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PLC-16-3391 Permit NO. PLC-12-16-3391 `5H01tE°h9�Q Miami Shores VillageEt Permit Type:Plumbing-Commercial f r 10050 N.E.2nd Avenue NE n� ' Work C►assil5cation:Addition/Alteration Miami Shores,FL 33138-0000 P EDPermit Status:APPROVED Phone: (305)795 2204 F�ORIDp Issue Date: 12/21/2016 Expiration: 06/19/2017 Project Address Parcel Number Applicant 11300 NE 2 Avenue Number: Wiegand & Ani 1121360000050-10 BARRY UNIVERSITY INC Miami Shores, FL 33138-0000 Block: Lot: Owner Information Address Phone Cell BARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 LLL---= 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 Contractor(s) Phone Cell Phone Valuation: $ 12,000.00 ALL FIRE SERVICES (954)367-3607 -.. .._� _._ .... _,, ......_ _.... _. ...... Total Sq Feet: 0 Type of Work:REPLACE(3)LEAKING FIRE HYDRANT AN Available Inspections: Type of Piping: Inspection Type: Additional Info: Classification:Commercial Top OutRe Pipe Scanning:3 Main Drain Heater Water Service Final Water Main Lavatory Underground Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $7.20 DBPR Fee InvOICe# PLC-12-16-62383 $5.40 12/16/2016 Check#:5186 $50.00 $349.00 DCA Fee $5.40 Education Surcharge $2.40 12/21/2016 Check#:5236 $349.00 $0.00 Permit Fee $360.00 Scanning Fee $9.00 Technology Fee $9.60 Total: $399.00 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 su responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECT AL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFID IT: I ce ify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction oning. F hermore,I authorize the above-named contractor to do the work stated. December 21, 2016 Authoriz gnature: caner / Applicant / Contracto / Agent Date Building Department Copy December 21,2016 1 e2n�eA- Vo MpVT,- ,- Miami Shores Village C ` �\. Building Department DEC 16 ?016 BY: ' 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 20 BUILDING Master Permit No.°: P PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC (- ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL j53PLUMBING ❑ MECHANICAL PUBLIC WORKS F-� CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores Countv Miami Dade Zip: Folio/Parcel#: C"US.d Is the Building'HistoricallyDesignated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):_ Phone#: �0 �ti{ S Address:—k \ I C YlL City: \"v---\y._t State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: -y c �Cic _y, :ZLu\ Phone#: 41' "1\moi Address: -D'}-1 `=�\r� c wti ,r•, °`a r City: \A. State: c.s Zip j:`� c) Qualifier Name: \`.N Phone#: State Certification or Registration#: `�a i�_�pA-2,) Q p l)-50 Certificate of Competency#: �., DESIGNER:Architect/Engineer: t 1 Phone#: Address: City: State: Zip: Value of Work for this Permit:$ k b rJ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New --[ Repair/Replace ❑ Demolition Description of Work: X VA",CA Y-C\,'N k� PL C �` Z Z Cac _ Specify color of color thru tile: Submittal Fee$ ?. ,0 0 Permit Fee$ 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) Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) V 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 will not be approved and a reinspection fee will be charged. ^Signature Signature OWNER or AGENT CONTRACTOR The fore ing instrument was acl ledged before me this The foregoing strumeynt was acknowledged before me this day o _day of , 03 yby A who is personally known to 3/ak N41—h A-.y KZ41c✓1 who is personally known to me or who has produced as me or who roduced as identification and who did take an oa ����111111111�///� identific ion and who d d•take:anroath- NOTARY PUBLIC: �`\ -'--040` ra#�y'c '� NOTA PUBLIC: ;o P Y a(;-i, NUBERT NUNEZ SS/p • :z» „�. Notary Public-State of Florida Z : dl 28, N*- o . ; My Comm.Expires Sep 11,2017 Commission #FF 043679 Bonded Through National Notary Assn. Print: T/x3 397 S Seal: �gTATEp, Seal: Ifi1H1 APPROVED BY ( �� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Jeff Atwater Casia Sinco CHIEF FINANCIAL OFFICER BUREAU CHIEF Julius Halas DIVISION DIRECTOR , Keith McCarthy SAFETY PROGRAM MANAGER FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE MARSHAL 200 East Gaines Street -Tallahassee,Florida 32399-0342 Tel.850-413-3644 Fax.850410-2467 CERTIFICATE OF COMPETENCY OFFICIAL COPY THIS CERTIFIES THAT: Johnathan D Keller 2027 Sherman St Hollywood FL 33020 BUSINESS ORGANIZATION:All Fire Services Inc. Contractor II is limited to the execution of contracts requiring the ability to layout, fabricate, install, inspect, alter,repair, and service water sprinkler systems,water spray systems, foam-water sprinkler systems, foam-water spray systems, standpipes,combination standpipes and sprinkler risers, all piping that is an integral part of the system beginning at the point of service, sprinkler tank heaters, air lines, thermal systems used in connection with sprinklers, and tanks and pumps connected thereto, excluding pre-engineered systems. Issue Date: 07/01/2016 Type: 07 Class: 12 County: Broward w= License/Permit#: 839613-0001-2002 Expiration Date: 06/30/2018 •'yam ..,�-c Chief Financial Officer i BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT { 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, ' FL 33301-1895—954-831-4000 VALID OCTOBER 1,2016 THROUGH SEPTEMBER 30,2017 DBA: j ALL FIRE SERVICES INC Receipt#-ALL18 OTHER TYPES CONTRACTOR 1 Business Name: Business Type* ; •(FIRE SPRINKLER CONTRACTOR)„ OwnerName:JONATHAN KELLER BusinessOpened:o5/01/2004 Business Location:2027 HOLLYWOOD SHEAN ST State/County/Cert/Reg:83961300012002 Exemption Code: Business Phone:954-367-3607 Rooms Seats Employees Machines Professionals � l 25 l For Vending Business Only F { Number of Machines: t Vending Type: ; I �TaxAmount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid , 81.00 0.00 0.00 0.00 0.00 0.00 81.00 t 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 I the business is sold, business name has changed or you have moved the -1 business location.This receipt does not indicate that the business is legal or that i it is in compliance with State or local laws and regulations. I Mailing Address: JONATHAN KELLER Receipt #WWW-15-00140534 2027 SHERMAN ST Paid 07/28/2016 81.00 HOLLYWOOD, FL 33020 i { Y ___ 2016 - 2017 ACORUa DATE IMWDDi"-M � CERTIFICATE OF LIABILITY INSURANCE F5/31/2016 THIS CERTIFICATE 1S 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(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 CONTNAME ACT Sharon R. Myers, AAI,Cris Frank H. Furman, Inc. PHONE (954)943-5050 FAX 1954)942-6310 1314 East Atlantic Blvd. 44AILADDRESS.aharonm@furmaninsurance.com P. 0. Box 1927 INSURERS AFFORDING COVERAGE NAIC p Pompano Beach FL 33061 INSURER A Nautilus Insurance Cc 17370 INSURED INSURERBAhio Security Insurance Co 24082 All Fire Services, Inc INSURERCNarth River Insurance Company 21105 INSURER DBrid afield Employers Ins Co 10701 2027 Sherman Street INSURER E: Hollywood FL 33020 INSURER F.- COVERAGES CERTIFICATE NUMBER:2016 Master w/o end# 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 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 INSURANCEADDLSUBR POLICY EFF POLICY EXP LTR POLICY NUMBER D LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAMAGRENTF A CLAIMS-MADE F OCCUR PR MI EES e occu40 ce S 100,000 ECP201752410 3/15/2016 3/15/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY T JEST LOC PRODUCTS-COMPIOP AGG S 2,000,000 OTHER: Professional E&O S 1,000,000 AUTOMOBILE LIABILITY COMABINE�DI SINGL UMI S 1,000,000 lEaB X ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BMS6725305 6/1/2016 12/20/2016 BODILY INJURY(Per occident) S AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE S AUTOS IPer accidentl Floirda PIP-Basic S 10,000 X UMBRELLA UAB X OCCUR EACH OCCURRENCE S 3,000,000 C EXCESS UAB CLAIMS-MADE AGGREGATE S 31000,000 DEO I S I RETENTIONS 0 5821048197 3/15/2016 3/15/2017 S WORKERS COMPENSATION X 9ERTU CrRH AND EMPLOYERS'UABIUTY Y I N ANY OPRIE9ERE%CLUDERI ECUTIVE FN] N/A E.L EACH ACCIDENT S 1,000,000 OFFICE D IMandatory In NH) 93052064 12/20/2015 12/20/2016 E.L.DISEASE-EA EMPLOYE S 1,000,000 H yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached 11 more space Is required) Fire Sprinkler Company with License No. 8396130001-2002 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village Building Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN 10050 NE 2nd Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Dirk. De Jong/SR �• ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025 rvotanrn 1 Miami Shores Village RR'CE1vED SEP 0 2015 Clio Building Department artment p ,,- 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 S FBC 201 BUILDING Master Permit No,-?Lc LC — VS- 2260 PERMIT APPLICATION ICELLEV ub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL XpLUMBINGMECHANICAL F-]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRALTO RAWINGS �(^ JOB ADDRESS: I E' City: Miami Shores County: Miami Dade U Zi :S-S 1 t Folio/Parcel#: �-� �'a �C)-5(I Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: F OWNER:Name(Fee Simple Titleholder): CST G CA Q``,C aC,— h ne Address: ) G � ..y 4 � Zi City: ({rn� �hSOS,- V, ((6Qgate: p: �J ! itj Tenant/Lessee Name: Phone#: Email: CPA ) CONTRACTOR:Company Name: �l �(# e, �eSi D I c`� n +~ Phone (�) Address: :S Yl es M Can i5 f City: g? `State: Zip: -nW Z-0 Qualifier Name: F��(1 4�v n �\ E e- _Phone#: State Certification or Registration#: ��E'er iT 000 c ertificate of Competency#: DESIGNER:Architect/Engineer: N Phone#: Address: I City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New X'Repai r/Re place1_ ❑ Demolition Description of Work: C' r C1 (�II < <-�'�K� A V`U eC Specify color of color thru tile: Submittal Fee$ ca Permit Fee$ %0'Of"/ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 4 (Revised02/24/2014) 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 bsn e f such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 , by -`� day of 201/ � by who is personally known to ��I^,ari'+T�a.� i 4 c<<(L ,who i personally known o ------------- me or who has produced as me or who has produced as identification and who did take an oath. identificatio n who did take an oath. NOTARY PUBLIC: foolNOTARY BLIC • \\�����`::� IRIS T,gq�����i//� % ` • �uss�gl, Si a '12 F % Si \J k��� �`O rn•; = Print: ,o YAP,,, HUBERT NUNEZ Print: —�� g zo• •�;; Notary Seal: OpF2�337 '*� Seal: •�; My Comm.Expires Sep 11,2017 g�S5� ���•.'�yy Commission # FF 043679 N.•�••�� �• ����`� F, °p` BondedThroughNationalNotaryAssn. STATE aF;a``� „ APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 07/11/2014 08:22 . 8504146119 BUREAU FIRE PREY PAGE 01/04 Jeff Atwater - Casio Since CHIEF FINANCIAL OMCER BUREAU CHEF Julius Ralas Dl{VMON DMCTOR Keith McCarthy ' SAFETY PICOGRAM MANAGER FLORIDA DEPARTMENT OF F)1i I gNCIAL SERVICES DIVISION OF STATE FIRE MARSHAL 200 East Gaines Snvet -Tallahassee,Florida 32394,0342 TeL 850413-3644 Fax.S50-410-2467 CERTIFICATE OF CONPETENCY OMCIAL COPY THIS CERTIFIES THAT: Johnathan D KeUer 2027 Sherman St Hollywood FL 33020 BUSINESS ORGA.NMA,TION: All Fire Services Inc. Contractor II is limited to the execution of contracts requiring the ability to layout,fabricate,install, inspect,alter,repair,and service water sprinkler systems,water spray systems,foam-water sprinkler systems,foam•-water spray systems,standpipes,combination standpipes and sprinkler risers,all piping that is arrintegral FArt of the system beginning at the point of service,sprinkler tank heaters,air lines,thermal systems used in connection with sprinklers,and tanks and pumps connected thereto,excluding pre- engineered systems. Issue Date: 07/0 112014 Type: 07 Class: 12 ,r County: Broward License/Permit 4: 839613-0001-2002 Expiration Date: 06/30/20'16 Chief Fi aancial Officer r 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:ALL FIRE SERVICES INC Receipt#:ALL 01 HER TYPES CONTRACTOR Business Name: Business Type:(FIRE SPRINKLER CONTRACTOR) Owner Name:JONATHAN KELLER Business Opened:o5/01/2004 Business Location:2027 SHERMAN ST State/County/CertlReg:83967.300012002 HOLLYWOOD Exemption Code: Business Phone:954-367-3607 Rooms Seats Employees Machines Professionals 25 For Vending Business Only _ Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 81.00 0.00 0.00 1 0.00 1 0.00 0.00 81.00 ` =S 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 business location.This receipt does not indicate that thebusiness is legal or that _ it is in compliance with State or local laws and regulations. Mailing Address: JONATHAN KELLER Receipt #05A-13-00011172 2027 SHERMAN ST Paid 09/18/2014 81.00 HOLLYWOOD, FL 33020 2014 - 2015 A�® CERTIFICATE OF LIABILITY INSURANCE 9�Zi2oi 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(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 Jennifer Martin NAME: Frank H. Furman, Inc. PHONE A No,ExtI, (954)943-5050 FAC o:(956)962-6310 1314 East Atlantic Blvd. n RIE :Jenny@ furmaninsurance.com P. 0. BOX 1927 INSURERS AFFORDING COVERAGE NAIC k Pompano Beach FL 33061 INSURER A:Greenwich Insurance Co (rm) 22322 INSURED INSURERB:Ohio Security Insurance Co 24082 All Fire Services, Inc INSURERCNorth River Insurance Company 1105 INSURER D.Bridgefield Employers Ins Co 10701 2027 Sherman Street INSURER E: Hollywood FL 33020 INSURERF: COVERAGES CERTIFICATE NUMBER:2015 Master w/o end# 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 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. ILTR ADDLSUBR TYPE OF INSURANCE POLICY NUMBER MPM/DDI EFF MMPOLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TURREATED- X COMMERCIAL GENERAL LIABILITY PREMISE Ea occurrence $ 100,000 A I CLAIMS-MADE Fx_1 OCCUR RNG640030904 /15/2015 /15/2016 MED EXP(Any one person) $ 5,000 X Professional E & O PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICYFX PROj F LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 XANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED BASS6725385 6/1/2015 /1/2016 AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Peraccitlent Florida PIP-Basic $ 10,000 X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 3,000,000 `. EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000 DED I X I RETENTION$ 10,00 821027047 /15/2015 /15/2016 $ D WORKERS COMPENSATION X I WC STATU- OTH- LIMAND EMPLOYERS'LIABILITY Y/N I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? FN] NIA 83052064 2/20/2014 2/20/2015 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Fire Sprinkler Company with License No. 8396130001-2002 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave. Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Dirk DeJong/SR A(5? 4�2 ��- ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INSn25 t9nlnns)m Tho A(_npn n2mc anA Inn^orm rnniefnrnrl mnrirc of Amp l 2027 Sherman St. ! l RLU E cos, Omaco Hollywood,FL 33020 y-� Web:www.allfireservices.net Dade:305.653.1142 Broward: 954.367.3607 M` NFPAm Toll Free: 800.815.9436 Fax: 954.367.1506 n°®-p®sal July 13, 2015 BARRY UNIVERSITY Transaction No: 78103 PURCHASING 11300 N.E. 2nd Ave. Miami Shores FL 33161 Attention : Yosef Shapiro lwj Phone: 305-899-4054 3 Fax: 305-899-4028 Email: LRiascos@barry.edu Jobsite: BARRY UNIVERSITY Sales Person: Angie Morrow-ja 'rA &A 11300 N.E. 2nd Ave MAIN BUILDING Miami Shores FL 33161 Yosef Shapiro 305-899-3832 Dear Sir; Per your request, we visited the above address and propose the following: SCOPE OF WORK: •••• . . .... ...... 1. Need proposal to expose Fire Hydrant leaking on ground. Have to dig first in Wigham •• •• • Building on N.E. corner_ ...... '.:..' ....:. Note: Repair not included. .... .... . . 2. Need proposal to replace one(1) leaking Fire Hydrant in front of Saint Dominick Statue in ..... Adrian Hall, leaking from seal on top cover. ...... ..:..' .. .. .. .. ...... 3. Need proposal to replace one(1) leaking Fire Hydrant leaking from top in Broad Auditorium ...... on nroth end in parking lot. • . . . . ...... 4. Need proposal to dig and expose pipe to make material list on 4"threated Fire Department CtVpt!cpon ••. ;" outside of OlaUghling Building. • 5. Need proposal to do flow test on three(3) Fire Hydrants in Adrian Hall Building EXCLUSIONS: Painting, Patching, Electrical Wiring, Plan and Permit. ***If plan and permit are required, there will be an additional charge.Also, please be advised that the permitting process could take up to four(4)weeks to complete*' We propose to do the above work For the sure of TWELVE THOUSAND FOUR HUNDRED FORTY FIVE DOLLARS AND NO CENTS($12,440.00), to include all labor, material and taxes. PLEASE NOTE: This price is effective for forty five(45)days from date. Payment for acceptance must be received before work can be scheduled. Page 1 . 1 AREA OF WORK C % FDIC (4) �� 06 ' � `fi � aug lin 6 CIO Wiegand Annex c T. ca Broad Pelican Nat al & He It NMTH Center Theatre Sci nces Bld AMERICAN Flow Control SubMttal Inlmmatlon (3) v, .w.w..an nc°n.rrc.aoawn.nn.x.o.un W A 'an ...: .Q 70 �! F� 7 0 f 100 -, ti.... "'p, Barry:!....� 1. � O University OWN gas NORTH SCOPE OF WORKS .. . .. . . . . .. . -1. REPLACE (1) LEAKING FIRE HYDRANT OW•NE.CZR1Va AIyU' ANNEX. -2. REPLACE (1) LEAKING FIRE HYDRANT IN FRONT OF SAINT OMINICK STATUE IN ADRIAN HALL. =3. REPLACE (1) LEAKING FIRE HYDRANT IN BROAD AUDITORIUM ON NORTH END IN PARKING LOT. -4, REPAIR (1) LEAKING FIRE DEPARTME jT-CI3NNECT�❑N OUTSIDE O�LAUGHLIN BUILDING. *ri Ij • •• • • • • • • • DATE ALL FIRE SERVICES, INC. DESCRIPTION: # Boa NAME. BARRY UNIVERSITY• ••• 2027 SHERMAN STREET Replace Fire Hydrants SC"�N.T.S 11300 N.E. 2nd Ave. ; ;, A HOLLYWOOD,FLA 33020 Miami Shores FI. DMYM 611 .:. :• •: •. .:. :f el 0054)-367-3607 Fax:(954)-367-1506 Ac t tw 1 4 AMERICAN Flow Control Submittal Information 5-1/4 WATEROUS PACER TRAFFIC MODEL WB67-250 FIRE HYDRANT, UL/FM AT (Dans 26.375 9.755 9.281 18.000 07.375 i 2.000 i GROUNDLINE GROOVE DEPTH OF TRENCH MADE TO SPECIFICATIONS i BASE, 6 IN. MECHANICAL JOINT SHOWN • • •••• •••••• __, • • • • (6) �il75 • • •• • 05.250 10.176 i • VALVE OPENING """ {— —+— 07.031 —+ •••••• •••• •••• • • 3.375 I I •••••� �••••� ••••• •••••• • • ••••• •• •• •• •• •••••• 2.500 09.500 •••••• • •� 5.125 7.313 12.250 • • ��•�% UL Listed • • • • • FM Approved •••• ; • ••• ;""; IL3576 NOTES: 1.250 prig rated working pressure. 2.Must be ordered in configurations which are UL Listed and FM Approved. 3.10 in.upper standpipe(traffic section)is standard.16 in.and 22 in.upper standpipes are available by special order.Nozzle /d + ;s� elevation will vary accordingly. 0' ) FLOW CONTROL 4.5-1/4"valve opening. 5.Hydrants are available with counterclockwise opening direction THE RIGHT WAY (open-left)or clockwise opening direction(open-right). AMERICAN Flow Control Waterous Company 6.Operating nut and nozzle cap wrench nuts are available in P.o.Box 2727 125 Hardman Avenue South VafIOUS Shapes and sizes. Birmingham,Al.35202-2727 South St.Paul,Mn.55075-1191 Phone:1-800-326-8051 Phone:1-888-266-3686 Fax:1-800-610-3569 Fax:1-800-601-2809 E-mail:afcsales@amedean-usa.com E-mail:afcsales@amedr-an-usa.com V',W,1V AM E RICAN-USA CC• Page 1of4 FH11005 Issued:5/27/15 60 99 6A 16 61 101 12 162 116 r' 118 102 117 119 11 17 12 10 11 / / 9A 98 10 / i 89 I 157 90 178 OPTIONAL ONE-PIECE ALSO REFER TO OPERATING NUT I 163 16 17A "ESA0 RSMELD \\\ OPERATING WITH WEATHERSHIELD 82 85 NUT DETAILS 86 I 16 165 101 164 I 162 98 628 102 OPTIONAL STORZ 64 178 PUMPER CONNECTION 56 6C 68 ,I 17A 84 40 113 71 INCLUDES 25 64 I 67 z 59 88 87 OPTIONAL TWO-PIECE OPERATING NUT 92 LIP DOWN 29 WITH WEATHERSHIELD 83 63 64 84 72 6C 30— 180 a 7 179 31 81 0000 34 • • - ,,�,�• 0000 0000•• 35 • • • 77 36 3 9 0000• ••�••• ••••�• 93 94 • 0000• • • • 3 0000•• 29 6C UL/FM DETAI!• • ••• 0000•• • • REF •0690000 0000• 63 • • 000000 • • 0000• 64_ 176 0000•• •••••t 0000•• 84 0000•• • • • • • • 0000•• 173 •••••• • • • •0000• 174 • • • 37 •• • 6C IL3567 TRAFFIC MODEL W667-250 i � s 10) FLOW CONTROL THE RIGHT WAY AMERICAN Flow Control Waterous Company P.O.Box 2727 125 Hardman Avenue South Birmingham,Al.35202-2727 South St.Paul,Mn.55075-1191 Phone 1-800-326-8051 Phone:1-888-266-3686 Fax.1-800-610-3569 Fax:1-800-601-2809 E-mail:afcsales@amehean-usa.com E-mail:afcsales@amercan-usa.com .,'A"'1VAMER C N-JSA CONA Page 2 of 4 FH11005 Issued:5/27/15 REF NO. DESCRIPTION MATERIAL E DESCRIPTION MATERIAL 3 0-ring(Lower Valve Seat) Buna-N 84 Support Wheel/Lower Buna-N Hex Head Bolt,5/8-11 x Standpipe Gasket 6A 3-314" Zinc Plated Steel,ASTM A307 Ductile Iron,ASTM A536 Grade 65- 85 Support Tube 45-12 6B Hex Head Bolt,5/8-11 x 3" Zinc Plated Steel,ASTM A307 Hex Nut,5/8-11(Above 86 Stop Nut,1"-8 Zinc Plated Steel 6C Ground) Zinc Plated Steel,ASTM A307 87 Coupling Nut,1/2-20 Brass Hex Nut,5/8-11(Below 88 Coupling Stud,1/2-20 x Stainless Steel,Type 430 6C Ground) Stainless Steel,Type 304,ASTM F594 2_9/t6^ 7 Drain Plunger Red Brass,ASTM 8135,UNS C23000 89 Nozzle Section Bushing Brass Nozzle Cap Chain,Single Zinc Plated Steel 90 Thrust Ring Polymer Bearing 9A,96 or Double 92 Upper Standpipe Neoprene Nozzle Cap,Hose or Ductile Iron,ASTM A536 Grade 65- Gasket P 10 Pumper 45-12 93 UL or FM Plate Aluminum 11 Cap Gasket,Hose or Neoprene 94 Drive Screw Zinc-Plated Steel Pumper P 99 Pipe Plug,1/4 NPT Brass 12 Nozzle,Hose Brass,ASTM B505,UNS C83600 Ductile Iron,ASTM A536 Grade 65- 12 Nozzle,Pumper Bronze,ASTM 8584,UNS C87600 101 Weathershield Nut 45-12 16 Flat Head Screw,1/4-20 Stainless Steel,Type 304 102 Heavy Spirol Pin,1/4 Stainless Steel,Type 302 x 1/2" x 2-1/4" 17 Operating Nut(One-Piece) Bronze,ASTM 8763,UNS C86500 or 113 Breakable Flange Ductile Iron,ASTM A536 Grade 65- UNS C86700 45-12 17A Lower Operating Nut Bronze 116 O-ring(Pumper Nozzle) Buna-N Ductile Iron,ASTM A536 Grade 65- 117 Pumper Nozzle Ductile Iron,ASTM A536 Grade 65- 176 Upper Operating Nut 45-12' Retainer 45-12 25 Rod Bushing Red Brass,ASTM B135,UNS C23000 118 0-ring(Hose Nozzle) Buna-N 29 Lower Standpipe Centrifugally Cast Ductile Iron Pipe, 119 Hose Nozzle Retainer Ductile Iron,ASTM A536 Grade 65- ANSI A21.51(AWWAC151) 45-12 30 Crossarm Bronze,ASTM B763,UNS C99500 162 Weathershield Nut Nitrile 31 Valve Seat Bronze,ASTM B584,UNS C87600 Gasket Ductile Iron,ASTM A536 Grade 65- 163 Nozzle,Pumper,Storz Bronze and Aluminum 34 Upper Valve Washer 45-12 (with cap and gasket) 35 Main Valve Rubber Urethane 164 1 StorzNozzle Cap,Pumper, Ourinum 00000 0 00.0 •••••• • Ductile Iron,ASTM A536 Grade 65-45- 36 Lower Valve Washer 12/Epoxy Coated,AWWA C550 165 Cap Gasket,Pumper, Sena-N 0 •••• •••• •••••• Storz • 37 Hydrant Bottom Ductile Iron,ASTM A536 Grade 65-45- 12/Epoxy Coated,AWWA C550 173 Valve Seat Insert Bronze, B584,UNS 7 0 ;••••; Centrifugally Cast Ductile Iron Pipe, 174 Valve Seat Insert •.0•Nitrile •••• ••;••0 40 Upper Standpipe ANSI A21.51(AWWA C151) Gasket 00000 Ductile Iron,ASTM A536 Grade 65- 176 Stud,5/8-11 x 5.650" Stainless�%,0Tjpe 304,QST& F05gi 000000 56 Support Wheel 45-12 Clevis Pin,1/4 x . •0 179 SOMI94%el,Type 18-8 • 57 O-ring(Operating Nut) Buna-N 1-11/16" 0 0 -00000 59 O-ring(Support Wheel) Buna-N 180 Kickout Ring Stpinless$teel,Type;1r t-0 0 0 60 Nozzle Section Ductile Iron,ASTM A536 Grade 65- 'Bronze material optional for some nuf kes: •9�:0 45-12 61 Bury Depth Plate Aluminum Hydrants are furnished as"Draining"unless optional 61 Bury Depth Plate Washer Zinc Plated Steel "Non-Draining"Configuration is otherwise noted below. 62B Upper Standpipe Flange Ductile Iron,ASTM A536 Grade 65- Optional"Non-Draining"Configuration required 45-12 63 Standpipe Flange Ductile Iron,ASTM A536 Grade 65- Open Direction: ❑Left(C.C.W.) [] Right(C.W.) 45-12 64 Flange Lock Ring Stainless Steel,Type 430 !j1 67 Coupling geSleeve(two- Gray Iron,ASTM A48 Class 30BhalvJ r FLOW CONTROL 71 Upper Rod Steel Rod,ASTM A575 ` 72 Lower Rod Steel Rod,ASTM A575 THE RIGHT WAY U er Valve Seat Buna N AMERICAN Flow Control Waterous Company 77 O-ring 9( pP ) P.O.Box 2727 125 Hardman Avenue South 81 Groove Pin,3/32 x 7/16" Beryllium Copper Birmingham,Al.35202-2727 South St.Paul,Mn.55075-1191 Phone 1-800-32"051 Phone:1-888-266-3686 82 O-ring(Upper Tube Seal) Buna-N Fax:1-800-610-3569 Fax:1-800-601-2809 E-mail:afcsales@american-usa.com E-mail:afcsales@american-usa.com 83 0-ring(Lower Tube Seal) Buna-N 'ANN"Af AM E RICAN-USA.C()M Page 3 of 4 FH11005 Issued:5/27/15 12.250 12.250 07.156 011.000 I 08'.656 3. 06.000 375 - 3.375 I 07.031 O 5.125 L 8.250 A (8) 0.875 HOLES EQUALLY 5.125 L 9.063 SPACED ON 09.500 BC, PER ASME/ANSI B16.1 CLASS 125 AND ANSI/AWWA C110/A21.10 6 INCH FLANGED INLET CONNECTION 6 INCH TYTON INLET CONNECTION O O O O + _q[- - - -- - - O O TWO 2-1/2 IN. HOSE NOZZLES TWO 2-1/2 IN. 0006 AND ONE PUMPER NOZZLE HOSE NOZZLES • • �••••� •44'6• 0. 044 0006 6004•0 O O • 6000.. . 44 ••44 0 . • + - . .. 0000 •4449 4• ... • . 44444 O .. .. .00000 •46.04 O 6 • . • r; 0000.. 444••6 .6 . 0. 4 000.. • • 01 • 0 0040. 6 • • THREE 2-1/2 IN. HOSE NOZZLES - NOZZLE ARRANGEMENTS NOTE: THE NOZZLE SECTION MAY BE ROTATED IN THE FIELD TO ANY POSITION. -1/)f'f t IL3585 3.1i#3'#t tr i � �''✓1i .�!i:"';�i�'��.+� s �����'T'S�`a✓s�Jfl t'/'�►! � ., . + ,rLO*,*OW CONTROL "THE RIGHT WAY '1.q " •�i'i t',f 'let lei PEX27Fow Coptrd �6• ./. P.O.Box 02 ljaLdman Avenue South Birmingham,Al.35202-2727 South$t Paul,Mn.55075-1191 Phone:1-800-326-8051 Phone:/-888-266-3686 Fax:1-800-610-3569 Fax:1-800-601-2809 E-mail:afcsales@amedean-usa.com E-mail:afcsales@amedcan-usa.com AAMW AM E RICAN-USA.COP t Page 4 of 4 FH11005 Issued:5/27/15 /V MIAMI-DARE FIRE RESCUE Process'No: n%unicipal Insp Ito: Project Name:___ ame:_ __, _AT-�& ') 7 J F n A. E r^ Not Applicable ��. PLUMING P� Approved D2�e Disapproved Disapp Not Applicable .00.00 •.•• • ••••�.•---- 0000---- 0000•• • • • •••• •••• 000: 0-0 0609 000 •-• •• 0000• •• •• � • • • •000.0 • • .•-,.use 0*0 —64 :....:`*'��- ,�,,•.�. r.._ ,.AZT. 1•lii.iST PROVIDE FIRE ft�i dP • •,@ •,T �� r� . :• z• b. •. ; ;y _UZRF.MENTS YZEC'�� - - x x•-:''?'��'� GF A FIRE INSPECTION. �T CVPkL1NSpV RENTED 1VIIAMI-DAD'S ; ORD CARD YS REQ 1tEQ� MEN'1i AND I ME OF FIRE INSPECTC�RA• ON THE JOBSt'L AT THE WITHOUT �NCPF.�"�N WILL NOT BE APPRO�D