FILED DEC 16 2009 ALEX SINK CHIEF FINANCIAL OFFICER Docketed by_ PLe _ STATE OF FLORIDA IN THE MATTER OF: CASE NO.: 105434-09-AG JORGE ANTONIO ESPINOSA / ADMINISTRATIVE COMPLAINT TO: Jorge Antonio Espinosa 7100 Biscayne Boulevard Blvd., Suite 216 Miami, FL 33138-5770 You, JORGE ANTONIO ESPINOSA, 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 a public adjuster in this state and as a result of which it is alleged: GENERAL ALLEGATIONS 1. Pursuant to Chapter 626, Florida Statutes, you, JORGE ANTONIO ESPIN OSA, are currently licensed in this state as a 3-20 Public Adjuster, and were so licensed at all times relevant to the dates and occurrences referenced herein. Your license identification number is E136012. 2. Pursuant to Chapter 626, Florida Statutes, the Florida Department of Financial Services (hereinafter referred to as the “Department”) has jurisdiction over your licenses, appointments, and your eligibility for licensure. Filed February 23, 2010 1:32 PM Division of Administrative Hearings. 3. At all times relevant to the dates and occurrences referenced herein you, JORGE ANTONIO ESPINOSA, were employed as a managing member and primary adjuster for, or otherwise affiliated with, Global Adjusters, LLC. (or Global), located at 7100 Biscayne Blvd., Suite 216, Miami, Florida 33138. 4. During the latter part of 2007, Roberto Marrero was one of the employees of Global whom you, JORGE ANTONIO ESPINOSA, supervised and who was subject to your control and direction. COUNT I 5. The above General Allegations are hereby realleged and fully incorporated herein by reference. 6. On or about May 29, 2007, Rolando A. Castafieda sustained a fire loss to his residence in Homestead, Florida. You, JORGE ANTONIO ESPINOSA, arrived at Mr. Castafieda’s house at about the same time the firemen arrived and at a time you knew or should have known that Mr. Castafieda was in shock or under serious mental or emotional distress as a result of the loss he was then suffering to his home. Nevertheless, you, JORGE ANTONIO ESPINOSA, proceeded to enter into a contract with Mr. Castafieda that same day. 7, On June 7, 2007, Mr. Castafieda received two checks from Citizens Property Insurance Corporation (Citizens) in the amounts of $2,500.00 and $3,500.00 issued jointly to Mr. Castafieda and Global Adjusters. 8. Several months later, in the latter part of 2007, Mr. Castafieda received another two checks from Citizens, one in the amount of $12,500.00 made payable to Mr. Castafieda and Global Adjusters; the other in the amount of $72,307.98 made payable to Mr. Castafieda and Wachovia Mortgage FSB (Wachovia). Mr. Castafieda endorsed both of these checks and took them to your office in Miami Beach. You, JORGE ANTONIO ESPINOSA, kept both checks. 9. On or about December 6, 2007, you, JORGE ANTONIO ESPINOSA, prepared an invoice showing that you had deducted a 10% fee from each of the above-described four checks. 10. You, JORGE ANTONIO ESPINOSA, returned the $72,307.98 check to Citizens on the false pretense that there was a second mortgage on the property so as to require an additional endorsement on the check. This latter action delayed Mr. Castafieda’s receipt of the $72,307.98 payment, required in order to repair his house, until February 4, 2008, some eight months after the fire loss to his home. 11. Because you, JORGE ANTONIO ESPINOSA, delayed the settlement of his claim and the forwarding of the proceeds resulting therefrom, Mr. Castafieda suffered the inconvenience and expense of not being able to repair and use his dwelling in a timely manner. IT IS THEREFORE CHARGED that you, JORGE ANTONIO ESPIN' OSA, 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: (a) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (b) Every adjuster shall adjust or investigate every claim, damage, or loss made or occurring under an insurance contract, in accordance with the terms and conditions of the contract and of the applicable laws of this state. [Section 626.877, Florida Statutes]; (c) An adjuster shall subscribe to the code of ethics specified in the rules of the department. The rules shall implement the provision of this part and specify the terms and conditions of contracts, including a right to cancel, and require practices necessary to ensure fair dealing, prohibit conflicts of interest, and ensure preservation of the rights of the claimant to participate in the adjustment of claims. [Section 626.878, Florida Statutes]; (d) _It is an affirmative duty of every public adjuster to supervise their business affairs and their staff to ensure to the extent it is within the public adjuster’s power that this Florida Insurance Code and Rule Chapter 69B-220, F.A.C., are not violated. [Rule 69B-220.051(5), Florida Administrative Code]; (e) Violation of any provision of this chapter or a rule or order of the Department. [Section 626.8698(1), Florida Statutes]; (63) Receiving payment or anything of value as a result of an unfair or deceptive practice; [Section 626.8698(2), Florida Statutes]; (g) Soliciting or otherwise taking advantage of a person who is vulnerable, emotional, or otherwise upset as the result of a trauma, accident, or other similar occurrence; [Section 626.8698(5), Florida Statutes]; (h) Violating any ethical rule of the department. [Section 626.8698(6), Florida Statutes); (i) The work of adjusting insurance claims engages the public trust. An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster’s own interests in every instance. The following are standards of conduct that define ethical behavior, and shall constitute a code of ethics that shall be binding on all adjusters: * * * (e) An adjuster shall handle every adjustment and settlement with honesty and integrity, and allow a fair adjustment or settlement to all parties without any remuneration to himself except that to which he is legally entitled. (f) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim. * * * (1) An adjuster shall not attempt to negotiate with or obtain any statement from a claimant or witness at a time that the claimant or witness is, or would reasonably be expected to be, in shock or serious mental or emotional distress as a result of physical, mental, or emotional trauma associated with a loss. The adjuster shall not conclude a settlement when the settlement would be disadvantageous to, or to the detriment of, a claimant who is in the traumatic or distressed state described above. [Rule 69B-220-201, Florida Administrative Code.] COUNT II 12. The above General Allegations are hereby realleged and fully incorporated herein by reference. 13. On or about December 3, 2007, Pedro Lereto Almeida sustained a fire loss to his residence in Miami, Florida. Roberto Marrero arrived at Mr. Almeida’s house while the fire was being extinguished, at a time he knew or should have known that Mr. Almeida was in shock or under serious mental or emotional distress as a result of the loss he was then suffering to his home. Nevertheless, Roberto Marrero proceeded to provide Mr. Almeida with a blank contract for adjusting services, advising Mr. Almeida that the fee for such services would be 10%. 14, On the same day as the fire, Robert Marrero sent Fire & Water Restoration, LLC to board up the destroyed house for which service it charged Mr. Almeida $5,105.00. Mr. Almeida later discovered that this billing was made subject to a 20% adjustment fee by you, JORGE ANTONIO ESPINOSA. 15. On or about December 4, 2007, Anita Thor, Property Claims Adjuster with Citizens, informed Mr. Almeida that Citizens was sending a company adjuster to inspect the loss. Asa result of such inspection, Mr. Almeida’s house was declared a total loss. 16, Shortly thereafter Mr. Almeida received a check dated December 5, 2007, in the amount of $5,000 issued in his name and in his wife’s name, Miroslava Almeida. 17. Pursuant to a request by Global, Mr. Almeida e-mailed a list of his family’s personal property losses to Global on December 17, 2007. 18. On December 31, 2007, Mr. Almeida was advised by a Citizens’ representative that the company was awaiting a list of the Almeida’ personal property losses and a W-9 form from Global. “19. Early in January, 2008, Mr. Almeida was advised by a Citizens’ representative that three company checks to cover his losses had been forwarded to the Global office in the amounts of: $210,688.00, $100,343.00, and $20,000. All three checks included Global as one of the payees. 20. You, JORGE ANTONIO ESPINOSA, met with Mr, Almeida and endorsed the checks on behalf of Global. You then deducted a 20% fee from the total amounts received from Citizens and paid the balance to Mr. Almeida, despite Mr. Almeida’s protest that this was twice the percentage fee agreed upon. 21. Because you, JORGE ANTONIO ESPINOSA, delayed the payment of his settlement sums, deducting therefrom remuneration to which you were not entitled, Mr. Almeida suffered inconvenience, financial loss, and an improper disposition of the claim by you and your employee’s unfair, deceptive and fraudulent dealings with him. IT IS THEREFORE CHARGED that you, JORGE ANTONIO ESPINOSA, 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: (a) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (b) Every adjuster shall adjust or investigate every claim, damage, or loss made or occurring under an insurance contract, in accordance with the terms and conditions of the contract and of the applicable laws of this state. [Section 626.877, Florida Statutes]; (c) An adjuster shall subscribe to the code of ethics specified in the rules of the department. The rules shall implement the provision of this part and specify the terms and conditions of contracts, including a right to cancel, and require practices necessary to ensure fair dealing, prohibit conflicts of interest, and ensure preservation of the rights of the claimant to participate in the adjustment of claims. [Section 626.878, Florida Statutes}; (d)—Itisan affirmative duty of every public adjuster to supervise their business affairs and their staff to ensure to the extent it is within the public adjuster’s power that this Florida Insurance Code and Rule Chapter 69B-220, F.A.C., are not violated. [Rule 69B-220.051(5), Florida Administrative Code]; (e) Violation of any provision of this chapter or a rule or order of the Department. [Section 626.8698(1), Florida Statutes]; (63) Receiving payment or anything of value as a result of an unfair or deceptive practice; [Section 626.8698(2), Florida Statutes]; (g) Soliciting or otherwise taking advantage of a person who is vulnerable, emotional, or otherwise upset as the result of a trauma, accident, or other similar occurrence; [Section 626.8698(5), Florida Statutes]; (h) Violating any ethical rule of the department. [Section 626.8698(6), Florida Statutes]; @ The work of adjusting insurance claims engages the public trust. An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster’s own interests in every instance. The following are standards of conduct that define ethical behavior, and shall constitute a code of ethics that shall be binding on all adjusters: * * * (e) An adjuster shall handle every adjustment and settlement with honesty and integrity, and allow a fair adjustment or settlement to all parties without any remuneration to himself except that to which he is legally entitled. (f) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim. ES * * (1) An adjuster shall not attempt to negotiate with or obtain any statement from a claimant or witness at a time that the claimant or witness is, or would reasonably be expected to be, in shock or serious mental or emotional distress as a result of physical, mental, or emotional trauma associated with a loss, The adjuster shall not conclude a settlement when the settlement would be disadvantageous to, or to the detriment of, a claimant who is in the traumatic or distressed state described above. [Rule 69B-220-201, Florida Administrative Code.] COUNT Ill 22. The above General Allegations are hereby realleged and fully incorporated herein by reference. 23. Commencing in July and August, 2006, Dominique Androuin was a roommate of Julia and Alexandra Poliadis (tenants) in a house they rented from the owner, Ms. Rachel Parnell Moscowitz, at 1037 NE 72" Street, Miami, Florida 33138. 24. On June 5, 2008, a fire broke out on the premises, destroying almost all of the tenants’ personal property. 25. Soon thereafter you, JORGE ANTONIO ESPINOSA, together with Ms. Moscowitz and her husband Rick Moscowitz, approached the tenants and advised them to let you handle the losses they sustained. 26. You, JORGE ANTONIO ESPINOSA, advised the tenants not to lay claim to the losses they suffered because they did not have renters’ insurance, but rather to allow the personal property losses to fall as losses to the owner(s) of the dwelling or, alternatively, to have a fake lease drawn up by a third party to facilitate reimbursement for the losses. When the tenants began to question you, JORGE ANTONIO ESPINOSA, about the phony financial arrangements made for recouping their losses, you threatened them. 27. Fearful of you, JORGE ANTONIO ESPINOSA, and the consequences of your misrepresentations and fraudulent conduct, the tenants reported these matters to the Department. IT IS THEREFORE CHARGED that you, JORGE ANTONIO ESPINOSA, 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: (a) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (b) Every adjuster shall adjust or investigate every claim, damage, or loss made or occurring under an insurance contract, in accordance with the terms and conditions of the contract and of the applicable laws of this state. [Section 626.877, Florida Statutes]; (c) An adjuster shall subscribe to the code of ethics specified in the rules of the department. The rules shall implement the provision of this part and specify the terms and conditions of contracts, including a right to cancel, and require practices necessary to ensure fair dealing, prohibit conflicts of interest, and ensure preservation of the rights of the claimant to participate in the adjustment of claims. [Section 626.878, Florida Statutes]; (d) It is an affirmative duty of every public adjuster to supervise their business affairs and their staff to ensure to the extent it is within the public adjuster’s power that this Florida Insurance Code and Rule Chapter 69B-220, F.A.C., are not violated. [Rule 69B-220.051(5), Florida Administrative Code]; (e) Violation of any provision of this chapter or a rule or order of the Department. [Section 626.8698(1), Florida Statutes]; () Receiving payment or anything of value as a result of an unfair or deceptive practice; [Section 626.8698(2), Florida Statutes]; (g) Violating any ethical rule of the department. [Section 626.8698(6), Florida Statutes]; (h) The work of adjusting insurance claims engages the public trust. An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster’s own interests in every instance. The following are standards of conduct that define ethical behavior, and shall constitute a code of ethics that shall be binding on all adjusters: * * * (d) An adjuster shall make truthful and unbiased reports of the facts after 10 making a complete investigation. (e) An adjuster shall handle every adjustment and settlement with honesty and integrity, and allow a fair adjustment or settlement to all parties without any remuneration ‘to himself except that to which he is legally entitled. (i) An adjuster shall not knowingly fail to advise a claimant of the claimant’s claim rights in accordance with the terms and conditions of the contract and of the applicable laws of this state, [Rule 69B-220-201, Florida Administrative Code.] COUNT IV 28. The above General Allegations are hereby realleged and fully incorporated herein by reference. 29, On June 13, 2008, Gilbert Bowles discovered a leak at his house. He notified his insurance carrier, Edison Insurance Company (Edison), and was advised to contract to have the leak fixed. Mr. Bowles hired Bob’s Plumbing Company to do the repair work. 30. Shortly thereafter Edison adjuster Lisa Wellins arrived at the Bowles residence and was upset to discover that the leak was already fixed. Ms. Wellins advised Mr. Bowles that a proper repair would require rerouting the piping through the roof. Sensing that he was going to have difficulty settling his claim, Mr. Bowles decided to retain the services of Global. On June 23, 2008, Mr. Bowles signed a Global contract. 31. | Mr. Bowles thereafter had difficulty obtaining services from Global. Mr. Bowles told you, JORGE ANTONIO ESPINOSA, that he was dissatisfied because the appraiser kept cancelling appointments and when finally appearing, refused to provide identification. You, JORGE ANTONIO ESPINOSA, threatened to put a lien on the Bowles property, if Mr. Bowles did not provide access to the property. Later in June 2008, Global sent an appraiser to inspect the damages. 11 32, On or about July 27, 2008, Edison sent a proof of loss form to Mr. Bowles. The form showed a loss of $55,305.08 for the repair costs and a replacement of contents loss of $17,500.00. Mr. Bowles called you, JORGE ANTONIO ESPINOSA, and requested an explanation for these figures. You told Mr. Bowles not to worry about them; that you would take care of everything. With this assurarice from you, JORGE ANTONIO ESPINOSA, Mr. Bowles signed and returned the notarized form to Edison. 33. On October 23, 2008, Edison’s attorney called Mr. Bowles and requested that he appear for an examination under oath regarding the claim figures noted above. On October 28, 2008, Mr. Bowles went to the law offices as directed and then saw, for the first time, the appraisal that you, JORGE ANTONIO ESPINOSA, or someone at your direction, submitted to Edison. On November 18, 2008, Mr. Bowles’ attorney contacted you, JORGE ANTONIO ESPINOSA, to cancel your adjuster contract with Mr. Bowles because some of the damages shown on the appraisal were fabricated and fraudulent. 34, On May 23, 2009, Mr. Bowles, following mediation, settled with Edison for $22,500. You, JORGE ANTONIO ESPIN' OSA, refused to cancel the adjustment contract with Mr. Bowles and required him to pay you a fee of $6,750.00, representing your 30% fee on the $22,500.00 settlement sum. IT IS THEREFORE CHARGED that you, JORGE ANTONIO ESPINOSA, 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: (a) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; 12 (b) Every adjuster shall adjust or investigate every claim, damage, or loss made or occurring under an insurance contract, in accordance with the terms and conditions of the contract and of the applicable laws of this state. [Section 626.877, Florida Statutes]; (c) An adjuster shall subscribe to the code of ethics specified in the rules of the department. The rules shall implement the provision of this part and specify the terms and conditions of contracts, including a right to cancel, and require practices necessary to ensure fair dealing, prohibit conflicts of interest, and ensure preservation of the rights of the claimant to participate in the adjustment of claims. [Section 626.878, Florida Statutes]; () It is an affirmative duty of every public adjuster to supervise their business affairs and their staff to ensure to the extent it is within the public adjuster’s power that this Florida Insurance Code and Rule Chapter 69B-220, F.A.C., are not violated. [Rule 69B-220.051(5), Florida Administrative Code]; (e) Violation of any provision of this chapter or a rule or order of the Department. [Section 626.8698(1), Florida Statutes]; . (f) Receiving payment or anything of value as a result of an unfair or deceptive practice; [Section 626,8698(2), Florida Statutes]; (g) Violating any ethical rule of the department. [Section 626.8698(6), Florida Statutes]; (nh) The work of adjusting insurance claims engages the public trust. An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster’s own interests in every instance. The following are standards of conduct that define ethical behavior, and shall constitute a code of ethics that shall be binding on all adjusters: * * * (d) An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation. (e) An adjuster shall handle every adjustment and settlement with honesty and integrity, and allow a fair adjustment or settlement to all parties without any remuneration to himself except that to which he is legally entitled. @) An adjuster shall not knowingly fail to advise a claimant of the claimant’s claim rights in accordance with the terms and conditions of the contract and of the applicable laws of this state. [Rule 69B-220-201, Florida Administrative Code.] WHEREFORE, you, JORGE ANTONIO ESPINOSA, are hereby notified that the Chief Financial Officer intends to enter an Order suspending or revoking your licenses 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, 626.692, 626.9521, and 626.8698, Florida Statutes, and under the other referenced sections of the Florida Statutes as set out in this Administrative Complaint and under the provisions of Rule 69B-231 , Florida Administrative Code. You are further notified that any order entered in this case revoking or suspending any license or eligibility for licensure held by you shall also apply to all other licenses and eligibility held by you under the Florida Insurance Code, NOTICE OF RIGHTS You have the right to request a proceeding to contest this action by the Department of Financial Services ("Department") pursuant to Sections 120.569 and 120.57, Florida Statutes, and Rule 28-106, 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 Department of Financial Services Agency Clerk, 612 Larson Building, 200 East Gaines Street, 14 Tallahassee, Florida 32399-0333. Your written response must be received by the Department no later than 5:00 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 SUSPENSION OR REVOCATION WILL BE ENTERED AGAINST YOU. If you request a proceeding, you must provide information that complies with the requirements of Rule 28-106.2015, 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, address, and telephone number, and facsimile number (if any) of the respondent (for the purpose of requesting a hearing in this matter, you are the "respondent'"). (b) The name, address, telephone number, facsimile number of the attorney or qualified representative of the respondent (if any) upon whom service of pleadings and other papers shall be made. (c) A statement requesting an administrative hearing identifying those material facts that are in dispute. If there are none, the petition must so indicate. (d) A statement of when the respondent received notice of the administrative complaint. (e) A statement including the file number to the administrative complaint. 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-examine 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 15 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. Mediation of this matter pursuant to Section 120.573, Florida Statutes, is not available. No Department attorney will discuss this matter with you until the response has been received by the Department. DATED and SIGNED this | _ dayof__((eCerm ber _, 2009. —PMarerrap teatom Deputy Chief Financial Officer 16 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT and the following ELECTION OF PROCEEDING has been furnished to: JORGE ANTONIO ESPINOSA, 7100 Biscayne Boulevard Blvd., Suite 216, Miami, FL 33138- 5770 by Certified Mail this I( day of __Oecer ber _, 2009, erty eo David J. Busch--~” Florida Department of Financial Services Division of Legal Services 200 East Gaines St. 612 Larson Building Tallahassee, Florida 32399-0333 (850) 413-4146 17 CERTIFICATE OF SERVICE 1 HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT and the following ELECTION OF PROCEEDING has been furnished to: JORGE ANTONIO ESPINOSA, 5104 SW 137 Court, Miami, FL 33175 and JORGE ANTONIO ESPINOSA at, Global Adjusters, LLC, 1150 NW 72 Avenue, Suite 500, Miami, FL 33126 by Certified Mail this / Ga day of 2010. DavitJ, Busch Florida Department of Financial Services Division of Legal Services 200 East Gaines St. 612 Larson Building Tallahassee, Florida 32399- 0333 (850) 413-4146 STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF LEGAL SERVICES IN THE MATTER OF: CASE NO.: 105434-09-AG JORGE ANTONIO ESPINOSA / . ELECTION OF PROCEEDING Thave received and have read the Administrative Complaint filed by the Florida Department of Financial Services ("Department") against me, including the Notice of Rights contained therein, and I understand my options. I am requesting disposition of this matter as indicated below. (CHOOSE ONE) Lt] 3.0) ¥ do not dispute any of the Department’s factual allegations and I do not desire a hearing. 1 understand that by waiving my right to a hearing, the Department may enter a final order that adopts the Administrative Complaint and imposes the sanctions sought, including suspending or revoking my licenses and appointments as may be appropriate. 1 do not dispute any of the Department's factual allegations and { hereby elect a proceeding to be conducted in accordance with Section 120,57(2), Florida Statutes. In this regard, I desire to (CHOOSE ONE): {] Submit a written statement and documentary evidence in lieu of a hearing; or [] Personally attend a hearing conducted by a department hearing officer in Tallahassee; or {J Attend that same hearing by way of a telephone conference call. I do dispute one or more of the Department's factual allegations. I hereby request a hearing pursuant to Section 120.57(1), Florida Statutes, to be held before the Division of Administrative Hearings, I have attached to this election form the information required by Rule 28-106.2015, Florida Administrative Code, as specified in subparagraph (c) of the Notice of Rights. Specifically, I have identified the disputed issues of material fact. TO PRESERVE YOUR RIGHT TO A HEARING, YOU MUST FILE YOUR RESPONSE WITH THE DEPARTMENT OF FINANCIAL SERVICES WITHIN TWENTY-ONE (21) DAYS OF YOUR RECEIPT OF THE ADMINISTRATIVE COMPLAINT. THE RESPONSE MUST BE RECEIVED BY THE DEPARTMENT NO LATER THAN 5:00 P.M. ON THE TWENTY-FIRST DAY AFTER YOUR RECEIPT OF THE ADMINISTRATIVE COMPLAINT. The address for filing is: General Counsel acting as Agency Clerk, Florida Department of Financial Services, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0333. Signature Print Name Date: Address: Date Administrative Complaint Received: If you are represented by an attorney or qualified Phone No.: representative, please attach to this election form his or her name, address, telephone and fax numbers Fax No.: 18

Docket for Case No: 10-000964PL