@a/15/2818 @d:41 8584146749 DEPR OGA Mar 16 2010 10:58 PAGE STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petittoner, VE. HARGROVE GRILL & GATERING License No, 2600560 R dent Licanse Typa 2010 espon , . Case No. 2009023582 ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, (‘Petitioner’), files this Administrative Complaint against HARGROVE GRILL & CATERING, ("Respondent"), and says: 1. Petitioner is the state agency charged with regulating the operation of public lodging establishments and public food service establishments, pursuant to Section 20.165 and Chapter 505, Florida Statutes. 2. Respondentis, and has been at all times material hereto, licensed by of subject to the jurisdiction of the Division of Hotels and Restaurants. The respondent's business address of record is 11 HARGROVE GRADE #E, PALM COAST, FLORIDA 32137.The mailing address of record is HARGROVE GRILL & CATERING, at 11 HARGROVE GRADE #€, PALM COAST, FLORIDA 32137. 3. Inspection of this establishment conducted pursuant to Sec. 509.032, Florida Statutes, revealed violations of the, provisions of Chapter 509, Florida Statutes, and /or the rules promulgated thereto goveming operation of the establishment. The violatlon(s) found and applicable law are described in Exhibit “A,” attached hereto and incorporated herein by reference. Inspection documents are attached as Exhibit "B”, incorporated herein by reference. WHEREFORE, Petitioner respectfully requests entry of an Order imposing one ar more of the following penalties: administrative fine not ta exceed $1,000 per offense; mandatory attendance at Respondent's expense at an educational program sponsared by the Department's Hospitality Education Program; suspension, revocation, or refusal of a llcense issued pursuant to this Chapter, and/or any other relief authorized by Chapter 509, Florida Statutes, or the rules promulgated thereto. Signed May 05, 2008 é fe Steven Von Bodungen, District Manager By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT: Charles F. Tunnicliff, Lead Attomey Florida Bar No, 0153831 Department of Business & Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32299-1007 CERTIFICATE OF SERVICE BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: 7160 _3901 9845 7125 8484 | HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this day of , 2009. Received by: Inspector's Signature Operator's Signature Title Title Case Number: 2009023582 — File Number: 134760 District Number: 05 License Number: 2800580 2010 Form revised 07.07.07 HARGROVE GRILL & CATERING a3/@5 Mar 16 2010 10:59 @a/15/2818 @d:41 8584146749 DEPR OGA PAGE @d/ a5 Exhibit A License Number: 2800580 License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2009023582 FC as cited herein references specific provisions of the Food Cade, Recommendations of the United States Public Health Service, Faod and Drug Administration, incorporated by Chapter 61C, Florida Administrative Code. NFPA as cited herein references specific provisions of the National Fire Protection Association Life Safely Code, incorporated by reference at Chapter 44-3, Fire Prevention, General Provisions, Florida Administrative Code, and 610-1 .004(5), Florida Administrative Coda. * denates a critical violation. itis alleged that on March 23, 2009 the licensee was in violation of Florida Statute 509(FS) and/or the Rules of the Division of Hotels and Restaurants, Florida Administrative Code (FAC), in the following particulars. Copy(s) of the repart(s) for he above referenced inspection(s) are attached hereto and incorporated by reference as Exhibit B. * §4,52-01-1 609.292(1) FS: (1) AN OPERATOR MAY NOT KNOWINGLY AND WILLFULLY MISREPRESENT THE IDENTITY OF ANY FOOD OR FOOD PRODUCT TO ANY OF THE PATRONS OF SUCH ESTABLISHMENT. THE IDENTITY OF FOOD OR ‘A FOOD PRODUCT IS MISREPRESENTED IF: (A) THE DESCRIPTION OF THE FOOD OR FOOD PRODUCT IS FALSE OR MISLEADING IN ANY PARTICULAR; (8) THE FOOD OR FOOD PRODUCT IS SERVED, SOLD, OR DISTRIBUTED UNDER THE NAME OF ANOTHER FOOD OR FOOD PRODUCT, OR (C) THE FOOD OR FOOD PRODUCT PURPORTS TO BE OR IS REPRESENTED AS A FOOD OR FOOD PRODUCT THAT DOES NOT CONFORM TO A DEFINITION OF IDENTITY AND STANDARD OF QUALITY IF SUCH DEFINITION OF IDENTITY AND STANDARD OF QUALITY HAS BEEN ESTABLISHED BY CUSTOM AND USAGE. OBSERVED IDENTITY OF FOOD OR FOOD PRODUCT MISREPRESENTED, POURING FRONTE BRAND CATSUP FROM CAN INTO MONARCH BRAND SQUEEZE BOTTLES FOR USE ON TABLES FOR CUSTOMERS. * denotes critical violation District: 05 Case Number: 2009023582 License Type: 2010 License Number; 2800580 File Number: 184760 HARGROVE GRILL & CATERING

Docket for Case No: 10-001260