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EL-15-2392 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Z60a Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-265980 Permit Number: EL-9-15-2392 Scheduled Inspection Date: August 24, 2016 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: LAWSON, PETRONELLA Work Classification: Alteration Job Address:665 GRAND CONCOURSE Miami Shores, FL 33138- Phone Number (305)458-8621 Parcel Number 1132060172160 Project: <NONE> Contractor: CAVALIERE ELECTRIC&SONS, INC Phone: (954)805-4356 Building Department Comments KITCHEN & BATHROOM REMODEL Infractio Passed Comments INSPECTOR COMMENTS False Inspector Com - Passed / Failed G/104-YOr Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 23,2016 For Inspections please call: (305)762-4949 Page 29 of 34 Permit NO. EL-9-15-2392 .,SORES h Miami Shores Village Mt Permit Type:Electrical -Residential. 10050 N.E.2nd Ir Work Classification:Alteration Miami Shores,FL 331383138-0000 Pettit Status:APPROVED Phone: (305)795-2204 f�ORiDp' issue Date:9/29/2015 Expiration: 03127/2016 Project Address Parcel Number Applicant 665 GRAND CONCOURSE 1132060172160 Miami Shores, FL 33138- Block: Lot: PETRONELLA LAWSON Owner Information Address Phone Cell PETRONELLA LAWSON 665 GRAND Concourse (305)458-8621 MIAMI SHORES FL 33138- 665 GRAND Concourse MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 5,000.00 CAVALIERE ELECTRIC 7 SONS, INC (954)805-4356 Total Sq Feet: 0 Type of Work:KITCHEN&BATHROOM REMODEL Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.00 Invoice# EL-9-15-57147 DBPR Fee $3.38 09/29/2015 Check#: 1738 $ 198.76 $50.00 DCA Fee $3.38 Education Surcharge $1.00 09/21/2015 Credit Card $50.00 $0.00 Permit Fee-Additions/Alterations $225.00 Scanning Fee $9.00 Technology Fee $4.00 Total: $248.76 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-named contractor to do the work stated. September 29, 2015 Authorized Signat e:Owner / Applicant / Contractor / Agent Date Building Department Copy September 29,2015 1 Miami Shores Village Building Department SEP 2 1 2015 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ° Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 !FBC 20W BUILDING Master Permit No. 1S'? O PERMIT APPLICATION Sub Permit No. E L 15-- 239 ,, ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: fbbS 6wujfl Lpuc;.24k,�- City: Miami Shores County: Miami Dade Zip 4. Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE:: ._ FFE: OWNER: Name(Fee Simple Titleholder):IAbq c a;._% 4 aFp Qb kW &3tj Phone#: T3 1�r—L1T y Address: a'la (NK►Js-3 (r3A/T � City: �,��,,ti� 1'OJ:�� State: fl, Zip: 31 lll�s Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: C rwfi� aa�u T �:z..>b VN C- Phone#: 4tiA 'Z13'00 Address: 'Skkg 1 City: I�IpLI.(a Lp°i'P State: Zip: 33� � Qualifier Name:_ C\?1U7 f.�Vlb(_.. Phone#:C1J'.A' nal State Certification or Registration#: �[_\'3t�Co �4 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ $�l`'' Cj Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: V_'-,u''= inn t" ep'-q0 r=1, Specify color of color thru tile: 0C 9;p Submittal Fee$ Permit Fee$ 2.5 o Ge, CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) � f Bonding Company's Name(if applicable) Bonding Company's Address _ City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing Information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. , "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500,the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days After the building permit is issued. In the absence of such posted notice, the inspection ry(I at be approved and a reinspection fee will be charged. Signature Signature OWNER or AG CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was ackn wledged before me this a- day of S{(�Ti m�?� 20 1S- by 7 day of 20 S by Pc4 f u-� \,j 50 n,who is personally known to b16S 00,VCA(l (' who is p rsonally known me or who has produced 1 L- 0 2-- as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: n Print: �_* •`� Notary Public-State qFlorlda Seal: EVELYN ARTOLA Seal: 'P',. Q'.•� Commission#EE Notary Public,State of FP"M " ' ded Through National N Cammissionit EE 16741J,48 Mfr eemm:expires Feb.7 APPROVED BY 3l SL°J�» Plans Examiner Zoning Structural Review Clerk (Revised02/24/2034) Sep 10 1503:02p Cavaliere Electric 954-974-9054 p.4 T ' STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION s� S` ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 CAVALIERE, CHRISTOPHER CAVALIERE ELECTRIC &SONS, INC. 5491 NW 15TH STREET, SUITE 16 MARGATE FL 33063 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range °' from architects to yacht brokers,from boxers to barbeque restaurants, STATE OF FLORIDA and they keep Florida's economy strong. a DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Every day we work to improve the way we do business in order to EC13004743 ISSUED: 07/24/2014 serve you better. For information about our services, please log onto www.myflaridalicense.com. There you can find more information about our divisions and the regulations that impact you,subscribe CERTIFIED ELECTRICAL CONTRACTOR to department newsletters and learn more about the Department's CAVALIERE, CHRISTOPHER initiatives. CAVALIERE ELECTRIC&SONS, INC. Our mission at the Department is:License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, IS CERTIFIED under the and congratulations on your new license) provlslons or Ch E�piretiai data: AUG 31,2016 t7407240724300170t750 DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD - •, <- K EC13004743 The ELECTRICAL CONTRACTOR '% Named below IS CERTIFIED =-4 Under the provisions of Chapter 489 FS. `°w�� � WU Expiration date: AUG 31, 2016 CAVALIERE, CHRISTOPHER 0 Q CAVALIERE ELECTRIC& SONS, INC. 5491 NW 15TH STREET, SUITE 16 MARGATE FL 33063 ISSUED: 07/24!2014 DISPLAYAS REQUIRED BY LAW SEa# 1-1407240001750 Sep 10 1503:02p Cavaliere Electric 954-974-9054 p.5 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2014 THROUGH SEPTEMBER 30,2015 DBA: Business Name:CAVP_LIERE ELECTRIC & SONS INC Receipt#:281-3342 Business Type-ELECTRICAL/ALARMS/CONTRACTO-R Owner Name:CHRISTOPHER M LAVALIERE/QIIAL (MASTER ELECTRICIAN CONTRACTOR) Business Location:5491 NN 15 ST STE 16 Business Opened:01/01/2006 MARGATE State/County/CeiVReg:EC 13004743 Business Phone:954-971-8381 Exemption Code: Rooms Seats Employees Machines 10 Professionals For Vending Number of Machines: Business Only ETax Amount Transfer Fee Vending Type: NSF Fee Penalty Prior Years 2`.0o 0.00 0.00 Coilecifon Cost Toial Paid C.00 0.00 0.0c 27.DD THIS RECEIPT MUST BE POSTED CONSPICUOUSLY MI YOUR PLACE OFBU THIS BECOMES A TAX RECEIPT This ta>-is �- SINESS leviein nature.d for the privilege of doing business within Broward County and is and/or Municipality lannin WHEN VALIDATED and zoo'ngorequireme sYThis Business Tax Rou must meet aiiueceipt must be transferred when the business is sold, business name has changed or you have moved the businesb location. This receipt does not indicate that the business is legal or that it is in cdmpliance with State or local laws and regulations. Mailing Address: CHRISTOPHER M CAVAI,IERE i /QUAL 5491 NW 15 ST STE 16 Recei t MARGATE, FL 3 P1CP-]3-00011328 3063 Paid 08/07/2014 27.00 2014 - 2015 i Sep 10 15 03:01 p Cavaliere Electric 954-974-9054 p.3 CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDJYYYY) 0811 1 12 01 5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Ral h Russo Russo Insurance Group PHONE 954 345-1904 fPX 954 345-1954 1700 North University Drive .MAIL ral h russoi .com Suite 215 INSURER(S) AFFORDIING COVERAGE NAIL¢ Coral Springs FL 33071 INSURER • COVINGTON SPECIALTY INS CO. INSURED IN CAVALIERE ELECTRIC&SONS,INC INSURER C. 5491 NW 15TH STREET,SUITE 16 INSURER D MARGATE, FL 33063 INSURERE NS E F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTE ==LEA D BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILT.NSR tiENERAL LIABILITY TYPE OF INSURANCE DL"wnURA POLICY EFF POLICY EXP POLICY NUMBER LIMITS EACH OCCURRENCE 12,000,000 A X COMMERCIAL GENERAL LtAB1UTY DAMAGE TO REN-ED PREMIS-S(Es 100 000 CLAIMS-MADE D OCCUR X VBA375496 05/11/2015 05/11/2016 MED EX' cne nI 35,000 PERSONAL&ADV INJURY 2j()00,000 GENERALAGGREGATE 2,000.000 rGEIL AGGREGATE LIMIT APPLIES?ER: PRODUCTS-COMPJOPAGG 2000000 POLICY pR0- LOC S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO ALLO',NNEDMRA&MADE BODILYINJURY(For person) S AUTOS BODILY INJURY(Per accidant) S HIREGAUTOS PROPERTY JAM1tAGE $ $ UMBRELLA tJ'AB EACH CCCURR=NCE EXCESS,LIAR I N AGGREGATE WORKERS COMPENSATION AND EMPLOYERS'LIAIMUTYANY YYC SYIN TATI,- OTH- FO FICCERRAEPROPRIMBER EXCLJDED ECIJTIV ] NIA E.L.EACH ACCIDENT (Mandatory In NH) Ir s,descrltw under E.L.DISEASE-EA EMPLOYE I IONQF 0 TIC w E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Addlticnal Remarks Schedule,If more space is requbed) ELECTRICAL SERVICE AND REPAIR CERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY, CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Building Department THE EXPIRATION DATE THEREOF, NOTICE WLL BE DELIVERED IN 10050 N.E.2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 AVTHORIZEDREPRESENTATIVE ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2otD105) Tho ACORD name and logo are registered marks of ACORD Sep 10 15 03:01 p Cavaliere Electric 954-974-9054 p.2 AC' CERTIFICATE OF LIABILITY INSURANCE r ATEIMMIDDI 08111/2015 THS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT.If the certificate holder is an ADDITIONAL INSURED,the policy(III must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions D1 the Policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in Ileu of such endorsement(s). PRODUCER CONTACT NAME; PHONE A/C.No Exll: 1.800-2T7-IE20■4800 FhX C.NoI: 727)797-0704 FrankCrum Insurance Agency,Inc, E-MAIL ADCRESS: 100 South Missouri Avenue WSURER(SI AFFORDING COVERAGE Naca Clearwater, FL 33756 INSURER A: ;Frank Winston Crum imilICo. 11600 INSURED INSURER B: I NSUR ER C FrankCrum UC/F Cavaliere Electric&Sons,Inc. INSURER D: 100 South Missouri Avenue INSURER E: Clearwater FL 33756 INSURER F: COVERAGES CERTIFICATE NUMBER: 322375 REVISION NUMBER: ISSUED TO THE INSURED NAME AB THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN OVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED MAY HAVE BEEN REDUCED BY PAID CLAIMS, ONHEREIN IS SU BJECT TO ALLTHE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN M-1 Al BURR OF INSURANCE WBRD lYVOPOLICY NUMBER POLICY EFF POLICY EXP( WODIYYYYI Inatzlol'YYY LIMITSY ( ) EACHOCCURRENCE 3 GEN ORAL LNBILRY DAMAGE TO RENTEDS-MADE OOCCUR PREVISES III cl=,rem. SN'ED EXP IMy one Jwnonl SPERSONAL SACY INJUl SGENERALAGGREGA.TE S UMI7 A?�LiES pBi:PROJE^- LOC PROCJCTS-CCFAI AC-G S AUTOMOBILE LIABILITY S COMBINED SINGLE LIMIT ANYAUTO I_'en'� 3 .ILL 01MIED SCHEDULED GODLY INJURY(Pe•person S AUTOS AUTOS HIRED AUTOS NON-OV�D GODLY INAIRY(Per a!e<yprll S AUTOS PRC�RTY DAVAGE S UMBRELLA LU1B OCCUR S EXCESS LIAB CLAIIIIII I EACH OCURRENICE $ DED RETENTIONS AGGREGATE 1 YJORNE RS COUPE.ASATI DN AND S A EMPLOYEPS•LLA61-ITT W0000 011012015 0110112016 X C20150VICSTATLTTORY o7T� ANY PROPRIETOMPARTNER,EXECUTNE YIN LDJJTS ER OFRCSVL'EMWR EXCLUDED? L N/A (YuWtlory M NHI E.L.EACHACCIDEN— 51.0011.000 I'Tea,tlesuEe ower DESCRIPTION OF OPERRTICNSbebw E.L.MS=ASE-EAELI-LOYEE 1.000000 .t.0)SEASE-FOL YLINrr 1000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORO 101,Addltional Remarks,Sci o' u! ,if move speer is requiretll Effective 05!26/2008,coverage is for 100%of the employees of FrankCrum leased to Cavaliere Electric&Sons,Inc.(Client)for wham the client is reporting hours to FrankCrum.Coverage is not extended to statutory employees. CERTIFICATE HOLDER CANCELLATION SHOULDANY OF THE ABOVE CANCELLED BEFORE THE ou TAUI TION DATE THEREOF NOTICEBEV•LOLL BEE DELIVERED IN ACCORDANCE WITH THE PROVISIONS. Miami Shores Village Building Department REPESENTATIVE � 2nd Avenue Miami Miami Shores,FL 33138 ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ®1886-2010 ACORD CORPORA710N.All rights reserved. .aco CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 08/11/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PHONE A/C,No,Ext): 1-800-277-1620 x4800 FAX A/C,No): 727 797-0704 FrankCrum Insurance Agency,Inc. E-MAILADDRESS: 100 South Missouri Avenue INSURERS AFFORDING COVERAGE NAIC# Clearwater,FL 33756 INSURER A: Frank Winston Crum Insurance Co. 11600 INSURED INSURER B: INSURER C: FrankCrum UC/F Cavaliere Electric&Sons,Inc. INSURER D: 100 South Missouri Avenue INSURER E: Clearwater FL 33756 INSURER F: COVERAGES CERTIFICATE NUMBER: 322375 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ASDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INS RD WVD (POLICY (MM/DDIYYYY) GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO REMED $ PREMISES Ea occurtence CLAIMS-MADE =OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ POLICY PROJECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Perperson) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIREDAUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND WC201500000 01/01/2015 01/01/2016 X WC STATUTORY OTH- A EMPLOYERS'LIABILITY Y/N LIMITS ER ANY PROPRIETOR/PARTNE.-CUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $1,000,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks,Schedule,if more space is required) Effective 05/26/2008,coverage is for 100%of the employees of FrankCrum leased to Cavaliere Electric&Sons,Inc.(Client)for whom the client is reporting hours to FrankCrum.Coverage is not extended to statutory employees. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village Building Department AUTHORIZED REPRESENTATIVE 10050 NE 2nd Avenue Miami Shores,FL 33138 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD of STATE OF FLORIDA ' _ t:.. r' , DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 CAVALIERS, CHRISTOPHER CAVALIERE ELECTRIC&SONS, INC. 5491 NW 15TH STREET, SUITE 16 MARGATE FL 33063 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range " ' STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. DEPARTPROFESMENT O REGULATION Every day we work to improve the way we do business In order to EC13004743 ISSUED: 07/2412014 serve you better. For information about our services,please log onto www.inyfloridalicense.com. There you can find more information CERTIFIED ELECTRICAL CONTRACTOR about our divisions and the regulations that impact you,subscribe to department newsletters and team more about the Departments CAVALIERS,CHRISTOPHER initiatives. CAVALIERE ELECTRIC&SONS,INC. Our mission at the Department is:License Efficiently,Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, IS CERTIFIED under the provisions of Ch-489 FS. and congratulations on your new license! Expiration date:AUG31,2018 1-140240001750 DETACH HERE RICK SCOTT, GOVERNOR KEN L.AWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATIONyM;f;:: ELECTRICAL CONTRACTORS LICENSING BOARD ' v EC13004743 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. --� Expiration date: AUG 31, 2016 CAVALIERE, CHRISTOPHER CAVALIERE ELECTRIC&SONS, INC_ 5491 NW 15TH STREET, SUITE 16 MARGATE FL 33063 ' ISSUED: 07/24/2014 DISPLAYAS REQUIRED BY LAW SEC)# L1407240001750 BROWARD COUNTY LOCAL BUSINESS — — R ati AX RECEIPT 115 S. Andrews Ave., Rm. A-900, Ft. Lauderdale, FL 33301-1895—954-831-4000 F, VALID OCTOBER 1,2015 THROUGH SEPTEMBER 30,2016 DBA; tI CAVALIERE ELECTRIC & SONS LLC ry Business Name:.. Receipt#'181-3342 Business Type;ELECTRICAL/ALARMS/CONTRACT04 (MASTER ELECTRICIAN CONTRAq R) #' Owner Name:CHRISTOPHER M CAVALIERE Business®pened:01/01/2008 [ Business Location:12358 WILES ROAD CORAL SPRINGS State/County/CertlReg:EC 13004743 Buslness Phone:954-.974-3955 Exemption Code: { Rooms Seats Employees10 Machines Professionals d For Vending Business Only F Number.of Machines: Vending Type: u'r Tax Amount Transfer Fee NSF Fee ' Penalty Prior Years Collection Cost TO Paid i I 27.00 3.00 0.00 0.00 — -� 0.00 0.00 30.00 Cks Y I THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature.You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed .or you have moved the l business location.This receipt does not indicate that the business is legal or that o f it is in compliance with State or local laws and regulations. I � Mailing Address: CAVALIERE ELECTRIC & SONS LLC Receipt #WW9P-14-00127149 I � l 5491 NW 15 ST #116 Rl MARGATE, FL 3063 paid 08/28/2015 30.00 f 2015 _ 2016 e CERTIFICATE OF LIABILITY INSURANCEDATE(MWDD/YYYY) F0411212016 THIS CERTIFICATIz IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOGS NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CEF TIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVEJ OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If t4 certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Ralph Russo NAM Russo insurance Grc up PHONE(AtC No 954 345-1904 FAX 954 345-1954 1700 North University Drive E"�L rel h russoi .Com Suite 215 INSURE S AF NG COVERAGE NAIL 9 Coral Springs FL 330171 INSURER A: COVINGTON SPECIALTY INS CO. INSURED INSURER 8, CAVALIERE ELECTRIC S SONS,INC INSURERc: 12358 WILES ROAD, INS D UNIT 5 INSURE CORAL.SPRINGS,FL 33076 NSURERF: COVERAGES I CERTIFICATE NUMBER: REVISION NUMBER.- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MSRI TYPE OF IAiSURANCE BPOLICY NUMBER POLICY EFF POLICY EXP IMMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE _S2,000,000 A X COMMERCIAL GE ERAL LIABILITY DAMAGE TO RENTED $100,000 CLAIMS-MADE T OCCUR X VBA375496 05/11/2015 05111/2016 MED Exp An one emon $5,000 PERSONAL&ADV INJURY $2,000000 GENERAL AGGREGATE s2,000,000 GEN'L AGGR GATE U 'IIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 X POLICY PlrztrT RO LOC $ AUTOMOBILE LLABILIT Ir INGLE LIMIT ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS AUTOSWNED PROPERTY DAMAGE $ UMBRELLA LIAROCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS-MADE AGGREGATE $ ED $ WORKERS COMPEN55AA��1n1ON WC STATU- OTH- AND EMPLOYERS,LLAf4 UTY f I.IFIR ANY PROPRIETOPJP NERIEXECUTI OFFICERIMEMBER EX UDED? NIA E.L.EACH ACCIDENT $ (Mandatory NN) F.L DISEASE-EA EMPLO $ It yes,describb e unFder IPTI N P 5 E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIOI 15/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if mora space is required) ELECTRICAL SERVICE AND REPAIR CBC 1255611 CERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED WITH RESPECT TO GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Qepartment ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.E.2nd Avenue Miami Shires,FL 33138 AUTHORIZED REPRESENTATIVE <DA> Q 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ,gCX�Rl CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) 01/05/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DO S NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICA OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the dertificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PHONE AIC,No,Ext): I-BW277-1820 x4800 FAX AIC,N.): M 787-0704 FrankCrum Insurance ggency,Inc. E-MAILADDRESS: 100 South Missouri Avenue INSURER(S)AFFORDING COVERAGE NAICit Clearwater,FL 33756 INSURER A: Frank Winston Crum Insurance Co. 11600 INSURED INSURER B: INSURER.C: Fra1,valliere Electric&Sons,Inc_ INSURER D: 100 South Missouri Avenue INSURER E: Clearwater FL 337561 INSURER F: COVERAGES CERTIFICATE NUMBER: 348507 REVISION NUMBER: THIS IS TO CERTIFYAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSUf ANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN RACED BY PAID CLAIMS. INSR TYPE INSURANCE INSUADDL SUER POLICY EFF POLICYEXP LTR INSRO WVD POLICYN UMBER (MDNYYY) (MM/DDNY`/1� EACH OCCURRENCE LIMITS GENERAL LU181L MID $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES a• me S CLAIMS MADE =OCCUR MED EXP VMry persw) S PERSONAL&ADVINJURY S GENERAL AGGREGATE S GEWLAGGREGATE MITAPPLIESPEIL PRODUCTS-COMP/OP AGG S PODCYPROJECT LOC S AUTOM081LE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO eaddent ALL OWNED SCHEDULED BODILY INJURY(Per person) S AUTOS AUTOS BODILY INJURY(Pa accldwd) $ FIRED AUTOS NON-OWNED PROPERTY DAMAGE ALTOS eracid $ S UMBRELLAB OCCUR EACH OCURRENCE S EXCESS LIAB CLNMS-MADE OED I Rt7ENilON$ AGGREGATE $S WORKERS COMPENIISATION AND WC STATUTORY O7H- A EMPLOYERV UABIUTY YIN WC20160Q000 01/01/2016 01/01/2017 % uMlrs ER ANY PROPR1EfURlr K ERIEXECUTIVE OFFtCER1MEMBER CLUDEDT a NIA E.L EACH ACCIDENT $11X10.000 (MantlSIM In NH) If yes,desabe under EL DISEASE-EA EMPLOYEE S1 000,000 DESCRIPTION OF TIONS blow E.L DISEASE-POIJCY LIMB $1,00D.000 DESCRIPTION OF OPERATIONS!LOCATIONS VEHICLES(Attach ACORD 101,Addltionaf Remarks,Schedule,if more apace is required) Effective 05/26/20081 coverage is for 100%of the employees of FrankCrum leased to Cavaliere Electric&Sons,Inc.(Client)for whom the client is reporting hours to FrankCrum.Coverage is not extended to statutory employees. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shoes Village Building Department AUTHORIZED REPRESENTATIVE 1005GPnd Ave Miami r Miami 5holes,FL 33138-2382 0 1988-2010 ACORD CORPORATION_All rights reserved_ ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD