2023A-11979-NPC-ROC Notice of Hearing and Packet MAILED

2023A-11979-NPC-ROC · Registrar of Contractors · 2023-11-29

REGISTRAR OF CONTRACTORS OF THE STATE OF ARIZONA

Phillip Martin Collins, Case No. 2023-11979 COMPLAINANT, Docket No. 2023A-11979-NPC-ROC v. NOTICE OF HEARING ON CONTESTED CASE Kortsen Pebler LLC License No. ROC 328611,

RESPONDENT.

This Notice of Hearing is issued under A.R.S. § 41-1092.05(D).

HEARING INFORMATION The hearing is set for:

January 8, 2024 1:00 PM Tammy Eigenheer Google Meet. A link will be provided directly from The Office of Administrative Hearings. Go to www.azoah.com to request to appear in-person.

If you have requested to appear in-person at the hearing, the hearing will be held at 1740 W Adams Street, Phoenix, AZ 85007.

You must attend this hearing. This is an adversarial hearing before an administrative

law judge, and is conducted in a similar manner as judicial proceedings. Thus, you must be

prepared to present evidence, including witness testimony and documents, in support of your case.

STATEMENT OF LEGAL AUTHORITY AND JURISDICTION The State of Arizona has determined that the licensing and regulation of construction contractors is a proper state function, and has vested authority in the Registrar of Contractors to administer Title 32, Chapter 10 of the Arizona Revised Statutes. A.R.S. §§ 32-1101 et seq. All hearings for alleged violations of Title 32, Chapter 10 are conducted under Title 41,

Chapter 6, Article 10. A.R.S. § 32-1156.

The statutes and rules governing the hearing can be found at: Arizona Revised

Statutes §§ 41-1092 to -1092.12, and Arizona Administrative Code R2-19-101 to -122.

PARTICULAR ARIZONA STATUTES AND RULES INVOLVED The statutes and rules the Respondent is alleged to have violated are cited in the

complaint and citation, which were served on the Respondent on October 31, 2023. SHORT AND PLAIN STATEMENT OF THE MATTERS ASSERTED The complaint and citation allege that the Respondent committed the following act(s): Charge: 1 A.R.S. § 32-1154(A)(10)

THE PARTIES TO THE ADMINISTRATIVE HEARING Because Respondent is a licensee and is charged with an act(s) or omission(s) that is cause for the suspension or revocation of a license, Respondent is a party to this case and will be a party to the hearing.

Because Complainant alleged Respondent committed an act(s) or omission(s) that is cause for the suspension or revocation of a license, Complainant is a party to this case and will be a party to the hearing. Respondent and Complainant, as the parties to the hearing, will present evidence and argument to the administrative law judge.

RIGHT TO BE REPRESENTED The parties to the administrative hearing may choose to be represented by an attorney.

A.R.S. § 41-1092.07(B). If one of the parties is a company, the company may be represented

by an officer or employee if that person satisfies the conditions set forth in A.R.S. § 32-

1156(B).

CHANGE OF ADDRESS Each party must inform the Registrar and the Office of Administrative Hearings of

any change of address within five (5) days of the change. A.R.S. § 41-1092.04. HEARING PROCEDURES AND RULES The administrative hearing will be conducted in accordance with A.R.S. §§ 41-1092 to -1092.12, and A.A.C. R2-19-101 to -122. The parties should review the statutes, rules, and processes governing the administrative hearing. Copies of the statutes, rules, and articles regarding the administrative hearing process can be found at https://www.azoah.com/.

REGISTRAR’S APPEARANCE BY VIDEO CONFERENCE OR TELEPHONE

The Registrar’s investigators, employees, and attorneys will appear at the hearing via

video conference or telephone unless requested by a party to appear in-person. Requests for

the Registrar’s investigators, employees, or attorneys to appear in-person must be filed with the Registrar and the Office of Administrative Hearings no later than seven (7) calendar days prior to the hearing date.

HEARING PACKET In the interests of administrative efficiency, the Registrar compiles and discloses certain documents to the parties and the Office of Administrative Hearings. These documents are attached to this Notice of Hearing as the “Hearing Packet.” If any party wishes to submit

additional evidence, they must do so during the hearing after completing a disclosure

statement. See “Disclosure Statement” section below.

SUBPOENAS FOR TESTIMONY FROM A WITNESS OR DOCUMENTS The parties to the hearing must be prepared to present evidence in support of their case. If a party wants to obtain testimony from a witness or documents not in the party’s possession, the party must prepare and file a written subpoena for the Administrative Law Judge to review and sign, if approved. A.R.S. § 41-1092.07(C). Forms for requesting a

subpoena can be found on the Office of Administrative Hearings’ website at www.azoah.com.

The party seeking a subpoena must serve notice on all the parties to the hearing, and on the

Registrar. A.R.S. § 41-1092.04.

DISCLOSURE STATEMENT At least seven calendar days before the hearing, each party must prepare and serve a

disclosure statement on all other parties, and file it with the Office of Administrative Hearings. A.A.C. R4-9-118; A.A.C. R2-19-108. The disclosure statement must include any exhibit the

party will use at the hearing. A party’s failure to timely disclose any witness or exhibit, without good cause, may result in the administrative law judge excluding those witnesses or exhibits from being used at the hearing. A.A.C. R4-9-118(C). A sample disclosure form is available on the Registrar’s website at https://roc.az.gov/content/prehearing-disclosure- statement.

CHANGING THE HEARING DATE The date of the hearing may only be advanced or delayed on the agreement of the parties or on a showing of good cause. A.R.S. § 41-1092.05(C). The date of the hearing may be changed by filing a written agreement of the parties to change the date of the hearing. The written agreement must be filed with the Office of Administrative Hearings, directed to the assigned Administrative Law Judge, and transmitted to the Registrar and all other parties. The assigned Administrative Law Judge may be found on the Office of Administrative Hearings’

web portal at www.azoah.com

If a party would like to move the date of the hearing without agreement of all parties,

the party must file a written motion with the Office of Administrative Hearings, directed to the

assigned Administrative Law Judge, and transmit a copy to the Registrar and all other parties.

The motion must state in detail good cause for why the date of the hearing should be advanced or delayed, and the position of all other parties regarding the advancement or delay. A party may also file a motion asserting a right to an expedited hearing upon a showing of extraordinary circumstances or the possibility of irreparable harm. A.R.S. § 41-1092.05(E).

RESOLUTION SHORT OF ADJUDICATION In any case which is resolved or settled by the parties, or which is withdrawn by the Complainant without objection from Respondent after the Notice of Hearing is issued, the parties must notify the Office of Administrative Hearings of the resolution or settlement. Any such cases will be listed on the Registrar’s website and its records under the category: “Closed Complaints – Resolved/Settled/Withdrawn.”

Dated November 29, 2023.

By: /s/ Erika Hoskin Erika Hoskin Legal Secretary Legal Department Arizona Registrar of Contractors

Copy mailed via USPS First Class mail November 29, 2023 to: Respondent(s) Kortsen Pebler LLC 22424 South Ellsworth Road #1822 Queen Creek, AZ 85142

Complainant(s) Phillip Martin Collins 3636 E Inverness Ave #2007 Mesa, AZ 85206

Copy sent electronically this same date to:

Respondent at email address on record with the Registrar Complainant at email address on record with the Registrar

Case No. 2023-11979 /

Katie Hobbs, Governor Martin Quezada, Director

Hearing Packet FAQ What is the Hearing Packet?

The Hearing Packet is a packet of certain documents collected or issued by the Registrar over the course of its investigation.

Who gets the Hearing Packet?

The Hearing Packet is assembled and distributed to all parties and to the Office of Administrative Hearings (“OAH”) prior to an administrative hearing.

What types of cases does the Registrar prepare a Hearing Packet for?

The Registrar prepares a Hearing Packet for Complainant-Handled Cases and No-Pay Cases. Note: If the Docket Number on the Notice of Hearing contains a “CHC” or “NPC”, your case is a Complainant-Handled Case or a No-Pay Case.

What is in the Hearing Packet?

The Hearing Packet contains essential case-specific documents and at a minimum will include the following documents:

● Original complaint;

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Within AZ 877.692.9762 · Fax 602.542.1599 · roc.az.gov Hearing Packet FAQ

Katie Hobbs, Governor Martin Quezada, Director

● Citation; and ● Answer.

The Hearing Packet will also contain the following documents (if applicable):

● Jobsite inspection notices, notes, and photos; ● Written directives; and ● Compliance inspection notices, notes, and photos.

What if there are documents missing from the Hearing Packet?

If there is any evidence you submitted to the Registrar that are not included in the Hearing Packet it is your responsibility to introduce that evidence at the administrative hearing. Note: The administrative law judge assigned to your case does not have access to the entire Registrar record.

If there is additional evidence you submitted to the Registrar during the investigation that you also want to introduce as evidence during your hearing, it is your responsibility to:

● Properly disclose that evidence to the other party; and ● Introduce the evidence during your hearing.

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Within AZ 877.692.9762 · Fax 602.542.1599 · roc.az.gov Hearing Packet FAQ

Katie Hobbs, Governor Martin Quezada, Director

How do I disclose evidence I intend to use at a Hearing?

You must properly disclose any and all documents and witnesses you intend to use at your hearing according to the Registrar’s Prehearing Disclosure Rules. See Arizona Administrative Code Section R4-9-118.

A sample prehearing disclosure form and instructions are provided to the parties by the Registrar.

How do I obtain documents I previously submitted to the Registrar?

If you previously submitted documents to the Registrar and need a copy of these documents, please contact the Registrar’s Legal Department or submit a public records request at https://roc.force.com/AZRoc/s/roc-public-request.

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Within AZ 877.692.9762 · Fax 602.542.1599 · roc.az.gov Hearing Packet FAQ

October 20, 2023

Via U.S. Mail and Email

Complainant Phillip Martin Collins 3636 E. inverness Ave #2007 Mesa, AZ 85206

Via U.S. Mail and Email Respondent Kortsen Pebler LLC 22424 South Ellsworth Road #1822 Queen Creek, AZ 85142

Re: Complaint No. 2023-11979

Dear Complainant and Respondent:

The Registrar received a complaint filed against Kortsen Pebler LLC for non- payment of materials or services rendered. This complaint is complete and will be substantively reviewed by the Registrar.

Respondent is free to raise any issue or affirmative defense to this complaint by filing a response with the Registrar by October 27, 2023. Please reference the complaint number listed above if you file a response. Respondent may file a response by:

Mail: P.O. Box 18244, Phoenix, Arizona, 85005-8244 In-Person: 1700 W. Washington St., Ste. 105, Phoenix, Arizona, 85007-2812 Email: [email redacted]

The Registrar will not issue a citation before October 27, 2023 and will review Respondent’s response, if one is submitted.

Please be advised that a response to the complaint is not the same as a written answer. If the Registrar issues a citation Respondent must file a written answer to that citation in accordance with A.R.S. § 32-1155.

Sincerely,

/s/ Dylan Warwick Dylan Warwick

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov Lg100 4/21 Legal Department 1700 W Washington St. Ste 105 Phoenix, AZ 85007

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov Lg100 4/21 Printed Name Signature Date Phillip M Collins RECEIVED LEGAL 10/21/2023

Legal New Mail - AZROC <[email redacted]>

Complaint No. 2023-11979 message

Legal Department <[email redacted]> Sat, Oct 21, 2023 at 1:23 AM To: "[email redacted]" <[email redacted]> Cc: Legal Department <[email redacted]>, "info kortsenpebler.com" <[email redacted]>, "[email redacted]" <[email redacted]>

October 21, 2023

Arizona Registrar of Contractors P.O. Box 18244 Phoenix, Arizona 85005-8244 [email redacted]

Re: Complaint No. 2023-11979

Dear Sirs and Madams, Kortsen Pebler LLC is in receipt of the above referenced complaint dated October 20, 2023. Kortsen Pebler LLC vehemently denies all allegations contained therein and requests a hearing with an Administrative Law Judge, regarding the Claim.

Additionally, Kortsen Pebler LLC will be engaging the following counter claims against Phillip Martin Collins ROC 295278,

1) Arizona Registrar of Contractors Complaint against Phillip Martin Collins ROC 295278 2) Pinal County Superior Court, Civil Summons & Complaint against Phillip Martin Collins ROC 295278

Finally, as a courtesy to the Arizona Registrar of Contractors and its Investigator, Kortsen Pebler LLC has made all active licensing inactive, will be formally dissolving, and filing for Bankruptcy Chapter 7, in the coming year of 2024. Should there be any questions or concerns, all matters may be directed to our offices via USPS Regular Mail or email at [email redacted]. Thank you for your prompt attention to this matter.

Respectfully,

Michael K. Vecino General Counsel and Chief Operating Officer

CC: Quarles & Brady LLP., General Counsel

attachments 20231020 Notice MAILED 2023-11979.pdf 951K Contractor Search.pdf 201K summit_response_10_21_23.pdf 151K RECEIVED LEGAL 10/21/2023

October 21, 2023

Arizona Registrar of Contractors P.O. Box 18244 Phoenix, Arizona 85005-8244 [email redacted]

Re: Complaint No. 2023-11979

Dear Sirs and Madams,

Kortsen Pebler LLC is in receipt of the above referenced complaint dated October 20, 2023. Kortsen Pebler LLC vehemently denies all allegations contained therein and requests a hearing with an Administrative Law Judge, regarding the Claim.

Additionally, Kortsen Pebler LLC will be engaging the following counter claims against Phillip Martin Collins ROC 295278, 1) Arizona Registrar of Contractors Complaint against Phillip Martin Collins ROC 295278 2) Pinal County Superior Court, Civil Summons & Complaint against Phillip Martin Collins ROC 295278 Finally, as a courtesy to the Arizona Registrar of Contractors and its Investigator, Kortsen Pebler LLC has made all active licensing inactive, will be formally dissolving, and filing for Bankruptcy Chapter 7, in the coming year of 2024. Should there be any questions or concerns, all matters may be directed to our offices via USPS Regular Mail or email at [email redacted]. Thank you for your prompt attention to this matter.

Respectfully,

Michael K. Vecino General Counsel and Chief Operating Officer

CC: Quarles & Brady LLP., General Counsel

ARIZONA CALIFORNIA NEVADA TEXAS 22424 South Ellsworth Loop Road azroc kb1 332775 480.389.4648 #1822 azroc ka 328611 [email redacted] Queen Creek, Arizona 85142 iicrc 192353 www.kortsenpebler.com RECEIVED 10/20/23, 3:10 PM Contractor Search LEGAL 10/21/2023 Ombudsman-Citizens' Visit OpenBooks (https://openbooks.az.gov/) Aide (https://www.azoca.gov/) Get the facts on COVID-19 (https://azdhs.gov/covid19/index.php)

Home Contractor Search (https://azroc.my.site.com/AZRoc/s/contractor- FAQ AZ.Gov (https://az.gov/search/google) (https://az.gov/) Login/Registe Arizona search) (https://azroc

Registrar of Contractors (https://roc.az.gov/)

Contractor Search

YOU SAVED THE FOLLOWING LICENSES FOR LATER USE: Just click the license number below to see that license's detailed information.

License #: ROC 343300 (/AZRoc/s/contractor-search?licenseId=a0o8y000000YXgzAAG) - X | Remove All

DISCLAIMER The data supplied below is based on your specific request(s) and is correct to the best of our knowledge as of the date and time it was extracted from our data files. The information is provided without personal research or analysis. The data is subject to change on a daily basis. You may obtain additional public records related to any licensee, including dismissed complaints and nondisciplinary actions and orders, by contacting the ROC directly. If this information is required for legal purposes, you may request an affidavit or certified copies for a fee as specified in A.R.S. 32-1104A3 (https://www.azleg.gov/viewdocument/?docName=http://www.azleg.gov/ars/32/01104.htm). Please read our Standard Terms of Use at roc.az.gov/terms (https://roc.az.gov/terms)

Please note: The company or individuals listed on this license may hold other Arizona contracting licenses. To view information, status and complaint history for the past two years on other licenses held, go to the License Inquiry page and do a "Company Name and Personnel" search by entering the name of the company or individuals listed on the license.

DETAILS FOR

Phillip Martin Collins LICENSE NUMBER ROC 295278 This information is current as of 2023-10-20 15:09:53

Share this License or Send it to Yourself: Email | Save for Later

If you are the contractor listed, feel free to contact our Licensing Department at (602) 542-1525 for more information.

CONTRACTOR LICENSE

Business Entity Name Phillip Martin Collins Class & Description General Residential B General Residential Contractor Doing Business As Summit Design and Build

Entity Type City and State Mesa, AZ, 85206 Sole Proprietorship Phone (480) 861-1730 Issued / Renewal Status / Action Active First Issued 2015-03-13

Renewed Through 2025-03-31

QUALIFYING PARTY & PERSONNEL The Qualifying Party listed below is associated with this license. All other persons named, if any, are associated with the company. They are not all necessarily associated with this license.

Name : Phillip M Collins Name : Phillip Martin Collins Name : Phillip M Collins Position : Qualifying Party Position : Qualifying Party Position : Owner

COMPLAINT INFORMATION Complaints against this contractor are listed below. Complaints that were cancelled, resolved or settled without a corrective work order or dismissed are not included. Contact the Registrar of Contractors at 602-542-1525 or toll-free statewide at 1-877-My AZROC (1-877-692-9762) to identify the ROC office location you need to visit to view complete complaint documentation. This website does not display all public sanctions or public information concerning a license's disciplinary history. Obtain any additional public information by using the Public Records Request form to confirm the license's entire history.

https://azroc.my.site.com/AZRoc/s/contractor-search?licenseId=a0ot0000000NgKhAAK 1/2 RECEIVED 10/20/23, 3:10 PM Contractor Search LEGAL CLOSED CASES 10/21/2023

0 0 Open Cases Disciplined Cases Resolved / Settled Cases

BOND INFORMATION How to collect from a license bond (https://roc.az.gov/recovery-fund?targetclass=answer-question-collect#question-collect) Bond Company Contact Information Sheet (https://roc.az.gov/sites/default/files/Surety%20Bond%20Companies%20List%2010.21.19.pdf)

Bond Type : Surety

Bond Number : az413826

Effective Date : 2014-11-03

Bond Company Merchants Bonding Company : (mutual)

Amount : $ 15000

Paid : $0

Available : $ 15000

Status : Active

To find out if a contractor's ROC license is current and see other information related to the license, enter their 6 digit license number or their name below. If searching by a person's name, be sure to use first then last - for example: 'John Doe' instead of 'Doe, John'. You can also use the ADVANCED SEARCH functions by clicking the gray "Advanced Search" button below to search by City, Classification, Status and more. Click to read the complete instructions.

Enter your search terms here*... Search

Advanced Search Export a List Clear

IF YOU EXPERIENCE A TECHNICAL PROBLEM, PLEASE CLICK HERE (mailto:[email redacted]).

FOR A LIST OF PENDING LICENSE APPLICATIONS CLICK HERE (https://roc.az.gov/posting-list#newAppsLicensesDiscipline) If you are looking for a complete list of our current contractors, we highly recommend using our Posting List (https://roc.az.gov/posting-list) page. For a list of contractors with their full information, please submit a Public Records Request through our Public Records Request One-Stop page. (https://azroc.my.site.com/AZRoc/s/roc- online-services) Thank you.

This resource is being provided for the information and convenience of the public. The listed businesses and their order of appearance do not constitute an endorsement, preference, or recommendation by the Registrar of Contractors.

While the Registrar of Contractors strives to make the information on this website as timely and accurate as possible, the Agency makes no claims, promises, or guarantees about the accuracy, completeness, or adequacy of the contents of this site, and expressly disclaims liability for errors and omissions in its contents. Please contact the Registrar at 877-692-9762 if you'd like to verify any of the information, or to report a discrepancy.

AZ ROC 1700 W. Washington St. Phone: (602) 542-1525 ©ROC 2021 Suite 105 Phoenix, Arizona Fax: (602) 542-1599 (https://twitter.com/az_RO 85007-2812 Find in Google Maps (https://www.google.com/maps/place/1700+W+Washington+St,+Phoenix,+AZ+85 (https://www.facebook.com

(https://www.linkedin.com/ registrar-of-

contractors/)

(https://www.instagram.co

(https://www.youtube.com

https://azroc.my.site.com/AZRoc/s/contractor-search?licenseId=a0ot0000000NgKhAAK 2/2 RECEIVED LEGAL 10/21/2023

October 20, 2023

Via U.S. Mail and Email

Complainant Phillip Martin Collins 3636 E. inverness Ave #2007 Mesa, AZ 85206

Via U.S. Mail and Email Respondent Kortsen Pebler LLC 22424 South Ellsworth Road #1822 Queen Creek, AZ 85142

Re: Complaint No. 2023-11979

Dear Complainant and Respondent:

The Registrar received a complaint filed against Kortsen Pebler LLC for non- payment of materials or services rendered. This complaint is complete and will be substantively reviewed by the Registrar.

Mail: P.O. Box 18244, Phoenix, Arizona, 85005-8244 In-Person: 1700 W. Washington St., Ste. 105, Phoenix, Arizona, 85007-2812 Email: [email redacted]

The Registrar will not issue a citation before October 27, 2023 and will review Respondent’s response, if one is submitted.

Sincerely,

/s/ Dylan Warwick Dylan Warwick

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov Lg100 4/21 RECEIVED LEGAL 10/21/2023

Legal Department 1700 W Washington St. Ste 105 Phoenix, AZ 85007

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov Lg100 4/21 RECEIVED LEGAL 10/21/2023 RECEIVED LEGAL Printed Name Signature Date 10/21/2023 Phillip M Collins RECEIVED LEGAL 10/21/2023 RECEIVED LEGAL 10/21/2023 RECEIVED LEGAL 10/21/2023 RECEIVED LEGAL 10/21/2023 REGISTRAR OF CONTRACTORS OF THE STATE OF ARIZONA

Case No. 2023-11979 Phillip Martin Collins,

COMPLAINANT, CITATION v. Kortsen Pebler LLC License No. ROC 328611, RESPONDENT.

The Registrar issues this Citation to Kortsen Pebler LLC (“Respondent”) under A.R.S. § 32-1155(A). If Respondent fails to answer this Citation by November 15, 2023, then under A.R.S. § 32-1155(C), Respondent’s failure to answer may be deemed an admission of the act or acts charged in the underlying complaint, and the Registrar may then suspend or revoke Respondent’s license(s).

of 5

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov Lg101 8/21 THE WRITTEN COMPLAINT On October 16, 2023, Phillip Martin Collins (“Complainant”) filed a written complaint with the Registrar. A copy of that Complaint is attached to this Citation. A FORMAL STATEMENT OF THE CHARGES AGAINST RESPONDENT The Registrar investigated this matter and finds cause to charge Respondent with violation(s) of Title 32, Chapter 10 of the Arizona Revised Statutes. Respondent is charged with violating: Charge :1 A.R.S. § 32-1154(A)(10) — Failure by a licensee or agent or official of a licensee to pay monies in excess of $750 when due for materials or services rendered in connection with the licensee's operations as a contractor unless the licensee proves that the licensee lacks the capacity to pay and has not received sufficient monies as payment for the particular construction work project or operation for which the services or materials were rendered or purchased.

If the matter proceeds to a hearing and the administrative law judge determines that any

of the charges listed above are supported by a preponderance of the evidence, then

Respondent’s license(s) may be subject to suspension or revocation, and Respondent may be

subject to other penalties provided by law, including civil penalties under A.R.S. §§ 32-1154(E)

and (F).

FILING A WRITTEN ANSWER

Respondent must appear by filing with the Registrar a written answer to the citation and

complaint showing cause, if any, why Respondent’s license(s) should not be suspended or

revoked. A.R.S. § 32-1155(A). Respondent’s written answer should contain the heading

“Written Answer to Citation and Complaint” and should include the case number, which is

Case No. 2023-11979. of 5

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov Lg101 8/21 How to File a Written Answer: Respondent’s written answer may be submitted in the following ways: In-Person: 1700 W. Washington St., Ste. 105, Phoenix, Arizona, 85007-2812 Mail: P.O. Box 18244, Phoenix, Arizona, 85005-8244 Email: [email redacted] The Registrar’s normal office hours are 8:00 a.m. to 5:00 p.m., Monday through Friday. If Respondent submits a written answer by mail, it is not filed with the Registrar until the Registrar actually receives it. Deadline for Filing a Written Answer: Respondent must file a written answer with the Registrar no later than November 15, 2023. This deadline is calculated under A.R.S. §§ 32-1155(A) and (B), which provides a deadline ten days after service of the Citation. Service of the Citation and Complaint is complete five days after the Registrar mails a copy of the Citation and Complaint to Respondent’s latest address of record in the Registrar’s office. Consequences for Failing to File a Written Answer: If Respondent fails to answer, Respondent’s failure may be deemed an admission of the act or acts charged in the written complaint. A.R.S. § 32-1155(C). The Registrar may then suspend or revoke Respondent’s license(s). THE ADMINISTRATIVE HEARING If Respondent files a timely written answer contesting any charges in the Complaint, then the Registrar will request the Office of Administrative Hearings set a date for an administrative hearing and will notify all the parties at least 30 days before that hearing. A.R.S. § 41-1092.05(D). RESPONDENT’S RIGHT TO REQUEST AN INFORMAL SETTLEMENT CONFERENCE Under A.R.S. § 41-1092.06, if Respondent submits a request to the Registrar for an of 5

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov Lg101 8/21 informal settlement conference, the Registrar must hold a conference within 15 days after receiving the request. Respondent’s request for an informal settlement conference must be in writing and must be filed no later than 20 days before the administrative hearing. A.R.S. § 41- 1092.06(A). The Registrar will not close or settle any case without both parties’ appearance at the Settlement Conference. The parties participating in the settlement conference must have the authority to settle the case and must waive their right to object to the participation of the Registrar’s settlement conference representative in the final administrative decision. A.R.S. § 41-1092.06(B). Any statements, either written or oral, made by the parties at the conference, including a written document, created or expressed solely for the purpose of settlement negotiations, are inadmissible in the administrative hearing. A.R.S. § 41-1092.06(B). RESPONDENT’S PRIOR RECORD Under A.A.C. R4-9-117, in determining the appropriate discipline, the administrative law judge and the Registrar may consider not only facts in the current case, but also facts in prior cases and any documents regarding Respondent on file with the Registrar. Respondent’s prior disciplinary record and current license(s) status may be considered as a mitigating or aggravating factor in determining the appropriate discipline. EVIDENTIARY DISCLAIMER By issuing this Citation, the Registrar is directing Respondent to file a written answer to the Citation and Complaint, showing cause, if any, why Respondent’s license(s) should not be suspended or revoked. A.R.S. § 32-1155(A). This Citation does not constitute proof that any charge or allegation in Complainant’s written complaint is in fact true. This Citation does not constitute proof that Respondent violated any statutory provision or rule adopted by the Registrar. of 5

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov Lg101 8/21 Dated October 31, 2023. By: /s/ Robert Stirling Robert Stirling Assistant General Counsel Legal Department Arizona Registrar of Contractors COPY of the foregoing mailed by Certified Mail, Return Receipt Requested, October 31, 2023 to: Respondent Certified Mail No: [number redacted] Kortsen Pebler LLC 22424 South Ellsworth Road #1822 Queen Creek, AZ 85142

Copy mailed by USPS First Class mail this same date to: Kortsen Pebler LLC 22424 South Ellsworth Road #1822 Queen Creek, AZ 85142

Complainant Phillip Martin Collins 3636 E. Inverness Ave #2007 Mesa, AZ 85206 Copy sent electronically this same date to: Respondent at email address on record with the Registrar Complainant at email address on record with the Registrar

Case No. 2023-11979 /

of 5

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov Lg101 8/21 Printed Name Signature Date Phillip M Collins 11/16/23, 8:24 AM State of Arizona Mail - Re: Complaint No. 2023-11979

Answers - AZROC <[email redacted]>

Re: Complaint No. 2023-11979 message

Legal Department <[email redacted]> Wed, Nov 15, 2023 at 8:57 PM To: "[email redacted]" <[email redacted]>, "[email redacted]" <[email redacted]> Cc: "info kortsenpebler.com" <[email redacted]>, Legal Department <[email redacted]>, Steven Kortsen- Pebler II <[email redacted]>

November 15, 2023

Arizona Registrar of Contractors P.O. Box 18244

Phoenix, Arizona 85005-8244 [email redacted]

[email redacted]

Re: Complaint No. 2023-11979

Dear Sirs and Madams,

Additionally, Kortsen Pebler LLC will be engaging the following counter claims against Phillip Martin Collins ROC 295278, 1) Contract: unlawful A) AZROC license number NOT identified on Invoice OR Craigslist Advertisement.

B) Contract Retainer Section: Contract initial phase was fully earned, fully funded, thus NOT actionable.

https://mail.google.com/mail/b/AEoRXRTDSSFxhMjtqiw8DWz_zs4n7b30bNbRM88XiXknHRZytV30/u/0/?ik=581c53cf5c&view=pt&search=all&permthi… 1/8 11/16/23, 8:24 AM State of Arizona Mail - Re: Complaint No. 2023-11979

C) Contract Final Section: Contract final phase was clearly Contracted as a secondary phase of Contract. The Contract does NOT define the secondary Contract phase as a requirement, fully earned, or otherwise. Claimant is Splitting their Cause of Action as Complainants' Contract, page 1, paragraph 3, Start of Contract, line 1, clearly defines the Contract foundation with a non-refundable retainer deposit, which was paid in full on, in the amount of, made payable to Summit Design. This binding contractual provision of non-refundable Retainer, to the Contract, and non-refundable payment, fully satisfied the Contract integrity by the Respondent, allowing the Respondent to legally cancel, stop, cease, or terminate the Contract. The Contract also states, page 1, paragraph 4, Price, additional fees, such as square footage, if any may be billed as extra. Respondent clearly stated in the email dated 09/14/23 @ 156AM of the Contractual concerns, needs to discuss Contract matters with Team, and to NOT proceed until following up end of month with discussion outcome. Claimant was NOT permitted to proceed with any additional completed the Contract termination via email, mail ((USPS), and phone call, Claimant responded to the email, acknowledged, and understood cease directions, and Claimant agreed to Cease additional work.

2) Contract Addendum: not complied with

A) Communication Compliance: all communication via text or email.

B) Invoice Compliance: require Conditional or Unconditional Releases for all payments.

C) Plan Review Compliance: review by in house professional team (planning, engineering, building safety, OSHA safety, ADEQ compliance), prior to CD’s being distributed for PDF distribution for NEXUS Submittal.

D) Plan Distribution Compliance: plan distribution by PDF, to comply with Jurisdictional Authority for Standard Plan and Site-Specific Requirements on all submittals, through the Jurisdictional Authority NEXUS online system.

E) Plan Copy Distribution: plan document distribution by standard format plotting, printing, and storage only; NOT NEXUS Online plan submittals.

F) Lien Release Compliance: lien release as paid receipts per ARS § 33-1008(D).

3) Contract Retainer Deposit Invoice: unlawful

A) AZROC License number NOT identified on Invoice.

B) Contract Retainer Deposit Invoice: fully earned, funded, licensed contractor refused to provide.

https://mail.google.com/mail/b/AEoRXRTDSSFxhMjtqiw8DWz_zs4n7b30bNbRM88XiXknHRZytV30/u/0/?ik=581c53cf5c&view=pt&search=all&permthi… 2/8 11/16/23, 8:24 AM State of Arizona Mail - Re: Complaint No. 2023-11979

C) Lien Release Compliance: lien release as paid receipt per ARS § 33-1008(D), NOT met per pre-contract phone meeting on 07/11/23 @ 3PM.

4) Optional Contract Final Invoice: unlawful

A) Contract Final Phase Invoice: never distributed, never received, licensed Contractor unlawfully filed a Complaint 2023-11979.

B) Splitting Cause of Action: Complainants' Contract, page 1, paragraph 3, line 2, clearly defines the Contract foundation with a non-refundable retainer deposit, which was paid in full on, in the amount of, made payable to Summit Design. This binding contractual provision of non-refundable Retainer, to the Contract, and non-refundable payment, fully satisfied the Contact integrity by the Respondent, allowing the Respondent to legally cancel, stop, cease, or terminate the Contract. Respondent completed the Contract termination via email, mail (USPS), and phone call, Claimant responded to the email and acknowledged Claimant agreed.

5) Pre-Contract Addendum Details & Minutes: NOT complied with A) Communication Compliance: all communication via text or email.

B) Invoice Compliance: require Conditional or Unconditional Releases for all payments.

E) Plan Copy Distribution: plan document distribution by standard format plotting, printing, and storage only; NOT NEXUS Online plan submittals.

F) Lien Release Compliance: lien release as paid receipts per ARS § 33-1008(D).

6) Email Communication: unlawful A) AZROC license number NOT identified on email in signature, or elsewhere as required by law.

https://mail.google.com/mail/b/AEoRXRTDSSFxhMjtqiw8DWz_zs4n7b30bNbRM88XiXknHRZytV30/u/0/?ik=581c53cf5c&view=pt&search=all&permthi… 3/8 11/16/23, 8:24 AM State of Arizona Mail - Re: Complaint No. 2023-11979

EXHIBIT A: Contract: unlawful

A) AZROC license number NOT identified on Invoice.

B) Contract Retainer Section: initial contract phase was fully earned, fully funded, and NOT given and Notice to Proceed (NTP) for any new, modified, or other design work, Claimant simply re-engaged their Contract without legal Notice.

EXHIBIT B: Pre-Contract Terms & Conditions

A) Communication Compliance: all communication via text or email.

B) Invoice Compliance: require Conditional or Unconditional Releases for all payments.

E) Plan Copy Distribution: plan document distribution by standard format plotting & printing, NOT met per pre-contract phone meeting on 07/11/23 @ 3PM.

F) Lien Release Compliance: lien release as paid receipt per ARS § 33-1008(D), NOT met per pre-contract phone meeting on 07/11/23 @ 3PM.

https://mail.google.com/mail/b/AEoRXRTDSSFxhMjtqiw8DWz_zs4n7b30bNbRM88XiXknHRZytV30/u/0/?ik=581c53cf5c&view=pt&search=all&permthi… 4/8 11/16/23, 8:24 AM State of Arizona Mail - Re: Complaint No. 2023-11979

EXHIBIT C: Deposit Invoice: unlawful A) AZROC license number NOT identified on Invoice

B) Lien Release Compliance: lien release as paid receipt per ARS § 33-1008(D), NOT met per pre-contract phone meeting on 07/11/23 @ 3PM.

EXHIBIT D: Email Communication: unlawful

A) AZROC license number NOT identified on email in signature, or elsewhere as required by law

ARS LAW TO SUPPORT COMPLAINT #2023-11979 BEING CLOSED IN FAVOR OF RESPONDANT 1) KORTSEN PEBLER LLC IS CITING THE FOLLOWING AS A FOUNDATION AND BASIS FOR A RULING OF DISMISSMAL OF THE COMPLAINT #2023-11979 Section R4-9-108 - Workmanship Standards A. A contractor shall perform all work in a professional and workmanlike manner. B. A contractor shall perform all work in accordance with any applicable building codes and professional industry standards.

32-1154. Grounds for suspension or revocation of license; continuing jurisdiction; civil penalty 1. Abandonment of a contract or refusal to perform after submitting a bid on work without legal excuse for the abandonment or refusal.

2. Departure from or disregard of:

(a) Plans or specifications in any material respect that is prejudicial to another without consent of the owner or the owner's duly authorized representative and without the consent of the person entitled to have the particular construction project or operation completed in accordance with such plans and specifications and code.

(b) A building code of this state or any political subdivision of this state in any material respect that is prejudicial to another.

3. Violation of any rule adopted by the registrar.

6. The doing of a fraudulent act by the licensee as a contractor resulting in another person being substantially injured. For the purposes of this paragraph, "fraudulent act" means a material misrepresentation that a licensee makes, that is relied on by another person and that results in damage to that person or that person's property. 8. Failure in a material respect by the licensee to complete a construction project or operation for the price stated in the contract, or in any modification of the contract.

9. Attempting to evade this chapter by:

13. Knowingly entering into a contract with a contractor for work to be performed for which a license is required with a person that is not duly licensed in the required classification. 15. False, misleading or deceptive advertising whereby any member of the public was misled and injured.

https://mail.google.com/mail/b/AEoRXRTDSSFxhMjtqiw8DWz_zs4n7b30bNbRM88XiXknHRZytV30/u/0/?ik=581c53cf5c&view=pt&search=all&permthi… 5/8 11/16/23, 8:24 AM State of Arizona Mail - Re: Complaint No. 2023-11979

16. Knowingly contracting beyond the scope of the license or licenses of the licensee.

Note that licensees are still required to include their ROC license number on all bids, contracts, estimates, and documents used to correspond with the licensee's customers or potential customers. See A.R.S. §§ 32-1124(B)(2) and 32-1158(A) B. Licenses issued under this chapter and any renewals shall be signed by the registrar or the registrar's designated representative and by the licensee. The license is non-transferable, and satisfactory evidence of possession shall be exhibited by the licensee on demand. The license number appearing on any licenses held by the licensee must be preceded by the acronym "ROC" and shall be posted or placed as follows:

1. In a conspicuous place on premises where any work is being performed.

2. On all written bids and estimates submitted by the licensee.

3. On all published advertising, letterheads and other documents used by the licensee to correspond with the licensee's customers or potential customers in the conduct of business regulated by this chapter.

4. On all broadcast, internet or billboard advertising, unless the broadcast, internet or billboard advertising includes a website's uniform resource locator that directly links to a website that prominently displays the licensee's name and license number.

32-1158. Contract requirements; provision of documents and receipt at contract signing

A. Any contract in an amount of more than $1,000 entered into between a contractor and the owner of a property to be improved shall contain in writing at least the following information:

1. The name of the contractor and the contractor's business address and license number.

2. The name and mailing address of the owner and the jobsite address or legal description.

3. The date the parties entered into the contract.

4. The estimated date of completion of all work to be performed under the contract.

5. A description of the work to be performed under the contract.

6. The total dollar amount to be paid to the contractor by the owner for all work to be performed under the contract, including all applicable taxes.

7. The dollar amount of any advance deposit paid or scheduled to be paid to the contractor by the owner.

8. The dollar amount of any progress payment and the stage of construction at which the contractor will be entitled to collect progress payments during the course of construction under the contract.

9. That the property owner has the right to file a written complaint with the registrar for an alleged violation of section 32-1154, subsection A. The contract shall contain the registrar's telephone number and website address and shall state that complaints must be made within the applicable time period as set forth in section 32-1162, subsection A. The information in this paragraph must be prominently displayed in the contract in at least ten-point bold type, and the contract shall be signed by the property owner and the contractor or the contractor's designated representative. This paragraph does not apply to a person who is subject to and complies with section 12-1365.

B. When a contractor and an owner sign a contract, the contractor shall provide the owner with a legible copy of all documents signed and a written and signed receipt for and in the true amount of any cash paid to the contractor by the owner.

C. The requirements of this section are not prerequisites to the formation or enforcement of a contract. Failure to comply with the requirements of this section does not constitute a defense by either party to an action for compensation, damages, breach, enforcement or other cause of action based on the contract.

https://mail.google.com/mail/b/AEoRXRTDSSFxhMjtqiw8DWz_zs4n7b30bNbRM88XiXknHRZytV30/u/0/?ik=581c53cf5c&view=pt&search=all&permthi… 6/8 11/16/23, 8:24 AM State of Arizona Mail - Re: Complaint No. 2023-11979

Finally, Kortsen Pebler LLC requests a hearing on the matter to argue the case in front of an Administrative Law Judge.

Respectfully,

Michael K. Vecino General Counsel and Chief Operating Officer

CC: Quarles & Brady LLP., General Counsel

Legal Department

Kortsen Pebler LLC. 22424 South Ellsworth Loop Road, #1822, Queen Creek, Arizona 85142

480.389 4648 (o)

[email redacted] www.kortsenpebler.com

"AGRIDEVELOPERS SINCE 1910"

NOTICE: This electronic mail transmission is intended only for the addressee. It contains information that may be privileged, confidential, and exempt from disclosure under applicable law. Dissemination, distribution, or copying of this by anyone other than the addressee or the addressee's agent is strictly prohibited. If this electronic mail transmission is received in error, please notify the sender immediately by a "reply to sender only" message and destroy all electronic and hard copies of this communication and all attachments thereto. Thank you.

From: Legal Department <[email redacted]> Sent: Saturday, October 21, 2023 3:23:00 AM To: [email redacted] <[email redacted]> Cc: Legal Department <[email redacted]>; info kortsenpebler.com <[email redacted]>;

https://mail.google.com/mail/b/AEoRXRTDSSFxhMjtqiw8DWz_zs4n7b30bNbRM88XiXknHRZytV30/u/0/?ik=581c53cf5c&view=pt&search=all&permthi… 7/8 11/16/23, 8:24 AM State of Arizona Mail - Re: Complaint No. 2023-11979

[email redacted] <[email redacted]> Subject: Complaint No. 2023-11979

October 21, 2023

Arizona Registrar of Contractors P.O. Box 18244 Phoenix, Arizona 85005-8244 [email redacted]

Re: Complaint No. 2023-11979

Additionally, Kortsen Pebler LLC will be engaging the following counter claims against Phillip Martin Collins ROC 295278,

1) Arizona Registrar of Contractors Complaint against Phillip Martin Collins ROC 295278 2) Pinal County Superior Court, Civil Summons & Complaint against Phillip Martin Collins ROC 295278

Respectfully,

Michael K. Vecino General Counsel and Chief Operating Officer

CC: Quarles & Brady LLP., General Counsel

20231020 Notice MAILED 2023-11979_response_11_15_23_scan.pdf 5216K

https://mail.google.com/mail/b/AEoRXRTDSSFxhMjtqiw8DWz_zs4n7b30bNbRM88XiXknHRZytV30/u/0/?ik=581c53cf5c&view=pt&search=all&permthi… 8/8 Mediation Notice

Mediation Services Mediation services are available to the parties. What is Mediation? Mediation is a method of resolving disputes where the parties can end conflict without the expense and time associated with the full administrative process. Who Participates in During mediation, a mediator will attempt to help the Mediation? parties find an optimal solution to the conflict. Both parties must agree to participate in mediation, and both parties must bring a representative to mediation that has full authority to settle the entire matter. Mediation Is Not Neither the Registrar nor the Office of Administrative Mandatory Hearings will penalize a party for not agreeing to mediation. Where do the Parties The parties will meet at the Office of Administrative Meet for Mediation? Hearings to participate in mediation.

The Office of Administrative Hearings is located at 1400 West Washington, Suite 101, Phoenix, Arizona 85007. When does Mediation can occur after the Registrar issues a citation, but Mediation Occur? before the administrative hearing. Why Should Parties Mediation can be an alternative to the full administrative Consider Mediation? process. Mediation is beneficial because it is (1) time- efficient, (2) cost-effective, (3) confidential, and (4) capable of providing flexible solutions to complex problems. How to Request If the parties wish to mediate this case, they must file a Joint Mediation Request for Mediation with the Office of Administrative Hearings. A Joint Request for Mediation is included with this Mediation Notice. REGISTRAR OF CONTRACTORS OF THE STATE OF ARIZONA _________________________ Case No. _______________ COMPLAINANT,

v. JOINT REQUEST FOR MEDIATION _________________________ RESPONDENT.

REQUEST

The parties jointly request that this matter be referred to mediation in the Office of Administrative Hearings (OAH). ☐ This matter is set for hearing on __________________(date). ☐ This matter is not currently set for hearing. MEDIATION AGREEMENT By requesting this mediation and signing below, the parties understand, represent, and agree: 1. The parties are prepared to commence mediation and will be ready for mediation on _____________________(date); 2. The parties will participate in the mediation process in good faith; 3. This request for mediation is not intended to hinder or delay administrative proceedings; 4. No party will contend that the mediation limits the power of OAH and its administrative law judges to conduct an administrative hearing and issue decisions under A.R.S. §§ 41-1092 – 1092.12; 5. The parties will be courteous and respectful throughout the mediation process to all participants; 6. The mediation is completely voluntary and the principal purpose is to allow the parties a full and fair opportunity to discuss settlement; of 3 REGISTRAR OF CONTRACTORS 1700 W. Washington St. Suite 105 – PHOENIX, AZ 85007-2812 Telephone (602)542-1525 1-877-692-9762 7. The mediator may conduct joint and separate meetings with the parties and may suggest resolutions to the parties’ dispute, but the mediator has no authority to impose a settlement upon the parties; 8. The mediation process is confidential. Communications made, material created for or used during, and acts occurring during mediation are confidential and may not be discovered or admitted into evidence in any proceeding except as provided by A.R.S. § 12-2238; 9. The mediator is not subject to service of process or a subpoena to produce evidence or to testify regarding any evidence or occurrence relating to the mediation except as provided in A.R.S. § 12-2238(C); 10. Neither the mediator, nor the Registrar of Contractors, nor the Office of Administrative Hearings is subject to civil liability for any act or omission in connection with any mediation service or activity except for acts involving

intentional misconduct or reckless disregard of a substantial risk of injury to the rights of others; 11. Throughout the mediation process, each party must have a representative present who will have full settlement authority to settle all claims at issue in the administrative

proceeding. 12. The mediation process will terminate when: a. The parties reach settlement; b. The mediator determines that further efforts at mediation are no longer likely

to achieve a settlement; or c. One of the parties withdraws from mediation. _____________________________________ _______________________ Complainant (or representative) Date

_____________________________________ _______________________ Respondent (or representative) Date

of 3 REGISTRAR OF CONTRACTORS 1700 W. Washington St. Suite 105 – PHOENIX, AZ 85007-2812 Telephone (602)542-1525 1-877-692-9762 PREHEARING DISCLOSURE STATEMENT INSTRUCTIONS ***DO NOT SUBMIT THESE INSTRUCTIONS WITH THE PREHEARING DISCLOSURE FORM***

ADMINISTRATIVE RULES A copy of the Arizona Administrative Code’s Rules for the Registrar of Contractors can be located on the Registrar’s Website.

PREHEARING DISCLOSURE REQUIREMENT Under A.A.C. R4-9-118(A), before a hearing, the parties must prepare a disclosure statement. The disclosure statement must contain: • A list of all the witnesses the party will call to testify, including the witnesses’ contact information and a brief description of the subject matter of the witnesses’ expected testimony; and • A list of all the exhibits that the party will use at the hearing.

FILE PREHEARING DISCLOSURE STATEMENTS • The Prehearing Disclosure Statements and Exhibits may be submitted to the Arizona Office of Administrative Hearings using any of the following: • Electronically: https://portal.azoah.com/submission/ • In-Person or by Mail: 1740 West Adams Street, Lower Level, Phoenix, Arizona 85007

EXCHANGING DISCLOSURE STATEMENTS AND EXHIBITS Under A.A.C. R4-9-118(B) (effective November 5, 2017), a party to the hearing must serve on every other party and file with the Office of Administrative Hearings a copy of: • The disclosure statement; and, • Any exhibit that the party will use at the hearing. Service: The disclosure statement and exhibits must be served on all parties in accordance with Arizona Administrative Code R2-19-108 Filing Documents. Under A.A.C. R2-19-108, service is completed by: • Personal delivery; • 1st class, certified or express mail; or • Facsimile. Timing: The disclosure statement and the exhibits must be served and filed not less than seven calendar days before the date of the hearing. Under A.A.C. R2-19-108, a document is served on a party: • On the date it is personally served; • Five days after it is mailed by express or 1st class mail; • On the date of the return receipt if it is mailed by certified mail; or • On the date indicated on the facsimile transmission.

CONSEQUENCES FOR FAILING TO DISCLOSE Under A.A.C. R4-9-108(C), if a witness or an exhibit is not timely disclosed as required the rules, and good cause for the failure to disclose is not shown, then the administrative law judge may: • Order that certain witnesses or exhibits not be used at the hearing; • Order that a particular fact is or is not established for the record; or, • Order that a charge, a defense, a claim, or some portion thereof, be dismissed.

Form RC-L-800A Prehearing Disclosure Statement Rev. 10/08/2019 Instructions Form PREHEARING DISCLOSURE STATEMENT FORM RC-L-800A

PART 1: WITNESS LIST DOCKET NO. Under A.A.C. R4-9-118(A), before a hearing, a party must prepare a disclosure statement containing a list of all the witnesses the party will call to testify, including the witnesses’ contact information and a brief description of the subject matter of the witnesses’ expected testimony. If you need additional space to list all witnesses, complete and attach additional Witness Lists. Example 1. Name 2. Telephone Number 3. Email Address

John Doe (123) 456-7890 [email redacted] 4. Subject Matter of Expected Testimony

John Doe will testify regarding the poor workmanship and poor installation of the Garage Door. Mr. Doe will also testify regarding the invoices and change orders for the project.

Witness 1. Name 2. Telephone Number 3. Email Address

4. Subject Matter of Expected Testimony

Witness 1. Name 2. Telephone Number 3. Email Address

4. Subject Matter of Expected Testimony

Witness 1. Name 2. Telephone Number 3. Email Address

4. Subject Matter of Expected Testimony

Witness 1. Name 2. Telephone Number 3. Email Address

4. Subject Matter of Expected Testimony

Form RC-L-800A Prehearing Disclosure Statement Rev. 1/15/2019 Page 1 of 3 PART 2: EXHIBIT LIST DOCKET NO. Under A.A.C. R4-9-118(A), before a hearing, a party must prepare a disclosure statement containing a list of all the exhibits that the party will use at the hearing. Note: All exhibits listed below must be provided to all parties to the hearing. See A.A.C. R4-9-118(B). If you need additional space to list all witnesses, complete and attach additional Exhibit Lists. Example Contract for new garage door. Invoice #10001 – Cost for garage door replacement.

Exhibit Exhibit Name

Form RC-L-800A Prehearing Disclosure Statement Rev. 1/15/2019 Page 2 of 3 PART 3: ACKNOWLEDGEMENT & SIGNATURE I certify that the above information is true and correct and that I will serve a copy of this disclosure statement and any exhibits listed in Part 2 to all parties to the hearing in accordance with A.A.C. R4-9-118. I acknowledge and understand that if I fail to properly disclose a witness or exhibit, the administrative law judge may: • Order that certain witnesses or exhibits not be used at the hearing; • Order that a particular fact is or is not established for the record; or, • Order that a charge, a defense, a claim, or some portion thereof, be dismissed.

I am the (check one):  Complainant  Respondent Docket No.

Print Name Signature Date

Form RC-L-800A Prehearing Disclosure Statement Rev. 1/15/2019 Page 3 of 3