Jul 11 2005 16:40 @7/11/2665 16:39 s5ade7dga7 LEGAL SERVICES PAGE 83 : o _ A FLORIDA ‘a \ DEPARTMENT OF a FINANCIAL SERVICES : fe . Reet - TOM GALLAGHER CHIEF FINANCIAL OFFICER FILED STATE OF FLORIDA “JUN 10 2005 IN THE MATTER OF: Dooketed CASE NO.: 79886-05-AG JOHN KIRKHAM RAND / ADMINISTRATIVE COMPLAINT TQ: JOHN KIRKHAM RAND Rand Sports & Entertainment Insurance Inc. 400 South Atlantic Ave., Suite 101 Ormond Beach, FL 32176 JOHN KIRKHAM RAND 175 Orchard Lane Ormond Beach, FL. 32176 You, JOHN KIRKHAM RAND, license LD. #4214901, are hereby notified that the Chief Financial Officer of the State of Florida has caused to be made an investigation of your activities while licensed as an insurance agent in this state, as a result of which it is alleged: GENERAL ALLEGATIONS 1. Pursuant to Chapter 626, Florida Statutes, you, JOHN KIRKHAM RAND, are curently licensed in this state as a General Lines (Prop. & Cas.) (2-20), Health (2-40) Agent. 2. At all times pertinent to the dates and occurrences refetred to herein, you, JOHN KIRKHAM RAND, were licensed in this state as an insurance agent. 3. Pursuant to chapter 626, Florida Statutes, the Florida Department of Financial Services has jurisdiction over your insurance licenses and appointments. Jul 11 2005 16:40 a7/11/2885 16:39 s5848 74987 LEGAL SERVICES PAGE 4 ~~’ LA COUNT I 4. The above general allegations are hereby realleged and fully incorporated herein by reference. 5. In or around October 1, 1999, you JOHN KIRKHAM RAND, as a licensed insurance agent, consulted with VF concerning the sale to her of a general liability insurance policy for her company, In Any Event/The Foley Agency. Upon your instruction she provided to you initial premium checks totaling $1,000.00 and payable to Rand Insurance. Thereafter, you provided to her a certificate of liability insurance confirming the sale and existence of liability insutance for her company. She thereafter paid annual renewal premiums to you for subsequent years and you continued to provide to her certificates of ability insurance confirming the existence of insurance coverage for her company. She was never furnished copy of any insurance policy. 6. In or around June, 2002, a legal claim was asserted against In Any Event/The Foley Agency, and VF contacted you to inform of this occurrence in an effort to effect protection under the insurance coverage which you had sold to her. Thereafter, although you had claimed insurance to have been issued by Chubb Insurance Company, that company had no record of any application ever having been submitted to it in behalf of In Any Event/The Foley Agency, no record of ever having received premium moneys paid to you for any such insurance coverage, and no record of any policy of insurance ever having been issued. IT IS THEREFORE CHARGED that you, JOHN KIRKHAM RAND, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for the suspension or revocation of your licenses, registrations and appointments as an insurance agent: (a) All premiums, retum premiums, or other funds belonging to insurers or others received by an agent, customer representative, solicitor, or adjuster in transactions under his or license or trust funds received by the licensee in a fiduciary capacity. The licensee in the Jul 11 2005 16:40 B7/11/2685 16:39 8584874987 LEGAL SERVICES PAGE &5 applicable repular course of business shall account for an pay the same to the insurer, insured, or other person entitled thereto. [Section 626.561(1), Florida Statutes]; (b) Ifthe license or appointment is willfully used, or to be used, to circumvent any of the requirements or prohibitions of the Florida Insurance Code. [Section 626.61 1(4), Florida Statutes]; (c) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (d) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.61 1(8), Florida Statutes]; (e) Fraudulent or dishonest practices in the conduct of business under the licensure or appointment. [Section 626.611(9), Florida Statutes]; (f) Misappropriation, conversion, or unlawful withholding of moneys belonging to insurers or insureds, their beneficiaries, or to others and received in conduct of business under the license. [Section 626.611(10), Florida Statutes]; (g) Knowingly making, issuing, circulating or causing to be made, issued, or circulated, any estimate, illustration, circular, statement, sales presentation or omission, or comparison which misrepresents the benefits, advantages, conditions, or terms of any insurance policy. [Section 626.9541(1)(a)1., Florida Statutes]; . (4) Knowingly making a false or fraudulent written or oral statement or representation on, or relative to, an application or negotiation for an insurance policy for the purpose of obtaining a fee, commission, money, or other benefit from any insurer, agent, broker, or individual. [Section 626.9541(1)(k)L., Florida Statutes]. WHEREFORE, you, JOHN KIRKHAM RAND, are hereby notified that the Chief Financial Officer intends to enter an Order suspending or revoking your licenses, registrations, and appointments as an insurance agent or to impose such penalties as may be provided under the provisions of Sections 626.611, 626.621, 626.681, 626.691, and 626.9521, Florida Statutes, Jul 11 2005 16:41 B7/11/2685 16:39 8584874987 LEGAL SERVICES PAGE &6 Ne and under the other referenced Sections of the Florida Statutes as set out in this Administrative Complaint. NOTICE OF RIGHTS You have the right to request a proceeding to contest this action by the Department pursuant to Sections 120.569 and 120.57, Florida Statutes, and Rule 28-107, Florida Administrative Code. The proceeding request must be in writing, signed by you, and must be filed with the Department within twenty-one (21) days of your receipt of this notice. Completion of the attached Election of Proceeding form and/or a petition for administrative hearing will suffice as a written request. The request must be filed with the General Counsel as acting Agency Clerk, at the Florida Department of Financial Services, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0333. Your written response must be received by the Departinent no later than 3:00 p.m. on the twenty-first day after your receipt of this notice. Mailing the response on the twenty-first day will not preserve your right to a hearing. YOUR FAILURE TO RESPOND IN WRITING WITHIN TWENTY-ONE (21) DAYS OF YOUR RECEIPT OF THIS NOTICE WILL CONSTITUTE A WAIVER OF YOUR RIGHT TO REQUEST A PROCEEDING ON THE MATTERS ALLEGED HEREIN AND AN ORDER OF REVOCATION WILL BE ENTERED AGAINST YOU. If you request a proceeding, you must provide information that complies with the requirements of Rule 28-107.004, Florida Administrative Code. As noted above, completion of the attached Election of Proceeding form conforms to these requirements. Specifically, your response must contain: (a) The name and address of the party making the request, for purpose of service, (b) A statement that the party is requesting a hearing involving disputed issues of material fact, or a hearing not involving disputed issues of material fact; and Jul 11 2005 16:41 B7/11/2685 16:39 8584874987 LEGAL SERVICES PAGE &? (c) A reference to the notice, order to show cause, administrative complaint, or other communication that the party has received from the agency. If'a hearing of any type is requested, you have the right to be represented by counsel or other qualified representative at your expense, to present evidence and argument, to call and cross-exariiie witnesses, and to compel the attendance of witnesses and the production of documents by subpoena. Ifa proceeding is requested and there is no dispute of material fact, the provisions of Section 120.57(2), Florida Statutes, apply. In this regard, you may submit oral or written evidence in opposition to the action taken by the Department or a written statement challenging the grounds upon which the Department has relied. While a hearing is normally not required in the absence of a dispute of fact, if you feel that a hearing is necessary, one will be conducted in Tallahassee, Florida, or by telephonic conference call upon your request. However, if you dispute material facts which are the basis for the Department’s action, you must request an adversarial proceeding pursuant to Sections 120.569 and 120.57(1), Florida Statutes, These proceedings are held before a State administrative law judge of the Division of Administrative Hearings. Unless the majority of witnesses are located elsewhere, the Department will request that the hearing be conducted in Tallahassee, Florida. Failure to follow the procedure outlined with regard to your response to this notice may result in the request being denied. All prior oral communication or correspondence in this matter shall be considered freeform agency action, and no such oral communication or correspondence shall operate as a valid request for an administrative proceeding. Any request for an administrative proceeding received prior to the date of this notice shall be deemed abandoned unless timely renewed in compliance with the guidelines as set out above. Jul 11 2005 16:41 B7/11/2685 16:39 8584874987 LEGAL SERVICES PAGE 8 Mediation of this matter pursuant to Section 120.573, Florida Statutes, is not available. No Department attomey will discuss this matter with you until the response has been received by the Department of Financial Services. DATED and SIGNED this [CT day of rune, 2005. CHANDLER Deputy Chief Financial Officer CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT and ELECTION OF PROCEEDING has been fittnished to: JOHN KIRKHAM RAND, Rand Sports & Entertainment Insurance Inc., 400 South Atlantic Ave., Suite 101, Ormond Beach, FL 32176; JOHN KIRKHAM RAND, 175 Orchard Lane, Ormond Beach, FL 32176 by Certified Mail this |O_ day of June, 2005. EEL Dean Andrews Division of Legal Services 200 East Gaines St. 612 Larson Building Tallahassee, Florida 32399-033 (850) 413-4242 Florida Bar Number 0001959

Docket for Case No: 05-002468PL