FLORIDA % DEPARTMENT OF FINANCIAL SERVICES TOM GALLAGHER CHIEF FINANCIAL OFFICER STATE OF FLORIDA IN THE MATTER OF: MARIA CARMEN VALDES / . Ol-1Sd2 PC ADMINISTRATIVE COMPLAINT TO: MARIA CARMEN VALDES MARIA CARMEN VALDES 12151 Dakota Woods Lane 5145 Curry Ford Road Orlando, Florida 32824 Orlando, Florida 32812 You, MARIA CARMEN VALDES, 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, MARIA CARMEN VALDES, are currently, and at all times relevant to the dates and occurrences alleged herein were, licensed in this state as a General Lines, Property and Casualty (2-20) agent. Your license I.D. number is A271030. 2. Pursuant to Chapter 626, Florida Statutes, the Florida Department of Financial Services (“Department”) has jurisdiction over your license and appointments. COUNT I 3. The allegations contained in paragraphs 1 and 2 are hereby realleged and fully incorporated herein by reference. 4. During April and May of 2004, you, MARIA CARMEN VALDES, assisted Orlando Ride, Inc. (“Orlando Ride”), of Kissimee, Florida, to obtain a commercial auto policy (“Policy”) with National Casualty Insurance Company. AGREE . ; 5. The Policy’s effective period was April 30, 2004 to April 30, 2005. DG ee 6. The policy numer assigned by National Casualty Insurance Company to the Policy was CA00184403, PASE 7. On or around May 17, 2004, you MARIA CARMEN VALDES, signed a Certificate of Insurance (“Certificate”). 8. The Certificate stated the City of Orlando was listed as an additional insured on tt ; . . , GAL, the Policy. GG AEE, copy OF CBTET LY CATE OFS area [eh he 9. The Certificate listed the insurer as “National Casualty Ins. Co.”, the Policy AGlEsE, GrlJEh Wii BE Number as “04-389”, and the Policy Effective Date as “4/30/2004”, ewe peaap7ee! Jf Gy a ‘ Cnelande pif Fb Ee SVGSACE F Lule 10. On or around May 17, 2004, you MARIA CARMEN VALDES, sent or issued the ee CERTIFIAMES OT, Certificate, or had the Certificate sent or issued. olese: Si Se SEe 3 ey UE Beast ’ /SSSBvVES 4 Sea Gy Ge. Le The City of Orlando was not listed as an additional insured on the Policy until ; __ eet bE S CoprEs of Gherods GeKh, March 23, 2005, Oe gees fg 7s GA.- CDi TUS, Sete 12, You, MARIA CARMEN VALDES, knew, or should have known, that the City of Ws ine: fer, . ses : . oo 6 iss Se Orlando was not listed as an additional'insured on the Policy ung Mgreh 23,2005. , CLOEE A! Bs 13. You, MARIA CARMEN VALDES, knew, or should have known, that the City of ps AeRE Orlando was not listed as an additional insured on the Policy when the Certificate was signed, | ENC Be SSS CEPT VOGT ES VEG ECE O acl ag SENS OAELS, 14. You, MARIA. CARMEN VALDES, knew, or should have known, that the City of Orlando was not listed as an additional insured on the Policy when the Certificate was sent or : i . LDS Ae bee, A&A ae AGEN Ag acne aurhore) issued. 7 VSS UE CERTIFIOAFES, Even Set. Wally of Ft Atti FPO tof LAISUAEALE wt ThEOT fer Pe ff PEL GA, As fenG Ae They le ber tad we Th Af Cap 15. You, MARIA CARMEN VALDES, knew, or should have known, that the policy CRE Seley F all number assigned to the Policy was CAO0184403. So ey ved! GA CIES (ATE 16. You, MARIA CARMEN VALDES, knew, or should have known, that the policy LP ‘Ss ages, _number assigned to the Policy was CAO0184403 when the Certificate was s signed. GEC aa 7 ie set Zi 17. You, MARIA CARMEN VALDES, knew, or should have known, that the pokey ~* number assigned by National Casualty Insurance Company to the Policy was CA00184403 -y au? = Z DP ASe9 o derer, ill te OO DE MCE when the Certificate was sent orissued. FU'¢/ wee ES JP , IT IS THEREFORE CHARGED, based upon all or some of the foregoing, that you, MARIA CARMEN VALDES, have violated or are accountable under one or more of 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 and appointments: (a) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (b) 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]; (c) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under Part IX of this chapter. [Section 626.621(6), Florida Statutes]. (d) False statements and entries. Knowingly: - b. Making, publishing, disseminating, circulating, c. Delivering to any person, d. Placing before the public, e. Causing, directly or indirectly, to be made, published, disseminated, circulated, delivered to any person, or placed before the public, any false material statement. [Section 626.9541(1)(e)(1), Florida Statutes]; and (e) 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)(1), Florida Statutes]. WHEREFORE, you, MARIA CARMEN VALDES, 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, and 626.9521, Florida Statutes, and any other relevant section of the Florida Statutes, including those sections of the Florida Statutes referenced in this Administrative Complaint. 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 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 yout 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 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 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 (c) A reference to the notice, order to show cause, administrative complaint, or other communication that the party has received from the agency. Ifa 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 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 of Financial Services. oy ft _ DATED and SIGNED this_][i""_ day of February, 2006. IN 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 furnished to MARIA CARMEN VALDES at 13285 Northeast 6" Ave., #1 04, North Miami, FL 33161, and B21 Northwest 140" Street, Miami, FL 33168, via U.S. Certified Mail, restricted delivery, this air day of February, 2006. obert Alan Fox Division of Legal Services 200 East Gaines St. 612 Larson Building Tallahassee, Florida 32399-0333 (850) 413-4106

Docket for Case No: 06-001232PL