Jul 29 2008 14:15 FROM :DEPT OF FINANCIAL SERVICES FAX NO. + S584o7r4ogr Jul. 29 2668 1:22PM P3 FILED i FOUN 5 2008 REPRESENTING . CHIEF FINANCIAL OFFICER . STATE OF FLORIDA IN THE MATTER OF: CASE NO.: 90225-07-AG , JADE GIBSON WALTZ ADMINISTRATIVE COMPLAINT JADE GIBSON WALTZ 3451 Jade Lane Mulberry, Florida 33860 You, JADE GIBSON WALTZ, license I.D, # A277235, 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, JADE GIBSON WALTZ, are ‘ currently licensed in this state as a general lines agent, 2. At all times pertinent to the dates and occurrences referred to herein, you, JADE GIBSON WALTZ, were licensed in this state as a general lines agent. 3. From April 25, 2003 to January 1, 2006, you, JADE GIBSON WALTY, were an officer or director of Blanpo, Inc., dba Great Florida Insurance (“Great Florida”). 4, You, JADE GIBSON WALTZ, are currently an officer or director Great Florida. Jul 29 2008 14:16 FROM :DEPT OF FINANCIAL SERVICES FAX NO. + 85845749? Jul. 29 26688 @1:22PM P4 5. Pursuant to Chapter 626, Florida Statutes, the Florida Department of Financial Services (“Department”) has jurisdiction over your insurance licenses and appointments. COUNT I 6. The above general allegations are hereby realleged and fully incorporated herein by reference. 7. Sometime prior to May of 2003, you, JADE WALTZ GIBSON, met with the St. George Condominium Association’s Board of Directors regarding the purchase of various insurance, including property insurance, commercial liability insurance, and directors and officers liability insurance. 8. You, JADE WALTZ, GIBSON, proposed an insurance package for the St. George Condominium Association which included obtaining property insurance with Citizens Property and Casualty Insurance, commercial liability insurance with Columbia Casualty Company (“Columbia”), and directors and officers liability insurance with Chubb Insurance Group (“Chubb”). 9. You, JADE WALTZ GIBSON, quoted the St. George Condominium Association $25,228.95 as the premium cost of the proposed insurance package. 10. The St. George Condominium Association’s Board of Directors agreed to your proposed insurance package. 11. Applications for property insurance with Citizens Property and Casualty Insurance, commercial liability insurance with Columbia, and directors and officers liability insurance with Chubb were completed. Jul 29 2008 14:16 FROM :DEPT OF FINANCIAL SERVICES FAX NO. + 85845749? Jul. 29 2665 @1:23PM PS 12. On or around May 1, 2003, the St. George Condominium Association’s Board of Directors made a down payment of $5,483.25 on the insurance package, and financed the remaining amount. 13. Thereafter, the St. George Condominium Association paid $1,974.57 per month towards the insurance package. 14. You, JADE WALTZ GIBSON, signed a certificate of insurance dated May 2, 2003, indicating that the St. George Condominium Association was insured with Columbia Casualty Company for commercial general liability coverage and with Chubb for directors and officers liability insurance, for the period of May 1, 2003 to May 1, 2004 (“Certificate 1”). 14. You, JADE WALTZ GIBSON, furnished Certificate | to, or had Certificate 1 furnished to, the St. George Condominium Association. 16, You, JADE WALTZ GIBSON, signed a certificate of insurance dated August 15, 2003, indicating that the St. George Condominium Association was insured with Columbia Casualty Company for commercial general liability coverage and with Chubb for directors and officers liability insurance, for the period of May 1, 2003 to May 1, 2004 (“Certificate 2”), 17. You, JADE WALTZ GIBSON, furnished Certificate 2 to, or had Certificate 2 furnished to, the St. George Condominium Association. 18. You, JADE WALTZ GIBSON, never forwarded St. George Condominium Association’s application for directors and officers liability insurance to Chubb. 19, Chubb never received an application for directors and officers liability insurance on behalf of St. George Condominium Association. 20. Chubb never received any premium for directors and officers liability insurance on behalf of St. George Condominium Association. Jul 29 2008 14:16 FROM :DEPT OF FINANCIAL SERVICES FAX NO. + 85845749? Jul. 29 2668 @1:23PM Pe at. You, JADE WALTZ GIBSON, never obtained directors and officers liability insurance for the St. George Condominium Association from Chubb or any other insurer. 22. You, JADE WALTZ GIBSON, knew, or should have known, that you never obtained directors and officers liability insurance for the St. George Condominium Association from Chubb or any other insurer. 23. St. George Condominium Association has not been refunded the money it paid for the non-existent directors and officers liability insurance policy, IT 18 THEREFORE CHARGED that you, JADE WALTZ GIBSON, 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 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) Fraudulent or dishonest practices in the conduct of business under the license or appointment. [Section 626.611(9), Florida Statutes]: (d) In the conduct of business under the license or appointment, having otherwise shown himself or herself to be a source of injury or loss to the public, [Section 626.621(6), Florida Statutes]; Jul 29 2008 14:17 FROM :DEPT OF FINANCIAL SERVICES FAX NO. + S584o7r4ogr Jul. 29 2668 1:23PM Pr (e) 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 LX of this chapter. [Section 626.621(6), Florida Statutes]; (f) Knowingly: a. Filing with any supervisory or other public official, b. Making, publishing, disseminating, circulating, ¢. 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 (g) | 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, JADE GIBSON WALTZ, 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, and 626.9521, Florida Statutes, and under the other referenced sections of the Florida Statutes as set out in this Administrative Complaint. Jul 29 2008 14:17 FROM :DEPT OF FINANCIAL SERVICES FAX NO. + 85845749? Jul. 29 2665 @1:23PM Pe 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 28-106, 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 General Counsel acting as the 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 JIN WRITING WITHIN TWENTY-ONE (21) DAYS OF YOUR RECEIPT OF THIS NOTICE WILL CONSTITUTE A WATVER 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”). Jul 29 2008 14:17 FROM :DEPT OF FINANCIAL SERVICES FAX NO. + 85845749? Jul. 29 2668 @1:24PM Pa (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 mymber 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. If a proceeding is requested and there is no dispute of material fact, the provisions of Séction 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 cal! 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. Jul 29 2008 14:18 FROM :DEPT OF FINANCIAL SERVICES FAX NO. + S584o7r4ogr Jul. 29 26688 @1:24PM Pile 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 ware day of 2 , 2008. AREN CHANDLER Depity Chief Financial Officer Jul 29 2008 14:18 FROM :DEPT OF FINANCIAL SERVICES FAX NO. + 85845749? Jul. 29 2688 @1:24PM Pil CERTIFICATE OF SERVICE WALTZ, 3451 Jade Lane, Mulberry, Florida 33860; by Certified Mail this, “ah day 2008. Robert Alan Fox Senior Attomey Department of l'inancial Services Division of Legal Services 612 Larson Building 200 East Gaines Street Tallahassee, Florida 32399-0333 (850) 413-4227

Docket for Case No: 08-003725PL