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JIMENEZ, SAMUEL FLORES Agents File Checklist.pdfAGENTS Completed File Check List
Folder Named Properly - (LAST, FIRST - 06/15/25 - NZ)
All Files are named correctly in Folder, - (DOE, JOHN - PREMIUM )
Booking Sheet / Mugshot (Current or Previous)
TLO's for all parties involved
Clerk Search for "ALL" Relevant Counties
State ID's for all signers
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Unclassified | 225.8 KB | 2025-09-26 18:54:03 uploaded 125d after created | no | Dropbox · History |
JIMENEZ, SAMUEL FLORES 1 EP V10.92024 - Orange.pdfIndemnitor:
Brayan Jimenez
Ind Add.
5803 citadel drive
Social Security:
City:
Orlando
ACF#:
State:
Florida
Zip:
32839
Ind Home#
Ind Cell #
Email :
Relationship to Def.:
How long known Def.:
IA
PN
Collateral Explained:
Mortgagee Deed ($17.00)
FULL COLLATERAL CHARGED TO CC ENDING IN
Vessel Title ($75.00 fee)
Collateral in Amount of
$ 250.00
Cash
Check
CC
MO
Collateral held by
Bondsman
Surety
Condition(s) of Bond: _
DEFENDANT MUST COMPLETE PAPERWORK 48 HRS UPON RELEASE
Defendant Name:
JIMENEZ, SAMUEL FLORES
Booking #
dob: 3/7/74 doa:
5/23/25
sex:
race:
Execution Date: _
5/24/25
Power No: _
AlA TRANSFER
Bond Amount: $ 250.00
Charge: OPERATE MOTOR VEHICLE W/O VAL
Detainer:
Premium: $ 100.00
Court:
Case No:
County: _
Court Date:
Time: _
Agent:
- Agent Lic No:
City:
State:
Total Premium$ 100.00
Total Liability$ 250.00
$ 101.88
Misc Charges:
Total Charges:
Money Received on Account:
$ 201.88
20250465
COUNTY
HARDEE
$ 201.88
Packet Completed by:
BAIL BOND APPLICATION - INDEMNITOR
COMPANY
ALLEGHENY CASUALTY COMPANY
P.O. Box 9810, CALABASAS, CA 91372-9810
TELEPHONE (800) 935-2245
BAIL 2 GO
P.O. Box 592643, ORLANDO, FL 32859-2643
TELEPHONE (407) 254-5554
1. Name-
First
2. Residence Address.
Brayan Jimenez Valencia
Middle
Last
5803 citadel drive
My friends/family know me as
City
3. How Long at Current Address
2yr
Rent Free
Lease
_ Own X
4. Is Mortgage/Lease in your name? Yes
5. Cell Phone #
3212792146
No
When does Lease Expire
Cell Carrier I Mot iPhone or Android
6. Employer
Alpha builder one
Length
3yr_ Position
Any ownership greater than 20% in any Corporation, LLC, or S-Corp
7. Social Security No.
766094791
ID#
J552072014440
8. Have you ever filed Bankruptcy.
M
Orlando
Do you have any judgements or liens against you currently
12/04/2001
Orlando
_ State Florida zip
32839
Landlord/Mortgagor Name
Email_ Brayanjim105@gmail.com
iPhone
Worker
How Long with Cell No.
4yr
Work #
_ Any specialized license to work
wx220Ht 5,9 Race Hispa Eye Color Brow Hair Black
_ If so, where
Yes
Marital Status
How Long
10. Have many years have you lived in FL?
11. Vehicle Year
Vehicle Color
Are you a convicted felon?
_ Are you on any type of Probation or Parole ?
Vehicle Make
Friend
Tag No.
Vehicle Miles
12. Relationship to Defendant
How long have you known Defendant
Amount Owed
3yr
Defendants Home Address
5749 kings gate Dr AptD
Defendants Cell Phone Number
13. Emergency Contact Name
Address
Phone No.
13. Children Yes
No
No
Amount of children
Ages
Do kids reside with you
14. Attorney
Phone No.
May we reach out on the defendants behalf
15. How did you hear about us?
Personal References First & Last Name
Relationship
City / State
Phone
1._
2.
3.
4.
5.
6.
I hereby represent and warrant that the foregoing information is true, complete and correct and is made for the purpose of
inducing International Fidelity Insurance Company/Allegheny Casualty Company to issue, or cause to be issued, bail bond(s) for
Warning: Any person who knowingly and with intent injure, defraud or deceive any insurer, files a statement of claim or an application
containing and false, incomplete or misleading information is guilty of a felony of the third degree.
Indemnitor
Sign
Print
Brayan Jimenez
ID#
SSN
DOB
J5552072014440
766094791
12/04/2001
CO
allegheny
CASUALTY COMPANY
PO Box 5600, Thousand Oaks, CA 91359
800.935.2245 info@aiasurety.com
BAIL BOND AGREEMENT ("Agreement")
PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE:
%DIOT * 2 Orlando (Orange County)
16 RX- RKQ< RXQJ 3N2\
2 LOQGRI) / MOL
THIS IS A DOUBLE SIDED DOCUMENT
READ ALL SIDES CAREFULLY
In consideration of Allegheny Casualty Company ("Surety"), through Surety's duly appointed independent bail producer
("Bail Producer"), (Surety and Bail Producer are sometimes together referred to as "Surety"), issuing, or causing to be
issued, a criminal appearance bail bond described as:
Date
Defendant Name
5/24/25
JIMENEZ, SAMUEL FLORES
Indemnitor Name(s)
Brayan Jimenez
Total Bond Amount $
$ 250.00
Total Premium $
$ 100.00
Power Number(s)
AIA TRANSFER
("Bond")
I/we represent and warrant that I/we have read, approve and agree to all of the terms and conditions found on following
pages (front and back).
Signed, sealed and delivered this
Defendant Signature
5/24/25
Indemnitor Signat
Print Name
JIMENEZ, SAMUEL FLORES
Print Name
Brayan Jimenez
Indemnitor Signature
Indemnitor Signature
Print Name
Print Name
Indemnitor Signature
Print Name
Indemnitor Signature
Print Name
Si no puede leer ni entender Inglés, favor de marcar este cuadro.
Check box and complete the
(If you cannot read or understand English, please check this box.)
following if translation is required
Translation Certification. The undersigned translator makes this affidavit and hereby certifies, under penalty of perjury,
that he/she read verbatim and translated this entire document, including the reverse side, and all related bond
application documents including disclosures, promissory notes, security instruments and trust deeds, to the Indemnitor
signing below in his/her primary language.
Translator Print Name
Translator Signature
Translator Full Address
Date
Confirmo por mi colocación de mis iniciales que las dos caras de este acuerdo han sido traducidos completamente a mi
satisfacción. (I confirm by my affixing my initials that this contract has been translated to my satisfaction.)
INDEMNITOR Initials
READ ALL TERMS AND CONDITIONS ON THE FRONT AND BACK OF EACH PAGE
Form# ACC.FL.0307 (10/21)
+0 8L15,
Page 1 of 4
Terms And Conditions
You, the undersigned (referred to herein as "Indemnitor," "Defendant," or together as "you" or "your," as applicable),
agree to be bound to the following terms and conditions:
1. The premium for the Bond is fully earned upon the release of Defendant from custody. The premium is not refundable
except as stated herein or provided by law.
The fact that Defendant may have been improperly arrested, the bail
reduced, or the criminal case dismissed shall not obligate the Surety to return the premium, or any portion of it.
2. Detendant agrees to appear in any Court as required in connection with the Bond at the dates and times stated in the
Bond and/or as may be ordered by the Court. Indemnitor will ensure that Defendant appears in Court as so required or
as ordered by the Court.
. Surety shall have control and jurisdiction over the Detendant during the term for which the Bond is in ettect and sha
lave the rant to apprenend. arrest and surrender the Detendant to the proper otticials at anv time as provided ov lav
and/or this Agreement. It the Detendant is surrendered betore a tailure to appear in Court, and tor a reason other than
as stated in paragraph 4,
, you may be entitled to a refund of the Bond premium if required by applicable law (if any) and
as may be stated in the Supplemental Terms and Conditions.
4. Unless otherwise provided by applicable law (it any), the tollowing events shall constitute a breach of vour obligations
to the Surety, and the Surety shall have the right to immediately apprehend, arrest and surrender Defendant to custody,
and you shall have no right to the refund of premium whatsoever:
a Detendant departs the jurisdiction of the court without the prior written consent of the Court and the Surety
) Detendant moves trom his/her current address without prior written consent of the Suretv, or Detendant tail
o notity Surety ot any changes in address; (C) Detendant commits any act that constitutes reasonable evidenc
t the intention to cause a torteiture of the Bond or Detendant's tailure to appear in Court as required; (d
Defendant is arrested and incarcerated for an other offense (other than a minor traffic violation); (e) Defendant
or an Indemnitor makes any materially talse statement in any material submitted to Surety for the Bonc
ncluding the Bail Bond Application and Indemnitor Application; (f The bail for Defendant is increased; (g
Indemnitor requests the surrender to custody of the Defendant; and/or (h) There is a material increase in the
risk assumed by the Surety (as determined by the Surety in its sole and absolute discretion), including, by way
of example, but not limited to, depreciation or impairment of any collateral pledged as security for the Bond.
5. In the event that the apprehension and surrender of Detendant to custody is required tor any reason, includina the
failure to appear by Defendant at any required Court proceeding or hearing,
and
acknowledges that such apprehension and surrender involves risk of harm to Detendant and others, and as such
Defendant accepts the risk of such harm that may be caused to Defendant and/or others.
Defendant also agrees to
defend, indemnify and hold Surety harmless (including all agents and employees thereof) from any injuries
harm
osses, claims, actions, lawsuits, damages, liability, demands, fees and expenses, including attorneys fees and costs
made by any third party against Surety (including all agents and employees thereof) arising out of such apprehension
and surrender of Defendant.
6. You, jointly and severally (together and separately) with any other indemnitor, shall indemnify the Surety and keep the
Surety indemnified and hold it harmless from and against any and all claims, lawsuits, damages, losses, liability,
demands, actions, judgments, fees, fines, penalties and expenses (including attorneys fees and costs), relating to,
arising out of, Surety's issuance or procurement of the Bond (together, "Liabilities"), including, but not limited to, the
following:
a) the principal amount of any forfeiture of, or judgment on, the Bond, plus any related court costs, interest anc
egal fees incurred; (b) any fugitive recovery fee if there is a forfeiture of the Bond (which fee is typically ten t
wenty percent 10-20% of the amount of the Bond plus any out of pocket expenses); c any and all cost
ncurred to extradite and/or apprehend and return Defendant to custody; and/or (d) if a collection action is requires
under this
Agreement, reasonable and actual attorney's fees plus any and other costs,
expenses
and/or
assessments that may be incurred as a result thereof the forfeiture of the Bond as subject to applicable law (if any).
The voucher, check or other evidence of any payment made by Surety shall be conclusive evidence of such payment in
anv action against vou as to the proprietv of such pavment and as to the extent of vour liabilitv to Suretv tor such
payment hereunder.
-urther, you will, upon demand, place with Surety the requisite cash funds to meet any Liabilities (including a pendin
inpaid judgment or forfeiture demand), whether the demand is made before or after Surety has paid or advanced suct
7. Subject to applicable law (it any), any collateral (real or personal, including cash or securities) pledged to or deposited
with Surety as security for the obligations under this Agreement ("Collateral"
the Bond and/or to place the Surety in cash funds so as to protect the Surety
also with the right to purchase said Collateral at such sale or sales, freed and discharged from any equity or redemption,
except as otherwise provided by applicable law.
8. The Surety shall not be liable for the depreciation of any Collateral or for any interest thereon. In the event of
depreciation of the value of Collateral, or any part thereof, or of any Collateral that may be hereafter pledged to or
deposited with the Surety, upon request of the Surety, you shall provide the Surety with additional and satisfactor
Collateral so that the total value of the Collateral shall equal the value of the Collateral at the time of the initial pledge or
deposit. Subject to applicable law (if any), if you fail to deposit such additional Collateral, the Surety shall have the full
9. If a Confession of Judgment ("COJ") is taken as security for the Bond, the Surety shall have the right to enter, record
and file the COJ at any time, and such COJ shall constitute a lien entitled to a preference against any of your property,
Form# ACC.FL.0307 (10/21)
Page 2 of 4
whether or not the Surety is entitled to be indemnitied at the time of the entry, recording or tiling of such COJ. It such
COJ is entered, recorded or filed by the Surety against you, the COJ entered shall be effective and available to the
Surety against you.
10. You acknowledge and agree that the Surety may foreclose against the Collateral and/or exercise any of the rights or
remedies_provided under this Agreement or take any combination of such actions without waiving any other right or
remedy. Failure to exercise any rights or remedies of the Surety at any one time shall not constitute a waiver of the right
to exercise them at any other time. Any security or Collateral you give may be substituted, subordinated, or released by
the Surety without affecting any other rights. The Surety shall not be obligated to enforce its rights against any security,
Collateral or indemnitor prior to enforcing its rights against you or any other indemnitor.
11. Subject to applicable law (if any), the Surety will return the Collateral to you when all of the following are satisfied:
(a) the Surety receives sufficient and competent written legal evidence satisfactory to the Surety (for example,
written notice from the Court) of the discharge, release or exoneration of the Surety from all liability under the
Bond; (b) there are no outstanding Liabilities of any kind arising out of or relating to the Bond or this Agreement;
c) there are no other obligations executed by, for or on behalf of the Defendant for which the Surety may deem
t advisable to retain such Collateral for its protection; and (d) upon the request by Surety, you shall execute anc
deliver to Surety a legal release of claims upon the return by Surety of the Collateral to you.
f the Surety deems it necessary to make any outlay to protect any Collateral or security in its possession, whether foi
real or personal property, you authorize the
Surety to do so, and vou agree to indemnity and reimburse the surety to
any such outlay as in the judgment of the Surety may be necessary to protect the Collateral, including payment of taxes,
liens or mortgages and any attorney's tees, costs and service tees tor time spent and/or special services rendered.
12. The Surety shall have the right to transfer and/or assign, in whole or in part, its rights and obligations in this
Agreement, and/or in the Bond, to the Bail Producer or any other person or entity ("Assignee") without notice to or
Assignee shall have the right to
one anen on one are her one out a no and yes awe any aro, ner earn or rene,
that Assignee does not have the right to enforce such rights in any such action, proceeding or otherwise.
13. You hereby acknowledge and agree that neither the Surety nor Bail Producer has recommended or suggested any
specific attorney or firm of attorneys to represent the Defendant in any capacity
14. This Agreement may not be terminated or modified orally. Any modification and termination of this Agreement,
including any release of liability hereunder, must be in writing and signed by the Surety and you.
federal law (including, but not limited to,
Title 28, Privacy Act-Freedom of Information Act and Title
Reporting Act) and any local or state law relating to Surety obtaining, and vou consent to and authorize Surety to obtain,
any and all private or public information and/or records concerning you from any party or agency, private or
governmental (local, state or federal), including, but not limited to, credit reports, Social Security Records, criminal
records,
civil records, driving records, tax records.
telephone records, medical records, school records, worker
compensation records, and employment records. You further authorize, without reservation, any party or agency, private
or governmental (local, state or federal) contacted by Surety to furnish to Surety or Bail Producer, in accordance with
applicable law, any and all private and public information and records in their possession concerning you to the Surety
and direct that a copy of this document shall serve as evidence of said authorization.
16. You irrevocably grant to Surety and Bail Producer, and their agents and employees, the right to enter your
residence, or any other residence or real property you own or occupy, without notice,
at any time, for the purpose of
ocating, arresting, and returning the Detendant to custody, and subject to applicable law, you waive and release any
and all causes of action in connection therewith, including without limitation, torts of trespass and false imprisonment.
17. Defendant agrees that Surety may attach a location tracking device on any vehicle owned or driven by Defendant, at
any time, without notice, and monitor the location of the vehicle through any available technology. Defendant further
agrees that Surety may use location technologies to locate and track any wireless device of Defendant at any time
during the period of the Bond is in force and any applicable Bond remission period, and the Bond is conditioned upon
the full compliance by Defendant with the following terms and conditions:
a) Surety, at its discretion, will use network-based location technologies to locate Defendant; (b) This is the only
notice Defendant will receive for the collection of location information; (c) Surety will retain location data only
while the Bond is in force and during any applicable Bond remission period; (d) Surety may disclose location
I POU UP A 100 TRACKING DURNE THE PERIOD THE BOND IN FORCE
AND ANY APPLICABLE BOND REMISSION PERIOD.
Direct all questions regarding this paragraph to the Surety.
18. If Defendant leaves the state in which the Bond was issued, subject to applicable law, Defendant waives any rights
to oppose extradition proceedings.
19. In the event any provision herein shall be deemed to exceed any applicable state or federal law, then such provision
shall automaticallv be deemed to have been revised to comply with such law so as to provide Surety with the maximum
rotection from any Liabilities. The invalidity or unenforceability of any provision herein (or portion thereof) shall in no
way effect the validity or enforceability of any other provision (or portion thereof) of this Agreement
20. This Agreement and all documents that are executed in connection with this Agreement set forth all the terms of the
of no force or effect whatsoever in determining the rights, obligations and/or liabilities between the
Surety and you. You further agree to execute and be bound by any other future documents necessary to carry out and
effectuate this Agreement.
Form# ACC.FL.0307 (10/21)
Page 3 of 4
1. Surety, as bail, shall have control and jurisdiction over Defendant during the term for which the Bond is executed and
shall have the right to apprehend, arrest and surrender Defendant to the proper officials at any time as provided by law.
2. In the event Defendant's surrender is made prior to the time set for Defendant's appearances, and for reasons other
than as enumerated below in paragraph 3, then a refund of the Bond premium shall be made to the person whose name
appears as Payer on the Premium Receipt.
. It is understood and agreed that the happening ot any one of the tollowing events shall constitute a breach o
etendant's obligations to Suretv, and Surety shall have the right to immediately apprehend, arrest and surrende
and no person shall have any right to any refund of premium whatsoever. The events which constitute a
breach of Defendant's obligations hereunder are:
a It Detendant departs the jurisdiction of the Court without the written consent of the Court and Surety or Bal
Producer; (b) If Defendant moves from one address to another within the State of Florida without notifyinc
Surety or Bail Producer in writing prior to moving; (c) If Defendant commits any act which constitutes reasonable
evidence of Defendant's intention to cause a forfeiture of the Bondi(d) If Defendant is arrested and incarcerated
for any offense other than a minor traffic violation; or (e) If Defendant makes any material false statement in the
4. INFORMATIONAL NOTICE. For any complaints or inquiries, you may contact the Department of Financial Services
Division of Consumer
Services,
Section,
East Gaines
Street,
Tallahassee, FL 32399-0322,
1-877-693-5236 (in-state)
5. The person whose name appears as Payer on the Premium Receipt shall be entitled to a refund of premium for the
Bond if and when it is found that Surety had no liability under the Bond because Defendant did not come under the
jurisdiction of the court to which Defendant is returnable or Defendant is not released from custody, except where the
Bond is written to allow Defendant to serve a sentence in another jurisdiction.
6. For good and valuable consideration, you agree to indemnify and hold harmless the Surety or its agent for all losses
not otherwise prohibited by law or by rules of the Department of Financial Services.
7. You acknowledge receipt of copies of this Agreement, which includes statements as to () the restrictions placed or
Defendant as a condition of the Bond and (b) the Bail Producer's and Surety's powers relating to the cancellation of the
Bond and recommitment of Defendant.
8. The specific fees for which you are required to indemnify Surety in accordance with the Agreement are as follows:
(a) Costs necessary to apprehend Defendant in the event Defendant attempts to flee the jurisdiction of the
courts; (b) Attorneys tees and court costs associated with tiling of motions; (c) Documented transportation and
lodging expenses outside the jurisdiction of
_aw enforcement costs for housing,
transportation and extradition; and (e) A maximum fee of $100 for a surrender allowed by law when there has
been no forfeiture of the Bond
9. Collateral will be returned to the person whose name appears as "Depositor" on the Collateral Receipt within 21 days
after proof of final termination of liability on the Bond has been provided to the Surety.
entitled to deduct from collateral held or any return
authorized by applicable law, including Fiorida Administrative Code 69B-221 Premium all fees, expenses, and charges
a conflict between the terms and conditions of the Agreement and this
Supplement shall control.
Form# ACC.FL.0307 (10/21)
Page 4 of 4
allegheny
CASUALTY COMPANY
PO Box 5600, Thousand Oaks, CA 91359
800.935.2245 info@aiasurety.com
BAIL BOND INFORMATION SHEET
PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE:
Bail 2 GO Orlando (Orange County)
3800 South John Young Pkwy
Orlando, FL 32839
(407) 254-5554
Defendant Name
JIMENEZ, SAMUEL FLORES
Power Numbers)
AIA TRANSFER
Case Number
As principal (detendant) and/or indemnitor (guarantor) on a bail bond, you must be given a copy of any collateral
documents that you sign relating to the above bond(s)
When all agreements have been fulfilled, bond is discharged in writing by the court, and without loss expense on the
bond(s), your collateral will be returned to you.
BE AWARE: YOUR COLLATERAL IS AT RISK if the principal fails to appear in court or if the principal commits any
breach (violation) of agreement.
ANY OF THE FOLLOWING HAPPENINGS IS A BREACH OF AGREEMENT:
1. If principal fails to appear in court;
2. If principal shall depart the jurisdiction of the court without the written consent of the court and the Surety, or its agent;
3. If principal shall move from one address to another without notifying the Surety, or its Agent, in writing, prior to said
move;
4. If principal shall commit any act which shall constitute reasonable evidence of principal's intention to cause a forfeiture
of the bond(s);
5. If principal is arrested and incarcerated for any offence other than a minor traffic violation;
6. If principal shall make any material false statement in the application;
7. If principal shall violate any special restriction or condition of the bond(s) imposed by the Court.
For general information regarding your collateral, contact the agency as shown on the top of this sheet.
For further inquiry / complaint, contact
Department of Financial Services
Bail Bond Section
200 East Gaines Street
Tallahassee, FL 32399-0320
Phone: (850) 413-5660
**** Read carefully prior to signing ****
PRINCIPAL/INDEMNITOR ACKNOWLEDGMENT
I/We have received a copy of this information sheet.
INe have received a copy of all collateral documents that I/e signed regarding the above bond(s).
Defendant Signature
Print Name
Date
Indemnitor Sishatt
Print Name
Brayan Jimenez
Signed original to agent's bond file; Copy to defendant and each indemnitor
Date
5/24/25
Form# ACC.FL.0028 (10/22)
Page 1 of 1
CONTINGENT PROMISSORY NOTE
This Contingent Promissory Note ("Note") is being executed by the undersigned ("Maker") to secure Allegheny Casualty
Company, as Surety, upon forfeiture or estreature of the surety bond(s) posted on behalf of defendant:
JIMENEZ, SAMUEL FLORES
("Defendant").
On demands after date, for value received, I/We promise to pay to the order of Allegheny Casualty Company the sum of $
$ 250.00
Dollars, at PO Box 5600, Thousand Oaks, CA 91359, with interest thereon at the
rate of eighteen percent (18%), per annum from call date until fully paid. The Maker further agrees to waive demand, notice of
non-payment and protest, and in case suit shall be brought for the collection hereof, or the same has to be collected upon
demand of an attorney, to pay reasonable attorney's fees and assessable costs, for making such collection.
It is further agreed and specifically understood between the parties to this Note that there is presently no outstanding loan or
debt represented by this Note, and that this Note is given only to secure future advances. It is further agreed and specifically
understood that this Note shall become null and void in the event the said Defendant shall appear in the proper court at all the
time or times so directed by the Judge or Judges of competent jurisdiction until the obligations under the appearance bond or
bonds posted on behalf of the Defendant have been fulfilled and the Surety discharged or exonerated of all liability thereunder,
in writing, otherwise to remain in full force and effect.
Case number(s)
, HARDEE
COUNTY, FLORIDA
PIA number(s) AIA TRANSFER
Signature
Brayan Jimenez
Maker Name
Form# ACC.FL.0036 (10/21)
* 08212*
Signature
Date
Reset Form
COLLATERAL RECEIPT
allegheny
CASUALTY COMPANY
PO Box 5600, Thousand Oaks, CA 91359
800.935.2245 info@aiasurety.com
•
| Deposit of collateral: Depositor hereby acknowledges receipt of
a copy of this document and agrees to the terms on the reverse
side. The collateral identified below is deposited as security for
the bail bond(s), premium owed, if any, and all lawful expenses
incurred due to underwriting the referenced bail bond(s).
Date Received
5/24/25
Depositor Name(s)
Brayan Jimenez
Depositor Address
5803 citadel drive
Power Number(s)
Case Number
AIA TRANSFER
Items) Received - describe below, specify condition
Promissory Note, Signature
$
Bail Bond Agreement
$
Collateral funds - in form of FULL COLLATERAL CHARGED TO CC I $$ 250.00
If applicable, I acknowledge a Credit Card fee of
% in the amount of $$7.50
epositor
Signature
FLORIDA USE ONLY
Form# ACC.FL.0304-2 (01/23)
Print Name
Brayan Jimenez
Bail Producer
Signature
Print Name
Receipt No.: ACFL-
PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE
Bail 2 GO Orlando (Orange County)
3800 South John Young Pkwy
Orlando, FL 32839
(407) 254-5554
Return of collateral: Depositor hereby surrenders the original and acknowledges
the return and receipt of collateral listed herein and that the collateral has been
eturned in good and sufficient condition. Depositor hereby relieves the surety anc
ts bail producer from any further liability or responsibility in relation to the collatera
Returning collateral from receipt numbers)
Depositor Phone Number
Defendant Name
JIMENEZ, SAMUEL FLORES
Bond Amount
$ 250.00
Amount or Estimated Value
Held By
Bail Producer
Bail Producer
Bail Producer
L
L
Surety
Surety
Surety
COLLATERAL RECEIPT
Except as otherwise provided by applicable law (if any) as stated in the Bail Bond Agreement ("Agreement"), you are depositing the collateral
as security for the payment of any and all monies and sums due to Surety or its Bail Producer, including all liability, claims, demands, debts
(including promissory notes), damages, judgments, losses, interest, premiums, expenses, services charges, expenditures, attorneys' fees and
costs suffered, sustained, made or incurred by Surety or its Bail Producers on account of, arising out of or relating to the above bail bond and
transactions contemplated thereby, your failure to comply with the terms and conditions of the Agreement and any and all debt or other
obligations arising out of or evidenced by any agreement executed by you, Defendant or any other indemnitors) for the benefit of Surety or its
Bail Producer, all of the terms of which are made a part of this receipt by this reference ("Liabilities").
The Bail Producer will make the collateral available for return to the person whose name appears as Depositor on the Collateral Receipt (or
that person's heir, legal representative, or successor in interest) within 10 days, or as stated in the Agreement, after receiving written notice
from the court that the Bond and the Surety have been exonerated, and must verify with the court that the obligation has been exonerated
before returning the Bond.
If the collateral you provided included a document that conveys title to a lien on real property and such document was recorded, the Bail
Producer or Surety shall deliver a reconveyance of the property, executed in such a manner that it may also be recorded, to you or your heir,
legal representative or successor in interest within 10 working days, or as stated in the Agreement, after the Bail Producer or Surety receives
notice of the exoneration of the Bond in writing by the court. The Bail Producer or Surety shall deliver such reconveyance document to you by
making the document available at its principal place of business or mailing it to you upon your request.
The Bail Producer or Surety will not return any collateral to you until you provide the written receipt that identifies the Bond, describes the
collateral, and shows your signature.
For any complaints or inquiries, you may contact the Department of Financial Services, Division of Consumer Services, 200 East Gaines
Street, Tallahassee, FL 32399-0322, (877)693-5236 (in-state), (850)413-3089 (all areas), www.MyFloridaCFO.com/Division/Consumers.
PREMIUM RECEIPT and STATEMENT OF CHARGES
allegheny
CASUALTY COMPANY
PO Box 5600, Thousand Oaks, CA 91359
800.935.2245 info@aiasurety.com
Date Received
5/24/25
Payer Name
Brayan Jimenez
Defendant
JIMENEZ, SAMUEL FLORES
Power Numbers)
AIA TRANSFER
Court
COUNTY
Payment • Cash
Method
• Check
• Credit Card
• Money Order
Receipt No.: AP-
20250465
PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE:
Bail 2 GO Orlando (Orange County)
3800 South John Young Pkwy
Orlando, FL 32839
(407) 254-5554
Credit Card Authorization Code
Amount Received ($)
$ 201.88
Payer Phone Number
Bond Amount ($)
$250.00
Case Numbers)
Appearance Date
Appearance Time
Collateral Received Collateral Receipt Numbers)
• Yes • No
Itemized Expense(s) (if and as permitted by applicable law)
Expense Amount
$ 101.88
Expense(s)
$
$
Bail Bond Premium
Total Expense(s)
Prior Payments)
$
$
$100.00
$ 201.88
$
$
Amount Received
Remaining Balance
($
($
$
$ 201.88
$ 0.00
Payer Signatur
*08185 *
Form# ACC.0304-1 (10/21)
Print Name
Brayan Jimenez
Received By
Producer/Representative Signature
Producer/Representative Print Name
)
PREMIUM RECEIPT and STATEMENT OF CHARGES
I understand that the premium owing or paid is fully earned upon the Defendant's release from custody, and the fact that the
Defendant may have been improperly arrested, re-arrested, the case dismissed, or the bail reduced shall not obligate the return
or forgiveness of any portion of the premium except as otherwise provided by applicable law (if any) as stated in the Bail Bond
Agreement.
allegheny
CASUALTY COMPANY
PO Box 5600, Thousand Oaks, CA 91359
800.935.2245 info@aiasurety.com
FOR FURTHER ACTION ON THIS BOND NOTIFY:
Bail 2 GO
P.O. Box 592643
Orlando, FL 32859
Email: courtdates@bail2go.com
Transfer agent
dob: 3/7/74
doa: 5/23/25
sex: M
General Surety Appearance Bond
_race: W
Power Number AIA TRANSFER
Arrest Number
20250465
STATE OF FLORIDA
IN THE_COUNTY
VS:
COURT
JIMENEZ, SAMUEL FLORES
HARDEE
COUNTY
KNOW ALL MEN BY THESE PRESENTS: That we, the above captioned defendant as Principal, and Allegheny Casualty
Company, a New Jersey corporation, as Surety are held and firmly bound unto the State of Florida and its successors, to the
penal sum of ($)
$ 250.00
for the payment whereof well and truly to be made we bind ourselves,
our heirs, representatives, successors, and assigns firmly by these presents.
The condition of this obligation is such that if said Principal shall appear on
at
the next Regular or Special term of the above court and shall submit to the said Court to answer a charge of:
OPERATE MOTOR VEHICLE W/O VALID LICENSE
for case number
and shall submit to orders and process
of said court and not depart the same without leave, then this obligation to be void, else to remain in full force and virtue.
Signed, sealed and delivered this 5/24/25
TAKEN BEFORE ME AND APPROVED BY ME:
(L.S.)
_, Clerk / Sheriff
(Principal)
Allegheny Casualty Company
By
By
(Attorney in fact) (SURETY)
Agent / License Number
Agent Name
This bond not valid for deferred sentence, fines, pre-sentence investigation, pre-trial intervention programs or appeals
STATEMENT OF BONDSMAN
1, the undersigned, am a duly licensed bail bond agent pursuant to Chapter 648, F.S., and have registered for the current
year with the office of the Sheriff and Clerk of Court of the aforementioned county, and have filed a certified copy of my
appointment by Power of Attorney for the Surety with the office of the Sheriff and Clerk of the Court of the aforementioned
County. That said Principal of 5803 citadel drive
(Address) has (given or promised to give) the sum of ($)
$ 100.00
as consideration for Bail Bond Number
AIA TRANSFER
filed with the Clerk of the above captioned court located in said county together with the (promise
or receipt) of security belonging to Brayan Jimenez
(Indemnitor(s)) as follows:
(provide detailed description and source of security) (if none, so state).
That a duly signed receipt has been given to the said Principal for the consideration given and/or that the said
indemnitor has (also been) given a receipt for the security described above.
(Bondsman)
(Agency)
Bail 2 GO Orlando (Orange County)
|
Indemnitor app (digital) | 6.8 MB | 2025-09-26 18:54:03 uploaded 121d after created | no | Dropbox · History |
JIMENEZ, SAMUEL FLORES ADDRESS.pdf5749 Kingsgate Dr D - Google Maps
Google Maps
PAVE
Harbor Chase Cia
Tulip Ave
Oak Harbor Apartments O
• Danial Berhane
• Ciworld/Energy
Breskin Ave
Brookgreen Ave
David Ave
W Oak Ridge Rd
idere St
5/24/25, 11:41 PM
5749 Kingsgate Dr D
Queen Anne: Dr
Kingsport Dr
Castlegate Dr
Seabridge Dr
Kingsbridg…
[show full stored text] |
Unclassified | 1.5 MB | 2025-09-26 18:54:03 uploaded 125d after created | no | Dropbox · History |
JIMENEZ, SAMUEL FLORES COLLATERAL.pdfAmerican Spirit Processing Payment Gateway
5/24/25, 6:01 PM
Transaction Successful
Transaction Receipt
Merchant:
Address:
Date/Time:
Transaction ID:
Transaction Type:
Entry Method:
Amount:
Credit Card Information
CC Type:
CC Number:
Auth. Code:
Processor:
Billing Information
BRAYAN JIMENEZ
BRAYANJIM…
[show full stored text] |
Unclassified | 82.9 KB | 2025-09-26 18:54:03 uploaded 125d after created | no | Dropbox · History |
JIMENEZ, SAMUEL FLORES Credit Card Authorization Form - signed.pdf .pdfCredit Card Authorization form
1, BRAYAN JIMENEZ VALENCIA
Indemnitor
, give permission to Axiom Surety Corp dba Bail 2 GO to charge
my card for the following transaction(s). My card details will be stored under my Bail 2 GO
profile and will only be used for approved transaction(s) and incurred expen…
[show full stored text] |
Unclassified | 288.4 KB | 2025-09-26 18:54:03 uploaded 124d after created | no | Dropbox · History |
JIMENEZ, SAMUEL FLORES Credit Card Authorization Form.pdfCredit Card Authorization form
BRAYAN JIMENEZ VALENCIA
, give permission to Axiom Surety Corp dba Bail 2 GO to charge
Indemnitor
my card for the following transaction(s). My card details will be stored under my Bail 2 GO
profile and will only be used for approved transaction(s) and incurred expenses…
[show full stored text] |
Unclassified | 550.8 KB | 2025-09-26 18:54:03 uploaded 125d after created | no | Dropbox · History |
JIMENEZ, SAMUEL FLORES EDP V10.9.1.2024 - Orange.pdfPacket Completed By: SC
Defendant: JIMENEZ, SAMUEL FLORES
Def Add.
Def Home #
_ City:
Def Cell #
Condition(s) of Bond:
Check in Schedule:
Phone In Days :
Walk In Days :
Mon
Mon
Tues
Tues
Social Security:
State: _
Email :
FULL COLLATERAL
FULL COLLATTERAL
Wed
Wed
Thur
Thur
Fri
- Fri
Zip: _
• Sat
• Sat…
[show full stored text] |
Defendant app (digital) | 1.4 MB | 2025-09-26 18:54:03 uploaded 125d after created | no | Dropbox · History |
JIMENEZ, SAMUEL FLORES INDEM ID.pdfSEAL
Florida....
DRIVER LICENSE
200000
9 CLASSE
USA
: 12/04/2001
4b EXP
12/04/2027
12 REST NONE
Sa END
NONE
UNDER 21 UNTIL
12/04/2022
15 SEX
M
16 HGT
5'-08°
4o Iss 01/14/2019
5: 00 G/62002040329
REPLACED 02/04/2020
4d DEN
3552-072-01-444-0
I JIMENEZ-VALENCIA
2 BRAYAN LEONARDO
84835 AL WAY
ORLANDO, F…
[show full stored text] |
State ID | 458 KB | 2025-09-26 18:54:03 uploaded 125d after created | no | Dropbox · History |
JIMENEZ, SAMUEL FLORES PREMIUM AND TRANSFER FEE.pdfAmerican Spirit Processing Payment Gateway
5/24/25, 6:02 PM
Transaction Successful
Transaction Receipt
Void
Refund
Transaction Information
Merchant: Axiom Surety Corp - (Orlando, FL)
Transaction ID: 10745800970
Amount: $201.88
Date: 05/24/2025 6:02:17 PM EDT
Transaction Type: Card Sale
Entry Method:…
[show full stored text] |
Unclassified | 106.4 KB | 2025-09-26 18:54:03 uploaded 125d after created | no | Dropbox · History |
Transfer_Bond_Confirmation (86).pdfAIA Surety
Transfer Bond Confirmation
Date:
To:
5/24/2025
xavier
Fax:
Authorization:
(866) 425-8119
4e8c067f-266803
This fax confirms that your office requested the following transfer bond:
Request Date:
Defendant:
05/24/2025
Samuel Flores Jimenez
County:
Hardee
Bond Amounts):
$250.00
Transfer Bond …
[show full stored text] |
Unclassified | 57.1 KB | 2025-09-26 18:54:03 uploaded 125d after created | no | Dropbox · History |