INFORMATION COUNT I. ARTHUR GRAHAM., in Tulsa County, State of Oklahoma, fiom approximately November

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1 IN THE DISTRICT COURT OF TULSA COUNTY STATE OF OKLAHOMA THE STATE OF OKLAHOMA, Plaintiff, V. Case No. ) ARTHSJRGRAHAM, Defendant. INFORMATION In the name and by the authority of the State of Oklahoma: E. SCOTT PRUITT, Attorney General of Oklahoma, in and for the State and County aforesaid, gives the Court to know and be informed as follows: COUNT I ARTHUR GRAHAM., in Tulsa County, State of Oklahoma, fiom approximately November 0, 20, through December 0, 20, did unlawfully, willfully, intentionally, knowingly and feloniously commit the crime of WORKERS COMPENSATION FRAUD, a felony, in violation of Title 2 O.S (C)(lO), in the manner and form as follows, to-wit: Said Defendant, with the intent to injure, dehud, and deceive Charles Daniels, Daniels and Daniels Construction, with respect to a certificate ofworkers compensation insurance, did knowingly, intentionally, and fi-audulently alter, falsie, forge, distort, and change said certificate, more specifically as follows: The Defendant altered, falsified, forged, distorted, and changed the certificate of workers compensation insurmce on Republic Fire and Casualty Insurance Company Policy in the name of Hang-em and Frame-em AKA Frameem and Hangem Construction, LLC, and presented the same to Charles Daniels of Daniels and Daniels Construction, during the construction of B rae Garage, pursuant to a subcontractor agreement which required the Defendant and Hange-em and Frame-em AKA Framem and Hangem Construction, LLC, to obtain and maintain workers compensation insurance. The Defendant presented said certificate of workers compensation insurance with the intent to deceive and defraud Charles Daniels and Daniels and

2 Daniels Construction, and did so in the following manner, to wit: physically altered the policy number, effective policy dates, and date of signature, to show that the policy was in effect, all of which was false and meant to deceive Daniels and Daniels Construction, as the workers compensation insurance policy RFCOO had, in fact, been cancelled by Republic Fire and Casualty Insurance Company for nonpayment of premium, all of which is contrary to the form of the Statutes in such cases made and provided and against the peace and dignity of the State of Oklahoma. COUNT I From approximately November 5, 20, through December 0, 20, in Tulsa County, Oklahoma, ARTHUR GRAHAM., did then and there unlawfully, willfdly, intentionally and knowingly commit the crime of FAILURE TO PROVIDE WORKERS COMPENSATION, a misdemeanor, in violation of Title 85 O.S. $354, in the manner and form as follows to-wit: While doing business as Hang-em and Frame-em AKA Framem and Hangem Construction, LLC, as a subcontractor to Daniels and Daniels Construction, and performing drywall and framing work through the employ of one or more employees as a subcontractor to Daniels and Daniels Construction, in the construction of Brazee Garage in Tulsa County, failed to either obtain or maintain workers compensation insurance during this period of work, as his Republic Fire and Casualty Insurance Company Policy # for workers compensation insurance had been cancelled on April 03,2007, for non-payment ofpremium, and the Defendant had not obtained workers compensation coverage through another carrier, all of which is contrary to the form of the Statutes in such cases made and provided and against the peace and dignity of the State of Oklahoma. E. SCOTT PRUITT ATTORNEY GENERAL OF OKLAHOMA Assistant Attorney General 33 N.E. 2 Street Oklahoma City, OK (405)

3 STATE OF OKLAHOMA COUNTY OF TULSA ss. I do solemnly swear that the statements and allegations set forth in the within Information are true and correct to the best of my information and belief. ALVIN JONES, JR. Assistant Attorney General SUBSCRIBED AND SWORN to before me thi ay of September, 20 2, by Alvin I have examined the facts in this case and recommend a warrant issue. E. SCOTT PRUITT AIITORNEY GENERAL OF OKLAHOMA ALVIN JONES, JR. Assistant Attorney General Violation and Penalty: 2 OS Not more than seven (7) years and/or $0, O.S. $354 - Not more than six (6) months and/or $,000 3

4 Witnesses: Carl Reed Office of Attorney General 3 3 N.E. 2" Street Oklahoma City, OK Charles Daniels, Owner Daniels & Daniels Construction 350 W. Kenosha Broken Arrow, OK 7402 Eric Rhedin, Special Investigator First Comp Insurance 222 S. 5'h Street, Suite 500 Omaha, NE Bernadette Jost Daniel Boone Agency, LLC 8 7 W. Broadway Columbia, MO 6528 Elizabeth Alway, Agent Rich & Cartmill Agency 238 E. 5d Street, Suite 400 Tulsa, OK 7405 Teece Chambers, Former Shelter Agent 4609 E. 78* Street Tulsa, OK

5 i IN THE DISTRTCT COURT OF OKLAHOMA COUNTY STATE OF OKLAHOMA THE STATE OF OKLAHOMA, Plaintiff, V. Arthur Graham DOB:05/5/57 Defendant. AFFIDAVIT OF PROBABLE CAUSE O m mlm, COURT CLERK OF O%TUL% COUN~ The undersigned, being first duly sworn and upon oath, does depose and state as fo OW I, Carl Reed, am employed as an investigator with the Workers Compensation and Insurance Fraud Unit in the Office of Attorney General. I was assigned to investigate an alleged case of insurance fraud involving Arthur Graham DOB:05/5/57. In the course of my investigation I interviewed witnesses, obtained and reviewed various documents to include: a certificate of insurance showing Arthur Graham d/b/a Frame-em and Hang-em Construction, had workers compensation and employers liability insurance, policy number: RFC , with effective dates of 08// through 08//2. Arthur Graham presented a fraudulent certificate of insurance to Charles Daniels, PresidenKEO of Daniels and Daniels Construction, 350 W. Kenosha, Broken Arrow, Oklahoma, as proof of insurance in order to secure a subcontracting project. The certificate presented to Charles Daniels was an altered copy of a certificate issued to Arthur Graham, d/b/a Frame-em & Hang-em Construction in The effective dates of the certificate were altered to show the dates of 08// through 08//2. The address for DanielBoone Agencywas altered using a bogus address of 87 West Broadway, Bentonville, AR Arthur Graham d/b/a Frame-em & Hang-em, purchased a workers compensation policy (REC ) from Teece Chambers, an insurance agent with Shelter Insurance, on August 24,2006. Frame-em & Hang-em was described as drywall installation. On April 3,2007, the policy was canceled due to non-payment of premium. The certificate Graham gave to Charles Daniels was a version of the 2006 certificate of insurance to altered reflect effective dates of August 5,20 through April 5,202. Agent Chambers ended his employment with Shelter Insurance in Based on the above information, I believe that probable cause exists to show Arthur Graham committed the crime of Workers Compensation Fraud, in violation of 2 OS (C) (0). Therefore, I request that a warrant be issued for his arrest. Carl Reed, AFFIANT

6 STATE OF OKLAHOMA ) ) ss. COUNTY OF OKLAHOMA ) Subscribed and sworn to before me this ich:,,f by Carl Reed. Notary Public (SEAL) My Commission Witnesses

7 FINDING OF PROBABLE CAUSE On the, day of, 202, the above captioned case came before me, the undersigned Judge of the District Court of Tulsa County, Oklahoma, upon the Affidavit of Probable Cause of Carl Reed, Investigator with the Office of Attorney General, requesting that a Warrant of Arrest issue for the within named Defendant, Arthur Graham, that he might be arrested and held to answer for the offenses of Workers Compensation Fraud and Failure to Provide Workers Compensation. Based upon said Affidavit, I am satisfied and do hereby find that the offenses of Workers Compensation Fraud and Failure to provide Workers Compensation had been committed, that there is probable cause to believe the within named Defendant has committed said offenses and that a Warrant of Arrest should issue. Dated this day of, 202. Judge of the District Court 4