18-001159 Department Of Financial Services, Division Of Workers&Apos; Compensation vs. Tjb Construction, Llc Status: Closed Settled and/or Dismissed prior to entry of RO/FO on Monday, June 18, 2018.

FILED

Chief Financial Offiper

Docketed by:

CHIEF FINANCIAL OFFICER

JIMMY PATRONIS STATE OF FLORIDA

DEPARTMENT OF FINANCIAL

SERVICES, DIVISION OF

WORKERS' COMPENSATION,

Petitioner,

VS. Case No . 17-294-1A-WC

TJB CONSTRUCTION, LLC,

Respondent.

FINAL ORDER CLOSING FILE

attached Settlement Agreement . The Settlement Agreement is approved and adopted.

on this & day of 2018.

E. TANNER HOLLOMAN, DIRECTOR

of Workers ' Compensation

NOTICE OF RIGHT TO APPEAL

A party adversely affected by this final order may seek judicial review as provided in section

120.68, Florida Statutes, and Florida Rule of Appellate Procedure 9.190. Judicial review is

initiated by filing a notice of appeal with the Agency Clerk, and a copy of the notice of appeal,

accompanied by the filing fee, with the appropriate district court of appeal. The notice of appeal

must conform to the requirements of Florida Rule of Appellate Procedure 9.110(d), and must be

filed (i.e., received by the Agency Clerk) within thirty days of rendition of this final order.

Filing with the Department's Agency Clerk may be accomplished via U.S. Mail, express overnight

delivery, hand delivery, facsimile transmission, or electronic mail. The address for overnight

delivery or hand delivery is Julie Jones, DFS Agency Clerk, Department of Financial Services, 612

Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0390. The facsimile number is

[phone]. The email address is Julie.Jones(a),myfloridacfo.com .

COPY FURNISHED TO:

TJB Construction , LLC Adrian Middleton

306 Allen Lake Road 1469 Market Street

Sopchoppy , Florida 32358 Tallahassee , FL 32312

MAILED

0

CIZEF FINANCIA L OFFICER

JIMMY PATRONIS STATE OF FLORIDA

DEPARTMENT OF FINANCIAL

SERVICES , DIVISION OF WORKERS'

COMPENSATION,

Petitioner,

vs. Case No. 17-294-IA

TJB CONSTRUCTION LLC.,

Respondent.

SETTLEMENT AGREEMENT

This agreement is made and entered into by and between the Florida Department of

Financial Services , Division of Workers ' Compensation (" Department") and TJB Construction

LLC. (Employer).

Upon the complete execution of this settlement agreement by both parties, the

Department and Employer agree to the following:

I. The Department rescinds Stop - Work Order number 17 -294-1A served against

Employer in this matter. The rescission is final in this case . The Department will refund

Employer $ 1,000.00.

2. Employer ' s request for administrative review filed in this matter is dismissed with

prejudice.

3. The Department and Employer agree that this settlement agreement i s entered into

voluntarily and with full authority of the parties, and with the intent to settle this matter without

proceeding to litigation through a formal hearing. i

4. For the purposes of this settlement agreement , " execution" refers to the time when

both parties have signed the settlement agreement.

5. Employer expressly waives in this matter the right to any hearing pursuant to

sections 120.569 or 120 . 57, Florida Statutes , and all other proceedings to which there may be

entitlement by law or rule of the Department regarding the previously issued stop - work order in

this matter , this proceeding , and any and all issues arising or that may arise from the action.

Employer agrees not to challenge or contest this settlement agreement in any forum that may

now or in the future be available to it , including any administrative proceeding , circuit or federal

court action , or any appeal . Nothing herein shall be construed to limit any party ' s right to enforce

the terms and conditions of this settlement agreement.

6. The Department's determination to enter into this Settlement Agreement is based

on the specific facts and circumstances of this case , and has no applicability to any other matter

arising or that may arise from actions taken by the Department against employers under section

440.107, Florida Statutes.

7. Each party agrees that it shall bear its own costs and attorney fees in this matter.

Employer expressly waives any rights to claim attorney fees or costs under sections 57.041,

57.061 , 57.105 , 57.111, and 120.595 , Florida Statutes , or any other statute or other authority.

2

I

Dated this V4 ' day of 3&) \\ , , 2018.

Department of Financial Services, TJB Construction LLC.

Division of Workers ' Compensation

Taylor Anderson Printed Name : Adrian S. Middleton

Attorney , Workers ' Compensation For TTB Construction LLC.

Department of Financial Services 306 Allen Lake Rd,

200 East Gaines Street Sopchoppy, Florida 32358

Tallahassee , Florida 323994229