 07-23 124.27 21376 5,545.64 21288 07-05 167.59 21377 07-007-09 9 3,831.00 21289 07-11 178.64 21379* 07-09 2,292.95 21310* 07-03 1,770.38 21380 .13 21315* 07-03 . 9,491.78 21381 p7-11 6,07-09 2,889191.00 21318* 07-03 486.83 21382 07-09 1,395.16 21326* 07-19 509.43 21383 07-10 1,420.16 21329* 07-05 2,514.43 21384 07-18 355.81 21330 07-31 5,533.32 21385 07-25 1,311.26 07-02 1,875.00 21386 6,241.69 21333* 24.62 21387 07-13 21334 07-03 21337* 07-09 938.50 21388 07-19 110.00.70 21338 07-02 7,313.70 21389 07-17 1,07-13 3,307307.70 21339 07-06 4,028.25 21390 07-18 1,248.84 21340 07-03 2,559.60 21391 07-24 402.74 21341 07-02 4,926.25 21392 28.69 21342 07-09 75.00 21393 07-19 07-29 7 728.59 21343 07-03 1,855.00 21394 90.00 21344 07-02 3,485.64 21395 07-07-16 16 13.10 21345 07-05 2,356.79 21396 21346 07-03 1,479.52 21398* 07-06 07-19 12,0129.20 21347 07-03 1,882.50 21399 07-09 1,000.00 21348 07-09 200.00 21 * 401 07-12 60,473.26 21349 07-02 1,410.80 21402 07-11 1,063.51 21350 07-05 5,100.00 21403 21351 07-05 291.20 21405* 07-19 07-20 9 386.40 21352 07-10 119.00 21418* 07-20 336.30 21353 07-20 179.60 21419 07-17 1,484.00 21354 07-18 2,348.88 21420 07-17 7,812.32 21355 07-05 647.59 21421 07-16 2,752.87 21356 07-05 670.23 21422 07-17 5,736.97 21357 07-05 647.59 21423 07-16 2,945.00 21358 07-05 647.59 21425* 07-16 268.80 21359 07-09 43.15 21426 160.69 21362* 07-09 10,661.68 21427 07-107-16 6 4,560.60 21363 07-30 4,572.63 21428 07-24 1,239.69 21364 07-02 1,369.53 21429 21365 07-05 930.00 21430 07-25 368.20 07-25 310.20 21366 07-02 131.00 21431 07-25 921.64 21367 07-09 53.53 21432 .38 21368 07-03 5,575.82 21433 50 0 07-26 07-25 172 72.18 21370 07-03 07-02 9,550.00 21434 45.79 21369 0 21435 07-30 21371 07-09 1,099.69 21436 07-30 62.70 07-36 1,118.10 21372 07-09 747.00 21438* 07-25 53.55 21373 07-20 100.00 21440* 07-16 1,604.04 21374 07-09 2,981.25 21442 21375 07-16 1,421.60 21443 07-16 17,463.74 1246 -4873 • ABBEY CARPET OF NAPLES LLC Page 3 r� July 31,2012 Amount Number Date amount 21483 21446* 07-27 56.49 Amou 868.64 Number Date 07-25 * 07-24 2665.27 21448* 07-19 5,127.78 21485 07_24 447.74 07-16 11,487.44 214 07-24 236. 21449 3,943.04 21490* 1,935.58 21450 07-16 07-24 21451 07-19 6,127.50 21491 07_24 343.65 07-17 1,899.80 21492 07-30 24 21452 21498* 29,334.79 21453 07-30 7,695.00 21455* 07-30 416.00 21504 07-30 1,581.50* 07-30 291.62 21456 07-30 300.00 21506* 07-31 1,676.06 21460 2,187.59 07-30 270.00 21 * 4,551.93 21509 07-30 21462 07-18 * 07-30 2,888.70 21465* 07-20 5,747.55 21511 p7_30 3 200.00 21466 07-24 311.21 21512 07_30 12 896.68 21467 07-23 227.38 21514* 07-30 2,500.00 07-23 1,000.00 21515 07-30 1,500.51 21468 07-26 4,093.46 21516 1,884.43 21469 07-23 8,975.47 21517 07-30 21470 21524* 07-30 22,335.15 21471 07-31 500.00 21472 07-26 200.00 21526* 07_30 11,639.71 07-30 12,464.71 21474* 07-24 5,701.40 21527 * 07-30 5,538.12 21476* 07-23'- 7,685.16 21536* 07-30 1,092.00 21477 07-23 1,768.65 21548* 07-31 50.00 07-23 1,736.86 21554 21478 07-24 6,840.00 *Skip in check sequence 21479 21480 07-20 18,764.78 Subtractions DEBITS 26,054.27 Date Descri.lion 07-02 ' Preauthorized Wd PAYCHEX TPS TAXES 120702 45598300022123X 7,165.35 07-02 ' Preauthorized Wd PAYCHEX-HRS 401(K)120702 267.83 0000015848019 07-02 ' Preauthorized Wd PAYCHEX EIB INVOICE 120702 X45608400004273 4,361.85 07-03 ' Preauthorized Wd PAYMENTECH FEE 120703 5263167 17,337.17 07-06 ' Preauthorized Wd 7,159.37 THE DIXIE GROUP CUSTOMERS SEE NOTES 07-06 ' Preauthodzed Wd THE DIXIE GROUP CUSTOMERS 1882717,1884183,1 888166 32,052.94 07-11 ' Preauthorized Wd MOHAWK FACTORING PAYMENTS 120710 1246 -4814 ABBEY CARPET OF NAPLES LLC Page 4 July 31, 2012 Subtractions Date Descri on 646.29 07-11 ' Preauthorized Wd TD Auto Finance Web Pa 120711 1 p9.06 07-11 ' Preauthorized Wd MOHAWK FACTORING PAYMENTS 120710 31,331.51 07-1.2 ' Preauthorized Wd SHAWUSD PAYMENTS 120711 36,024.70 07-13 ' Preauthorized Wd PAYCHEX INC.PAYROLL 120713 45803100016453X 12,969.77 07-16 ' Preauthorized Wd PAYCHEX TPS TAXES 120716 45806700027716X 2,652.48 07-16 ' Preauthorized Wd PAYCHEX-HRS 401(K)120716 0000015922038 232.58 07-16 ' Preauthorized Wd PAYCHEX EIB INVOICE 120716 X45817200007339 17,088.49 07-20 ' Preauthorized Wd FLA DEPT REVENUE CO1 120720 000000012969052 2,046.95 07-24 Preauthorized Wd WRIGHT EXPRESS FLEET DEBI 120724 25,291.35 07-25 ' Preauthorized Wd MOHAWK FACTORING PAYMENTS 120724 71.19 07-27 Preauthorized Wd AMERICAN EXPRESS COLLECTION 120727 152,483.62 07-30 ' Preauthorized Wd THE DIXIE GROUP CUSTOMER SEE NOTES 15,657.59 07-30 Preauthorized Wd THE DIXIE GROUP CUSTOMER SEE NOTES 2 87Q,40 07-30 ' Preauthorized Wd THE DIXIE GROUP CUSTOMER 1910308,1918734,1 921493 1,734.88 07-30 ' Preauthorized Wd THE DIXIE GROUP CUSTOMER 1863452,1876970 70 008.63 07-31 ' Preauthorized Wd PAYCHEX INC.PAYROLL 120731 46014900016088X CREDITS Additions Date Description 29,274.22 07-02 ' Capture Deposit 1246 -4875 ABBEY CARPET OF NAPLES LLC Page 5 ��5 July 31,2012 A Date Descri, on 8 Additions dditi 362.54 07-02 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120702 6,216.04 07-02 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120702 6,107.43 07-02 ' Preauthorized Credit PAYMENTECH DEPOSIT 120702 5263167 4,930.96 07-03 ' Preauthorized Credit PAYMENTECH DEPOSIT 120703 5263167 4,231.28 07-03 ' Ca I ture De•'sit 3,228.96 07-03 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120703 2,621.26 07-03 Preauthorized Credit PAYMENTECH DEPOSIT 120703 5263167 2,197.25 07-03 De s•sit 4,000.00 07-05 ' Cash Mgmt Trsfr Cr REF 1871002L FUNDS TRANSFER FRMDEP 1001400934 FROM FUNDS TRANSFER 3,675.03 07-05 Preauthorized Credit PAYMENTECH DEPOSIT 120705 5263167 2,396.75 07-05 Preauthorized Credit PAYMENTECH DEPOSIT 120705 5263167 1,743.85 07-05 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120705 173.22 20 07-05 ' Ca sture De••Sit 55,087. 07-06 ' Capture Des•sit 55,087.20 07-06 ' Ca I ture Des•sit 5,141 07-06 ' Capture De, 5,9 .27 81.27 07-06 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120706 6,643.48 07-09 ' Preauthorized Credit PAYMENTECH DEPOSIT 120709 5263167 782.75 07-09 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120709 721.45 07-09 ' Capture Deposit 1246 -4876 ABBEY CARPET OF NAPLES LLC Page 6 July 31,2012 Additions Date Descri' "on 649.26 07-09 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120709 14,688.54 07-10 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120710 13,233.07 07-10 ' Ca•ture Del• it 07-10 P N Credit 6,027.23 P� EPOSIT 120710 5263167 2,298.79 07-10 ' Preauthorized Credit PAYMENTECH DEPOSIT 120710 4,511.71 5263167 07-11 ' Ca•ture De••sit 2,837.22 Credit 07-11 PAYMENTECH DEPOSIT 120711 5263167 689.12 07-11 ' Ca•ture De•osit 186.32 07-11 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120711 19,880.00 07-12 Ca•ture De••sit 10,589.73 07-12 ' Preauthorized Credit PAYMENTECH DEPOSIT 120712 5263167 2,290.74 07-12 Ca•ture Des•sit 6,900.31 07-13 ' Preauthorized Credit PAYMENTECH DEPOSIT 120713 2,887.78 5263167 07-13 Ca•ture De•osit 2,798.63 07-13 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120713 16,719.36 07-16 ' Ca•ture Del•sit 12,806.91 07-16 ' Preauthorized Credit PAYMENTECH DEPOSIT 120716 5263167 3,320.79 07-16 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120716 1,087.49 p7-16 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120716 8,746.54 07-17 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120717 1246 -4817 ABBEY CARPET OF NAPLES LLC Page 7 July 31,2012 Additions Date pescri•don 3,744.31 07-17 ' Preauthorized Credit PAYMENTECH DEPOSIT 120717 NINIMIMON 5263167 2,734.64 07-17 ' Preauthorized Credit PAYMENTECH DEPOSIT 120717 5263167 6,283.13 07-18 ' Preauthorized Credit PAYMENTECH DEPOSIT 120718 5263167 3,147.65 07-18 ' Ca•ture De••sit 24.61 07-18 ' De••sit 1,1,1124.63 07-18 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120718 905.00 07-18 Des•sit 28,954.80 07-19 ' Ca•ture De•osit 28,954.80 07-19 ' Ca•ture De•osit 4, 42.56 07-19 ' Preauthorized Credit PAYMENTECH DEPOSIT 120719 5263167 41,219.38 07-20 Ca•ture De••sit 5,204.10 07-20 ' Preauthorized Credit PAYMENTECH DEPOSIT 120720 5263167 62.03 07-20 ' Preauthorized Credit PAYCHEX TPS TAXES 120720 45919100018511X 15,067.01 07-23 Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120723 6,176.58 07-23 ' Preauthorized Credit PAYMENTECH DEPOSIT 120723 5263167 6,151.24 07-23 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120723 2,627.00 07-23 ' Ca•ture De••sit 14,357.60 07-24 ' Ca•ture De••sit 6,764.94 07-24 ' Preauthorized Credit PAYMENTECH DEPOSIT 120724 5263167 1,592.11 07-24 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120724 1,427.02 07-24 ' Preauthorized Credit PAYMENTECH DEPOSIT 120724 5263167 73,908.54 • 07-25 ' Capture Deposit 1246 -4878 • ABBEY CARPET OF NAPLES LLC /Ilia Page 8 8 July 31,2012 Additions Date Descri• r on 5,835.43 07-25 ' Ca+ture ''+•�'it 5,207.02 07-25 ' Preauthorized Credit •�� AMERICAN EXPRESS SETTLEMENT 120725 3,034.16 07-25 ' Preauthorized Credit PAYMENTECH DEPOSIT 120725 175,000.00 5263167 07.28 ' Cash Mgmt Trsfr Cr REF 20814121 FUNDS TRANSFER FRMDEP 1001400967 17,415.96 FROM FUNDS TRANSFER g 969,53 07.26 ' Ca•ture De••s� 07-26 ' Preauthorized A TCHH DCEPOSIT 120726 5263167 108,253.28 07.27 ' Ca+ture De••sit 10,073.30 07-27 ' Ca•ture De••sit Credit 8,559.65 07-27 PPAYMENTECH DEPOSIT 120727 5263167 2,866.29 p7_27 Ca•ture De••sit 15,388.38 07-30 ' Ca•ture De•*sit 5,38 6.38 07-30 ' Preauthorized Credit PAYMENTECH DEPOSIT 120730 9 144.37 5263167 07-30 Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120730 7548 40 07-30 Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120730 g 563.61 07-31 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120731 g 586.03 07-31 Preauthorized Credit PAYMENTECH DEPOSIT 120731 3,000.00 Credit 5263167 07-31 PAYMENTECH DEPOSIT 120731 5263167 641.46 07-31 ' Capture Deposit 1246 -4879 ABBEY CARPET OF NAPLES LLC Page 9 July 31,2012 OVERDRAFT/RETURN ITEM FEES Total for Total this period year-to-date Total Overdraft Fees $0.00 $0.00 Total Returned Item Fees $0.00 $0.00 Thank you for banking with EverBank 1246 -4880 _ : 0 EverBaflk Last statement:July 31,2012 This statement:August 31,201 31 Total days in statement period: Page 1 wiliMINSIS 220 MO 232 ##00123 8 232) ABBEY CARPET OF NAPLES LLC Direct inquiries to: 3471 BONITA BAY BLVD 888-882-3837 BONITA SPRINGS FL 34134-4364 EverBank 1185 lmmokalee RD Naples,FL 34110 Business Analysis Checking Beginning balance $227,239.79 Enclosures Account number 232 Total additions 1,156,855.19 E Total subtractions 1,255,129.42 Ending balance $128,965.56 CHECKS Amount Number Date Amount Number 08-02 78.00 19698 08-02 1,257.46 21459* 1 9699 0&02 1 073.51 21 461 * 08-01 08-23 11,413.73 19700 08-02 692.15 21463* 08-02 12,057.75 19701 08-03 757.95 21464 08-20 2,935.40 19702 08-06 1,572.79 21473* 08-10 3,142.65 19703 08-01 3,230.66 21475* 08-17 4,823.98 19704 08-20 1,132.49 21481 * 4 19705 08-17 1,091.37 21484* 08-09 8.09 41.94 19706 08-17 704.05 21487* 19707 08-20 1,572.84 21488 08- 35 08-15 08 830,90.35 19708 08-16 3,230.66 21489 0815 187.84 21237* 08-08 665.34 21494* 08-06 2,131.80 21240* 08-01 2,271.66 21497* 0&01 4,823.00 21332* 08-01 2,760.05 21502* 08-06 2,048.00 21378* 08-10 3,043.45 21505* 0&01 * 437.53 21507* 1,634.90 21400 08-07 08-06 21424* 08-10 1,974.25 21510* 08-10 1,780.40 21437* 08-08 75.00 21513 081 3,200.40 21439* 08-07 693.28 21518* 08-09 640.59 21441 * 08-06 22,110.75 21519 08-09 670.23 21444* 08-06 100.00 21520 0&09 647.59 0&01 1,100.00 21521 647.59 21454* 135.00 21522 08-09 21457* 08-08 11 Oval Drive•Suite 107 • Islandia,NY 11749-1416 ABBEY CARPET OF NAPLES LLC Page 2 a�� August 31,2012 Amount Number Date Date amount 08-14 5 718.63 Number 08-10 425.19 21584 08-08 2,642.96 21523* 08-08 257.41 21585 08-07 438.64 21525 08-07 387.52 21586 238.50 21528* 46.26 21587 08-17 21529 860.06 21530 08-08 180.44 21589* 0�8-108 9,381.85 21531 08'10 3`�5'� 2159 08-23 2,057.98 21532 08-16 128.04 08-06 21,001.32 21533 08-10 7,50 21593* 08-16 3,715.07 21534 08-06 985.53 21595 08-24 100.00 21535 08-01 3,343.06 08-22 215.24 21537* 08-13 1,015.18 21596 778.13 2,350.00 21597 08-08 56.77 21538 08-13 33.95 21598 08-20 21539 08-20 13.07 08-08 361.12 21599 96.95 21541 * 0&0S 461.68 21600 08-16 1 080.00 21542 08-08 • 963.37 21601 08-15 08-10 5,083.00 21543 08-06 3,590.31 21602 5,443.60 21544 * 08-15 29.93 21604* 08-09 2,956.85 21546 780.62 21605 56.27 21547 08-06 2,493.52 21606 0 736.88 21549* 08-02 21550 08-29 860.00 21607 08-07 18,244.60 16.00 21608 08-14 2,250.00 21551 08-1 359.87 21609 11,836.90 21552 * 08-01 5,424.60 21611 * 08-10 641.20 21558 08-02 3 836.59 21612 08-17 21559 08-13 602.00 21560 08-06 2,114.37 21613 08-13 42 080.05 21561 08-02 5 000.00 21614 08-10 18,932.57 08-01 12,000.00 21615 08-15 35.50 2 21562 08-02 28,387.45 21616 450.00 21563 13,80 .79 21617 08-15 21565* 08-07 21566 08-06 1,204.34 21618 08-10 4,512.79 08.14 31,282.02 21567 08-06 292.50 21619 08-14 263.86 21568 08-08 404.80 21620 .19 21569 1865.12 015 ,977221572 4,322.21 586130 iiii1Iiiiiii 1,290.35 08-16 1,350.71 6 1,049.61 8 4,897.50 6 3 3,998.01 21631 * 08-13 2,307.63 21579 08-13 487.64 21632 08-13 6,130.21 21580 08-13 200.00 21633 08-15 9,392.50 21581 08-14 319.28 21634 08-14 2,000.00 21582 08-10 1,684.56 21635 08-14 2,078.81 21583 08-14 1,016.10 21636 1238 -5102 • • ABBEY CARPET OF NAPLES LLC Page 3 August 31,2012 iiiIIIMINIP Amount Number Date Amount 211637 637 08-20 28-e 4,950.33 21698 08-29 1725.38 21639* 08-14 946.98 21699 08-24 100.00 08-28 7,511.20 MNNIMMS 21640 08-29 1,446.17 21700 08-29 2,909.05 21641 08-20 62.59 21702* 08-29 30.36 21643* 08-16 38,322.88 21704* 5,032.00 00 21644 08-27 •2,353.66 21705 8 17,005.16 21646* 08-27 1,733.79 21709* 08-17 2,588.41 21647 08-30 27,309.81 21710 21648 08-23 14,454.50 21711 08-27 13,572.50.22 21649 08-23 1,639.40 21712 08-28 1,147147.94 21650 08-30 350.00 21714* 08-29 800.00 21651 08-27 780.65 21716 21653* 08-30 720.00 21717 08-29 3,300.00 21655* 08-13 2,706.68 21718 08-29 2,450.00 21656 08-21 8,265.13 21719 08-28 2,131.80 21657 08-31 15,094.40 21720 08-28 308.32 08-27 805.00 21658 08-21 1,552.50 21722* 08-27 1,411.04 21659 08-20 1,536.47 21724 21660 08-20 280.86 21725 08-27 2,971.03 21661 08-21 1,000.00 21726 08-27 8,218.95 21662 08-20 14,035.65 21727 08-29 2,796.77 08-28 , 21663 08-27 5,948.85 21729* 5 08-27 5,66555.60 08-27 3,450.3 21664 08-21 1,001.90 21730 5 21665 08-21 5,836.04 21731 3850.56 21666 08-20 1,870.70 21732 08-23 20,688.84 21668* 08-20 1,584.28 21734* 08-28 22,335.15 21669 08-27 1,026.00 21738* 08-28 4,347.25 21670 08-21 866.96 21739 21671 08-21 3,231.10 21741 * 08-27 2,366.31 990.97 21672 08-20 6,231.00 21742 .02 21673 08-21 2,515.61 21743 08-27 5363 85 21675* 08-20 550.00 21746* 08-28 21676 08-24 1,000.00 21747 701.29 1,732.78 21677 08-20 2,099.63 21749 21679* 08-29 959.50 21760* 08-28 1,638.55 21680 08-23 3,450.00 21769* 08-28 1,117.59 25 1, 0 21681 08-27 342.15 21779* 08-29 40.40 21682 08-27 904.96 21782* 08-30 21683 08-22 6,656.92 21783 08-28 3,266.75 433.02 21784 08-27 7,803.19 21684 08-30 21785 08-29 1,448.89 937.92 2 21686* 08-29 21687 08-28 1,104.99 21786 0&28 9,185.40 21688 08-24 5,944.29 21791 * 08-31 35,014.69 21690* 08-28 3,623.01 21831 * 08-31 10,000.00 21695* 08-20 19,316.23 *Skip in check sequence 21697* 08-24 1,090.96 1238 -5103 • • ABBEY CARPET OF NAPLES LLC Page 4 August 31,2012 DEBITS Subtractions Date Descri s Lion Su,446.85 08-01 ' Preauthorized Wd PAYCHEX TPS TAXES 120801 46016600015608X 19,293.99 08-01 ' Preauthorized Wd MOHAWK FACTORING PAYMENTS 120731 19,281.41 08-01 ' Preauthorized Wd SHAWUSD PAYMENTS 120731 6, 08-01 ' Preauthorized Wd PAYCHEX-HRS 401(K)120801 0000015986139 8 08-01 ' Preauthorized Wd PAYCHEX EIB INVOICE 120801 X46024400001644 3,712.93 08-03 Preauthorized Wd PAYMENTECH FEE 120803 5263167 646.29 08-03 ' Preauthorized Wd TD Auto Finance Web Pay 120803 4,862.53 08-07 Preauthorized Wd BEAULIEU GROUP L QUICK PAY 120807 405011 3,936.42 08-07 ' Preauthorized Wd BEAULIEU GROUP L QUICK PAY 120807 405020 36,485.73 08-15 Preauthorized Wd PAYCHEX INC.PAYROLL 120815 46254000001522X 30,527.10 08-15 ' Preauthorized Wd MOHAWK FACTORING PAYMENTS 120814 13,184.90 08-16 ' Preauthorized Wd PAYCHEX TPS TAXES 120816 46255300020231X 2,666.50 08-16 ' Preauthorized Wd PAYCHEX-HRS 401(K)120816 0000016061401 224.58 08-16 ' Preauthorized Wd PAYCHEX EIB INVOICE 120816 X46261000002491 19,73$,7$ 08-20 ' Preauthorized Wd FLA DEPT REVENUE CO1 120820 000000012969052 681.68 08-21 ' Preauthorized Wd PAYMENTECH DEPOSIT 120821 5263167 1238 -5104 ABBEY CARPET OF NAPLES LLC Page 5 August 31,2012 Subtractions Date Descri.tion 21,591.26 08-24 ' Preauthorized Wd SHAWUSD PAYMENTS 120823 4,360.99 08-29 ' Preauthorized Wd WRIGHT EXPRESS FLEET DEBI 120829 0410007090079 539.40 08-30 ' Cash Mgmt Trsfr Dr REF 2430911L FUNDS TRANSFER TO DEP 1001400967 FROM PAYROLL ITEM 60,140.63 08-30 ' Preauthorized Wd PAYCHEX INC.PAYROLL 120830 46471600016070X 24,510.80 08-31 ' Preauthorized Wd PAYCHEX TPS TAXES 120831 46473500012817X 6,058.76 08-31 ' Preauthorized Wd PAYCHEX-HRS 401(K)120831 0000016138802 271.81 08-31 ' Preauthorized Wd PAYCHEX EIB INVOICE 120831 X46478400000412 CREDITS ns dditio Date Descri•tion 14 Additions 08-01 ' Preauthorized Credit PAYMENTECH DEPOSIT 120801 5263167 57,403.54 08-02 ' Ca•ture Des•sit 12,435.48 08-02 ' Preauthorized Credit PAYMENTECH DEPOSIT 120802 5263167 3,135.24 08-02 ' Ca•ture De••sit 48.40 08-02 ' Ca•ture De••sit 39,1148.40 08-03 ' Ca•ture De•osit 5,921.22 08-03 ' Wire Transfer-IN DECCO LTDCITIBANK DECCO LTD 5,357.42 08-03 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120803 3,296.39 08-03 ' Preauthorized Credit PAYMENTECH DEPOSIT 120803 5263167 23,692.75 08-06 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120806 9,834.58 08-06 ' Preauthonzed Credit PAYMENTECH DEPOSIT 120806 5263167 1238 -5105 Pa e 6 ABBEY CARPET OF NAPLES LLC August 31,2012 Additions Date Descri s tion 1,0 . 0 08-06 ' Ca•ture '-••,it 21212.000 08-06 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120806 69,154.06 08-07 ' Capture I-•• it 69,69,15154.06 08-07 ' Capture Dee•sit 3,312.97 08-07 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120807 ,400.00 08-07 ' Ca•ture De••sit 2 2,400.00 08-07 ' Preauthorized Credit PAYMENTECH DEPOSIT 120807 5263167 380.68 08-07 ' Preauthorized Credit PAYMENTECH DEPOSIT 120807 5263167 8 08-08 ' Ca•ture De••sit 8 42 42,832.,832.88 08-08 ' Ca•ture De••sit 2,483.31 08-08 ' Preauthorized Credit PAYMENTECH DEPOSIT 120808 5263167 1,496.12 08-08 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120808 3,547.77 08-09 ' Preauthorized Credit PAYMENTECH DEPOSIT 120809 5263167 3,287.68 08-09 ' Ca•ture De•*sit 4.08 08-09 ' Ca•ture De••sit 5 5554.08 08-09 ' De•• it 3,102.02 08-10 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120810 1,51 6.86 08-10 ' Preauthorized Credit PAYMENTECH DEPOSIT 120810 5263167 22,501.80 08-13 ' Capture Des•sit 10,498.10 08-13 ' Preauthorized Credit PAYMENTECH DEPOSIT 120813 5263167 5,430.54 08-13 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120813 4,435.55 08-13 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120813 18,000.00 08-14 ' Capture Deposit 1238 -5106 ABBEY CARPET OF NAPLES LLC page 7-� August 31,2012 Additions Date Descri. r on 13,678.51 08-14 ' Preauthorized Credit PAYMENTECH DEPOSIT 120814 5263167 5,585.21 08-14 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120814 .92 08-14 ' Ca s ture De s•sit 474744.92 08-14 ' Preauthorized Credit PAYMENTECH DEPOSIT 120814 5263167 . 7220 08-15 ' Capture Deposit 12,272.20 528.02 08-15 08-15 ' Preauthorized Credit PAYMENTECH DEPOSIT 120815 5263167 5,500.00 08-15 ' Capture Deposit 5,500.00 08-15 ' Capture Deposit 529.97 08-15 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120815 129.32 , 08-15 ' Capture Deposit 39429.32 08-16 ' Capture Deposit 39,452.28 08-16 ' Preauthorized Credit PAYMENTECH DEPOSIT 120816 5263167 19,853.68 08-16 ' Capture Deposit 895.50,895.5 08-16 ' Capture Deposit 591 08-17 ' Capture Deposit 59,656.81 08-17 ' Preauthorized Credit PAYMENTECH DEPOSIT 120817 5263167 1,148.15 08-17 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120817 ,082.21 08-20 ' Capture Deposit 42 42,082.21 08-20 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120820 10,392.39 08-20 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120820 7,492.86 08-20 ' Preauthorized Credit PAYMENTECH DEPOSIT 120820 5263167 76.91 1 08-20 ' Capture Deposit 17 7, .91 08-21 ' Ca.ture Des I it 12,176,000.00 08-21 ' Capture Deposit 1238 -5107 Page 8 ABBEY CARPET OF NAPLES LLC August 31,2012 Additions Date Descri.tion 6, dditio 08-21 ' Preauthorized Credit PAYMENTECH DEPOSIT 120821 5263167 6,170.86 08-21 ' Preauthorized Credit PAYMENTECH DEPOSIT 120821 5263167 3,557.58 08-21 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120821 16,093.47 08-22 ' Preauthorized Credit PAYMENTECH DEPOSIT 120822 5263167 08-22 ' Ca•ture Del•sit 5,649.11 ,69. 08-22 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120822 299.98 08-22 ' De••sit 1 08-22 ' Ca•ture De•'sit 9 58,205.205.19 08-23 ' Ca•ture De•osit 8,081.46 08-23 ' Preauthorized Credit PAYMENTECH DEPOSIT 120823 5263167 22.69 08-23 ' Ca•lure De••sit 104,0135.99 72.40 08-24 ' Ca•ture De••sit 18, 08-24 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120824 1,625.80 08-24 ' Preauthorized Credit PAYMENTECH DEPOSIT 120824 5263167 7,627.22 08-27 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120827 2,256.05 08-27 ' Preauthorized Credit PAYMENTECH DEPOSIT 120827 5263167 520.38 08-27 ' Preauthorized Credit AMERICAN EXPRESS SETTLEMENT 120827 6,931.71 08-28 ' Ca•lure De••sit 3,239.65 08-28 ' Preauthorized Credit PAYMENTECH DEPOSIT 120828 5263167 ,000.00 08-28 ' Ca•ture De••sit 2 2,000.05 08-28 ' Preauthorized Credit PAYMENTECH DEPOSIT 120828 5263167 1,129.46 08-28 ' Capture Deposit 1238 -5108 ABBEY CARPET OF NAPLES LLC Page 9 31,2012 Additions Date Descri• 'on 26 Additions 08-29 ' Ca•ture a-•• ft 61,666.06 08-30 ' Capture '-•• it 61,666.06 08-30 ' Ca•ture De••sit 6,098.45 08-30 ' Preauthorized Credit PAYMENTECH DEPOSIT 120830 5263167 2,500.00 08-30 ' Cash Mgmt Trsfr Cr REF 2430910L FUNDS TRANSFER FRMDEP 1001400934 FROM FUNDS TRANSFER 14,1 08-31 ' Preauthorized Credit PAYMENTECH DEPOSIT 120831 5263167 6,189.00 08-31 ' Ca•ture De••sit 3,369.00 08-31 ' Capture Deposit OVERDRAFT/RETURN ITEM FEES Total for Total this period year-to-date Total Overdraft Fees $0.00 $0.00 Total Returned Item Fees $0.00 $0.00 Thank you for banking with EverBank 1238 -5109 STATEMENT OF OWNERSHIP � • 0°CaleX a a )- member or This certifies that I, SS-k-(1 • _Lao (APPLICANTS NAME) Managing member of t / •' A t ISI bit I. CO -.16 LLC (LIMITED LIABI Tip COMP Y NAME) , I own % of the units issued by the Limited Liability _____,V-- Company listed above. Affidavit of Applicant: I certify that the information contained is a true and correct statement to the best of my knowledge. • • O. V • - (PRINT N E) II 0 ■A 1 Lk ell A' 0 (APPLI NTS SIGNATURE) ck 2 (D TE) www.sun Department-Deparent of State Fage 1 or z "i D E i';l i. I YEN'. OF S D :t'HO 0 C. '.'1i:()P\l :t — — — — Forms Help Home Contact Us — E-Filing Services Document Searches Previous on List Next on List Return To List Entity Name Search Submit No Events No Name History Detail by Entity Name Florida Limited Liability Company ABBEY CARPET OF NAPLES, LLC Filing Information Document Number L02000030026 FEIIEIN Number 050542678 Date Filed 11/12/2002 State FL Status ACTIVE Principal Address 3471 BONITA BAY BLVD. BONITA SPRINGS FL 34134 Mailing Address 3471 BONITA BAY BLVD. BONITA SPRINGS FL 34134 Registered Agent Name &Address GUTIERREZ,PHILIP 3471 BONITA BAY BLVD. BONITA SPRINGS FL 34134 Manager/Member Detail Name&Address Title MGRM GUTIERREZ,PHILIP 3471 BONITA BAY BLVD BONITA SPRINGS FL 34134 Annual Reports Report Year Filed Date 2010 04/23/2010 2011 04/20/2011 2012 04/30/2012 Document Images 04/30/2012—ANNUAL REPORT I View image in PDF format 04/20/2011 —ANNUAL REPORT View image in PDF format 04/23/2010—ANNUAL REPORT I View image in PDF format brrn•//www.sunbiz.orl?/scripts/cordet.exe?action=DETFIL&ing_doc_number=L020000300... 9/27/2012 LV1 L. www.sunbiz.org-Department of State I QE,‘.. 04/14/2009--ANNUAL REPORT I View image in PDF format 04/21/2008—ANNUAL REPORT I View image in PDF format 04/26/2007—ANNUAL REPORT I View image in PDF format 04/25/2006--ANNUAL REPORT I View image in PDF format 04/28/2005—ANNUAL REPORT View image in PDF format 04/21/2004—ANNUAL REPORT I View image in PDF format 04/30/2003—ANNUAL REPORT I View image in PDF format 11/12/2002—Florida Limited Liabilites I 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 Entity Name Search Submit No Events No Name History Forms I Help I I Home I Contact us I Document Searches I E-Filing Services I Copyright©and Privacy Policies State of Florida,Department of State http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&inq_doc_number=1_,020000300... 9/27/2012 2012 LIMITED LIABILITY COMPANY ANNUAL REPORT FILED Apr 30, 2012 DOCUMENT# L02000030026 Secretary of State Entity Name: ABBEY CARPET OF NAPLES,LLC Current Principal Place of Business: New Principal Place of Business: 3471 BONITA BAY BLVD. BONITA SPRINGS,FL 34134 Current Mailing Address: New Mailing Address: 3471 BONITA BAY BLVD. BONITA SPRINGS,FL 34134 FEI Number:05-0542678 FEI Number Applied For( ) FEI Number Not Applicable( ) Certificate of Status Desired( ) Name and Address of Current Registered Agent: Name and Address of New Registered Agent: GUTIERREZ, PHILIP 3471 BONITA BAY BLVD. BONITA SPRINGS, FL 34134 US The above named entity submits this statement for the purpose of changing its registered office or registered agent,or both, in the State of Florida. SIGNATURE: Date Electronic Signature of Registered Agent MANAGING MEMBERS/MANAGERS: Title: MGRM Name: GUTIERREZ,PHILIP Address: 3471 BONITA BAY BLVD City-St-Zip: BONITA SPRINGS,FL 34134 I hereby certify that the information indicated on this report is true and accurate and that my electronic signature shall have the eceiver effect as if made to exec to this hreport as required by Chapter 608,Florriiidaf Statuested liability company or the SIGNATURE: PHILIP GUTIERREZ MGRM 04/30/2012 Electronic Signature of Signing Managing Member, Manager,or Authorized Representative/Date Credit Information General Information Company: Abbey Carpet of Naples,LLC Physical Address: 13250 Tamiami Trail N. Naples,FL. 34110 Mailing Address: 25321 Bernwood Dr. Attn: Accounts Payable Bonita Springs,FL 34135 Ship to Address: 25321 Bernwood Dr. Bonita Springs,FL 34135 Phone: (239) 596-5959(store) (239) 947-3172 (accounting) Fax: (239) 596-5993 (store) (239) 947-3491 (accounting) Organization Date: November 12, 2002 Tax ID: 05-0542678 Member Officers: Philip Gutierrez Bank Reference Bank: Everbank Contact: Joseph Sullivan Address: 3401 Tamiami Trail North Phone: (239) 254-2100 Naples,FL 34103 Fax: (239) 254-2104 Affiliated Companies Abbey Carpet Co., Inc. The Floor Club, Inc. Floors To Go, LLC Credit References Acct: 018889 SHORELINE FLOORING SUPPLIES Contact: Do403-1790 3406 Dean Street Naples,FL 34104 Fax: 239-403-1792 LOLOI RUGS Contact: Joni Thomas Acct: 102769 4501 Spring Valley Rd Phone: 972-503-5656 x212 Dallas,TX 75244 Fax: 972-387-0436 .I Contact: Bill Tillberg Acct: 50AB1220 3500 SW 42"d Avenue Phone: 772-403-5008 Palm City,FL 34990 Fax: 866-800-3946 3201 661,St SW Naples Florida,34105 Phone(239)896-6199 Fax(239)657-8508 Castillomarble73cyahoo.com October 2,2012 Collier County Licensing Section 2800 North Horseshoe Drive Naples,Fl.34104 To whom it may concern, The purpose of this letter is to see if I can reinstate or re-qualifier my county license under the specialty trade of Marble&Granite,fabrication and installation.Two year back I was face with a decision shut down all operation of business due to lack of incoming fund being paid to my company and or lack of sale to provide fund for operation.The difficulty of all this was not being able to provide income for great group of guys for months we went with out any sales and when we did we work next to nothing or we where under bid almost penny to the dollars by non licensed contractors.Then in some cases we were not paid for some of our jobs with all of these factors we exhausted our funds to continue in a daily manner.Basically when the bottom of this economy fell out usually smaller company's don't survive simply because smaller company have far less capital,I started this company in 2006 I only had a few years to build up some company capital.In 2008 is when the business started to decline due to the economy.For what I saw in this hard time many home owners were no longer spending there extra funds on flooring because they where taking loses in less income per house hold too,I think it because the flooring business is more of an up grade and not a necessity.So I hung in there as long as I could until the company ran out of funds to provide payroll.In some cases I even gave some of the guys odd jobs to due around my house until they could find some type means to provide for themselves other than being employed with me.Finally I had no choice but to call my workers comp and make my final payment it up to date and cancel for the following year as I was canceling their services they said they would be glad to help me get stared again if I ever needed there services again. As for myself I've been employed at Seminole Construction&Development,Inc for the past five years and in the last two have also not been so great either for this company until mid way of this year.I was once an officer of this company until a new opportunity came about needless to say I am still a partner only not as an active officer of the company or am I the qualifier of this company license.I an know an employee of this company and my job task are;bid estimators of complete construction of new home and land development of new home construction,purchasing,attendance of pre-bid meetings,attendance of pre-construction meetings and supervisions of jobs.With my involvement here at scdinc I have seen more and more activity in the area so this one of the reason I would like to reinstate my county license for marble&granite and the main reason is mostly due to the contractors that I have done business with over these years have been asking for me to place bids on up coming projects and as far as I know we took pride in our work we were honest and professional about all are job big or small.I shall wait patiently on your decision on my reinstatement of my county license and thank you for taking the time to read this letter. Sincerely, / 1 of 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: )ct Corporate/Business Name:On Si u) l3 frj / - Fiction Name/DBA: Qualifier Name: a rye r r_A r;_ AC6, ��Physical Address: (Number & Street) (City) (State) (Zip Code) Mailing Address: rte.� _ .J ( ,*h , (JP, ( D I �;� _e^J—tiL"�? (Number & Street) Ci ( ty) (State) (Gip.Code) Telephone: t � ( i �' E-Mail: 00,�-t-1/1C`.0' r ' ^r TYPE OF LICENSE: ❑ General $230.00 ❑ Electrician $230.00 ❑ Building $230.00 ❑ Plumber $230.00 ❑ Residential $230.00 ❑ Air Cond. $230.00 ❑ Mechanical $230.00 ❑ Swimming Pool $230.00 ❑ Roofing $230.00 ❑ Specialty $105.00 S Malty trade: Q-GERARDO MARTINEZ 09/25/2012 C14NGE OF STATUS: REINSTATEMENT$205.00 RENEWAL 2010 TO 2011 W/LATE FEE$185.00 ( ,) Reinstatement ( ) From One Business to Another RENEWAL 2011 TO 2012 W/LATE FEE $185.00 RENEWAL 2012 TO 2013$125.00+ Late Fees Page 1 of 4 Per Month Till Reinstated. i 1. The names, titles, home address and phone numbers of all Officers/Managing Members of the Firm. (A)s-,'l r.-105 li let t n Q."Z C" r t1_V4) ,o_ Wk -s:*--kT -•. r 0,d,5--, \ 7_,(0 (•y:, ( . r t V J ; l C 7 . r ; ![/�/ t i- , , 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. I rkCUL ll s 4 t V I ,� II� '7 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. j\J AFFIDAVIT i I, 0�K 7t'c d I.(_}T-1-1 itl ,certify that the foregoing is true and correct to the best of my knowledge. A / /A orb Officer 'the Fimi STATE OF FL9RIQ , COUNTY OF Loatcrl,, The foregoing instrument as acknowledged before me this OCti,4-k., // ,..20 /1-- j (Date) �/ f of 04...,s4lt, . I ..d (Nam- o offi..,, title/-•ent) (Name of Corporation) ',"'�''^��`` Corporation on behalf of the corporation. (State or Place of Corporation) j 1 -le/She has produced di6 identification and did not take an oath. (Type of identification) ' • aliHIINlNIinR *ARY'S Nary Pak s o w dfknde i -'. : Commission OMNI257 ( r ":,,,• —41 *Comm bp.October L2013 4 Wad llov Awoken SOP/Cowes - (SI "ATURE OF NOTARY) i � . Page2of4 QUALIFIER INFORMATION: I"Name: 0-10 S--,3 F''-_ 1') \V \CI(- 1./i A9:17 'Address: `- .J ' r/4 (OS (Number& Street) '(City) (State) (Zip Code) Telephone: -- J — � f( Date of Birth: 04—(\ --- r-9-S S.S. #: 000-00i E-Mail:Clc-•_' ( _ p i cz , Driver's License: �.�, �:.� - - - --() 1. Type of Certificate of Competency for which application is made. -1- ( r (11( 2 e names and telephone`numbers of two persons who will know your whereabouts. • . ,----z fq — 1 1(,- (cL.71 1 ) rr-‘,. ,-. - s—Cr7,—c2_1 •--7-(i-- - 1 T L . — t:� _` � 'I 3. Have you ever been convicted of a crime related to Contracting? ,J (If yes attach extra sheet with explanation) 7. Have you or any firms you have been associated with ever filed bankruptcy? J )0 8. List all debts you or any company(s)associated with you refused or failed to pay and reasons why. U0 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. 1r •', .1., � x - ' .1 f t () J Pane 3 of d 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 PRINT) ■�1 �t 7 r I1 �' t ., NAME OF CO PANY , � SIGNATURE OF APPLICANT STATE OF FLO !pA COUNTY OF ,� ,�,�� The foregoing instrument as acknowledged before me this f--)2c/ ; (Date) By who has produced 46 3~ -73 / 7 (Name of person ck -..in (Type of identification) as identification and did not take an oath. x.10,; NS SETH HU NOT' •`''• *WY PubhC-State of Fl Commission 1257 3 /� . , E+P•oaoaa Ocfobor a,10 t a Co uncfi 1 '(S cry URE OF N TARP) -- Page 4 of 4 Qualifier ISM Qualifier No First Name Middle Name Last Name Postfix 26570 !GERARDO 'MARTINEZ 0 Detail 1 Addresses Associated Tables 'Update Info f ■ ID No. Description Exam Date Score Location Sponsor 18066 TILE 1&MARBLE 9/1012005 76 NAPLES COLLIER cob • 17453 BUSINESS&LAW 7/9/2005 80 NAPLES COLLIER CO Certificates 1 Examinations hi Certificate - ,7 01/164414 Certificate No Qualifier Name DBA Status 29229 IGERAFIDO MARTINEZ r170 1CASTILLO MARBLE&GRANITE,INC. !INACTIVE Detail 1 DBA Info! LIAB Ins 1 WC Ins Bond Iris 1 Associated Tables 1 Update Info Class Code 14420 krt. TILE MARBLE CONTR. County Original Issue Date 15/8/2006 173 Comp Card I Expiration Date Renewal Date 1 OL Exempt r Expiration Date 19/30/2010 rzi OL Number 1053700 OL Expiration Date 19/30/2010 131 Cancel Date State Number 1 Expiration Date Reinstate Date 12/27/2009 MI Other Debit Account 1 rtr0 OL Number 1 Expiration Date 1 Planning Comm. 1 rtro '4■4 AFFIDAVIT It is understood and acknowledged by the Collier County Contractors' Licensing Board and myself that if I fail to acquire, or maintain at all times effective Workmen's Compensation Insurance it will result in the possible revocation of my� Certificate of Competency. SIGNATURE OF1APPLICANT ftj BUSINESS NAME'" f() 1 i7 DATE • LFORE ME this day personally appeared,P Y PPe ,�' 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 FLOC. ID/} COUNTY OF ( :^�C{ w The foregoing instrument was acknowledged before me this (Date) by 7 r //j ,it t- - • who has produced 7/) as Identification and who did not take an oath. - • - ""• , BETH HUNTS* • ' 0: %ivy Public tate of Rohr • • Coinm uion#00931257 ' 1 Tr' - OF NOTARY AR ',' my Cipmat.Exp.Octob.r e.2013 114160.TANI*mow Sall Council NOTARY PUBLIC . AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER �4 ' �� ����7�! , am a resident of ( �'//' County, FL,/ (State) and have resided here for more than five (5) years. uring the last,five years I have known ern eD Ina f-r/ e Z (Applicant). I have had ie opportunity to observe his or her business and personal dealings and find him or her to be a person of >nesty, integrity and good character. (Signature / (Address) 7 C )l �3(+ c j Telephone) 2:39 4/31/ STATE OF FLORIDA COUNTY OF 1 The foregoing instrument was acknowledged before me this /3A)3! by —--- C (Date) �1- Dr i-Ve■I s who has produced s It;L, Ki '3 (name of person acknowledging) (Type otidentification) as identification and who did not take an oath. /97 / 44" srG Notary Public State of Florida NA E 0 OTARY r f4 Lora L Jmo s 00829460 .ExWfaf 11112!2012 •� (PRINT NAME OF NOTARY) NOTARY PUBLIC 9 __-~ - -~~~-~ ~~~-___ _- �~,�'-~ �- ' - - • . 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THE :USINESS WAS INCORPORATED ON JANUARY 13, 2006 IN FLORIDA. COMPANY BACKGROUND INFORMATION THE FOLLOWING WAS PRO ADED BY THE STATE OF FLORIDA. HISTORY : BUSINESS INCORPORATED ON JANUARY 13, 2006 AS A FOR-PROFIT CORPORATION. FEDERAL TAX ID IS 204348799. CHARTER NUMBER IS P060000073. CURRENT STATUS : ACTIVE BUSINESS. AGENT IS MARTINEZ GERARDO LOCATED AT 3201 66TH ST SW, NAPLES, FL. PRIMARY PRODUCT/SERVI. : MASONRY AND OTHER STONEWORK SIC: 1741 ADDL PRODUCT/SERVICES BRICK, STONE, & RELATED MATERIALS SIC: 5032 ADDL PRODUCT/SERVICES : TERRAZZO, TILE, MARBLE, MOSAIC WORK SIC: 1743 NONRESIDENTIAL CONSTRUCTION, NEC 1542 NO. OF EMPLOYEES : 2 ESTIMATED SALES : $150,000 PRINCIPAL(S) : GERARDO MARTINEZ TITLE: PRESIDENT RAUIL GARCIA TITLE: VICE PRESIDENT THE INFORMATION HEREI IS FURNISHED IN CONFIDENCE FOR YOUR EXCLUSIVE USE FOR LEGITIMATE BUSINE=S PURPOSES AND SHALL NOT BE REPRODUCED. NEITHER EXPERIAN INFORMATION =OLUTIONS, INC. , NOR ITS SOURCES OR DISTRIBUTORS WARRANT SUCH INFORMATION NOR 'HALL THEY BE LIABLE FOR YOUR USE OR RELIANCE UPON IT. COPYRIGHT 2012 EXPERIAN INFORMATION SOLUTIONS, INC. ALL RIGHTS RESERVED. **END REPORT** MERIT CREDIT HAS RETRFEVED THE ABOVE REPORT FOR LICENSING PURPOSES OR OTHER PERMISSABLE PURPOSE A? REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPOT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY (INCLUDING PINELLAS) , STATE AND FEDERAL LEVELS. PUBLIC RECORDS LEARNED: 0 SOURCES OF INFORMATIO : EXPERIAN IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUEST ONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1-800-371-3348 OR 239-277-3202. ' 10/02/2012 11:59 2392773259 MERIT CREDIT PAGE 01/03 Prepared By: Merit Credit (239) 277-3202 (800) 371-3348 TRANSUNION CREDIT REPOT [FOR] [SUB N' E] [MKT SUB] [INFILE] [DATE] [TIME] (I) Z NP6284423 MERIT CREDIT 16 NP 9/02 10/02/12 10:57CT [SUBJECT] [SSN] [BIRTH DATE] MARTINEZ, GERARDO 4/73 [CURRENT ADDRESS] [DATE RPTD] 3201 SW. 66TH 5T., NA-LES FL. 34105 7/11 [FORMER ADDRESS] 4270 ATOLL CT., #6. N°PLES FL. 34116 4/07 3601 SW. 21ST AV., NILES FL. 34117 MODEL PROF I L E ***FICO CLASSIC 04 S •RE +610 : 038, 013, 010, 019 " "" C R E D I T S U M A R Y * * T O T A L F I L E H I S T O R Y PR=0 COL=1 NEG=0 OTNEG=2--4 TRD=4 RVL=2 INST=2 MTG=0 OPN=0 INQ=1 HIGH C',ED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE CLOSED W/BAL: $2796 $0 $56 TOTALS: $ $ $2796 $0 $56 C O L L E C T I O N SURNAME SUBCODa ECOA OPENED CLOSED $PLACED CREDITOR MOP ACCOUNT# VERIFIED BALANCE REMARKS MERCHANTSCOL Y 2057401 I 11/11 $87 10 FLORIDA POWER L 093 11934207 3/12A $87 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/LOANTY:E CLSD/PD BALANCE REMARKS MO 30/60/90 GECRB/SANS D 23504S 11/08 $639 111111111111 RO1 9/12A $600 $0 111111111111 I CHARGE ACCOUNT • 12/09C $0 ACCT CLSD BY CONSUMER 46 1/ 0/ 0 SUNGST FCU Q 298Q017 6/06 $6246 MIN56 12/11 111111213211 R01 9/12A $5000 $0 $74 03 111111111111 I CREDIT CARD 12/11C $2796 CLOSD BY CRDT GRANTOR 48 2/ 1/ 0 SUNCOAST CU Q 298Q0'1 4/06 $24.3K 72M587 111111111111 I01 2/12A $0 111111111111 I AUTOMOBILE 2/12C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 SUNCOAST CU Q 298Q041 7/03 $21.0K 72M353 111111111111 101 4/06A $0 111111111111 I AUTOMOBILE 4/06C $0 CLOSED 34 0/ 0/ 0 I N Q U I R I E S DATE SUBCODE SURNAME TYPE AMOUNT 10/02/12 ZNP6284423( LA) MERIT CREDIT 10/02/2012 11:59 2392773258 MERIT CREDIT PAGE 02/03 C R E D I T R E P O T S E R V I C E D BY : TRANSUNION 800-888-4213 2 BALDWIN PLACE P_0. sOX 1000,CHESTER, PA. 19022 Consumer disclosureS an be obtained online through TransUnion at: http://www.trans nion.COm CREDITOR CONTACT INFO'MATION MERCHANTSCOL YC20S7001 (800) 226-6188 PO BOX 2842 1AMPA FL. 33602 GECRB/SAES DV235046S PO BOX 965005 IRLANDO FL, 32896 SUNCST ECU QC298Q007 (813) 621-7511 6801 HILLS AVE AM PA FL. 33680 SUNCOAST CU QU298Q001 (813) 621-7511 PO BOX 11904 AMPA FL. 33680 END OF TRANSUNION REPORT MERIT CREDIT HAS RETRI' VED THE ABOVE PERSONAL CREDIT REPORT FOR LICENSING PURPOSES AS rEQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PU: IC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED 'T THE COUNTY, STATE AND FEDERAL LEVELS. PUBLIC RECORDS HAVE A SO BEEN VERIFIED FOR PINELLAS COUNTY. . PUBLIC RECORDS LEARNED 0 SOURCES OF INFORMATIO : CREDIT DATA SERVICES, INC/EXPERIAN IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT ■T: 1-800-371-3348 OR (239) 277-3202. 2012 FOR PROFIT CORPORATION ANNUAL REPORT ApFILED 012 DOCUMENT# P06000007309 Secretary of State ntity Name: CASTILLO MARBLE&GRANTIE INC Current Principal Place of Business: New Principal Place of Business: 3201 66TH STREET SW NAPLES, FL 34105 Current Mailing Address: New Mailing Address: 3201 66TH STREET SW NAPLES, FL 34105 FEI Number:20-4348799 FEI Number Applied For( ) FEI Number Not Applicable( ) Certificate of Status Desired( ) Name and Address of Current Registered Agent: Name and Address of New Registered Agent: MARTINEZ, GERARDO 3201 66TH ST SW NAPLES, FL 34105 US The above named entity submits this statement for the purpose of changing its registered office or registered agent,or both, in the State of Florida. SIGNATURE: Electronic Signature of Registered Agent Date OFFICERS AND DIRECTORS: tie. P ame: GERARDO,MARTINEZ • Address: 3201 66TH ST SW City-St-Zip: NAPLES.FL 34116 Title: VP Name: RAUL,GARCIA Address: 3201 66TH STREET SW City-St-Zip: NAPLES,FL 34105 I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath;that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 607, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. IGNATURE: GERARDO MARTINEZ VP 04/16/2012 :>,•, Date Electronic Signature of Signing Officer or Director -------"'nffil‘ ® Policy Number: 8090017825 Date Entered: AC R° CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 10/3/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED EPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. 'IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Perlin Insurance Agency NAME: PO Box 366697 Bonita Springs, FL 34136 /A/c No.Est): (239)263-3141 FAX No)_ (239)263-8696 E-MAIL 24520 Production Cr. , #4 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Bonita Springs, FL 34135 _INSURER A NORTHPOINTE INS. CO. INSURED CASTILLO MARBLE & GRANTIE, INC. INSURER B: RAUL GARCIA INSURER C: 3201 66th ST SW INSURERD: NAPLES„ FL 34105 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSR WVD- POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY �/ EACH OCCURRENCE $100,000 AMAGE TO A X COMMERCIAL GENERAL LIABILITY 8090017825 11/07/2011 11/07/2012 PREM PREMISES(EaEoccurrrence) $100 000 CLAIMS-MADE X OCCUR MED EXP(Any one person) _ $5,000 LIMITS AS OF PERSONAL BADVINJURY $100,000 INCEPTION DATE GENERAL AGGREGATE _ $200,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $200,000 POLICY PRO LOC $ '!N JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT —I (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER _ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) INTERIOR/EXTERIOR INSTALLATION OF TILE & MARBLE CERTIFICATE HOLDER CANCATIO COLLIER COUNTY CONTRACTORS LICENSING BOARD SHOU W.• HE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE T PIRAT• D• - 'F, NOTICE WILL BE DELIVERED IN DEVELOPMENT SERVICES CENTER AC ORe•NCE HE POLIC P ONS. 2800 N. HORSESHOE DRIVE NAPLES, FL 34104 FAX (239) 252-2469 AUTHORIZED R_- • It& `.\. illilillik( DEEDRA WILL' �1111111r © q88-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks4CORD Produced using Forms Boss Plus software.www.FormsBoss corn;Impressive Publishing 800-208-1977 I NOTICE OF ELECTION TO BE EXEMPT If this application contains incomplete or inaccurate information, it may cause a delay in the issuance of your exemption.An officer electing an exemption under Chapter 440, Florida Statutes, is not entitled to benefits under this chapter. ,section 1: "''`APPLICANT INFORMATION First& Last Name: GERARDO MARTINEZ FL Driver's License Number: OR FL ID Number: Date of Birth: 4/7/1973 Social Security Number(last four digits): 5715 Email Address: CASTILLOMARBLE73 @YAHOO.COM Section 2: CONSTRUCTION INDUSTRY APPLICANT($50 FEE REQUIRED) Officer of a Corporation (Construction) Corporate Title: PRESIDENT Section 3: This section should be completed with information specific to your corporation or to the limited liability company in which you are a member. The name of the corporation or limited liability company listed on this application MUST match the name of the corporation or limited liability company as registered with the Florida Division of Corporations. ame of Corporation or LLC: CASTILLO MARBLE&GRANTIE INC FEIN: 20-4348799 i YOU NEED TO APPLY FOR A FEIN,CLICK HERE Business Name (DBA): Phone: (239)896-6199 Applicant's Address of Record: 3201 66TH ST SW City NAPLES State: FL Zip 34105 County: Collier Click on the arrow(s)next to the text box(s)to view a list of available Scope classifications/trades for the form type chosen in Section 2. Click on the appropriate scope to select. If you are unsure as to which classification/trade to choose, please contact your workers' compensation insurance carrier. If you do not have a workers' compensation insurance policy, contact the National Council on Compensation Insurance(NCCI)at 1-800-622-4123 option 5 to obtain a classification code. Scope 1: 05348 Ceramic Tile, Scope 2: Scope 3: Scope 4: Indoor Stone,Marble, or Mosaic Work Section 4: The corporation of which you are an officer or limited liability company of which you are a member must be registered and in ACTIVE status with the Florida Division of Corporations.Applicants applying as an officer of a corporation must be listed as an officer of the Corporation with the Florida Division of Corporations. List the document number on file with the Florida Division of Corporations. P06000007309 Section 5: List all certified or registered licenses issued pursuant to Chapter 489, F.S. (contractor licensing law)held by the applicant or the certified or registered license numbers held by the qualifier for the corporation or limited liability company listed on this application.The business name listed on the license MUST match the name of the corporation or limited liability company as registered with the Florida Division of Corporations and on this Notice of Election to be Exempt. 29229 I Section 6: If you have submitted an electronic payment for this application,the transaction confirmation number is listed in the following space: Confirmation Number: 127739993 Application Number: E00044784 ction 7: N/A Are you affiliated with any corporation or limited liability company other than the corporation or limited liability company to which this application applies? Name: FEIN Name: FEIN Name: FEIN Section 8: CONSTRUCTION INDUSTRY APPLICANTS ONLY To be eligible for a construction industry exemption, an applicant must have the required ownership of corporation or limited liability company. I am a shareholder owning at least ten percent(10%)of stock of the corporation listed on this application Section 9: I certify that any employees of the corporation or members of the limited liability company listed in Section 3 are covered by workers' compensation insurance. Please identify the workers'compensation insurance carrier that covers any non-exempt employees. Carrier Name: My business does not have any non-exempt employees Section 10: FRAUD NOTICE A. Any person who, knowingly and with intent to injure, defraud, or deceive the department or any employer or employee, insurance company or any other person,files a Notice of Election to be Exempt containing any false or misleading information is guilty of a felony of the third degree. B. Attestation of applicant—By providing my name below, I attest that I have read, understand and acknowledge the foregoing notice. C. Acknowledge that this Notice of Election to be Exempt does not exceed limits for corporate officers, including any affiliated corporations as provided in Section 440.02, Florida Statutes. First Name: GERARDO Last Name: MARTINEZ Note: The Division has 30 days to review your application to determine if it meets the eligibility requirements for the issuance of an exemption. The Division will either issue a Certificate of Election to be Exempt or notify you that your application is incomplete. The Division reviews and processes exemption applications in the order they are received. Exemption information is reflected on the Proof of Coverage database the day following the issuance of the exemption.Visit the Division's website at http://www.myfloridacfo.com/wc to print your certificate. Ni A u � 1. i , , COLLIER COUNTY COLLIER COUNTY BOARD OF COMMISSIONERS LICENSING SECTION 2800 NORTH HORSESHOE DR. NAPLES, FL. 34104 Re: Reinstate of Stucco Contractor license Garrod Stucco Inc., held a license in Collier County in 2009-2010. Due to the economic recession no work was performed in 2011 and for monetary reasons we were not able to renew it. In order to be able to expand our business with an improving economy and looking forward to do future business if licensed is approved, we are presenting the documentation required in hopes to receive a positive answer. Sincerely, Claudio Bifaretti. IF" -ter ..ecrulpity 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: G�l� f 7 Exact Corporate/Business Name: 0, � Fiction Name/DBA: Qualifier Name: C '6,kd f© ( V Physical Address: Lfy) .S-,)-reid A oval- Out r.�f o Vic- FL _.nY0 (Number & Street) (City) (State) (Zip Code) Mailing Address: -10 6QD b(D (Number 86 Street) (City) (State) (Zip.Code) Telephone: q g - r-if �(0 E-Mail: 4)OY:03 — �'��CT✓✓��u��o TYPE OF LICENSE: ❑ General $230.00 ❑ Electrician $230.00 ❑ Building $230.00 ❑ Plumber $230.00 ❑ Residential $230.00 ❑ Air Cond. $230.00 ❑ Mechanical $230.00 ❑ Swimming Pool $230.00 ❑ Roofing $230.00 pecialty $205.00 Specialty trade: 3 LLB rRANGE OF STATUS: einstatement ( ) 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. C a 0' 6,ft ( esii eA`IJ l.L-k\ -- 6or PL `s $3 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. aJ 3. List all debts you or any company(s)associated with you refused to pay and the reasons for the refusal to pay. Attach extra pages if needed. AFFIDAVIT I, (1 r (,-(A) C)i-i--I7-h i-1 i certify that the foregoing is true d correct to 'e 'esj41..u ••wledge. Aut orized Officer of the Firm STATE OF FL WIDA. COUNTY OF n We- The foregoing instrument as acknowledged before me this '' //'' (� (Date) By C r 4'0 6t 4 v j f of G a.V/D d (Name of officer, title/agent) (Name of Corporation) a (nD✓i`4a Corporation on behalf of the corporation. (State or Place of Corporation) [Ole he has produced qQ ,,.a t. I "LG-%.� identification and did not take an oath. (Type of jlentification) NOTARY'S SEAL ,0 1.i° c KATHRYN M.AtirONEW * * MYCOMMISSION;tEE173t91 1 1 pip 4.: EXPIRES:February 28,2018 ! A -e/C1 shoiw gaiotdiful Noffys AoK (S GNATURE OF NOTARY) Page2of4 QUALIFIER INFORMATION: Name: C( i ( C'_... _ Lk,C vc,Z ( Address: 2510 1f[vir( � . "V d . /1tl'1T-1 6oak /L 33'r 3 (Number& Street) (� (City) (State) (Zip Code) Telephone: i 4 I � S (Lt(,c- Date of Birth: [C ( �' i(0S S.S. #: 000-00- E-Mail: iCt krtroA_ ,5"/Lcca (f ai't o.Coin Driver's License: 1J - j 1. Type of Certificate of Competency for which application is made. pia_s+ey j 3--tkcco ebA±iicLd L 2. The names and telephone numbers of two persons who will know your whereabouts. -Bract 6ar∎vo L 3. Have you ever been convicted of a crime related to Contracting? n G (If yes attach extra sheet with explanation) 7. Have you or any firms you have been associated with ever filed bankruptcy? r Y 8. List all debts you or any company(s) associated with you refused or failed to pay and reasons why. das- 9. List your business or work experience during the past ten years. V SUJt L c.'c cvit-4-*ex_ATs 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. C/ w10 f3r4aVe_ff APPLICANT(PLEASE PRINT) Cu rad , CC , dilC . NAM. 0F COMP' . Y y i . SIG ATURE OF APPLIC'NT STATE OF FLOR DA COUNTY OF ND.vla-ff1- The foregoing instrument as acknowledged before me this cL a c Ort Q 1)16v , u- (Date) / By l'LG kit 0 k lle: i' who has produced fScJ(c. �..1'�0 .'(Name of person acknowledging) (Type of id tification) as identification and did not take an oath. NOTARY'S SEAL ,►�'r�'ei, KATHRYN M.ANTONELLI I ' '!1�� r�'� MY COMMISSION#EE 173191 'I NATURE OF NOTARY) ``'tin;', EXPIRES:February 26,2016 %OFFoe &(dBd{rNlBudget May Services Page 4 of 4 1 AFFIDAVIT It is understood and acknowledged by the Collier County Contractors' Licensing Board and myself that if I fail to acquire, or maintain at all times effective Workmen's Compensation Insurance it will result in the p ssible revocation of my Certificate of Competency. i -1; SIGNATURE OF A'PLICANT Ga VI'D CI (541Aao 4/1C BUSINESS NAME DATiCPF - BEFORE ME this day personally appeared ilia ftth 0 6r.'-favP i. 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 (a'1 a-1/10 l_ The foregoing instrument was acknowledged before me this - ' hi Agri 1 >• j- Rate) /r by �f li AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I, 6r' ii4— V , am a resident of l 607 6 b County, (State) and have resided here for more than five (5) years. During the last five years I have known i O 0 l (Applicant). I have had the opportunity to observe his or her business and personal dealings and find him or her to be a person of honesty, integrity and good character. (Signature) ,. (Name) 60:64-- UC�Ir1bd (Address) 1{A I japuti greick P074- C -v foJ 'Ft 33i.S7-o Telephone) q Z ( /113 ') i bL STATE OF FLORIDA COUNTY OF ,�' r The foregoing instrument was acknowledged before me this i C 1i't ., o ttr. by ate) G (' el d' 6edfkr.GQ who has produced it VSovtcc (name of person acknowledging) (Type of identification) as identification and who did not take an oath. 4 1 ,1, KATHRYN M.ANTONEW At s% „ MY COMMISSION#EE 173191 '0_4.Tu' EXPIRES:February 26,2016 �'%� d',/,,tomtn, Bonded rnre Budget Notify servkas S;GN rbE OF NOTARY 41/1.04 NOTARY'S SEAL (P INT NME OF NOTARY) NOTARY PUBLIC 9 Claudio Bifaretti 25149 Derringer Rd. Punta Gorda Fl. 33983 Professional Experience: 2005 —Present Garrod Stucco, Inc Port Charlotte, fl. Construction Filed President/Owner 2002—2009 Garrod Painting, Inc. Port Charlotte, FL Construction Field Vice-president/Owner 1996—2002 Fruticola de Occidente Maracaibo, Venezuela Agriculture Industry Vice-president/Owner 1995 —2002 TuAuto las Delicias, C.A. Maracaibo, Venezuela Automobile Dealership Vice-president/Owner 1991 — 1995 Industria Metalurgica Zuliana, C. A. Maracaibo Venezuela Oil Industry Son of Proprietor/Administrative Assistant 1987— 1990 Hacienda Santa Maria Maracaibo, Venezuela Agriculture and Breeding Son of Proprietor/Administrative Assistant Internship Program: August 1986—October 1986 Carbones del Zulia, Petroleos de Venezuela, S.A. Financial Manager Assistant Formal Education: "UNIVERSIDAD RAFAEL BELLOSO CHACIN"; Bachelor Degree in Business Administration; Maracaibo, Venezuela; Graduated in November 1988. High School: "ANTONIO ROSMINI" school; Maracaibo, Venezuela; graduated in July 1982; Bachelor of Science. Elementary School: "ANTONIO ROSMINI" school; Maracaibo, Venezuela; graduated in July 1997. Important Courses: UNIVERSITY OF PITTSBURGH; Intensive English Course: Basic- Intermediate- Advanced, Graduated in December 1983. MOTOR VEHICLE TRAINING SCHOOL; 16 hours training seminar for Independent Dealer License (VI). Languages: Fluent in Spanish, Italian and English. References and Duties description can be furnished upon request --- .. • . . , . . - , ' '1 ••• • , 1 . . . , , • ••• -, , . • .' ,' . ., . , . - . • - . , . . • . „ . 1.- . „. . - . ' - • i . . ,:id'1• "..,." -%'• \ ; .' -',.' ,-,•••••' N ,,i '•,::, j,'. k.,1 i•i ,,,,,... ,,. . " '„:"--• , 1?,";;,....•..r...,...: -' 1 (-' '- ,,,Ii> G-1 '•:-':-,--:--.-:-': - - : - -. - _ -..:-_-..I■ ;'.."(.111 _.,----.T.-.44'—''-7F-',7.. 'D ' 7 . ' : 1••■ .'". ...;/ ifi)i I '.' . 'ILI ill '''''.. .- ' ! -1 A ''''.,' ' i- i.-i-. ..> . •-•,-.= tli) = ....' ..• iS.......-:‘.t,'',! 3S ''01 ....* 0 ts• to) 1,•-:, - '•_-. '..,. . / •Will Ci.) CI) . 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' BDR:iiv6..E'3R-1...iiciE6Nli6E5c..aL,A6s8s..E0 ARETTI ,,,,4 '''Q',rtLAUDIO R E3IF ,",,.-- t-';CLAUDIO 26149 DE RRINGER RD • ' ' 4.7.`..-4:..Y-..-:-'.':-..A.,..:Ti.' .',1:‘• PUNTA GORDA,FL 33983'6°59 44...'-1.. -:',':„'TD. o.B.,‘.-..,1°1-°-1,.: 1. 9''65S ,:.'7'1 14 7,.4,T' 5-06-06 i§ .ED- 5,24-2007 108,20ir: iES): : ...--Vf74:A. G1/4 "---: .614 %,"/I*71/4'” :',.."'le,,.'7,--:::,-..: ....-.-.4.-,-`f;.-,•--: '- -.-.. 2-- ' M7207 t r e'SAFE c0C 3 n 7s't I r E.-Yu tEeRs consent P.any sobnety test required bY law Operatio°n5o2f9a0°m0°50 v • • I , ® DATE(MMIDDM/YY) �'�° CERTIFICATE OF LIABILITY INSURANCE 9/17/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Christine Herrick NAME: Amberg Insurance Center (aCNN .Frth (941)639-7050 (AAIC,Not:(941)637-8390 1900 Tamiami Trail, Suite C ADDRIESS:chris @ambergins.com INSURER(S)AFFORDING COVERAGE NAIC# Punta Gorda FL 33950 INSURER A:Auto Owners Insurance Co. 18988 INSURED INSURER B:Southern Owners Insurance 10190 Garrod Stucco, Inc INSURER C: PO Box 494410 INSURER D: INSURER E: Port Charlotte FL 33949 INSURERF: COVERAGES CERTIFICATE NUMBER CL1242302431 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POUCY EFF POLICY EXP TYPE OF INSURANCE LTR INSR WVD POLICY NUMBER (MMIDD/YYYYI_IMMIDD/YYYYI LIMITS GENERAL UABILITY X X EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) A CLAIMS-MADE X OCCUR 20668057 5/11/2012 5/11/2013 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENII AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 31 POLICY JECOT- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 500 000 X ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED 4640402500 6/7/2012 6/7/2013 BODILY INJURY(Per accident) $ X AUTOS _ AUTOS NON- WNED PROPERTY DAMAGE $ X HIRED AUTOS _ AUTOS O (Per accident) Medical payments $ 5,000 UMBRELLA LIAB - OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION TORY LIMITS 0TH- AND EMPLOYERS'LIABILITY ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.N/A E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in N )EXCLUDED? 20029766 4/27/2012 4/27/2013 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Claudio Bifaretti, President, is excluded from the Workers' Compensation coverage. CERTIFICATE HOLDER CANCELLATION (239)252-2469 xl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Collier County Contractor Licensing Board 2800 N. Horseshoe Drive AUTHORIZED REPRESENTATIVE Naples, FL 34104 David Amberg/CHRIS — - ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 mmnn /m The Ar_r1Rr1 name and Innn are renic+ererl marlrc of A(tORf 08-18-2011 JEFF ATWATER 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: 08/18/2011 EXPIRATION DATE: 08/17/2013 PERSON: BIFARETTI CLAUDIO FEIN: 202241711 BUSINESS NAME AND ADDRESS: GARROD STUCCO INC P 0 BOX 494410 PT CHARLOTTE FL 33949 SCOPES OF BUSINESS OR TRADE: 1- STUCCO 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 under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(121, 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. QUESTIONS? (850) 413-1609 DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA IMPORTANT DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION 3` F Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who CONSTRUCTION INDUSTRY elects exemption from this chapter by filing a certificate of election CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA Y' ,: :1 L under this Section may not recover benefits or compensation under this WORKERS'COMPENSATION LAW D chapter. EFFECTIVE: 08/18/2011 EXPIRATION DATE: 08/17/2013 Pursuant to Chapter 440.05(12), F.S., Certificates of election to be PERSON: CLAUDIO BIFARETTI H exempt... apply only within the scope of the business or trade listed on FEIN: 202241711 E the notice of election to be exempt. BUSINESS NAME AND ADDRESS: E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt GARROD STUCCO INC and certificates of election to be exempt shall be subject to revocation P 0 BOX 494410 if, at any time after the filing of the notice or the issuance of the PT CHARLOTTE, FL 33949 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 SCOPE OF BUSINESS OR TRADE: person named on the certificate to meet the requirements of this 1- STUCCO section. QUESTIONS? (850) 413-1609 CUT HERE * Carry bottom portion on the job, keep upper portion for your records. • DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 i Q a, vii t. p i. Z � � y v_� O ‘e . Z 13C OZ E ' - O u Z � � a, E s u ES OU L c ° ° •....`^ fl. ® OW u ±' � O .01 to ns LL O -' � Ce .'^ -o E cc Q fl. aJ o �' D u `� _ 'a� a t . a/ LL 13- EI> U u H •~ .0 ° W ra 0 of a1 al 7 9— X MUM aJ u u co fa a uLLI 011 M m aJ +� ° Q 3 ai �a ° `—° u = uni U <iii— Ual 0 E 3 -92 o a O o = Ce atU Cs o t IIIMM in N i X t GJ Z 5 n3 Cq L Q a% < (IN 0 V j L E O O LL X o all 1 . • O CI ' limn L 0 N 0 +` ° u O u sai 0 Z CX) ° =o Z O =a t2 °I1h1 p 7 cv 15 'n rti(faa) Vi) 0 s N� l O : 0. .v Li c To: C°= O + ° V 1-- co 0 Ta 6 U a L _a O J m ° °N 13 L );.•�I ++ * 'L E F- ON 1- al VaJ � u re 0 cn CU _ C H ce u 'u O c 1-i U E a a -o u O c = E a,U •Nu g. 8 w <lc (NI 41:C M a m i H N V O 0 3 1... W N LL V 1'" u 0. A H H CC 0 AL 1 a W rW Q 'J . .4. +�+ LL C W 'ire a cc F� a V aJ O C +0+ V1 c U., ri 0 O a Z V H >` N N -, 4J d N N fC X al cu .N co +, _ a Q A m O Tr Q re of F- 0 LV •- �;,, 0 _ XI W H N X - CU U N. 8 X V E.D. 1- co c .N ;o = c CA O n m R a) 0 t0 .= s y Q .I N o0 O t ct, vs ++ H H O I U as o � m o I- o � I N 2009/2010 CHARLOTTE CCUNTY ACCOUNT 10292 • LOCAL BUSINESS TAX RECEIPT MUST BE DISPLAYED IN A CONSPICUOUS PLACE EXPIRES September 30,2010 TYPE OF BUSINESS 001503 CONTRACTOR OTHER SPECIAL TRADE NEW BUSINESS X RENEWAL BUSINESS VARIOUS LOCATIONS SUPPLEMENTAL ADDRESS CHARLOTTE COUNTY TRANSFER R ORIGINAL TAX 35.00 BUSINESS GARROD STUCCO INC NAME AMOUNT 35.00 PENALTY 0.00 OWNER CLAUDIO BIFARETTI TOTAL 35.00 MAILING P O BX 494410 ADDRESS PORT CHARLOTTE, FL 33949 Vickie L. Potts Charlotte Count y Tax Collector THIS FORM BECOMES A RECEIPT ONLY WHEN VALIDATED This receipt does not constitute a franchise,an agreement.or permission or authority PAID-8014461.0001-0001 WEB 09/23/20C9 35.00 to perform the services or operate the business described hereon when a franchise, agreement.or other counts-commission,state or federal permission or authority Is required by county.state or federal law. 2009/2010 CHARLOTTE COUNTY ACCOUNT 10292 LOCAL BUSINESS TAX RECEIPT MUST BE DISPLAYED IN A CONSPICUOUS PLACE EXPIRES September 30,2010 TYPE OF BUSINESS 001503 CONTRACTOR OTHER SPECIAL TRADE NEW BUSINESS X RENEWAL SUPPLEMENTAL BUSINESS VARIOUS LOCATIONS TRANSFER- ADDRESS CHARLOTTE COUNTY - ORIGINAL TAX - 35.00 BUSINESS GARROD STUCCO INC NAME AMOUNT 35.00 PENALTY 0.00 OWNER CLAUDIO BIFARETTI TOTAL 35.00 MAILING P 0 BX 494410 ADDRESS PORT CHARLOTTE,FL 33949 Vickie L. Potts Charlotte County Tax Collector- THIS FORM BECOMES A RECEIPT ONLY WHEN VALIDATED - This receipt does not constitute a franchise an agreement,or permission or authority PAID-8014-461.0001-0001 WEB 09/23/2009 35.00 to perform the services or operate the business described hereon when a franchise, agreement,or other county commission;state or federal permission or authority is required by county.state or federal law. Charlotte County Tax Collector 18500 Murdock Circle Port Charlotte,Florida 33948 www.cctaxcol.com Tel:(941)743-1350 Dear Business Owner: Your 2009-2010 Charlotte County Local Business Tax Receipt is attached above.Please detach the receipt and display it in a place that is visible to the public and available for inspection. The Charlotte County Local Business Tax Receipt is in addition to any other license or certificate that may be required by law and does not signify compliance with zoning, health,or regulatory requirements.The Charlotte County Local Business Tax Receipt is non-regulatory and is not an endorsement of work quality. Your 2009-2010 Local Business Tax Receipt is valid from September 01,2009 through September 30,2010.Annual account notices are mailed in June to the address of record at that time.Any Changes to your Local Business Tax Account due to change of Business Name,Ownership, Physical Address or you are Closing your Business please contact our office at 941-743-1350. Vickie L. Potts Charlotte County Tax Collector 2010/ 2311 CHARLOTTE COUNTY LOCAL BUSINESS TAX RECEIPT ACCOUNT 10292 MUST BE DISPLAYED IN A CONSPICUOUS PLACE EXPIRES SEPTEMBER 30,2011 TYPE OF 1503 CONTRACTOR OTHER SPECIAL TRADE(CONTRACTOR OTHER SPECIAL TRADE) RENEWAL BUSINESS BUSINESS VARIOUS LOCATIONS ADDRESS CHARLOTTE COUNTY 00000 BUSINESS GARROD STUCCO AMOUNT 35.00 NAME PENALTY 0.00 OWNER CLAUDIO BIFARETTI TOTAL 35.00 MAILING P O BX 494410 Vickie L. Potts ADDRESS PORT CHARLOTTE, FL 33949 Charlotte County Tax Collector This receipt does not constitute a franchise,an agreement,or permission or authorttr THIS FOP,M BECOMES A RECEIPT ONLY WHEN VALIDATED to perform the services or operate the business described hereon when a franchise. Paid 10/04/2010 Receipt it 898-00000020 35•00 agreement.or other county commission,state or federal permission or authority is required by county.state or federal law. - 2010/ 2011 CHARLOTTE COUNTY LOCAL BUSINESS TAX RECEIPT ACCOUNT 10292 MUST BE DISPLAYED IN A CONSPICUOUS PLACE EXPIRES SEPTEMBER 30,2011 TYPE OF 1503 CONTRACTOR OTHER SPECIAL TRADE(CONTRACTOR OTHER SPECIAL TRADE) BUSINESS RENEWAL BUSINESS VARIOUS LOCATIONS ADDRESS CHARLOTTE COUNTY 00000 BUSINESS GARROD STUCCO AMOUNT 35.00 NAME PENALTY 0.00 OWNER CLAUDIO BIFARETTI TOTAL 35.00 MAILING PO BX 494410 Vickie Potts ADDRESS PORT CHARLOTTE, FL 33949 Charlotte lotte C linty Tax Co ecto THIS FORM BECOMES A RECEIPT ONLY WHEN VALIDATED This receipt-does not constitute a franchise,an agreement,or permission or authority to perform the services or operate the business described hereon vashen a franchise, Paid 10/04/2010 Receipt it 898-00000020 35.00 agreement.or other county commission,state or federal pertsiission or authority is required by county.state-or federal law. Charlotte County Tax Collector 18500 Murdock Circle Port Charlotte,Florida 33948 wwrr.cctaxcol.coni Tel:(941)743-1350 Dear Business Owner: Your 2010- 2011 Charlotte County Local Business Tax Receipt is attached above. Please detach the receipt and display it in a place that is visible to-the public and available for inspection. The Charlotte County Local Business Tax Receipt is in addition to any other license or certificate that may be required by law and does not signify compliance with zoning, health,or regulatory requirements.The Charlotte County Local Business Tax Receipt is non-regulatory and is not an endorsement of work quality. Your 2010 - 2011 Local Business Tax Receipt is valid from September 01, 2010 through September 30,2011 Annual account notices are mailed in June to the address of record at that time.Any Changes to your Local Business Tax Account due to change of Business Name.Ownership; Physical Address or you are Closing your Business please contact our office at 941-743-1350 VICKIE L.POTTS Charlotte County Tax Collector 2011 / 2012 CHARLOTTE COUNTY LOCAL BUSINESS TAX RECEIPT ACCOUNT 10292 MUST BE DISPLAYED IN A CONSPICUOUS PLACE EXPIRES SEPTEMBER 30,2012 TYPE OF 1503 CONTRACTOR OTHER SPECIAL TRADE(CONTRACTOR OTHER SPECIAL TRADE) RENEWAL BUSINESS BUSINESS VARIOUS LOCATIONS ADDRESS CHARLOTTE COUNTY 00000 BUSINESS GARROD STUCCO AMOUNT 35.00 NAME PENALTY 0.00 OWNER CLAUDIO BIFARETTI TOTAL 35.00 MAILING P O BX 494410 ADDRESS PORT CHARLOTTE,FL 33949 (HIS FONM BECOMES A RECEIPT ONLY,•'HEN VALIDATED - - Paid 09/26/2011 Receipt # INT-00018569 35.00 2011 / 2012 CHARLOTTE COUNTY LOCAL BUSINESS TAX RECEIPT ACCOUNT 10292 MUST BE DISPLAYED IN A CONSPICUOUS PLACE EXPIRES SEPTEMBER 30,2012 TYPE OF 1503 CONTRACTOR OTHER SPECIAL TRADE(CONTRACTOR OTHER SPECIAL TRADE) RENEWAL BUSINESS BUSINESS VARIOUS LOCATIONS ADDRESS CHARLOTTE COUNTY 00000 BUSINESS GARROD STUCCO NAME AMOUNT 35.00 PENALTY 0.00 OWNER CLAUDIO BIFARETTI TOTAL 35.00 MAILING P 0 BX 494410 ADDRESS PORT CHARLOTTE,FL 33949 THIS FORM BECOMES A RECEIPT ONLY WHEN VALIDATED Paid 09/26/2011 Receipt # INT-00018569 35.00 Dear Business Owner: Your 2011 -2012 Charlotte County Local Business Tax Receipt is attached above.Please detach the receipt and display it in a place that is visible to the public and available for inspection. The Charlotte County Local Business Tax Receipt is in addition to any other license or certificate that may be required by law and does not signify compliance with zoning,health,or regulatory requirements.The Charlotte County Local Business Tax Receipt is non-regulatory and is not an endorsement of work quality. Your 2011 -2012 Local Business Tax Receipt is valid from September 01, 2011 through September 30,2012 .Annual accouni notices Ore mailed in June to the address of record at that time.Any Changes to your Local Business Tax Account due to change of Business Name,Ownership. Physical Address or you are Closing your Business please contact our office at 941-743-1350 . VICKIE L.POTTS Charlotte County Tax Collector pliqtt... CHARLOTTE COUNTY LICENSING '■d CERTIFICATE OF COMPETENCY NOT VALID AFTER 09/30/2013 Lic.Type: L PLASTER STUCCO DBA. GARROD STUCCO INC Nbr: AAA00101119 CLAUDIO BIFARETTI PO BOX 494.410 PORT CHARLOTTE FL 33949- NAME,ADDRESS AND STATUS CHANGES must be sent to this office within 30 days: CHARLOTTE COUNTY Building and Growth Management Department 18400 Murdock Circle Port Charlotte, FL 33948 Building Construction Services Page of 2 caRiitr HELP Charlotte County Government 417-e- I Resident I Business Government I Visitor eServices I Departments Jobs I Search I Home er:stel (N an A..,.'): l R(;Gt:'t ,4) I _,Li112. Sesrcl7 Home Building Growth Mgmt&Land Dev Licenses Code Enforcement Licensed Professional Information: L PLASTER STUCCO FL-AAA00101119 Licensee Detail License Type:I PI.AS I T:R SMC::CO Type: State License Number;AAAO^10':119 Name:CLAUDIO FIFA i-TTI License State:I L Address:PC BOX 494,110 Licensing Board: PORT CHAR..O1TE F,. Phone 1:941-7-18-7250 Business Name:GAPROD STUCCO INU Phone 2:941..8_5 5455 Business License Number:10292 FAX: Business License Expiration Date: Email:GARR0DS- CC0 J A CD COvt License Issue Date::::3;1,1/20t)1 License Expiration Date: :;')/:OP:::3 Related Records Public Documents https://www2.charlottefl.com/CitizenAccess/ 9/20/2012 4 r l'o5oax)vitsg2- • (Requestors Name) I� (Address) 11111 i 500045340095 (Address) (City/State/Zip/Phone#) El PICK-UP El WAIT MAIL (Business Entity Name) ;•n r—r-r c_ r-c� (Document Number) n• x" N -' >�7 Certified Copies Certificates of Status xs q 3 -n© .* ai> Special Instructions to Filing Officer: O Office Use Only .1 rn co -;� { 12 r . r ATTORNEYS' TITLE Requestor's Name 1965 Capital Circle NE, Suite A Address Tallahassee, Fl 32308 850-222-2785 City/St/Zip Phone# CORPORATION NAME(S) & DOCUMENT NUMBER(S),(if known): 1- GARROD STUCCO, INC. 2- 3- 4-- ©Walk-in Pick-up time ASAP Da Certified Copy o Mail-out ow III wait Photocopy Mil Certificate of Status NEW FILINGS AMENDMENTS XX>Profit Amendment Non-Profit Resignation of R.A.,Officer/Director Limited Liability Change of Registered Agent Domestication Dissolution/Withdrawal Other Merger OTHER FILINGS REGISTRATION/QUALIFICATION Annual Report Foreign Fictitious Name Limited Partnership Name Reservation Reinstatement Trademark Other Examiner's Initials s FILED SECRETARY OF STATE TALLAHASSCE.FLORIDA ARTICLE, QF INCQRPORA TION QE 05JAN27 AN II: I0 GARfOD STUCC S INC. The undersigned subscriber to these Articles oflncorporation,a natural person competent to contract, does hereby sign and direct these Articles to be delivered to the Department of State,State of Florida, for the purpose of forming a corporation under the laws of the State of Florida. Article 1-Name and Main Address The name of this corporation is GARROD STUCCO,INC.and its mailing address shall be P.Q.Box 494410,Port Charlotte, Florida 33949. Article 2-Duration of Corporate Existence. This corporation shall exist perpetually. Article 3-Purge« The general purposes for which this corporation is organized include the transaction of any or all lawful business for which corporations may be incorporated under the provisions of Chapter 607,Florida Statutes,as the same now exists or as it may hereafter be changed. Article 4-Capital Stock The aggregate number of shares of stock this corporation is authorized to have outstanding at any time is 3,000 shares of common stock. There shall be no other type or class of stock. Article 5-Address and Resistered Agent The street address of the initial registered office of this corporation shall be 109 Taylor Street - Suite 112,Punta Gorda,FL 33950. The name of the initial registered agent at such address is Edward L. Wotitzky. Article 6-Directors This corporation shall have one director initially. The number of directors may be increased or decreased from time to time by Bylaws adopted by the shareholders, but shall never be less than one nor more than seven. • Article 7-Initiaj pirec(or The name and post office address of the initial director is: Name Address Brent A.Garrod P.O. Box 494410,Port Charlotte,FL 33949 Article 8-Inca orator The name and post office address of the incorporator of this corporation is: Name Addr�,s Brent A.Garrod P.O. Box 494410, Port Charlotte,FL 33949 Article 9-Pree 'dye Ri,hts Each shareholder of the corporation shall have the right to purchase,subscribe for,or receive a right or rights to purchase or subscribe for,at the price for which it is offered to others,that shareholder's pro rata portion of the following: A. Any stock of any class that the corporation may issue or sell,whether or not exchangeable for any stock of the corporation of any class or classes,and whether or not of unissued shares authorized by the Articles of Incorporation as originally filed or by any amendment thereof or out of shares of stock of the corporation acquired by it after the issuance thereof,and whether issued for cash or other consideration;or B. Any obligation that the corporation may issue or sell which is convertible into or exchangeable for any stock of the corporation of any class or classes,or to which is attached or pertinent any warrant or warrants or other instruments conferring on the holder the right to subscribe for or purchase from the corporation any shares of its stock of any class or classes. This right shall be deemed waived by any shareholder who does not exercise it and pay for the shares preempted within thirty(30)days after receipt of written notice from the corporation stating the price,terms and conditions of the issue ofshares and inviting the shareholder to exercise this preemptive right. This right may also be waived by a written waiver signed by the shareholder. Article 10-In rnniftcat{ga The corporation shall indemnify any person who was or is a party or is threatened to be made a party, to any threatened,pending,or completed action,suit,or proceeding whether civil,criminal,administrative, or investigative,by reason of the fact that he or she is or was a director or officer of the corporation,or is or was serving at the request of the corporation as a director or officer of any other corporation, partnership, joint venture, trust,or other enterprise against expenses(including attorneys'fees),judgments, fines,and amounts paid in settlements,actually and reasonably incurred by him;or her in connection with such action, suit,or proceeding, including any appeal thereof, if he or she acted in good faith and in a manner he or she Page 2 reasonably believed to be in or not opposed to the best interest of the corporation and, with respect to any criminal action or proceeding,had no reasonable cause to believe such conduct was unlawful. However,no indemnification shall be provided in any action or suit by or in the right of the corporation to procure a judgment in its favor,with respect to any claim, issue or matter as to which such person is adjudged to be liable for negligence or misconduct in the performance of his or her duty to the corporation. The termination of any action,suit or proceeding by judgment,order,settlement,conviction,or on a plea of nolo contendere or its equivalent,shall not,of itself,create a presumption that the person did not meet the applicable standard of conduct. Indemnification hereunder shall continue to a person who has ceased to be a director or officer, and shall inure to the benefit of the heirs,executors,and administrators of such person. Article 11 -Amendment These Articles of Incorporation may be amended in the manner provided by law.Every amendment shall be approved by the Board of Directors, proposed by them to the stockholders and approved at a stockholders'meeting by a majority of the stock entitled to vote thereon,unless all the directors and all the stockholders sign a written statement manifesting their intention that a certain amendment to these Articles of Incorporation by made. CTNESS WHEREOF,the undersigned has hereunto subscribed their name and affixed their seal thisAS ay of January,2005. Signed.Sealed and Delivered in the Presence of , /ft24,45 a / lN 4'NEAI. Brent A.Garrod P ' ed name of first witness '►, a . Printe name of second witness State of Florida County of Charlotte _/J The foregoing instrument was acknowledged before me this day ofJanuary,2005 by BRENT A.GARROD.lie is personally known to me or-r.. .mod .....,. .n. 4' 40, My Commission expires: `•- +_ �0 / Notary Public Sandra Mertzhon Braar Printed name of notary (i MYCOMMISSloN# D0018966 rtkn am July si YQ05 Serial or Commission Number A;;,,,:• 60NDEp iryRU TROY FAIN INSU RANG$INC • G:\Sandy\Corporation\Garrod Painting,Drywall&Stucco\Articles.wpd Page 3 CERTIFICATE DESIGNATING A REGISTERED AGENT AND REGISTERED OFFICE FOR THE SERVICE OF PROCESS In compliance with § 48.091 Fla. Stat,,the following is submitted: GARROD STUCCO, INC., desiring to organize under the laws of the State of Florida with its principal office,as indicated in the Articles of Incorporation at 109 Taylor Street-Suite 112,Punta Gorda, Charlotte County,Florida 33950,has designated EDWARD L. WOTITZKY, whose street address is 109 Taylor Street- Suite 112,Punta Gorda,Charlotte County, Florida 33950,as its agent to accept service of process within this state. GARROD STUCCO,INC. ACCEPTANCE Having been designated as agent to accept service of process for the above-named corporation,at the placed stated in this certificate, I hereby agree to act in this capacity and to comply with the provision of said law relative to same. Edward L. Wotitzky o cn r-rn c__ (--n a as xr11 ZZo MOD r cn •• xD G:1Sandy\Corporation\Garrod Painting,Drywall&Stucco\Reg.Agent.wpd 2009 FOR PROFIT CORPORATION AMENDED ANNUAL REPORT FILED DOCUMENT# P05000014582 Secretary of State Entity Name: GARROD STUCCO, INC. Current Principal Place of Business: New Principal Place of Business: 4271 JAMES ST PORT CHARLOTTE, FL 33980 Current Mailing Address: New Mailing Address: P.O. BOX 494410 PORT CHARLOTTE, FL 33949 FEI Number:20-2241711 FEI Number Applied For( ) FEI Number Not Applicable( ) Certificate of Status Desired(.) Name and Address of Current Registered Agent: Name and Address of New Registered Agent: WOTITZKY, EDWARD L 223 TAYLOR STREET PUNTA GORDA, FL 33950 US The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida. • SIGNATURE: Electronic Signature of Registered Agent Date • OFFICERS AND DIRECTORS: ADDITIONS!CHANGES TO OFFICERS AND DIRECTORS: Title: PTD ( )Delete Title: PT (X)Change ( )Addition Name: GARROD,BRENT A Name: BIFARETTI,CLAUDIO R Address: P.O.BOX 494410 Address: 25149 DERRINGER ROAD City-St-Zip: PORT CHARLOTTE,FL 33949 City-St-Zip: PUNTA GORDA,FL 33983 Title: VP ( )Delete Title: VPS (X)Change ( )Addition Name: BIFARETTI,CLAUDIO R Name: GARROD,BRENT A Address: P.O.BOX 494410 Address: 3289 SW WILDCAT RUN ROAD City-St-Zip: PORT CHARLOTTE,FL 33949 City-St-Zip: ARCADIA,FL 34266 Title: S (X)Delete Title: ( )Change ( )Addition Name: GARROD,BRADLEY J JR Name: Address: P.O.BOX 494410 Address: City-St-Zip: PORT CHARLOTTE,FL 33949 City-St-Zip: I hereby certify that the information supplied with this filing does not qualify for the exemption stated in Chapter 119, Florida Statutes. I further certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath;that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 607, Florida Statutes; and that my name appears above, or on an attachment with an address,with all other like empowered. SIGNATURE: CLAUDIO BIFARETTI PT 06/18/2009 Electronic Signature of Signing Officer or Director Date 2009 FOR PROFIT CORPORATION AMENDED ANNUAL REPORT FILED DOCUMENT# P05000014582 Secretary of State Entity Name: GARROD STUCCO, INC. Current Principal Place of Business: New Principal Place of Business: 4271 JAMES ST PORT CHARLOTTE, FL 33980 Current Mailing Address: New Mailing Address: P.O. BOX 494410 PORT CHARLOTTE, FL 33949 FEI Number:20-2241711 FEI Number Applied For( ) FEI Number Not Applicable( ) Certificate of Status Desired( ) Name and Address of Current Registered Agent: Name and Address of New Registered Agent: WOTITZKY, EDWARD L 223 TAYLOR STREET PUNTA GORDA, FL 33950 US The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida. SIGNATURE: Electronic Signature of Registered Agent Date OFFICERS AND DIRECTORS: ADDITIONS/CHANGES TO OFFICERS AND DIRECTORS: Title: PT ( )Delete Title: PVTS (X)Change ( )Addition Name: BIFARETTI,CLAUDIO R Name: BIFARETTI,CLAUDIO R Address: 25149 DERRINGER ROAD Address: PO BOX City-St-Zip: PUNTA GORDA,FL 33983 City-St-Zip: PORT CHARLOTTE,FL 33949 Title: VPS (X)Delete Title: ( )Change ( )Addition Name: GARROD,BRENT A Name: Address: 3289 SW WILDCAT RUN ROAD Address: City-St-Zip: ARCADIA,FL 34266 City-St-Zip: I hereby certify that the information supplied with this filing does not qualify for the exemption stated in Chapter 119, Florida Statutes. I further certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath;that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 607, Florida Statutes; and that my name appears above, or on an attachment with an address,with all other like empowered. SIGNATURE: CLAUDIO BIFARETTI PVTS 07/10/2009 Electronic Signature of Signing Officer or Director Date 1 „0„............,..v..........v............ -- ------se-----zz----N_ ,,-07,- ---Nen---""ivi.:011 Aft Ex oi■Volh i • o even, ® i • nirks • �s uy ,, ' 8_11i Y,.t►1 ei� 4011∎+1i11i►.-41W `i11∎ .t►/ oi�v,.t►1 �i'y 46 /�1 • �0 iv • oAtk Alb, : ' ,�* �w £ C c �ro 1<►�® { _ aD 41 P4:401 I o :-,:, cl) ..9 — T ',ettAA : 01 y u v ��AP V (A ° cO r 1 �4 1 a) '�cd ": •�►0 i a 44,,,,,f , 4- -,.-.... -4— 0) ci li - t3 ' tt ii) % AL. * t _ .s (- 4 ,- ›- ''' '‘' .--.4) , +40*„,k . / �r3 '" , O � _ ca �, V '09‘N 0 p1 3 E2 El o .o O' le: . i, +� , z o o ,ti �, IS I v ___) •'''' ®� _ 1 xtAbk � x N ,� r�-' a � c • " 5 3 a3 ' Z ®fie ono PfAtk : ; )4 li# Cf3 .,_, ,, .4-4 ci..) c.) .4 ?..-.. • ,N 0A♦®® H H o g ♦i0 010 -IL A Ld b.,0 ; 6* rt trt : . _ .OA 'IT 04 tit:1;ibk.iii., #Ib #A #Ae A #A C ‘111 etr ' 1e%. %..e00 4.4 to to 41.14".0 Reports 2 Hide Details FROM: • Merit Credit _ • GARROD_STUCCO@YAHOUCOM Tbuod^y.S,n� x m� 20.2O|2 |/:07AM As requested I have attached your information and faxed the reports to Collier County. Please call if you have any questions. Thank you for your business! Have a Great Day! Ashley Paulus Administrative Assistant Merit Credit, Inc 12734 Kenwood Lane, #85 Fort Myers, FL 33907 Phone: (239) 277-3202 or 800-371-3348 Fax: (239) 277-3258 or 800-595-8941 Email: reports@meritcreditservices.com Visit our Website: http://m/m/m/'mneritcreditserwioes.cmnn/ CONFIDENTIALITY NOTICE: This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s), Unauthorized in\mroepdon, naview, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy all copies of the communication. EXPERIAN BUSINESS REPORT PAGE RPT DATE TIME PORT TYPE 1 09/20/2012 09:54:30 -AN3 REPORT 404 GARROD STUCCO INC BIN: 744060253 4271 JAMES ST FILE ESTABLISHED: JAN. 2008 PORT CHARLOTTE FL 33980-8406 PHONE: 941-743-7266 COMPANY DESCRIPTION THE PRIMARY BUSINESS FOR GARROD STUCCO INC IS Concrete Work Contractors (SIC 17710000) . TRADE PAYMENT INFORMATION TRADE PAYMENT EXPERIENCES (TRADE LINES WITH AN {*} AFTER DATE REPORTED ARE NEWLY REPORTED) RECENT ACCOUNT STATUS HIGH -DAYS PAST DUE- BUSINESS DATE LAST PAYMENT CREDIT BALANCE 1- 31- 61- CATEGORY REPTD SALE TERMS $ $ CUR 30 60 90 91+ COMMENTS AIR TRANS 05-12 OTHER <100 <100 100% PAYMENT TOTALS CONTINUOUSLY REPORTED( 1) : <100 <100 100% DBT: 0 COPYRIGHT 2012 EXPERIAN INFORMATION SOLUTIONS, INC. ALL RIGHTS RESERVED. **CONTINUED** EXPERIAN BUSINESS REPORT PAGE 2 09/20/2012 GARROD STUCCO INC BIN: 744060253 COMPANY BACKGROUND INFORMATION THE FOLLOWING WAS PROVIDED BY THE STATE OF FLORIDA. CURRENT STATUS : ACTIVE BUSINESS. AGENT IS CLAUDIO BIFARETTI LOCATED AT 25149 DERRINGER ROAD, PUNTA GORDA, FL. FEDERAL ID : 20-2241711 PRIMARY PRODUCT/SERVICE: CONCRETE WORK SIC: 1771 PRINCIPAL(S) : CLAUDIO BIFARETTI TITLE: OWNER INQUIRIES BUSINESS 2012 CATEGORY SEP AUG JUL JUN MAY APR MAR FEB JAN --- --- --- --- --- --- --- --- ELEC DISTR 1 --- --- --- --- --- --- --- --- TOTALS 1 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 REPORT FOR LICENSING PURPOSES OR OTHER PERMISSABLE PURPOSE AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY (INCLUDING PINELLAS) , STATE AND FEDERAL LEVELS. PUBLIC RECORDS LEARNED: 0 SOURCES OF INFORMATION: EXPERIAN 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. ) Prepared By: Merit Credit (239) 277-3202 (800) 371-3348 TRANSUNION CREDIT REPORT [FOR] [SUB NAME] [MKT SUB] FINFILE] [DATE] [TIME] (I) Z NP6284423 MERIT CREDIT 16 NP 5/03 09/20/12 09:49CT [SUBJECT] [SSN] [BIRTH DATE] BIFARETTI, CLAUDIO R. 1111111111.111111111 '0/65 [ALSO KNOWN AS] BIFARATTI,CLAUDIO,R [CURRENT ADDRESS] [DATE RPTD] 25149 DERRINGER RD. , PUNTA GORDA FL. 33983 6/05 [FORMER ADDRESS] 495218 PO BOX 495218, PORT CHARLOTTE FL. 33949 3/05 25530 RAMPART DEEP CREEK BV. , PUNTA GORDA FL. 33983 [POSITION] [CURRENT EMPLOYER AND ADDRESS] [RPTD] [HIRE] GARROD PAINTING & STUCCO VICE PRES 10/05 10/02 M O D E L P R O F I L E * * * A L E R T * * * ***FICO CLASSIC 04 ALERT: SCORE +762 : 010, 011, 008, 014 *** IN ADDITION ***TO THE FACTORS LISTED ABOVE, THE NUMBER OF INQUIRIES ON THE CONSUMER'S ***CREDIT FILE HAS ADVERSELY AFFECTED THE CREDIT SCORE. C R E D I T S U M M A R Y * * * T O T A L F I L E H I S T O R Y PR=0 COL=0 NEG=O HSTNEG=0 TRD=21 RVL=15 INST=2 MTG=1 OPN=3 INQ=2 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $53.5K $74.9K $16.8K $0 $295 78% OPEN: $709 $ $ $ 100% MORTGAGE: $199K $ $176K $0 $880 TOTALS: $253K $74.9K $192K $0 $1175 T R A D E S SUBNAME SUBCODE OPENED HIGHCRED TERMS MAXDELQ PAYPAT 1-12 MOP ACCOUNT# VERFIED CREDLIM PASTDUE ANT-MOP PAYPAT 13-24 ECOA COLLATRL/LOANTYPE CLSD/PD BALANCE REMARKS MO 30/60/90 DISCOVER FIN B 9616003 2/10 $5228 MIN44 111111111111 RO1 9/12A $10.1K $0 111111111111 I CREDIT CARD ,$2177 30 0/ 0/ 0 BK OF AMER B 6331059 8/04 $22.9K MIN235 111111111111 RO1 CARD $14.6K 48 0/ 0/ 0 GECRB/SAMS D 235046S 12/04 $338 111111111111 RO1 8/12A $1500 $0 111111111111 I CHARGE ACCOUNT 2/08C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 SEARS/CBNA B 6256458 3/04 $2935 111111111111 RO1 8/12A $4000 $0 111111111111 I CREDIT CARD 10/08C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 I AMEX B 21WBO01 5/91 $17. 9K 1111111111X1 R01 8/12A $18.2K $0 111111X11111 I CREDIT CARD $0 48 0/ 0/ 0 GECRB/THMSVL H 9992608 6/05 $2432 111111111111 R01 8/12A $12.0K $0 111111111111 C CHARGE ACCOUNT 10/O8C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 GECRB/DREXEL F 9992736 11/06 $12.2K 111111111111 ROl 8/12A $10.0K $0 111111111111 I CHARGE ACCOUNT 6/11C $0 CLOSD BY CRDT GRANTOR 48 0/ 0/ 0 GECRB/SAMSDC B 235O61D 11/05 $818 MIN16 111111111111 R01 8/12A $9600 $0 111111111111 I CREDIT CARD $16 48 0/ 0/ 0 BUSEY BANK B 6425005 6/05 $199K 360M880 111111111111 MO1 8/12A $0 111111111111 I CONVENTIONAL REAL $176K 48 0/ 0/ 0 BK OF AMER B 1597029 11/08 $0 1 R01 12/O8A $5000 $0 I CREDIT CARD 12/O8C $0 ACCT CLSD BY CONSUMER 1 0/ 0/ 0 BK OF AMER B 1597029 10/08 $0 1 R01 11/O8A $3500 $0 I CREDIT CARD 10/08C $0 ACCT CLSD BY CONSUMER 1 0/ 0/ 0 CHASE B 26QKOO1 6/05 $4127 111111111111 R01 CARD 2/O8C $0 ACCT CLSD BY CONSUMER 39 0/ 0/ 0 FIA CSNA B 1597185 2/04 $6056 111111111111 R01 3/O8P $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 AMEX B 21WBOO1 8/91 $5957 1111 001 3/O8A $0 I CREDIT CARD 2/08C $0 ACCT CLSD BY CONSUMER 4 0/ 0/ 0 AMEX B 21WBOO1 5/91 $2904 001 11/07A $0 I CREDIT CARD 9/O4C $0 ACCT CLSD BY CONSUMER AMEX B 21WBOO1 3/05 $0 ROl 11/O7A $0 I CREDIT CARD 10/O5C $0 ACCT CLSD BY CONSUMER GTEFINANCIAL Q 449NOO1 2/04 $7263 48M167 111111111111 IO1 8/O5A $0 11111 I AUTOMOBILE 8/05C $0 CLOSED 17 0/ 0/ 0 AMEX B 21WBOO1 5/91 $2469 RO1 7/05A $0 I CREDIT CARD 9/O4C $0 ACCT CLSD BY CONSUMER 1ST NATBK FL B 1Y4FOO1 6/03 $1023 6M173 111111111 IO1 79109047 12/03A $0 I NOTE LOAN 12/03C $0 CLOSED 9 0/ 0/ 0 AMEX B 21WB001 5/91 $586 11 ROl 8/03A I CREDIT CARD 2 0/ 0/ 0 AMEX B 21WBOO1 5/91 $709 11 001 8/03A I CREDIT CARD 2 0/ 0/ 0 I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 9/20/12 ZNP6284423 (FLA) MERIT CREDIT 3/14/12 LNY0001103 (EAS) MARJAM C R E D I T R E P O R T S E R V I C E D BY : TRANSUNION 800-888-4213 2 BALDWIN PLACE P.O. BOX 1000,CHESTER, PA. 19022 Consumer disclosures can be obtained online through TransUnion at: http://www.transunion.com CREDITOR CONTACT INFORMATION DISCOVER FIN BC9616003 PCB 15316 WILMINGTON DE. 19850 BK OF AMER BC6331059 PO BOX 982235 EL PASO TX. 79998 GECRB/SAMS DV235046S PO BOX 965005 ORLANDO FL. 32896 SEARS/CBNA BC6256458 PO BOX 6282 SIOUX FALLS SD. 57117 AMEX BC21WB001 (800) 874-2717 P.O. BOX 981537 EL PASO TX. 79998 GECRB/THMSVL HF9992608 (866) 396-8254 C/0 PO BOX 965036 ORLANDO FL. 32896 GECRB/DREXEL FZ9992736 (866) 396-8254 C/O PO BOX 965036 ORLANDO FL. 32896 GECRB/SAMSDC BC235061D (866) 220-0254 PO BOX 965005 ORLANDO FL. 32896 BUSEY BANK BB6425005 201 WEST MAIN STRE URBANA IL. 61801 BK OF AMER BC1597029 PO BOX 982235 EL PASO TX. 79998 CHASE BC26QK001 (800) 945-2006 P.O. BOX 15298 WILMINGTON DE. 19850 FIA CSNA BC1597185 PO BOX 982235 EL PASO TX. 79998 GTEFINANCIAL QU449N001 (813) 871-2690 711 E. HENDERSEN TAMPA FL. 33602 1ST NATBK FL BZ1Y4F001 1150 CLEVELAND STR CLEARWATER FL. 33755 MARJAM L 0001103 (516) 249-4900 885 CONKLIN ST FARMINGDALE NY. 11735 END OF TRANSUNION REPORT BEFORE THE COLLIER COUNTY CONTRACTORS' LICENSING BOARD BOARD OF COUNTY COMMISSIONERS, COLLIER COUNTY, FLORIDA, CONTRACTORS' LICENSING BOARD Petitioner, V. Case Number: 2012-11 License Number: 25598 Karin Sacacian D/B/A—Olde Naples Tile& Marble, LLC. Respondent. / ADMINISTRATIVE COMPLAINT Collier County(County)flies the Administrative Complaint against Karin Sacacian ( Respondent),a Collier County Tile & Marble Contractor( license#25598),and states the following facts and allegations in support of the cited violations below: 1. The Respondent is currently licensed by Collier County as a Tile & Marble Contractor with License number 25598. 2. Under the provisions of Collier County Ordinance 90-105,as amended,Section 22-201,the following actions by a holder of a Collier County/city certificate of Competency shall constitute misconduct and grounds for discipline pursuant to Section 22-202. a. Ordinance 90-105, as amended,Section 22-201 (10). "Failing to promptly correct faulty workmanship or promptly replace faulty materials installed contrary to the provisions of the construction contract. Faulty workmanship means work that is not commenced, not continued, or not completed in accordance with all specifications of the applicable written agreement. Faulty workmanship includes any material flaw(s) in the quality and/or quantity of the unfinished work product, including any item that does not function properly as a part of the entire project. If there is no written agreement provision regarding the specific faulty workmanship issue, faulty workmanship exists if the work, process, product or part thereof does not meet generally accepted standards in Collier County in relation to the entire project. Faulty workmanship does not include matters of aesthetics unless the aesthetically related item clearly violates a written contract specification directly related thereto". Mrs.Sacacian constructed two showers that do not meet the generally accepted standards in Collier County. b. Thereafter, pursuant to Collier County Ordinance 90-105,as amended,Section 22-202 (b) and Section 22-202 (c),the complaint was investigated and found sufficient cause to file formal charges. 3. Collier County brings the following charge in this formal complaint against the Respondent. COUNT I 4. Ordinance 90-105, as amended, Section 22-201 (10). "Failing to promptly correct faulty workmanship or promptly replace faulty materials installed contrary to the provisions of the construction contract. Faulty workmanship means work that is not commenced, not continued, or not completed in accordance with all specifications of the applicable written agreement. Faulty workmanship includes any material flaw(s) in the quality and/or quantity of the unfinished work product, including any item that does not function properly as a part of the entire project. If there is no written agreement provision regarding the specific faulty workmanship issue,faulty workmanship exists if the work, process, product or part thereof does not meet generally accepted standards in Collier County in relation to the entire project. Faulty workmanship does not include matters of aesthetics unless the aesthetically related item clearly violates a written contract specification directly related thereto". 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 theJtespongent"g ilty of the violations charged. Dated: October 8, 2012 Signed: Collier County Contractors' Licensing Supervisor or Designee C.L.B. Case #2012-11 Karin Sacacian — D/B/A Olde Naples Tile & Marble, LLC. Summary On 7/5/11 Karin Sacacian/Olde Naples Tile & Marble, LLC. (Contractor) provided an invoice(E20) of$6,100.00, for the construction of removal and reinstall wall and floor tile in guest bath at the cost of$2,600.00, for construction and removal of wall and floor tile in master bathroom at the cost of$3,500.00. Records provided by Mr. Miernicki show an initial payment of$3,700.00(E21) on or about 7/15/11. On 2/1/12 Andrew &Joanna Miernicki (homeowners) submitted a Preliminary Complaint Form (E15-E19)to Contractors' Licensing Section, stating the specific complaint(s) being lack of completion of the only two bathrooms in the house, and faulty work failing to correct or guarantee. In researching the faulty work facet of the complaint, it was discovered that an e-mail to Mr. Sacacian, confirmed final payment of the invoice witnessed by Angela Burun of Angela's Marble &Tile (retail) in which Ms. Burun witnessed approx. $10,000.00 for all work. 2/15/12 With the Preliminary Complaint Form packet, Mr. Miernicki provided photographic evidence (E35-E43) and email correspondence (E44-E47), also a letter from Bard Sundvor, Bard's Plumbing wrote an e-mail (E31)to Karen Clements, Contractor Licensing Investigator stating that when the plumber installed the shower pan liner the curb as not yet built and that he left enough shower pan liner to bring up over the curb. Mr. Sundvor stated that the Olde Naples Tile & Marble, LLC, told him that they would bring the liner up into the curb after it was built. After the shower leaked Mr. Sundvor inspected the shower and could see that the shower pan liner was not going up into the curb, some drywall was removed and Mr. Sundvor found that the shower pan liner had been cut and was flush with the floor. Mr. Sundvor stated that Mr. Miernicki called Mr. Sacacian and he told him that his installer had made a mistake, and that he was willing to remove the tile and install a new shower pan liner. Mr. Miernicki then asked Mr. Sundvor to go to his house and check the showers because he had heard from Mr. Sacacian and the repair was made. Mr. Sundvor observed that approximately 1 square foot of tiles removed from the two front corners and adhesive had been applied in the corners to make the repair. Mr. Sundvor then called Mr. Miernicki who told him that the agreement with Mr. Sacacian was that the entire floor was to be removed so that a new shower pan liner could be correctly installed, and that he did not accept Mr. Sacacians' attempt to make a repair. . i 2/16/12 Met with Mr. Sacacian at 1:00 P.M. in the Contractors Conference room, Mr. Sacacian admitted to having done the job and was aware that the showers were leaking. Mr. Sacacian stated he would correct the problem, remove shower pan and have Bard's Plumbing replace it and then Old Naples Tile & Marble, LLC, would retile the shower. Present at the meeting were Michael Ossorio, Contractor Licensing Supervisor, Rob Ganguli and Karen Clements, Contractor Licensing Officers. Mr. Sacacian was given a written warning to correct the work within 30 days and was given written notice by Notice of Noncompliance (E49-E50) was given for Faulty Workmanship. Notice of Noncompliance was also posted on Mr. Sacacian's residence which is the office for Olde Naples Tile& Marble, LLC. 2/27/12 Mr. Sacacian was called and he stated that he had scheduled the work with his installer to begin 2/17 or 2/28/12. 3/7/12 Mr. Sacacian was called, stated that the removal of the floor tile had begun and they were waiting for Bard's Plumbing to install new shower pan liner, by the end of the week. Mr. Sundvor was called and he had not heard from Mr. Sacacian. 3/13/12 Called Mr. Sacacian and was told that the new shower pan liners had been installed by Mr. Sundvor, and that they were hoping to complete the work by the end of next week. 3/16/12 Mr. Ossorio, Contractor Licensing Supervisor talked to Mr. Sacacian and was told that he was in the process of obtaining more tile to complete the job and that he should have the job completed by the end of the week. 3/21/12 Could not get a hold of Mr. Sacacian by phone. Called Carlos, Mr. Sacacian's installer, stated he hoped to get to the Miernicki's tomorrow. 3/26/12 Mr. Ossorio and I went to the Miernicki's residence, no tile on either of the bathroom floors. Mr. and Mrs. Miernicki are will be here Sunday from Canada. Cannot make contact with Mr. Sacacian or Carlos. Mr. Ossorio and I went to Angela's Tile to see if Mr. Sacacian had ordered tile for the Miernicki residence and he had not ordered the tile. It has been determined that Mr. Sacacian has violated the Notice of Noncompliance by a 30 day recheck, and has been determined by Mr. Ossorio and I that Mr. Sacacian has failed to correct faulty work. 3/28/12 Notified Old Naples Tile & Marble, LLC, of the faulty work not being corrected, by letter (E48). 4/2/12 Mr. Miernicki (homeowner) had ordered the tile himself and contacted another Tile company to complete the work. Also had shower door Company come and reinstall the shower doors. He had to do this in order to be able to use his home. 4/16/12 Mr. Miernicki (homeowner) wishes to be reimbursed for the expense and additional cost finish and repair shower, he gave me an invoice at the total cost of$1,426.93. 4/23/12 Mr. Sacacian picked up bills from our office on Friday and is considering paying Mr. Miernicki in order to not go before the License Board. 10/5/12 Posted on residence of the Sacacians' a subpoena (E51) for Mr. Sacacian to appear at October 17`h, 2012 Contractor Licensing Board meeting, also sent subpoena by Certified Mail to residence of Mr. Sacacian. 10/8/12—No payment was made for the material by Mr. Sacacian. C.L.B. CASE #2012-11 Karin Sacacian-D/B/A Olde Naples Tile & Marble, LLC. Table of Contents El through E3 — Formal Complaint E4 through E10—Contractors' Licensing Code Case Details E10 through E11 — Certificate Detail Report— Olde Naples Tile & Marble, LLC. E13 through E14—State Division of Corporations/ Detail by Entity Name E15 through E19 — Preliminary Complaint Form E20—Olde Naples Tile & Marble, LLC. Invoice E21 —Copy of Check from homeowner to Olde Naples Tile & Marble, LLC. E22 through E24 — Ordinance 90-105, as amended, Section 22-201 (10). E25 — Notice of Hearing Mailed 9/25/12 (Certified Mail) E26— Certified Mail Receipt E27— USPS Tracking on Certified Mail E28— Notice of Hearing posted on garage door at Olde Naples Tile & Marble, LLC. E29 through 30— Certificate Detail Report— Bards Plumbing Service, Inc. E31— E-mail from Bards Plumbing Service, Inc. to Karen Clements, License Compliance officer. E32 — Witness Subpoena for Bards Plumbing Service Inc./Certified mailed 10/4/12. E33 — Certified Mail Receipt E34— USPS Tracking on Certified Mail E35 through E43 — Photo's of faulty work in bathrooms E44 through E47— E-mails regarding faulty work by Olde Naples Tile & Marble, LLC. E48-E49— Notice of Noncompliance E50 - Notification of Administrative Complaint being filed for Faulty Workmanship. Dated 3/28/12 E51—Witness Subpoena for Karin Sacacian dba Olde Naple Tile & Marble, LLC. /hand delivered and posted on property and sent Certified Mail 10/4/12. E52—Certified Mail Receipt E53 — USPS Tracking on Certified Mail Contractors' Licensing Board 2800 North Horseshoe Dr. Naples, Fl.34104 Complaint Number-2012-11 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: October 9, 2012 Against: Contractor's Name: Karin Sacacian Phone: 239-293-7061 Business Name:Olde Naples Tile& Marble, LLC. License Number if known: 25598 Collier County Competency number: 25598 Contractor's Business Address: 1691 Triangle Palm Terrace, Naples, FL. 34119 Filed By: El Name: Karen Clements/Collier County Contractors' Licensing Section/Growth Management Division Address:2800 N. Horseshoe Drive, Naples, FL. 34014 Business Phone: 239-252-2450 Address where work done: 2293 Pinewoods Circle, Naples, FL. 34105 City: Naples County: Collier Date of contract:July 5, 2011 Date job started:July 6, 2011 Date job completed or new home occupied: N/A Were there plans and specifications?Yes Is there a written contract?Yes. If yes,amount of Contract:$6,100.00 Has Contractor been paid in full?Yes. If not,what amount? N/A Was a Building Permit obtained? Not Required Building Permit number if known: N/A Have you communicated by letter with the licensee?Yes Date: 2/16/12 &3/28/12 & 10/4/12. Do you have a reply? No 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): 4.1.10—Failing to promptly correct faulty workmanship or promptly replace faulty materials installed contrary to the provisions of the construction contract. Faulty workmanship means work is not commenced, not continued, or not completed in accordance with all specifications of the applicable written agreement. Faulty workmanship includes any material flaw(s) in the quality and/or quantity of the unfinished work product, including any item that does not function properly as a part of the entire project. If there is no written agreement provision regarding the specific faulty workmanship issue, faulty workmanship exists if the work, process, product or part thereof does not meet generally accepted standards in Collier County in relation to the entire project. Faulty workmanship does not include matters of aesthetics unless the aesthetically related item clearly violates contract specification directly related thereto. El Please state the facts which you believe substantiate your charge of misconduct against the subject contractor. List facts separately for each subsection number above: a. Ordinance 90-105, as amended, sections 22-201(10). "Failing to promptly correct faulty workmanship or promptly replace faulty materials installed contrary to the provisions of the construction contract. Faulty workmanship means work that is_not commenced, not continued,or not completed in accordance with all specifications of the applicable written agreement. Faulty workmanship includes any material flaw(s) in the quality and/or quantity of the unfinished work product, including_any item that does not function Properly as a part of the entire project. If there is no written agreement provision regarding the specific faulty workmanship issue,faulty workmanship exists if the work, process, product or part thereof does not meet generally accepted standard 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". Mrs. Sacacian's worker installed tile in the master bathroom and guest bathroom and during the construction of the curb for the showers, the shower pan was improperly cut by the installer which enabled the water to run directly out under the shower and into the middle of the bathroom floor, causing damage to the drywall and newly installed tile flooring. (Complainant's signature) State of: Florida County of: Collier Sworn to(or aff ed)and sub cribed before me t is 9th day of October. 2012.• by •: d is ■/2-,a-/I '41 - (signature of person making statement). �►aY.P°gi, LINDA C.WOLFE .0 05 _ signature of Notary Public) a�f ; ° MY COMMISSION EE 144104 F EXPIRES:December 7,2015 Print,type or stamp commissioned name of Notary Public: r° �w�P�� �"� ieiarys« s Personally known or produced identification (3 cArersov.net Report Title: Code Case Details Date: 10/8/2012 8:06:23 AM Case Number: cemis20120002162 Case Number: CEMIS20120002162 Status: Preliminary Review Case Type: Misconduct Date &Time Entered: 2/10/2012 9:38:40 AM Priority: Normal Entered By: clements_k Inspector: clements_k Case Disposition: Case Pending Jurisdiction: Contractor's Licensing Origin: Complaint Detail Description: 2/9/12-Received complaint from Mr.Andrew Miernicki, regarding work by Olde Naples Tile& Marble LLC, (Karin R. Sacacian)(Mario Sacacian), 2 showers leaking, poor workmanship. Location Comments: 2293 Pinewoods Circle, Naples Fl. 34105 Property(67940720001 Complainant MIERNICKI,ANDREW&JOANNA J Contractor Olde Naples Tile & Marble, LLC 5�' Business Management& Budget Office 1 Ey Code Case Details Execution Date 10/8/2012 8:06:23 AM • Preliminary Investigation clements_k 9/1/2012 2/10/2012 Needs 2/9/12-Received complaint from Mr.Andrew Invoctigatio Miernicki regarding Olde Naples Tile& n Marble. Mr. Miernicki recently purchased his home at 2293 Pinewood Circle Naples FL. 34105, Olde Naples Tile&Marble, LLC.,was contracted by Mr. Mlernicki to tile the two bathrooms(Master Bedrooms Shower and Guest shower)in the shower areas and floor. Bard's Plumbing had done the plumbing and pan installation. Neither shower is usable at this time,when turned on the showers both leak out into the middle of the bathroom floors,from along the walls of the shower, and under the shower entrance.Master Bedroom shower was looked at by Bart Sandovor, Licensed Plumber, after examination the right- hand side corner of shower showed that the pan liner was cut all the way to the bottom of the shower floor. (Photo set No. 1).(Guest shower)had examination by Mr.Sandovor also when water was run it quickly leaked to the outside of the shower to the newly installed tile floor at the base of the shower. Mr. Sandovor advised the only solution to correct probelm was to open the floor and side tiles in both showers and replace the pan liner that had been cut to the floor by the installer of the tile. Mr.Sandovor advised Mr. Sacacian of what he had found at the Miernicki residence. Mr. Sacacian explained to the Miernickis'how he would recectify the problem, He assured them that the problem would be rectified within two weeks and would involve removing all tiles from the floor and side walls and that a new pan liner,walls and tiles would be correctly re-installed. He assured the Miernickis'that he would engage qualified personnel to properly remove and re- install the glass doors previously installed on both showers, he also assured that the newly installed vanities,toilets,walls would not be scratched or be damaged in any way in the process and assured that they would be properly protected. Mr. Miernicki was told by Mr. Sacacian that Bards Plumbing Service Inc would install new pan liners and assured futher proper installation of remaining works. Mr. Sacacian also calculated the number of tiles required for replacement and committed that he would order them from Angela's Marble and Tile. On January 17,2012, Mr. Sacacian requested access to the house to perform the work,that evening he informed the Miernickis'by phone that the entire floor in the master bedroom shower had already been removed and work was progressing well, Mr. Sacacian informed them that new tiles had been ordered and reinstallation of shower tile and remaining floor in bathroom would resume shortly. On January 18th, 2012, Mr. Miernicki had Mr. Business Management& Budget Office 5 E5 Code Case Details Execution Date 10/8/2012 8:06:23 AM Desc Assigned Required Completed Outcome Comments Cont. Investigation clements_k 3/7/2012 3/8/2012 Complete 3/7/12-Talked to Mario Sacacian on Monday, he said they had been in the house and had removed the floor tile in the showers and they are waiting for Bard from'lard's Plumbing to install new pan. He thought that they would be back out at the end of the week to reinstall floor tile.Called Bard and he had not heard from Mario. Bard was going to call Mario in case he missed a call from him. Cont. Investigation clements_k 3/16/2012 3/16/2012 Complete 3/16/12-Mario Sicacian talked to MGO on Wednesday and said he will get the tile and be done with the job probably by the end of this week or next. Cont. Investigation clements_k 3/16/2012 3/13/2012 Complete 3/13/12-Talked to Mario Sacacian yesterday, tile has been removed from showers and Bard from Bard's plumbing has set the new pans, Mario thinks they will be in to retile by the end of this week.Spoke to Mr.Miernicki,he will be down the end of next week and wants to have the shower complete and the doors replaced by then. I will call Mario again today. Cont. Investigation clementsk 3/21/2012 3/21/2012 Complete 3/21/12-Called Mario Sacacian,asked him per MGO to call me,no return call. Called Carlos(777-4167)Mario's Tile guy,he said he hoped to get to Mierniki's tomorrow to complete the work,he was working for himself on the 20th. I will stop by today to see if there is any work going on. Business Management& Budget Office 2 E (0 Code Case Details Execution Date 10/8/2012 8:06:23 AM Desc Assigned Required Completed Outcome Comments Cont. Investigation clements_k 3/26/2012 3/26/2012 Complete 3/26/12-Wont to Miernicki residence on Friday 3/16/12, the guest bathroom shower has the mud in it now,still no tile on floor in either bathroom. Miernicki's are coming in this weekend. MGO and myself called Mario this A.M., no answer, Mr. Miernickl called this A.M. got in early Sunday morning, no tile in showers. No contact with Mario and Carlos, called both, no response. MGO&myself went to the Miernicki residence to check and see if Mario Sacacian had finished the work, and to what degree.The Miernicki's are here from Canada,they can not believe the work was not completed after Mario told them it would be done.Mario will not return my phon calls or Mike Ossorio's calls. MGO and I went to Angela's Tile to see if Mario had in fact ordered the tile he said he would to complete the job, no it had not ordered.The Miernicki's are in c is e ief that Mario and his crew,went into their cabinets in the garage and used tile that the Miernickis had purchased for another purpose in their home and used it in the bathrooms, and then never reordered the tile or the tile they needed to finish the job that is completely paid for. The Miernicki's do not want Mario to finish the work,they are going to go before the board to get money returned to them,and will find another licensed contractor to complete their job. Cont. Investigation clements_k 4/3/2012 4/3/2012 Complete 4/3/12-Talked to Mr. Miernicki,homeowner, he had the tile finished in his bathrooms by another company. He had to order the tile from Angela's'rile and he will get us a copy of the bills,from Angela's Tile for the tile,from the other company that he had install the tile for labor,and the cost of re-installing the shower doors. He said probably over $1000.00 dollars.Mr.Miernicki will get the bills to my by Friday 4/6/12. Cont. Investigation clements_k 4/16/2012 4/16/2012 Complete 4/16/12-Received bills from Mr.Miernicki,he wishes to have Mario pay him for finish work and tile he had to finish the work.Mike called Mario and he will be in to get the bills. Cont. Investigation clements_k 4/23/2012 4/23/2012 Complete 4/23/12-Mario picked up bills from our office on Friday and is considering paying Mr. Miernicki in order to not go before the board. Cont. Investigation clementsk 5/1/2012 5/1/2012 Complete 5/1/12-Mario is to bring in check for the Miernickies and he has to do it by May 6th. Cont. Investigation clements_k 5/9/2012 5/9/2012 Complete 5/9/12-Waiting for Mario to bring in money for Mr. Miernicki. Business Management& Budget Office 3 El Code Case Details Execution Date 10/8/2012 8:06:23 AM Preliminary Investigation clements_k 9/1/2012 2/10/2012 Needs Sandovor check of the house around 2:00 Investlgatlo P.M., Mr. Sandovor informed Mr.Miernicki n that only a few selected tiles had been removed in two corners at the entrance to the shower and some kind of black caulking had been applied in the two Corners.Also concrete was applied to the outside corner which previously displayed the cut pan liner(photos No.2), Mr. Sandovor was not contacted to reinstall new pans in the showers.The shower still leaks as before, (photo No.3),the quick fix did not work. Mr. Miemicki has repeatedly left phone messages and written an e-mail (attached),and has had no response from Mr. Sacacian. Mr.Miernicki requested a response from Mr. Sacacian by January 31,2012, if he had any intention on rectifiying the situation, no response. 2/16/12-Met with Mario Sacacian at 1:00 Contractors Conference Room,Mr. Sacician admitted to having done the job and was aware that the showers were leaking. He said he will correct the problem, remove shower pan and have Bard's Plumbing replace it, and then retile shower. Present at the meeting were Michael Ossorio, Rob Ganguli and Karen Clements.Mr. Sacician was given 30 days to correct the problem,notice of noncompliance was given,faulty workmanship.2/27/12-Talked to Mario Sacacian 1/22/12, he is planning to start the repair work on the 27th or 28th or February. Cont. Investigation clements_k 10/1/2012 10/1/2012 Complete 10/1/12-Mr.Miemicki is coming to Florida this month. He will be attending the Contractor Licensing Board Hearing on October 17th, 2012,to hear his case againt Olde Naples Tile &Marble, Mario Sacacian. Cont. Investigation clementsk 10/5/2012 10/5/2012 Complete 10/3/12-Meet with the Mlernlckl's with MGO, they are being sued by Carlos Gomez,Mario's employee,for non payment.The Miernicki's paid Mario for the work.Per MGO,Carlos Gomez to come in to see MGO.Called and left two messages.Called Bard Sundovar and left two messages for him to appear at the Contractor Licensing Board 10/7/12 at 9:00 A.m. Business Management& Budget Office 6 E S Code Case Details Execution Date 10/8/2012 8:06:23 AM Desc Assigned Required Completed Outcome Comments Cont. Investigation clements_k 5/14/2012 5/14/2012 Complete 5/14/12-Talked to Mario today who handed the phone to Carlos when I asked about the money owed back to Miernicki's. Carlos explained he had been in two weeks ago and gave$500.00 check to Mike Ossorio regarding the money owed,Mike did not accept it because of the amount being incorrect. Check should have been for $1,426.93. Carlos gave phone back to Mario who did not want to talk to me and hung up on me.We will be taking Old Naples Marble and Tile before the CLB(board)in September,per the homeowners request. Cont. Investigation clements_k 7/12/2012 7/12/2012 Complete 7/11/12-Called Mario(Olde Naple Tile& Marble),he is still unwilling to return money to Mr.Miernicki,Mario claims is worker Carlos should return the money. Cont. Investigation clementsk 8/13/2012 8/13/2012 Complete 8/13/12-will be going to board in November 2012,that is when homeowner can come back down. Business Management& Budget Office 4 E ? Code Case Details Execution Date 10/8/2012 8:06:23 AM Desc Assigned Required Completed Outcome Comments Cont. Investigation clements_k 10/5/2012 10/5/2012 Complete 10/4/12-Letter for the Miernicki's continuance for the law suit was drawn up by myself and I took the letter to the Miernicki's house at Pinewoods Circle to be signed.Then took the letter down to the Court House,Civil Division and gave It to Stacy at 1:50 P.M.Got information for the Mirnicki's to have the court hearing by telephone from Canada.Two Subpeona's were drawn up,one for Mario Sacacian and one for Bard Sundovar (Plumber)to appear at the Contractor Licensing Board on October 17th,2012,9:00 A.M. I personally delivered both of the subpoena's.Mario Sacacian's was attached to his garage door,black truck in driveway,no one answered door.Bard's was given to his wife. Investigation clements_k 10/10/2012 Pending 14 .,.. ... ,._: .; ....- s ..v: ..=, .,, Violation Description Status Entered Corrected Amount Comments 4.1 Misconduct-County/City Open 2/10/2012 $0 Certificate of Competency Title I Reason I Result I Compliance I Fine/Day 1 Condition Business Management& Budget Office 7 ElO Certificate Detail Report CDPR2305 - Certificate Detail Report CERT ,NBR QUALIFIER NAME DBA STATUS 25598 KARIN R. SACACIAN OLDE NAPLES TILE & MARBLE, LLC ACTIVE DETAIL CLASS CODE CLASS DESC STATE NBR 4420 TILE & MARBLE CONTR. ORIG ISSD DATE STATE EXP DATE 1/6/2004 RENEWAL DATE COUNTY COMP CARD COUNTY EXP DATE EXPIRE DATE 9/30/2013 0TH OL NBR COUNTY OL EXEMPT N CNCL DATE COUNTY OL NBR COUNTY OL EXP DATE 0TH OL EXP DATE 010374 9/30/2013 REINSTATE DATE DBA PHONE FAX (239)293-7061 (239) 594-6878 MAILING ADDRESS PHYSICAL ADDRESS 1691 TRIANGLE PALM TERR 1691 TRIANGLE PALM TERR NAPLES FL 34119- NAPLES FL 34119- LIABILITY INSURANCE COMPANY EXP DATE WEEMS INSURANCE OF NAPLES 8/31/2013 PHONE EFFECTIVE DATE (000) 000-0000 8/31/2012 POLICY NUMBER CNCL DATE GFL10263370081 INSURANCE LIMITS 200000 WORKERS COMPENSATION INSURANCE WC EXEMPT Y COMPANY EXP DATE ASSURE LLC 1/1/2013 PHONE EFFECTIVE DATE (491) 739-5121 1/1/2012 POLICY CNCL DATE Collier County Board of County Commissioners Printed on 10/9/201 9:53:21AM CD-Plus for Windows 95/NT Page 1 ElI Lurxz3uo - uertiricate Detail Report 830-46947 BOND INSURANCE COMPANY EXP DATE PHONE EFFECTIVE DATE POLICY CNCL DATE INSURANCE LIMITS LAST UPDATE DATE LAST UPDATE USER PREV UPDATE DATE PREV UPDATE USER 10/9/2012 CLEMENTS K 10/9/2012 CLEMENTS K Collier County Board of County Commissioners Printed on 10/9/201 9:53:21AM CD-Plus for Windows 95/NT Page 2 �� www.sunbiz.org - Department of State Page 1 of 2 Log.IF3aA DEPARTMENT OF STATE DIVISION t` CORPORATIONS Home Contact Us E-Filing Services Document Searches Forms Help Previous on List Next on List Return To List e ._......._...' Entity Name Search Events No Name History Submit.;; Detail by Entity Name Florida Limited Liability Company OLDE NAPLES TILE&MARBLE LLC Filing Information Document Number L04000000942 FEI/EIN Number 043782186 Date Filed 01/05/2004 State FL Status ACTIVE Effective Date 01/01/2004 Last Event CANCEL ADM DISS/REV Event Date Filed 01/04/2006 Event Effective Date NONE Principal Address 1691 TRIANGLE PALM TERRACE NAPLES FL 34119 US Changed 01/04/2006 Mailing Address 1691 TRIANGLE PALM TERRACE NAPLES FL 34119 US Changed 01/04/2006 Registered Agent Name & Address SACACIAN, KARIN R 1691 TRIANGLE PALM TERRACE NAPLES FL 34119 US Address Changed:01/04/2006 Manager/Member Detail Name&Address Title MGRM SACACIAN, KARIN R 1691 TRIANGLE PALM TERRACE NAPLES FL 34119 US Title MGRM SACACIAN,MARIUS 1691 TRIANGLE PALM TERRACE NAPLES FL 34119 US E13 http://sunbiz.org/scripts/cordet.exe?action=DETFIL&ing_doc_number=L04000000942&in... 10/8/2012 www.sunbiz.org - Department of State Page 2 of 2 Annual Reports Report Year Filed Date 2010 01/04/2010 2011 01/04/2011 2012 01/04/2012 Document Images 01/04/2012--ANNUAL REPORT NiewjaggeOREQE,foring, 01/04/2011 —ANNUAL REPORT qmpprtfgrAwt 01/04/2010--ANNUAL REPORT .V ljg#tp PDF format. 04/14/2009--ANNUAL REPORT View Fina ,q i!1 PPF format 01/16/2008—ANNUAL REPORT •+ � ® .v., 12/04/2007--ANNUAL REPORT � : , Ppi , 01/05/2007--ANNUAL REPORT 1��� ae tnWPPF format 01/04/2006--REINSTATEMENT Vlew image in PDF format j 01/06/2004--Florida Limited Liability 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 Entity Name Search Events No Name History Submit_= I Home I Contact us I Document Searches F-Filing Services I Forms I Help I Cuuyric4htts�and Privacy Policies State of Florida,Department of State http://sunbiz.org/scripts/cordet.exe?action=DETFIL&inq_doc_number=L04000000942&in... 10/8/2012 f COLLIER COUNTY BUILDING REVIEW & PERMITTING 11416 CONTRACTOR'S LICENSING ��i 2800 N. Horseshoe Drive • Naples, Florida 34104 • (239) 252-2432 • Fax (239) 252-2469 J PRELIMINARY COMPLAINT FORM Your Name: RAIDREdti/ $ 7o/3NA/ M/Ece A//c,1/ Date: F£8RaRE y D// 20/2_ Address: 2/8/ yoN&-E STRIXT.t /202 City: TORorv7D State:O/VT9i /c'Zip: MIS 3i/7 Home Phone: 4/4. '34"! -/Q2.0 Business Phone: 4/6 -3/i c17' THIS COMPLAINT IS AGAINST: it C Company Name: ex DE NdPIES Tiz E R MAi28LE; License# c oLz/EC . /C. 255-9 6 Contractor or Person in Charge: (If Known) MAR/r7 SA CAC/RN g Address: /(en TR/ANGLE PALM TERR/9c 61 N PLCii Fl, 341i 9 Phone: 2 39- 2 t9 3 - 706./ Date of Contract: 704 V /S,20// (c-%PAZ) THE SPECIFIC COMPLAINT IS: (Attach additional sheets as necessary) SEE /TTyc///t'/VT f%;,/O 5//C 7-_5) l/4 TED Plea/€E SST Ws./2A V I LL A-TI CNE'b i/�ron4-r/vti � �'ELfiTES Tp /0(4T/ow AT,' 2 2 q 3 P/N Cet/0,c>7>S C/Z' ./ N9-PL Es/ L. 5',4/0S-- z Attach Copies of All Appropriate Documents: Contracts, Checks, Liens, Permits, Etc. Contractor Licensing Officers: Michael Ossorio (Supervisor) - (239) 252-5706 Ian Jackson- (239) 252-2451 Allen Kennette- (239)252-2468 j Robin Ganguli- (239) 252-2914 Karen Clements- (239) 252-2450 i ) r Signatur•. t r Ed El5 C o L [ i e C o u n t y y RE: leaking water from two improperly installed showers and unfinished floor installation in the master bathroom Our recently purchased home(2293 Pinewood Circ., Naples, FL. 3/1103) has just undergone a full renovation in 2011. There are two existing showers in the house and both were renovated/remodeled by Mr. Mario Sacacian, Collier Lic. No. 25598 owner of the Olde Naples Tile &Marble, LLC (hereafter ONTM). The one in the master bedroom has a size of approx. 47"x 60", and the second, in the guest bathroom is approx. 30"x 60". Post installation, water from both showers is badly leaking during use. Thus, at present, we can not use the showers as they have been improperly installed and would expose the house to mold and cause greater damages to walls and floors. There is no bathtub, nor additional shower in the house, so we can not normally use and enjoy the house. This also prevents us from being able to invite our children and grandchildren from Europe nor any overnight guests as previously planned nor do we have the option to rent the house. The information outlined below contains some chronological events as it demonstrates the unwillingness of Mr. Sacacian to rectify the inappropriate installations as well as his unethical conduct. We have also included names of witnesses when applicable and have attached relevant pictures. Mr. Sacacian may not be aware that we obtained pictures to confirm the evidence as described below. The final invoice payment to install the showers and all other services was witnessed and signed by Angela Burun, owner of Angela's Marble and Tile retail (239-403-4445). This signature was necessary since trust was breached based on the poor quality of some other work and previous contractor conduct. All the high-quality 24"x 24"tiles and tile installation related materials were directly acquired from Angela's Marble and Tile and delivered by ONTM. As far as we know, Mr. Sacacian conducts his business in close cooperation with Angela's Marble and Tile. The ONTN were responsible and were paid for the entire installation of both showers including walls, tiles,pan liner and all plumbing.At the time that the showers were installed,we were in Canada(we are both Canadian)and did not witness the installation. Glass doors were then installed on both showers by a separate professional company after ONTM completed all work related to shower installations. Concrete floor remained in part of the master bathroom directly in front of the shower as tiles and the baseboard had not yet been installed. ONTM has been paid for the tiles and baseboard installation but the work is still outstanding. When we started to use the master bedroom shower in late December 2011, during our stay in Naples, a substantial amount of water was leaking from underneath the shower entrance to the concrete floor in front of the shower and to the adjacent walls. An experienced licensed plumber(Bart Sundovor of Bart's Plumbing Service, Inc. tel. 239-435-1233 State Certified Lic. #CFC 1425694) was called, and he examined and E ito tested both showers. An outside examination of the right-hand side corner in the master bathroom shower showed that the pan liner that should line the shower walls above the. bottom of the shower, was cut all the way to the bottom of the shower floor(see attached picture set No. 1). For the guest shower(where the new shower and floor had already been installed), the plumber suggested a simple test. He plugged the drain, filled the shower with approx. 1"of water and asked to leave it on for at least one hour. In less than 5 minutes, the water started to quickly leak to the outside of the shower to the newly installed tile floor at the base of the shower and the plumber immediately released the drain. He advised us that the only solution to correct the problem was to open the floor and side tiles in both showers and replace the inappropriately installed pan liner. Given the poor installation and the substantial amount of leaking water, he also advised looking for other incorrect installations. He later communicated to us that he advised Mr. Sacacian of what he had found. It should be disclosed that Mr. Sundover and Mr. Sacacian met previously on different job sites. On January 12, 2012,Mr. Sacacian examined the showers together with his original installer and another adviser that he brought with him.When he applied water from the shower head directly to the back end of the shower floor, the water started to pour out from underneath the shower to the concrete floor. After consulting with the adviser, Mr. Sacacian stayed in the house and took time to explain to us how he would rectify the problem. He assured us that the problem would be rectified within two weeks and would involve removing all tiles from the floor and side walls and that a new pan liner, walls and tiles would be correctly re-installed. He confirmed that he would engage qualified personnel to properly remove and re-install the glass doors previously installed on both showers. He told us that the newly installed vanities,toilets, walls would not be scratched, or be damaged in any way in the process, and assured us that they would be properly protected. He acknowledged that Bait's Plumbing Service, Inc. would install new pan liners and assured further proper installation of remaining works. Finally,he calculated the number of tiles required for replacement and committed to us that he would order them from Angela's Marble and Tile. He asked us not to worry and wished us a safe trip back to Canada on January 14, 2012. Before we left, we arranged with Mr. Sandovor to open the side garage door, which locks automatically on closure, for Mr. Sacacian to access our home. This door was to be re- opened for Mr. Sacacian the next day. We find Mr. Sandover to be knowledgeable and ethical and this arrangement provided us with some assurance of proper re-installation. On January 17, 2012, Mr. Sacacian requested access to the house to perform the works. By evening he informed us over the phone that the entire floor in the master bedroom shower had already been removed and the work was progressing well. He also informed us that new tiles had been ordered from Angela's Marble and Tile and the re-installation of shower tiles and remaining floor in the bathroom would resume shortly. E1 On January 18, 2012, we had the house inspected by Mr. Sandovor at around 2:00 p.m. and were informed that only a few selected tiles had been removed in two corners at the entrance to the shower and some kind of black caulking had been applied in the two corners. In addition concrete was applied to the outside corner which previously displayed the cut pan liner(see attached set of pictures No. 2 c-mailed to us on Jan. 18, 2012). He advised us that this was an inappropriate"temporary quick fix"to address existing problems and that he had not been contacted by Mr. Sacacian to schedule any pan liner installation. In the evening after 8:00 p.m. we asked our neighbor(Peter and Judy Townsend 239-354-1296), who we asked to oversee our home, to double check if the house had been properly locked. They informed us that the side door was locked but the door to the lanai had been left unlocked for the night. In addition, we were informed that there were freshly installed tiles in the corners of the master bedroom bathroom,but calking had still not been applied between the tiles (this must have happened between 2 p.m. and 8 p.m.). Previously,Mr. Sacacian had informed us that if all tiles had been re- installed already in the entire house we would not have a case against him. We called Mr. Sacacian but he did not respond to our messages. As it became apparent that Mr. Sacacian did not have any intention to properly rectify the problem, as he agreed, and that he had attempted to cover up any evidence of that,we requested to no longer provide access for him to our house until a proper explanation is provided. To date, no response or explanation has been provided. The following morning we called Angela's Marble and Tiles and learned that no replacement tiles had been ordered by Mr Sacacian for our bathrooms. On January 23,2012,we requested this "temporarily and quick fix" shower to be tested again by applying water to the back end of the shower(with no flow the recently"fixed corners"). The water instantly poured out in large quantities from underneath the shower as it had done before(see attached set of pictures No. 3 e-mailcd to us on Jan. 23, 2012). The"temporary fix"only confirmed that there is a bigger problem with the proper shower installation than initially thought. On January 26, 2012, we sent a long e-mail to Mr. Sacacian outlining our observations and advising him that even the"temporary fix"did not improve the situation as identified above by the test. We requested him to respond in writing by January 31, 2012 if he has any intention to properly rectify the problem. No answer or phone call has so far been received. At this stage, we would greatly appreciate the help of the county to assist in rectifying the problem. The renovation inside the house is completed but the house can not be decorated, properly used by us or our guests nor can it be rented out, if so desired. A significant amount of money has been spent to buy, renovate and now pay each month to maintain the house. A delay in correcting the defective showers and to complete the floor in the bathroom translates to additional stress and actual financial loses as we carry on having monthly expenses and do not have use of our property for a prolonged period of time. In addition, we are engaging our time, energy, using our vacation time and baring additional £ 18 travel expanses to oversee the works of an unreliable contractor. At the same time, Mr. Sacacian has already collected money for all his services and at this point there are no financial or any other consequences applicable to him for a problem that he created and is refusing to rectify. Your assistance and guidance with this matter would he invaluable. Andrew and Joanna Miernicki El? 1 h A / Olde Naples Tile & Marble, LLC ' Ill 1691 Triangle Palm Terrace Invoice Naples, FL 34119 Number 1012 Tel: (239)293-7061 Fax: (239) 594-6878 Date: July 05,2011 Bill To: Ship To: Andrew Miernic.✓ki 416-625-2830 2293 Pine Wood Circle 416- 944-1920 Naples, 1'L 34105 PO Number Terms Customer# Service Rep. Project 3ALANCE DUE : 7-6-111 Description Quantity/Hours Price/Rate Tax Amount remove and reinstall wall and 1.00 2, 600. 00 2, 600.001 floor tile in guest bath remove and reinstall wall and 1.00 3, 500.00 3, 500.00 floor tile in master bath c I i cluiu.t tie . 1' I i--- ) 3/0n C 9, i - 4c Edgy 1/ A,„,„/. G;s/- z?Oa All material is guaranteed to be as specified.All work is to be completed in a workmanlike manner according to standard practice.Any alterations from the above specifications involving extra cost will be executed upon written orders,and will become an extra charge over and above proposed amount.All agreements contingent upon strikes,accidents,or delay beyond our control.This proposal subject to acceptance within 60 days and is void thereafter.No guarantee againsta staining and shading,the causes being beyond our control. _ IS RI' 4-(5. e.'t d{ , i'4 ijntt�1/F>z, #9 / 7//5/Zc)// Sub-Total $6,100.00 rr-u�/ ,� IrG� State Tax 6.00%on 0.00 0.00 y / i / Total $6,100.00 C/Ct't /V7/) % /C X /�.4- /te 4 1 G ki // no /9/�ce , ,�N 014 ,'ie CUA,i 1 ,/ P/�2 r /� I�i�""' .1,4 Amount Paid: 2 000.00 /..�/ /4e-c' �i'e' _ - OcXn v r " � .ac- ---- Amount Due: 4, 100,00 ^q` A I 1` 0 -30 says 31 -60 days 61 -90 days > 90 days Total r r " a r s ``5' t t -§ *-4 s s r 1 xs x rm "f x t x a, -r . f �f f '? 7. , i iii".yam' �+w SZ so es, 63-128834172 1015 ANDRZEJ MIERNICKI 11/10 JOANNA MIERNICKI _. ,;�, it = A r / (/ !y YL G RBC Bank' Bank(USA) • R BC w 11 • EZI ARTICLE V. BUILDING TRADES* Page 27 of 36 (i) Any individual who fails to renew his/her certificate of competency prior to December 31 of the year following its expiration shall thereby automatically have a certificate of competency that is null and void. To acquire a valid certificate from the county the individual must pay the then applicable full application fee in accordance with the schedule of fees and charges adopted by resolution pursuant to section 22-182(a)(4) herein, and must submit an entire new application. If, as of the date of receipt by the county of said new application, three years have passed since the date of his/her most recent examination that the individual passed to acquire the former certificate, that individual must pass all then applicable testing requirements. If the request is to reactivate a dormant certificate, the re-testing requirement can be waived by staff if the applicant proves that he/she has been active in the trade in another jurisdiction, or has been active as an inspector or investigator in the trade; or for other valid reason that would render such re-testing superfluous. (Ord. No. 90-105, § 1.4; Ord. No. 92-61, § 1; Ord. No. 94-34, § 1; Ord. No. 97-68, § 1, 10-28-97; Ord. No. 99-45, § 1.4--1.4.9, 6-8-99) Secs. 22-192--22-200. Reserved. DIVISION 3. STANDARDS OF CONDUCT AND DISCIPLINE* *State law references: Discipline of contractors, F.S. §§489.129, 489.533. Sec. 22-201. Misconduct--Collier County/city certificate of competency. The following actions by a holder of a Collier County/city certificate of competency shall constitute misconduct and grounds for discipline pursuant to section 22-202: (1) Knowingly combining or conspiring with an unlicensed contractor by allowing one's certificate of competency to be used by an unlicensed contractor with intent to evade the provisions of this article. When a licensed contractor acts as the qualifying agent for any firm without first making application under this article to represent said firm, such act shall constitute prima facie evidence of intent to evade the provisions of this article. When a certificate holder allows his certificate to be used by one or more companies without having any active participation In the operations, management, and control of such companies, such act constitutes prima facie evidence of an intent to evade the provisions of this article. Active participation requires job site supervision, knowledge of and participation in the business operations of the company, including all contractual matters. a. If any individual qualifying any business organization ceases to be affiliated with such business organization, he shall so inform the board. In addition if such individual is the only certified individual affiliated with the business organization, the business organization shall notify the board of the individual's termination and shall have no more than 60 days from the date of termination of the individual's affiliation with the business organization in which to affiliate with another person certified under the provisions of this article. In any event, the business organization shall not enter into any new contracts and may not engage in any new contracting until such time as a qualifying agent is employed. (2) Contracting to do any work outside of the scope of his competency as listed on his E 22. AG'70/1 P7/_/A 1 M_:1:a__n nn,' AC. ARTICLE V. BUILDING TRADES* Page 28 of 36 competency card and as defined in this article or as restricted by the contractors' licensing board. (3) Abandoning a construction project in which he is engaged or under contract as a contractor. A project may be presumed abandoned if the contractor terminates the project without Just cause, or fails to notify the owner in writing of termination of the contract and basis for same, or fails to perform work for 90 consecutive days without just cause and no said notice to the owner. (4) Diverting funds or property received for the execution of a specific contract project or operation or diverting funds earmarked for a specified purpose to any other use whatsoever. (5) Departing from or disregarding in any material respect the plans or specifications of a construction job without the consent of the owner or his duly authorized representative. (6) Disregards or violates, in the performance of his contracting business in the county, any of the building, safety, health, insurance or workers' compensation laws of the state or ordinances of this county. (7) Falsifying or misrepresenting any material fact in his application and supporting papers for the purpose of obtaining a certificate of competency under this article. (8) Committing mismanagement or misconduct in the practice of contracting that causes financial harm to a customer. Financial mismanagement or misconduct includes, but is not limited to, any of the following: a. The contractor fails to fulfill his contractual obligations to a customer because of inability, refusal or neglect to pay all creditors for material furnished or work or services performed in the operation of the business for which he is licensed, under any of the following circumstances: 1. Valid liens have been recorded against the property of a contractor's customer for supplies or services ordered by the contractor for the customer's job; the contractor has received funds from the customer to pay for the supplies or services; and the contractor has not had the liens removed from the property, by payment or by bond, within 30 days after the date of such liens; 2. The contractor has abandoned a customer's job and the percentage of completion is less than the percentage of the total contract price paid to the contractor as of the time of abandonment, unless the contractor is entitled to retain such funds under the terms of the contract or refunds the excess funds within 30 days after the date the job is abandoned; 3. The contractor's job has been completed, and it is shown that the customer has had to pay more for the contracted job than the original contract price, as adjusted for subsequent change orders, unless such increase in cost was the result of circumstances beyond the control of the contractor, was the result of circumstances caused by the customer, or was otherwise permitted by the terms of the contract between the contractor and the customer. b. The contractor's job been completed, and it is shown that the customer has incurred financial harm by having to seek a variance or other administrative remedy because of actions by the contractor. (9) Performing any act which assists a person or entity in engaging in the prohibited unlicensed practice of contracting, if the licensed contractor knows or should have known that the person or entity was unlicensed. EZ3 ARTICLE V. BUILDING TRADES* Page 29 of 36 (10) Failing to promptly correct faulty workmanship or promptly replace faulty materials installed contrary to the provisions of the construction contract. Faulty workmanship means work that is not commenced, not continued, or not completed in accordance with all specifications of the applicable written agreement. Faulty workmanship includes any material flaw(s) in the quality and/or quantity of the unfinished work product, including any item that does not function properly as a part of the entire project. If there is no written agreement provision regarding the specific faulty workmanship issue, faulty workmanship exists if the work, process, product or part thereof does not meet generally accepted standards In Collier County in relation to the entire project. Faulty workmanship does not include matters of aesthetics unless the aesthetically related item clearly violates a written contract specification directly related thereto. (11) Failure to maintain at all times, with an insurance company authorized to do business in the state, the limits of liability and other categories of insurance as required by this article. (12) Failing to claim or refusing to accept certified mail directed to the contractor by the contractors' licensing board, or its designee. (13) Failing to maintain a current mailing address. (14) Failing to appear in person or through a duly authorized representative at any scheduled hearing on a complaint filed against the contractor. (15) Being convicted or found guilty, regardless of adjudication, of a crime in the county which directly relates to the practice of contracting or the ability to practice contracting. (16) Allowing another to take a qualifying examination on the applicant's behalf. (17) Engaging in contracting business in the county or the city when prohibited from doing so by the contractors' licensing board. (18) Proceeding on any job without obtaining applicable permits or inspections from the city building and zoning division or the county building review and permitting department. (19) Failing in any material respect to comply with the provisions of this article as a contractor or as a qualifying agent for a business entity engaging in contracting. (20) Signing a statement with respect to a project or contract falsely indicating that the work is bonded; falsely indicating that payment has been made for subcontracted work, labor, or materials which results in a financial loss to the owner, purchaser, or contractor; or falsely indicating that workers' compensation and public liability insurance are provided. (21) Failure of a qualifying agent for a firm/legal business entity to comply with the requirements set forth in F.S. §§489.119 and 489.1195. (22) Falsifying or misrepresenting any material fact to another person with the intent or for the purpose of engaging In the contracting business, providing materials or services, or soliciting business for an employer, as a contractor, or as an employee, regardless of any financial consideration. (23) Failing or refusing to provide proof of public liability and property damage insurance coverage and workers compensation insurance coverage. (24) Misconduct in the practice of contracting (see section 22-201.1 below). (Ord. No. 90-105, § 4.1; Ord. No. 92-61, § 4; Ord. No. 94-34, §4; Ord. No. 97-68, § 1, 10-28-97; Ord. No. 99-45, § 4.1-4.1.24, 6-8-99) 2 4 liffrc•//lihrarcr') i-nil rnr1A •nm lIC'70/1 11 IA17t.:1:-.--rr AL. ....... CERTIFIED MAIL# 7007 2560 0001 1485 5155 RETURN RECEIPT REQUESTED Date: 9/25/12 Mrs.Karin R. Sacacian 1691 Triangle Palm Terrace Naples,FL. 34119 RE: Complaint filed against you by Andrew&Joanna Miernicki Dear Mrs. Sacacian: A complaint has been filed against you by the above referenced individuals. A hearing of this complaint will be held by the Contractors' Licensing Board on October 17th,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) 4.1.10 of Ordinance#2006-46 the range of disciplinary sanctions which may be imposed are from an oral reprimand to a suspension or revocation of your Collier County Certificate# C25598 and/or suspension or revocation of your permit privileges against your County license# C25598. Sincerely, Karen Clements Licensing Compliance Officer Phone#(239)252-2450 kc/j b £ 25 U.S. Postal ServiceT., CERTIFIED MAILTM RECEIPT (Domestic Mail Only;No Insurance Coverage Provided) r a For delivery information visit our website at www.ucps.com.;, 4r1 OFFICIAL USE cp Postage $ r-q Certified Fee r-4 D Return Receipt Fee Postmark D (Endorsement Required) Here Restricted Delivery Fee MIN D (Endorsement Required) -D 1-7 Total Postage&Fees ru sent To rl r, orPOBoxNo. I(q [ trig-n�1e,__P. m-TTrrxaCt.---. City,State,ZIP+4 . ti deg- /?L. 341119 PS Form 3800,August 2006 See Reverse for Instructions 4E2G USPS.com®- Track& Confirm Page 1 of 1 . English Customer Service USPS Mobile Register f Sign In Vr P..7+irO Search USPS.com or Track Packages Quick Tools Ship a Package Send Mad Manage Your Mai! Shop Business Solutions Track & Confirm GET EMAIL UPDATES PRINT DETAILS • YOUR LABEL NUMBER SERVICE STATUS OF YOUR ITEM DATE&TIME LOCATION FEATURES • 70072560000114855155 Notice Left Soptombor 28,2012,1:31 pm NAPLES,FL 34119 Certified Mall'" www.usps.comrredelivery or calling 800-ASK- LISPS,or may pick up the item at the Post Office indicated on the notice.If this item is unclaimed after 15 days then a will be returned to the sender.Information,if available,is updated periodically throughout the day.Please • Check again later."> Depart USPS Sort September 28,2012 FORT MYERS,FL 33913 Facility Processed through September 28,2012,2:09 am FORT MYERS,FL 33913 USPS Sort Facility Check on Another Item What's your label(or receipt)number? Find LEGAL ON USPS.COM ON ABOUT.USPS.COM OTHER USPS SITES Privacy Policy; Government e Home yServics, About USPS Hoe+ Business Customer Gateway Terms of Use+ Buy Stamps l"Strop+ Newsroom' Postal Inspectc:r; FOIA• Print a Label with Postage; Mail Service Updates Inspector General No FFAR Act FEG Data, Customer Service; r,-.rmt A Pr'niicat.rsru: 1,05101 Explorer Site index+ Careers r Copyright0 21112 USPS All Rights Deserved. EZ7 https://tools.usps.com/go/TrackConfirmAction.action 10/8/2012 1 Z. - £gy v '" 3� vF` .., , - ,.,s •-,--t,:07.. Sr ;„4. ' r' r 4 � } t" d.. . 1. it .... .. '.••)!7. � .' 'd!I SSSY :a£y'::.:w nw:'.My,i;# :.fti !" uaxin•...j - _ '' 1 - zsr.•. 45 R•rdilnr::tl• .. ' ..r..S:'::ij .. r r Y t 1rR 4e+..:. . .,.�, :'' •x.. ��' `aF „� 1 fir. 4'le:�: Y SS. , , A 1:;r._. 1 1. ? 1, 1:3y.4 r. £3; E I, r * � >c L i, `: ,r=7. "r,. ;F R,'.,-am g " jj ar•. y3 r 4:' x 3 •" .. - ' _ ., .: ' ' ''''' i .v.! • \le Y : .7-4..,,� 5 1 ?1 '''.,'-?:::'.t:=„:3�x L �.11 xri y is 4 � t,....4i. _r . 4 r: 1Y E g:F $ t,,,, M ,i,s,. y wC M''Y. " t •f 1 'f..I ' f • H t E K 1 t t n f N A . ; pi1::,,t f - - -. 5?,`,„,.:,-9<'£A : ,� �3.� Y1CiGLtn a l f „ {*t 1 E 7j ., -Ir X ,' + 'vii t x. r $'rn L. i'r 'Alt,-41 '' vc„ ' �` r ,, I jv „4'' .�` -. Y �E.�� t. �.>-akh�l- '7 + ' ���}„2GVE, �3 � s� in. v " ki ,f { a r 'Y r !k3 v i i t �.y ' ; r1, Ti 1:'•1!,1 Y z , V ' ;t Y c � ?,.?,91, , i ,-, ,, - ,-,t ,.. ,:. -i: - , ,,,' , -- ' 2, ; ,1 , z- ' ; ,1,1,11.:w.fit'Z 44 ,,, 0.4 t r , .1V .4 ,..... , ,,, I, ' J .. ., ' 4' ' Y5 � . $ � �i�� ' !� t f,l',#.,-, �,Y ti + .: 3 :t � 1.4 - 4 ' � 'r � rvi ` r i d r r .{�. � wE ( a •� tk a x v i - r £ le , t• - '- x�sr t • P N ., Certificate Detail Report CDPR2305 - Certificate Detail Report ' CERT* NBR QUALIFIER NAME DBA STATUS 23849 BARD SUNDVOR BARDS PLUMBING SERVICE, INC. ACTIVE DETAIL CLASS CODE CLASS DESC STATE NBR 3010 PLUMBING CONTR.-CERTIFIED CFC 1425694 ORIG ISSD DATE STATE EXP DATE 8/5/2002 8/31/2014 RENEWAL DATE COUNTY COMP CARD COUNTY EXP DATE EXPIRE DATE 8/31/2014 OTH OL NBR COUNTY OL EXEMPT N CNCL DATE COUNTY OL NBR COUNTY OL EXP DATE 0TH OL EXP DATE 962476 9/30/2013 REINSTATE DATE DBA PHONE FAX (239)435-1233 MAILING ADDRESS PHYSICAL ADDRESS 2413 PINEWOOD CIRCLE 2413 PINEWOOD CIRCLE NAPLES FL 34105- NAPLES FL 34105- LIABILITY INSURANCE COMPANY EXP DATE TIM SHAW INSURANCE, GROUP TNC, FT MYERS, 5/4/2013 PHONE EFFECTIVE DATE (239) 939-1010 5/4/2012 POLICY NUMBER CNCL DATE ACP5905002989 INSURANCE LIMITS 2, 000, 000 WORKERS COMPENSATION INSURANCE WC EXEMPT N COMPANY EXP DATE TIM SHAW INSURANCE GROUP INC, FT MYERS, 4/1/2013 PHONE EFFECTIVE DATE (239) 939-1010 4/1/2011 POLICY CNCL DATE Collier County Board of County Commissioners Printed on 10/9/201 9:48:37AM CD-Plus for Windows 95/NT Page 1j CDPR2305 - Certificate Detail Report 10641675 BOND INSURANCE COMPANY EXP DATE PHONE EFFECTIVE DATE POLICY CNCL DATE INSURANCE LIMITS LAST UPDATE DATE LAST UPDATE USER PREV UPDATE DATE PREV UPDATE USER 9/7/2012 WHITEWAY C 5/9/2012 CLEMENTS K Collier County Board of County Commissioners Printed on 10/9/201 9:48:37AM CD-Plus for Windows 95/NT Page 2 030 . ClementsKaren From: bsundvor @gmail.com on behalf of Bard Sundvor[bardsplumbing @gmail.com] Sent: Wednesday, February 15, 2012 1:10 PM To: ClementsKaren Subject: Andrew/Mario Regarding Andrew When we installed the shower pan liner the curb was not yet built, and we left enough shower pan liner to bring it up over the curb. The tile company told us that they would bring the liner up into the curb after it was built. When the homeowner discovered that the shower was leaking, we inspected the shower and could see that the shower pan liner was not going up into the curb. We could see this because the outside right corner of the curb was not finished with tile. We then removed some of the drywall in that corner, and confirmed that the liner was on the floor only,not going up. It looked like the tile installer had cut the shower pan liner before the curb started instead of folding it up into the curb. Andrew told me that he called Mario and that Mario told him that his tile installer had made a mistake, and that he was willing to remove the tile and install a new shower pan liner. Andrew called me a couple of weeks later from Canada and asked if I could look at his shower because Mario told him it was repaired. I observed that there had been approximately lsq ft. of tiles removed from the two front corners, and adhesive had been applied in the corners to make the repair. I called Andrew, and he informed me that his agreement with Mario was that the entire floor was to be removed so that a new shower pan liner could be correctly installed, and that he did not accept Mario's attempt to make a repair. Bard Sundvor Master Plumber Bard's Plumbing Service, Inc. State Lic.# CFC 1425694 1 E31 COLLIER COUNTY CONTRACTORS' LICENSING BOARD COLLIER COUNTY,FLORIDA COLLIER COUNTY,a political subdivision of the State of Florida, CISPetitioner, Collier County Contractor Licensing Board 3299 E. Tamiami Trail 1420, Naples,FL. 34112 vs. CASE NO.2012-l 1 Karin Sacacian dba Olde Naples Tile&Marble LLC, Respondent. WITNESS SUBPOENA DUCES TECUM To: Bard Sundvor dba Bard's Plumbing Service, Inc. 2413 Pinewood Circle Naples, FL. 34104 GREETINGS: YOU ARE HEREBY COMMANDED, pursuant to Section 162.08, Florida Statutes, and Collier County Ordinance No. 90-105, as amended, to be and appear before the Contractors' Licensing Board of Collier County, Florida, located at the Commission Meeting Room, 3301 East Tamiami Trail, Administration Building, Third Floor, Naples, Florida, on the 17th day of October, 2012, at 9:00 A.M., to give testimony regarding an alleged violation of Ordinance 90.105, as amended, of Collier County Florida. In addition, YOU ARE COMMANDED to bring with you the following: Any photos or documentation pertaining to the Miernicki Residence at 2293 Pinewoods Circle, Naples, FL. 34104, pertaining to the tile and restoration work in the Master bathroom and guest bathroom in which your company and Olde Naples Tile& Marble,LLC.,were involved in. You are being subpoenaed by the party or attorney whose name appears below on the left side of this subpoena and, unless excused from this subpoena by that party or attorney, you shall respond to this subpoena as directed. FAILURE TO APPEAR SUBJECTS YOU TO PENALTIES OF LAW. Dated this 4`h, day of October, 2012. CONTRACTORS' LICENSING BOARD, Respondent or Attorney for Respondent COLLI ' COUNTY, FLORIDA Address By: dA(1 a-/i • ices Tele.No. / 5P— y—1 , Chairman E31 U.S. Postal'ServiceTt, CERTIFIED MAIL , RECEIPT (Domestic Mail Only;No Insurance Coverage Provided) -- For delivery Information visit our website at www.usps.coms cp OFFICIAL USE ,,.p Postage $ m Certified Fee -_ m Postmark O Return Receipt Fee Here CI (Endorsement Required) Rootriotcd Dolivery Fee (Endorsement Required) ri (N- Total Postage&Fees Sent To Mr. -rd sand vQ..r Sueet, 3'; ' wPOewnh, 413 r► rlWQ City, a�z s L. 3U 14 PS Form 3800,August 2006 See Reverse for Instructions • USPS.com®- Track & Confirm Page 1 of 1 . , English Customer Service USPS Mobile Register!Sign In u, / s '4/a Search USPS.corn or Track Packages Quick Tools Ship a Package Send Mail Manage Your Mad Shop Business Solutions Track & Confirm GET EMAIL UPDATES PRINT DETAILS YOUR LABEL NUMBER SERVICE STA Ws OF YOUR ITEM DATE 8 TIME LOCATION FEATURES 70070710000336984625 Delivered October 06,2012,1:02 pm NAPLES,FL 34105 Certified Mall' Depart USPS Sat October 06,2012 FORT MYERS.FL 33913 Facility Processed through October 05,2012,11:32 pm FORT MYERS,FL 33913 l ISPS Sort Facility Check on Another Item WI lays yuul label(or receipt)number? • Find LEGAL ON USPS.COM ON ABOUT.USPS.COM OTHER USPS SITES Privacy Policy' Government Servic es> About LISPS Home. 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Eli3, ,...,,,,,,„..... ... ..-.4.-•-,.-:,-i." —- -- - --: '''•••:,-;•-,- x.. �, . , i t y GlomentsKaren From: andrew mierncki[andrewmiernicki @hotmail.comn] Sent: Friday, February 10, 2012 10:58 AM To: ClementsKaren Subject: FW: Leaking Water From Two Newly Installed Showers Mrs Clements, As requested, I am forwarding the a-meil that was sent to Mario Sacacian at Olde Naples Tile& Marble outlining our observations and requesting to respond in writing by January 31, 2012 if he has any intention to properly rectify the problem. No answer or phone call has been received and on Feb. 2, 2012, we mailed the complaint form to the County. Thank you Andrew and Joanna Miernicki From: andrewmiernicki @hotmail.com To: ksacacian @comcast.net CC: angelas_tm @yahoo.com Subject: FW: Leaking Water From Two Newly Installed Showers Date: Thu, 26 Jan 2012 21:15:43 -0400 Mr. Sacacian Subject: Leaking water from two newly installed showers: To recall some background, you were introduced to us and we engaged you for works based on a high recommendation from Angela's Marble and Tile. Recently, you installed two showers in our home at 2293 Pinewoods Cir. in Naples at a price of$6,100. The final payment of your invoice and all other services was witnessed and signed by Angela Burun, owner of Angela's Marble and Tile retail. This signature was necessary since trust was breached based on the poor quality of some other work and your previous conduct. All tiles and related materials for all work was directly acquired from Angela's Marble and'file (approx. $10,000 for all works) and delivered by you. You were responsible for the installation of walls, tiles, pan and all plumbing. Glass doors were then installed on both showers by a separate professional company after you completed all work related to shower installations. A substantial amount of 24"x 24"high end tiles were unnecessarily cut in half and wasted during the installation. The amount of ordered tiles was estimated and scheduled to be installed in the showers as well as on some additional walls in the bathroom. Since there were no tiles left we ended up having to give up on installing any tiles on the walls. Angela's Marble and Tile was involved from the initial stage as outlined above. Based on the reasons outlined above, more tiles are required to now be pre-ordered by you. Therefore, for information purposes, I have copied Angela Burun on this e-mail. At the time that the showers were installed, we were in Canada. When we started to use the showers in late December 2011, during our visit to Naples, we noticed that a substantial amount of water was leaking from underneath the shower entrance to a concrete floor in front of the shower(not yet completed by you) and to the adjacent walls. Experienced licensed personnel were called, they examined and tested both showers and advised that the only solution to correct the problem was to open the floor and side tiles and replace the inappropriately installed pan 1 E q ill liner. They also advised looking for other incorrect installations given the poor installation they found. You • wete advised about this situation by us as well as the licensed individual. At present, the inappropriately installed showers expose the house to mold and potentially greater damages to walls and floors. Since there is no bathtub, nor other shower available in the house we can not normally use and enjoy the house and we can not invite our children, grandchildren or any overnight guests as previously planned. On January 12, 2012, you examined the showers together with the original installer and another adviser that you brought with you. When you applied water directly to the back end of the shower, the water started to pour out from underneath the shower to the concrete floor. You stayed in the house and took time to explain to us how you would rectify the problem. You assured us that the problem would be rectified in two weeks by removing all tiles from the floor and side walls and that a new pan liner, walls and tiles would be correctly re-installed. You confirmed that you would engage qualified personnel to properly remove and re-install the glass doors previously installed on both showers. You checked that the newly installed vanities, toilets, painted walls would not have scratches, or he damaged in any way in the process, and assured us that they would be properly protected. Finally, you calculated the number of Sahara Brown and Sahara Beige tiles required for replacement and assured us that you would order them from Angela's Marble and Tile. You asked us not to worry and wished us a safe trip back to Canada on January 14, 2012. Before we left, we arranged with an independent person to open the side garage door, which locks automatically on closure, for you to access our home. This door was to be re-opened for you the next day. On January 17, 2012, you requested access to the house to perform the works. By evening you informed us over the phone that the entire floor in the master bedroom shower had already been removed and the work was progressing well. On January 18, 2012, we had the house inspected and were informed that only a few selected tiles had been removed in two corners at the entrance to the shower and some kind of caulking had been applied in the two corners. In the evening we asked our neighbor, who oversees our house, to check if the house had been properly locked, They informed us that the side door was locked but the door to the lanai had been left unlocked for the night. In addition, we were informed that there were freshly installed tiles in the corners of the master bedroom bathroom, but calking had still not been applied between the tiles. Previously, you had informed us that if all tiles had been re-installed already in the entire house we would not have case against you. Since you did not respond to our messages, we requested to have the doors locked and no longer provided access to our house. The following morning we called Angela's Marble and Tiles and learned that no replacement tiles had been ordered by you for our bathrooms. Please be informed that your attempt to "temporarily and quick fix" and cover up any evidence did not work. We had this-temporary fix" shower tested in the some way you tested it by applying water to the back end of the shower(not the "fixed corners"). The water poured out in large quantities from underneath the shower as it had done before. The "temporary fix"only confirmed that there is a bigger problem with the proper shower installation than initially thought. At this point it became apparent that you did not have any intention to rectify the problem, which means that you have left us with currently useless showers unlike you had agreed. The following first steps would be required by you (in writing) to address the problem: 2 E 45 1. All necessary replacement tiles (for floor and walls, as originally planned) have to be ordered and paid for by • . yOu•from Angela's Marble and Tiles and confirmed to us by the retailer by January 30, 2012; 2. Written assurance, with copy to Angela Burun, must be provided by January 31, 2012 stating that the problem will be rectified in a fashion recommended by a licensed individual as outlined above; 3. Qualified shower installer should be engaged and approved by us to rectify the problem (we do not agree for the original inexperienced installer to be engaged) 4. Licensed plumber should be selected and approved by us to install the pan liner as required by the installation code; 5. Professional shower glass door installer will be selected and approved by us to remove and re-install the glass doors in both showers. If the above is not confirmed by you in writing by January 31, 2012, we will understand that you are refusing to rectify the problem. 3 E ,C,omentsKaren From: andrew mierncki [andrewmiernicki @hotmail.corn] Sent: Sunday, February 12, 2012 4:07 PM To: ClementsKaren Subject: FW: Leaking Water From Two Newly Installed Showers You may have noticed that in the third paragraph of the e-mail to Mr Sacacian we remained him that a substantial amount of tiles were wasted during the shower installation. To clarify that statement for you, we ordered a 204 sq. ft. (17 boxes)of of Sahara Beige tiles (invoice No. 9728 from Angela's Marble&Tiles) to be installed in the master bathroom shower and on two additional walls in the master bathroom. The shower has total area of 111 sq. ft. consisting of 3 walls (60"x 96", 60"x96" and 47"x96"). Since there were no single tile left after the shower installation we ended up having to give up on installing any additional tails on the two walls. Not much can be done now to rectify the waste and our primary goal is to have properly functioning showers, however the waste is contrary to the Olde Naples Tile &Marble statement on their invoice that "All work is to be completed in a workmanlike manner according to standard practice". Thank you Andrew and Joanna Miernicki From: andrewmiernicki @hotmail.com To: karenclements @colliergov.net Subject: FW: Leaking Water From Two Newly Installed Showers Date: Fri, 10 Feb 2012 11:58:29 -0400 Mrs Clements, As requested, I am forwarding the e-meil that was sent to Mario Sacacian at Olde Naples Tile& Marble outlining our observations and requesting to respond in writing by January 31, 2012 if he has any intention to properly rectify the problem. No answer or phone call has been received and on Feb. 2, 2012, we mailed the complaint form to the County. Thank you Andrew and Joanna Miernicki From: andrewmiernicki@hotmail.com To: ksacaclanOcomcast.net CC: angelas_tm @yahoo.com Subject: FW: Leaking Water From Two Newly Installed Showers Date: Thu, 26 Jan 2012 21:15:43 -0400 Mr. Sacacian Subject: Leaking water from two newly installed showers: To recall some background, you were introduced to us and we engaged you for works based on a high recommendation from Angela's Marble and Tile. Recently, you installed two showers in our home at 2293 Pinewoods Cir. in Naples at a price of$6,100. The final payment of your invoice and all other services was witnessed and signed by Angela Burun, owner of Angela's Marble and Tile retail. This signature was necessary since trust was breached based on the poor quality of some other work and your previous conduct. All tiles and related materials for all work was directly acquired from Angela's Marble and Tile (approx. $10,000 for all works) and delivered by you. You were responsible for the installation of walls, tiles, pan and all plumbing. Glass doors were then installed on both showers by a separate professional company after you completed all work related to shower installations. 1 E147 +O?�LYLty Growth Management Division Planning & Regulation Operations Department Licensing Section Date: February 16, 2012 Mario Sacasian Olde Naples Tile & Marble, LLC. 1691 Triangle Palm Terrace Bonita Springs, FL 34135 Notice of Noncompliance Mr. Sacasian; As stated on February 3rd, 2012, there was a preliminary complaint letter sent by the property owners Andrew&Joanna Miernicki,2293 Pinewoods Circle, Naples, FL. 34105. Concerning Contractor Licensing case CEMIS20120002162, this office, conducted a preliminary investigation on your construction activity at the above address. We have determined that a violation of the County Ordinance does exist at this time; the following is the Ordinance which has been violated: 1. Ordinance#2006-46,as amended, Section 4.1.10 failing to promptly correct faulty workmanship or promptly replace faulty materials installed contrary to the provisions of the construction contract. Faulty workmanship means work that is not commenced, not continued, or not completed in accordance with all specifications of the applicable written agreement. Faulty workmanship includes any material flaw(s) in the quality and/or quantity of the unfinished or finished work product, including any item that does not function properly as a part of the entire project. If there is no written agreement provision regarding the specific faulty workmanship issue, faulty workmanship exists if the work, process, product or part thereof does not meet generally accepted standards in Collier County in relation to the entire project. Faulty workmanship does not include matters of the esthetics unless the esthetically related item clearly violates a written contract specification directly related thereto. Pursuant to 4.1.10 Faulty Workmanship: As the Contractor Licensing Supervisor, I have reviewed the preliminary complaint that involves your company, Olde Naples Tile& Marble, LLC, and have concluded that this is considered a violation prescribed by this Ordinance for the following reasons: A. Both showers have had the shower pans prematurely cut by your installer which has caused both showers to leak when the showers are running. B. You have had a meeting with the homeowners and discussed the process you would take to correct the problem. Both showers were to have the tiles removed and the shower pans replaced, and then tile reinstalled. Growth Management Division*Planning&Regulation*2800 North Horseshoe Drive*Naples,Honda 34104*239-252-2400*www.colliergov.net Eti 8 I Ca 1E M-r Cou-H.ty Growth Management Division Planning & Regulation Operations Department licensing Section As the Contractor Licensing Supervisor, I determined that the following corrections need to be adhered to: 1. Olde Naples Tile&Marble, LLC, will correct all faulty workmanship and will have the shower pans replaced by Bards Plumbing, and then the tiles to be replaced by Olde Naples Tile and Marble, LLC, to correct the code violation and correct all faulty work. This work shall be completed within 30 days of this date. Contractor Licensing Officer, Karen Clements advised you through a Notice of Noncompliance Order to correct the Faulty Workmanship, if for any reason the Noncompliance Order is not met, a filing of an Administrative Hearing will be scheduled. Therefore, this day February 16, 2012, consider this letter your Notice of Noncompliance. In the future if further violations occur and are founded concerning Olde Naples Tile& Marble, LLC, an Administrative Complaint may be required and may be referred to the Collier County Contractor Licensing Board. As a qualifier of a Collier County Tile Contractor License, it is your responsibility to abide by the Licensing Ordinance and conduct your business accordingly. This Noncompliance letter is an Official document and will be placed in your file for future reference if required. Mi .-e Ossorio --- 4W / Con -ct. icensing Supervisor Mario ac __ �� Date /7 Olde Naples Tile&vMarb LC. Growth Management Division*Planning&Regulation"2800 North Horseshoe Drive*Naples,Florida 34104*239-252-2400*www.colliergov.net E YIP f March 28, 2012 Mrs. Karin R.Sacacian C/0 Olde Naples Tile & Marble, L.LC. 1691 Triangle Palm Terrace Naples, FL. 34119 RE: Contractor Licensing Case#CEMIS20120002162,Andrew&Joanna Miernicki,2293 Pinewoods Circle, Naples FL. 34105. Mrs.Sacacian; On February 3`d, 2012 there was a preliminary complaint letter sent by the above property owners. We conducted the investigation and it was determined and agreed upon by your company, that your employee, under your direction, installed faulty materials and faulty workmanship, during the installation and the cutting of the pans.A non compliance order was issued on February 16th, 2012,to correct the faulty work and a period of 30 days was agreed upon.We had several communications with your company and we were reassured,that the faulty would be corrected no later than Friday March 23rd, 2012. Upon a re-inspection the faulty has work has not been abated and non compliance order not complied with.Therefore the Contractor Licensing Supervisor has determined to open up an Administrative Complaint pursuant to the Ordinance 2006-46, for failing to correct faulty workmanship. If you have any questions,or if you would like to contact me,feel free to call me at 239-252-2450. Karen Clements, Collier County License Compliance Officer E S G • . • COLLIER COUNTY CONTRACTORS' LICENSING BOARD COLLIER COUNTY,FLORIDA COLLIER COUNTY,a political subdivision of the State of Florida, Petitioner, Collier County Contractor Licensing Board 3299 E. Tamiami Trail Naples,FL, 34112 vs. CASE NO,2012-11 Karen Sacacian dba Olde Naples Tile&Marble LLC., °� Respondent. WITNESS SUBPOENA DUCES TECUM To: Mario Sacacian 1691 Triangle Palm Terrace Naples, FL. 34119 GREETINGS: YOU ARE HEREBY COMMANDED, pursuant to Section 162.08, Florida Statutes, and Collier County Ordinance No. 90-105, as amended, to be and appear before the Contractors' Licensing Board of Collier County, Florida, located at the Commission Meeting Room, 3301 East Tamiami Trail, Administration Building, Third Floor, Naples, Florida, on the Am day of October, 2012, at 9:00 A.M„ to give testimony regarding an alleged violation of Ordinance 90-105, as amended, of Collier County Florida, In addition, YOU ARE COMMANDED to bring with you the following: Any photos, e-mails, documentation pertaining to the Miernick residence at 2293 Pinewoods Circle, Naples, FL. 34104, pertaining to the tile and restoration work in the • Master bathroom and guest bathroom in which your company,Olde Naples Tile& Marble, LLC.,were involved in. You are being subpoenaed by the party or attorney whose name appears below on the left side of this subpoena and, unless excused from this subpoena by that party or attorney, you shall respond to this subpoena as directed. FAILURE TO APPEAR SUBJECTS YOU TO PENALTIES OF LAW. Dated this ,`�` day of CONTRACTORS' LICENSING BOARD, Respondent or Attorney for Respondent COLLJ. 4 OUNTY, ORIDA Address / By: e 1r .< �Ul� Tele.No. l a. �/Z / Chairman 6 1 U.S. Postal Service,,, CERTIFIED MAIL, RECEIPT m (Domestic Mail Only;No Insurance Coverage Provided) fU For delivery information visit our website at www.usps.comg u'! OFFICIAL USE Postage rq Certified Fee Postmark Return 17 (Endorsement Required ) Here O Restricted Delivery Fee O (Endorsement Required) 117 Total Postage&Fees ru tt Sent To Mr• Man'o Sacct.ciat,n p &root Apr.Tlo c or PO Box No- NC?! Tr%' .te--P_sf m. .:�t cny State,ZIPw FL. 34119 PS Form 3800,August 2006 See Reverse for Instructions • ig £ 52. 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