2023A-12134-CHC-ROC Notice of Hearing and Packet MAILED

2023A-12134-CHC-ROC · Registrar of Contractors · 2024-03-05

REGISTRAR OF CONTRACTORS OF THE STATE OF ARIZONA

Jerry Lawson , Case No. 2023-12134 COMPLAINANT, Docket No. 2023A-12134-CHC-ROC v. NOTICE OF HEARING ON CONTESTED CASE Reva's Floor Decor Inc License No. ROC 159668 and 338766

RESPONDENT.

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

HEARING INFORMATION The hearing is set for:

April 19, 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 February 8, 2024.

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)(2)(a)

Charge: 2 A.R.S. § 32-1154(A)(3) - R4-9-108(a)

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.

The Registrar’s assigned investigator will appear as a witness at the hearing.

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/forms/RC-L-800A%20- %20Prehearing%20Disclosure%20Statement%2020191007v4.pdf

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 March 5, 2024.

By: /s/ Erika Hoskin Erika Hoskin Legal Secretary Legal Department Arizona Registrar of Contractors Copy mailed via USPS First Class mail March 5, 2024 to: Respondent(s) Reva's Floor Decor Inc 340 N Pleasant St Prescott, AZ 86301

Complainant(s) Jerry Lawson 126 Josephine Street Prescott, AZ 86305

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. 2023-12134 /

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

Complainant: Jerry Lawson 126 Josephine Street Prescott, AZ 86305

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

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C008 05/21 Respondent: Reva's Floor Decor Inc 340 N Pleasant St Prescott, AZ 86301

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

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C008 05/21 October 25, 2023

Jobsite Inspection Notice Re: Complaint Number 2023-12134

Dear Complainant and Respondent:

A formal complaint has been filed with the Arizona Registrar of Contractors.

A jobsite inspection is scheduled for November 14, 2023 at 10:00 AM. The Complainant is required to be present. The Respondent’s attendance is requested and encouraged. The Registrar encourages both parties to make a good faith effort to resolve this complaint prior to the jobsite inspection.

COMPLAINANT: 1. Under A.R.S. § 32-1155(D)(1), the Respondent must be allowed, upon request, the opportunity to inspect the work complained of within fifteen (15) days of receiving this notice. If Respondent is not provided an opportunity to inspect the work within the fifteen (15) day time period, the Registrar may be prohibited from taking further action on this complaint. 2. The Registrar may also be precluded from taking further action on this complaint, if the work that is the subject of the complaint is subject to neglect, modification, or abnormal use. A.R.S. § 32-1155(D)(2) 3. You must provide safe access to any area to be inspected. If access to a roof or other elevated area is required, you must provide a means to safely access the area (ladder or manlift as appropriate). Additionally, please secure any animals.

RESPONDENT: 1. Enclosed is a copy of the complaint. Under A.R.S. § 32-1155(D) you must be allowed, upon request, the opportunity to inspect the work complained of within fifteen days of the date of receipt of this notice. 2. To assist the assigned investigator in evaluating the merits of the complaint, please submit a response to the enclosed complaint to the assigned investigator prior to the scheduled inspection. 3. If you do not attend the jobsite inspection, your absence may negatively impact the investigation, and your interests. 4. If a building permit(s) was required for this project, please have the building permit information available at the jobsite inspection.

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

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C008 05/21 If either party needs to reschedule the jobsite inspection, please notify the assigned investigator at least three business days prior to the inspection date to schedule a new date and time.

If the parties resolve the complaint prior to the inspection, please notify the assigned investigator in writing and by phone as soon as possible.

Sincerely,

/s/ Jim Dimond #170 Jim Dimond #170, Investigator 1700 W. Washington St., Suite 105/Yavapai County Phoenix, Arizona, 85007 Phone: (602)542-1525 Office: (928)637-1463 Cell: (623)680-9585 Email: [email redacted]

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

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C008 05/21 A Guide to Jobsite Inspections

Purpose of the Jobsite Inspection When the Registrar receives a complaint against a contractor’s license alleging poor workmanship, the Registrar generally schedules a Jobsite Inspection. The Jobsite Inspection serves two purposes: 1. To give the contractor an opportunity to inspect the complaint items; and 2. To give the Registrar an opportunity to determine if the contractor’s work violates Arizona law.

Jobsite Inspection Rights and Responsibilities Access to inspect: The property owner has complete control over who they allow on the property. However, if the Registrar’s investigator or the contractor cannot inspect the work, the Registrar will not move forward with a citation.

Cooperation: Arizona law enables injured parties to seek relief for damages through several paths. When dealing with a licensed contractor, the Registrar of Contractors’ administrative complaint process may serve as one of those possible paths. However, in order to use that path, the Registrar relies on the cooperation of all parties to a complaint.

Minimum workmanship: The Registrar investigates workmanship complaints for compliance with minimum workmanship and professional industry standards. The Registrar does not issue citations for work that meets these standards.

Scope: The scope of the Jobsite Inspection is limited to items listed in the complaint filed with the Registrar’s office. It is the complainant’s responsibility to point out the complaint item(s) and the Investigators role to review the item(s). If the complainant identifies additional workmanship items not listed in the original complaint, they must file an addendum to the complaint. The Registrar’s Investigator may identify additional administrative violations by the contractor (e.g. work performed out of scope of the license and failure to provide a contract that meets requirements set by Arizona law) at the time of the inspection.

The Role of the Investigator At the Jobsite Inspection, the Registrar’s investigator will: Only investigate the items listed on the complaint form filed with the Registrar. Will gather evidence to make an informed decision about the complaint items.

What to expect after a Jobsite Inspection After doing a Jobsite Inspection, the Registrar’s Investigator will leave the jobsite and review the evidence provided during the inspection. Generally, the investigator does not make any determination at the time of the jobsite inspection regarding whether the allegations listed in the complaint are supported. If the allegations are confirmed, the Registrar’s Investigator may issue a Written Directive telling the contractor to correct the poor or incomplete work. If the allegations are not confirmed, the Registrar’s Investigator will close the complaint.

Questions? If you have already filed a complaint and it was assigned to an investigator, you are encouraged to contact that investigator directly with the information listed in your jobsite inspection letter.

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

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C008 05/21 If you have not filed a complaint yet or have not been assigned an investigator, you can reach the Registrar’s compliance department at (877) 692-9762.

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

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C008 05/21 A Guide to Written Directives Purpose of the Jobsite Inspection When the Registrar receives a complaint against a contractor’s license, the Registrar generally schedules a Jobsite Inspection. The Jobsite Inspection serves two purposes: 1. To give the contractor an opportunity to inspect the complaint items; and 2. To give the Registrar an opportunity to determine if the contractor’s work violates Arizona law.

What to expect after a Jobsite Inspection After doing a Jobsite Inspection, the Registrar’s Investigator will determine whether the allegations listed in the complaint are supported. If the allegations are confirmed, the Registrar’s Investigator may issue a Written Directive telling the contractor to correct the poor or incomplete work. If the allegations are not confirmed, the Registrar’s Investigator will close the complaint.

Written Directives Access: In order to use the administrative process offered by the Registrar, a property owner must provide reasonable access to allow the contractor to fix their work as directed by the Registrar in a Written Directive. Complainants may not put any additional, unnecessary restrictions on the Respondent above and beyond the initial contract requirements agreed upon at the beginning of the project. Respondents are required to make repairs on items identified on any Written Directive, not otherwise restricted by local code or HOA limitations. Complainants must make access available to the Respondent to make the required repairs and failure to provide reasonable access may result in the Registrar dismissing the complaint.

Contractor obligations: The Written Directive will set a deadline for compliance. This is the period of time determined by the Investigator as necessary to complete the items listed in the Directive. The deadline for compliance assumes the contractor will promptly begin working on the items listed in the Directive. Do not wait. Both parties should communicate quickly to schedule the work.

Extensions: If good cause exists to extend this deadline, either party may submit a written request to the Investigator. The Registrar will review requests for extension and determine if the Directive should be extended.

Manner and method of performance: The Registrar does not provide specific instructions for how to correct poor work. A licensed contractor is expected to have the skill and professionalism to complete the work. Moreover, the complainant may not dictate the manner of repair. If the contractor fails to appropriately correct the work according to the contract, the Registrar will issue a citation.

Compliance Inspection: After the Written Directive expires, the Registrar’s Investigator will contact the complainant to determine if the contractor performed any corrective work. If the contractor did corrective work, the Investigator may schedule a Compliance Inspection to determine if the poor work is corrected. If the contractor did not perform any corrective work, the Registrar’s Investigator will not do a Compliance Inspection and will determine whether to issue a citation based on the administrative record.

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

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C008 05/21 Work performed after the directive ends: After the Directive period ends, a property owner may choose to allow the contractor to continue its work. The Registrar encourages parties to work cooperatively, but cannot require a homeowner to continue to allow a contractor access to the property after the Directive period ends in order for the administrative process to continue. Denying access after the Directive ends is not grounds to close or dismiss a complaint.

Questions? If you have already filed a complaint and it was assigned to an investigator, you are encouraged to contact that investigator directly with the information listed in your jobsite inspection letter. If you have not filed a complaint yet or have not been assigned an investigator, you can reach the Registrar’s compliance department at (877) 692-9762.

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

602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C008 05/21 Jobsite Inspection Notes

Case No.: 2023-12134 Investigator: Jim Dimond Inspection Date: November 14, 2023 Inspection Time: 10:00 AM

Complainant: Jerry Lawson Respondent: Reva's Floor Decor Inc Jody Lawson Mark Breyer, Neighbor Kjirsten Conrad, Emp Sue Davidson, Emp Brad MacPhee Sr, Installer Brad MacPhee Jr, Installer Ryan Winkler, Installer

Not Present: Not Present:

Jobsite General Notes:

At the inspection I took pictures with my state issued Google Pixel 6pro cellphone camera and I have uploaded the pictures to the complaint document file.

I also digitally recorded the inspection on my state issued Olympus DS-30 digital audio recorder and I have uploaded the audio recording to the complaint document file.

Complaint Item: 1 - Floor was not properly leveled prior to installation of product

Investigator’s Observation: The floor in the living room has been pulled up and was stacked against the wall.

It appears that part of the floor has had leveling compound installed.

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Toll Free 877.692.9762 · roc.az.gov RCC100 08/19

A long straight edge was brought in and there one small area that was maybe 3/16" of a dip.

For the most part, the area checked was flat.

Where the floor was installed in the house, I noted no areas of concern for flatness.

Governing Rule: A violation cannot be sustained regarding this item

Complaint Item: 2 - Installer did not follow manufacturer’s guidelines for product installation

Investigator’s Observation: As previously stated, the flooring in the living room has been pulled up.

I have reviewed the manufacturer installation guidelines and the offset of the planks in parallel rows are not the minimum 24".

Transition strips are recommended for doorways.

The humidity in the home appears to be relatively close to the manufacturer requirements.

The floor in my opinion is within requirements for flat in the area of concern.

As to level, the house was built in 1954 on a rock foundation. It appears that the east end of the home is slightly lower than the remainder of the home.

This end is in the same general area of where the floor was floated out.

Governing Rule: Violation of any rule adopted by the Registrar; 1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Toll Free 877.692.9762 · roc.az.gov RCC100 08/19

Namely A.A.C. R4-9-108(a): A contractor shall perform all work in a professional and workmanlike manner.

Complaint Item: 3 - After installation was complete and problems began to arise owner failed to return phone calls and inquiries about workmanship in a timely and professional manner many times sending a third party

Investigator’s Observation: The ROC lacks the authority to regulate customer service

Governing Rule: A violation cannot be sustained regarding this item

Complaint Item: 4 - Owner failed to provide flooring inspectors report multiple times after agreeing to provide to customer report still has not been delivered to customer

Investigator’s Observation: The ROC cannot mandate that the respondent turn over the document.

Governing Rule: A violation cannot be sustained regarding this item

Complaint Item: 5 - After multiple requests to cure improper installation the installer was unprofessional and failed to follow-up with customer after removing flooring and installing humidity gauge also failed to show up for scheduled appointments without notice.

Investigator’s Observation: The ROC does not have the authority to regulate customer service matters.

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Toll Free 877.692.9762 · roc.az.gov RCC100 08/19

Governing Rule: A violation cannot be sustained regarding this item

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Toll Free 877.692.9762 · roc.az.gov RCC100 08/19

Complainant: Jerry Lawson 126 Josephine Street Prescott, AZ 86305

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C009 04/21 Respondent: Reva's Floor Decor Inc 340 N Pleasant St Prescott, AZ 86301

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C009 04/21 January 11, 2024

License No. ROC 159668

Re:Complaint No. 2023-12134

WRITTEN DIRECTIVE FROM THE REGISTRAR

Dear Respondent:

After investigation, the Registrar determined that you failed to meet the requirements of A.R.S. § 32-1154(A), and now issues this Directive requiring you to take appropriate corrective action. Failure to comply with this Directive constitutes a violation of A.R.S. § 32-1154(A)(22) and may result in the issuance of a citation, discipline of your license, and a civil penalty pursuant to A.R.S. § 32-1154(E) of up to $500.00. You must notify the Registrar’s assigned Investigator of your compliance with this Directive prior to 5:00 p.m. on January 31, 2024.

RESTRICTIONS You may not perform or hire other contractors to perform work that is outside the scope of your license. If your license is currently suspended for administrative reasons1, or is inactive, expired, or cancelled, you may not perform any corrective work nor contract in any manner, which includes hiring other contractors to perform work, until the suspension of your license(s) has been lifted or your license(s) has been reactivated.

DIRECTIVE REQUIREMENTS You are directed to remedy the following violations by the appropriate means:

Compliance Item: 2 - Installer did not follow manufacturer’s guidelines for product installation

Investigator’s Observation: As previously stated, the flooring in the living room has been pulled up.

This means the license is suspended for lack of qualifying party, lack of bond, nonrenewal, Recovery Fund payout, or for any reason listed in A.R.S. § 32-1124(F).

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C009 04/21 I have reviewed the manufacturer installation guidelines and the offset of the planks in parallel rows are not the minimum 24" required by the manufacturer.

Transition strips are recommended for doorways.

The humidity in the home appears to be relatively close to the manufacturer requirements.

The floor in my opinion is within requirements for flat in the area of concern.

As to level, the house was built in 1954 on a rock foundation. It appears that the east end of the home is slightly lower than the remainder of the home.

This end is in the same general area of where the floor was floated out.

Governing Rule: Violation of any rule adopted by the Registrar; Namely A.A.C. R4-9-108(a): A contractor shall perform all work in a professional and workmanlike manner.

ITEMS NOT REQUIRING CORRECTION

The following complaint items require no action by the Respondent:

Compliance Item: 1 - Floor was not properly leveled prior to installation of product

Investigator’s Observation: The floor in the living room has been pulled up and was stacked against the wall.

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C009 04/21 It appears that part of the floor has had leveling compound installed.

A long straight edge was brought in and there one small area that was maybe 3/16" of a dip.

For the most part, the area checked was flat.

Where the floor was installed in the house, I noted no areas of concern for flatness.

Governing Rule: A violation cannot be sustained regarding this item

Compliance Item: 3 - After installation was complete and problems began to arise owner failed to return phone calls and inquiries about workmanship in a timely and professional manner many times sending a third party

Investigator’s Observation: The ROC lacks the authority to regulate customer service

Governing Rule: A violation cannot be sustained regarding this item

Compliance Item: 4 - Owner failed to provide flooring inspectors report multiple times after agreeing to provide to customer report still has not been delivered to customer

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C009 04/21 Investigator’s Observation: The ROC cannot mandate that the respondent turn over the document.

Governing Rule: A violation cannot be sustained regarding this item

Compliance Item: 5 - After multiple requests to cure improper installation the installer was unprofessional and failed to follow-up with customer after removing flooring and installing humidity gauge also failed to show up for scheduled appointments without notice.

Investigator’s Observation: The ROC does not have the authority to regulate customer service matters.

Governing Rule: A violation cannot be sustained regarding this item

Please direct all questions regarding this Directive to the undersigned Investigator.

Sincerely,

/s/ Jim Dimond #170 Jim Dimond #170, Investigator 1700 W. Washington St., Suite 105/Yavapai County Phoenix, Arizona, 85007 Phone: (602)542-1525 Office: (928)637-1463 Cell: (623)680-9585 Email: [email redacted]

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C009 04/21 Complainant: Jerry Lawson 126 Josephine Street Prescott, AZ 86305

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C013d 04/21 Respondent: Reva's Floor Decor Inc 340 N Pleasant St Prescott, AZ 86301

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C013d 04/21 January 29, 2024

WARNING LETTER

Re: Complaint No. 2023-12134; License No. ROC 159668

Dear Respondent:

The Registrar received information indicating that you are contracting while your license is suspended or inactive. Contracting while your license is suspended or inactive violates A.R.S. § 32-1151:

It is unlawful for any person, firm, partnership, corporation, association or other organization, or a combination of any of them, to engage in the business of, submit a bid or respond to a request for qualification or a request for proposals for construction services as, act or offer to act in the capacity of or purport to have the capacity of a contractor without having a contractor’s license in good standing . . . .

Additionally, contracting or offering to contract while your license is suspended or inactive violates A.R.S. § 32-1154(A)(17) and constitutes grounds to suspend or revoke your license.

The Registrar does not presently intend to pursue disciplinary action for the alleged violations. However, this warning letter does not preclude the Registrar from electing to pursue action against your license for these violations in the future.

If you have any questions, feel free to contact me.

Sincerely,

/s/ Jim Dimond #170 Jim Dimond #170, Investigator 1700 W. Washington St., Suite 105/Yavapai County Phoenix, Arizona, 85007 Phone: (602)542-1525 Office: (928)637-1463 Cell: (623)680-9585 Email: [email redacted]

1700 W. Washington Street, Suite 105 · Phoenix AZ 85007-2812 602.542.1525 · Toll Free 877.692.9762 · roc.az.gov C013d 04/21 REGISTRAR OF CONTRACTORS OF THE STATE OF ARIZONA

Jerry Lawson Case No. 2023-12134 COMPLAINANT, v. Reva's Floor Decor Inc CITATION License No. ROC 159668 and 338766

RESPONDENT.

The Registrar issues this Citation to Reva's Floor Decor Inc (“Respondent”) under

A.R.S. § 32-1155(A). If Respondent fails to answer this Citation by February 23, 2024, 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).

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1700 W. Washington Street, Suite 105 ꞏ Phoenix AZ 85007-2812 602.542.1525 ꞏ Toll Free 877.692.9762 ꞏ roc.az.gov Lg101 8/21 THE WRITTEN COMPLAINT On October 20, 2023, Jerry Lawson (“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)(2)(a) 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.

Charge 2: A.R.S. § 32-1154(A)(3) - R4-9-108(a) Violation of any rule adopted by the Registrar; Namely A.A.C. R4-9-108(a): A contractor shall perform all work in a professional and workmanlike manner.

Charge 3: A.R.S. § 32-1154(A)(17) Contracting or offering to contract or submitting a bid while the license is under suspension or while the license is on inactive status.

Charge 4: A.R.S. § 32-1154(A)(22) Failure to take appropriate corrective action to comply with this chapter or with rules adopted pursuant to this chapter without valid justification within a reasonable period of time after receiving a written directive from the Registrar.

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1700 W. Washington Street, Suite 105 ꞏ Phoenix AZ 85007-2812 602.542.1525 ꞏ Toll Free 877.692.9762 ꞏ roc.az.gov Lg101 8/21 The written directive shall set forth the time within which the contractor is to complete the remedial action. The time permitted for compliance shall not be less than fifteen days from the date of issuance of the directive. A license shall not be revoked or suspended nor shall any other penalty be imposed for a violation of this paragraph until after a hearing has been held. 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. 2023-12134. 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

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1700 W. Washington Street, Suite 105 ꞏ Phoenix AZ 85007-2812 602.542.1525 ꞏ Toll Free 877.692.9762 ꞏ roc.az.gov Lg101 8/21 Registrar no later than February 23, 2024. 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). INVESTIGATOR’S APPEARANCE AS A WITNESS The Registrar’s assigned investigator will appear as a witness at the hearing. If either party demands the attendance at the hearing of any other person, that party must obtain and serve a subpoena in compliance with the rules and processes established by the Office of Administrative Hearings. 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 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).

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1700 W. Washington Street, Suite 105 ꞏ Phoenix AZ 85007-2812 602.542.1525 ꞏ Toll Free 877.692.9762 ꞏ roc.az.gov Lg101 8/21 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. Dated February 8, 2024. By: /s/ Dylan Warwick Dylan Warwick Legal Department Arizona Registrar of Contractors

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1700 W. Washington Street, Suite 105 ꞏ Phoenix AZ 85007-2812 602.542.1525 ꞏ Toll Free 877.692.9762 ꞏ roc.az.gov Lg101 8/21 COPY of the foregoing mailed by Certified Mail, Return Receipt Requested, February 8, 2024 to:

Respondent Certified Mail No: [number redacted]

Reva's Floor Decor Inc 340 N Pleasant St Prescott, AZ 86301 Copy mailed by USPS First Class mail this same date to: Reva's Floor Decor Inc 340 N Pleasant St Prescott, AZ 86301

Complainant Jerry Lawson 126 Josephine Street Prescott, AZ 86305

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. 2023-12134 / <<CreatedBy_DW>

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1700 W. Washington Street, Suite 105 ꞏ Phoenix AZ 85007-2812 602.542.1525 ꞏ Toll Free 877.692.9762 ꞏ roc.az.gov Lg101 8/21 Lawson - written statement describing the agreement that includes the following information

The reason a written contract is not being provided (e.g. the contractor did not provide a written contract, the contract is lost, the contract was destroyed);

• A written contract was not offered by Reva’s Floor and Décor for this project, the only documentation was an invoice for product and services rendered for installation.

A description of any written documents used to describe the contract, e.g. bids, proposals, invoices, receipts. (If you have copies of any of these documents, please provide them with the Complaint Form.);

• Invoice from Reva’s Floor and Décor for project is attached.

A description of the work to be performed under the contract (including any addenda or change orders)

• Purchase and professional installation of Longust Legante Southwest Laminate Flooring (Flagstaff in color) installed over scuba underlayment.

The names of the people who negotiated the contract.

• Sue – Store representative of Reva’s Floor and Décor • Jerry and Jody Lawson - Homeowners

The agreed upon payment schedule.

• $6500 upon acceptance • $7415.41 when original work was completed.

An explanation of who was to receive payment.

• Reva’s Floor and Decor

The date the work was to be completed.

• Work was to be completed within approximately 5 days of contractor arriving at our home on March 27, 2023.

For new homes provide a copy of the Purchase Agreement.

• Not applicable 2/21/24, 8:00 AM State of Arizona Mail - Case No. 2023-12134

Answers - AZROC <[email redacted]>

Case No. 2023-12134 message

Kjirsten Conrad <[email redacted]> Tue, Feb 20, 2024 at 4:55 PM To: [email redacted]

Good afternoon,

I am writing in regards to the complaint.

I was told a response had to be submitted by January 31st, 2024 by 5:00pm. I emailed Jim Dimond at 8:20am telling him that we are complying with the few citations we had (we ordered product and scheduled a time to work on our customers house). I also asked Jim to let me know what else I needed to do and if I needed to submit anything else to be within compliance.

Jim responded 4 minutes later and asked what license we were using. We use our only one which is under Conrad Flooring #338766.

Then I didn't hear back from him and thought we were in compliance.

I called Jim on Monday February 12th after I received more from the ROC saying we weren't in compliance. as I had questions regarding the installation of the laminate as what Jim stated we had to do was not possible. We called our rep and the manufacturer and they both stated that the installation manual was incorrect and I gave Jim our reps number so he could get his own questions answered. In our corrective directive it stated we had to maintain the laminate a minimum of 2 feet from the wall but also maintain a distance between the butt joints at 2ft as well. This created 2' and 4' parallel rows and the rep also stated we can't install in an 'H pattern'. We spent a day graphing out how is is possible and came to the conclusion it doesn't work. That is what prompted us to call the manufacturer of the laminate and even they were confused.

After speaking with Jim on February 12th, he stated he has our compliance date as January 29th and that is why we received the new paper work from the ROC saying we weren't in compliance with new charges.

We have never intended to not be in compliance and thought the January 31st by 5:00pm date was to say we were complying with the ROC and were taking action to correct the issues (ordering more product, talking with the customer and scheduling them for a date that worked for both parties). The homeowners came in multiple times and called multiple times reminding us we had to have our response in by January 31st, which I did.

Response to charges:

Charge 1: We have always planned to comply as stated in my email to Jim on January 31st (see attachments for email conversation). We have product in our warehouse scheduled to be dropped off to acclimate on the morning of Friday March 1st with the install date Monday March 4th - Wednesday March 6th.

Charge 2: Our employees are all held to a high standard of installation guidelines along with the way they conduct themselves in a customer's house. We will have another person at the house to document any interactions between the homeowners and installers to make sure the homeowners don't keep harassing our installers.

Charge 3: We have a valid license. The homeowners filed under the old owners ROC number. Our ROC is active and has been since we bought the business. Our license number is 338666.

Charge 4: The installation date is March 4th-March 6th. We agreed upon this date with the homeowners as a date that worked for all parties.

Please let me know what else I need to do if any at this time as I was under the impression we have been in compliance the entire time.

Thank you for your time, Kjirsten Conrad

https://mail.google.com/mail/b/AEoRXRTsCMLkA73wf6pYXdtayku9NqLQPRzP7PELNd_b6uoh1NKv/u/0/?ik=581c53cf5c&view=pt&search=all&permt… 1/2 2/21/24, 8:00 AM State of Arizona Mail - Case No. 2023-12134

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https://mail.google.com/mail/b/AEoRXRTsCMLkA73wf6pYXdtayku9NqLQPRzP7PELNd_b6uoh1NKv/u/0/?ik=581c53cf5c&view=pt&search=all&permt… 2/2 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