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EL-15-5664 '.- Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION UNE PHONE NUMBER: (305) 762-4949 :777:WED i OCT; 2 2015 FBC 2010 BUILDING Master Permit No. Re, •(D -N • 2'34 PERMIT APPLICATION Sub Permit No. LL `j - ScoC) ❑BUILDING 123 ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP ��C-' CONTRACTOR DRAWINGS p J I/ JOB ADDRESS: tb O , L (mg, S 1R Q City: Miami Shores County: Miami Dade Zip: 3 \ 3.7 Folio/Parcel#: t1 2..Z32 • 03 Z • 0-4(-10 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type:�� Flood Zone: BFE:� FFE:% OWNER: Name (Fee Simple Titleholder): An IY• 1/1i'rrotf) i Phone#: 3-a:- - 9 5-6/ �o Address: 3\ 1 IBDO �L 't r��^o L. h s State: CC— zip: 33 dC) Tenant/Lessee Name: Phone#: / 27IDN/ G, /Y-i/L- . Co Email: CONTRACTOR: Com any Name: Address: �o 9 ©z/4' / l( ,t, f3 T/12 Zve Phone#: City: 0`.( /t/ f Qualifier Name: /2.3 ‘,11— State ,1LState Certification or Registration #: DESIGNER: Architect/Engineer: Address: Value of Work for this Permit: $ State: /tea /CAC / Zip: 33 / 6 ‘ Phone#:OF- 2/B-&(( 9c9 ooct 3i Certificate of Competency #: /2_coo_ oa Phone#: City: State: Zip: Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New Description of Work:L�ia /\/2._ mss' fn2 /LM// 121 Repair/Replace ❑ Demolition AZ/5'7e/..kc -- .L/ee,/ a,/k/le.4 Specify color of color thru tile: - 00 Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Permit Fee $ -4,41""' CCF $ CO/CC $ Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 8 t °O 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 will not be appro - . and a reinspection fee will be charged. Signature OWNER or AGENT The foregoing instrument was acknowledged before me this (dayofi� ►QQ PJ l ,20 1S ,by / \(i1%( _ivn- r l , who ispersonally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Pr t: s .t Qf ... LEYLAM. MARCOS MY COMMISSION 1 EE 171626 EXPIRES: May'7, 2016 Bonded Tbru Notary Public Undervniters Signature CONTRACTOR The foregoing instrument was acknowledged before me this 1(. day of c,Q�111�i V�-\( , 20 i5 , by ROLO1 tAn rX , who ispersonally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: • Print: YlVC )ti Y 47 Seal: **************************************************************** APPROVED BY (Revised02/24/2014) 0;1,5 L NICOLE GONIA M �!::!iL, 471 WC„NV SSION 1 FF 123688/ EXPIRES; July 18, 2018 Bonded Tlru Notary Put* Undenrrden • cif h�` **************************************** % Zo'ar Plans Examiner Zoning Structural Review Clerk trIkb Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 98E000031 VOLTECH ELECTRIC CO INC BOLOIX RAUL Is certified under the provisions of Chapter 10 of Miami -Dade County J Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 3866077 BUSINESS NAME/LOCATION VOLTECH ELECTRIC CO INC 6979 NW 53 TERR MIAMI, FL 33166 OWNER VOLTECH ELECTRIC CO INC RECEIPT NO. RENEWAL 4036612 SEC. TYPE OF BUSINESS LBT EXPIRES SEPTEMBER 30, 2016 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 196 ELECTRICAL PAYMENT RECEIVED BY TAX COLLECTOR CONTRACTOR 75.00 09/17/2015 Worker(s) 2 98E000031 0237-15-000654 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276. MI MI® For more information, visit www.miamidade.gov/taxcollector Municipal Contractor's Tax Receipt Miami—Dade County, State of Florida —THIS IS NOT A BILL — DO NOT PAY CC NO: 98E000031 BUSINESS NAME/LOCATION VOLTECH ELECTRIC CO INC 6979 NW 53 TERR MIAMI, FL 33166 OWNER VOLTECH ELECTRIC CO INC ELECTRICAL CONTRACTOR RECEIPT NO. 7472006 TYPE OF BUSINESS MIAMI MC EXPIRES SEPTEMBER 30, 2016 Pursuant to County Code Sec 10-24 PAYMENT RECEIVED BY TAX COLLECTOR 200.00 09/17/2015 0237-15-000654 This receipt is not valid in the following Municipalities: Aventura, Doral, Hialeah, Key Biscayne, Miami Gardens, Miami Lakes, Palmetto Bay, Pinecrest, Sunny Isles Beach, Town of Cutler Bay. For more information, visit www.miamidade.gov/taxcollector ACO EP CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/2/2015 • 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 poiicy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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 A QUICK & EASY ASSURANCE GROUP Eguino & Associates 7229 Coral Way Miami, FL 33155 A106088 CONTACT NAME: FENo.exo: (305) 662-7030 DRESS:rayguell@gmail. com (A/C 313-3738 INSURERS) AFFORDING COVERAGE NAICY INSURER A: Ascendant Underwriters INSURED VOLTECH ELECTRIC COMPANY, INC. 6979 NW 53 Street MIAMI, FL 33166 305-218-6166 INSURER B : Progressive Inusrance Company INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES 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 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 LTR TYPE OF INSURANCE ADDL INSD SUarr MVO POLICY NUMBER GL -52252-7 POLICY EFF (MMIDD/YYYY) 9/29/159/29/16 POLICY EXP (MMIDD/YYYY) LIMITS EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL UAOILITY CLAIMS -MADE X OCCUR PREMISES (Ea occurrence) $ 50, 000 MED EXP (Any one person) a 5,000 PERSONAL & ADV INJURY $ 1 , 000 , 000 GEM. AGGREGATE LIMIT APPLIES PER: PRO - POLICY EC LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGG $ 1,000,000 $ B AUTOMOBILE — — _AUTOS LIABILITY ANYAUTO ALLOW ED AUTOS — x ^ SCHEDULED AUTOS NON -OWNED UTOS 02090779-2 3/1/15 3/1/16 COMBINED -SINGLE -OMIT (Ea accident) _ $ BOOILYINJURY(Perpersen) $ 100000 BODILY INJURY (Per accident) S 300,000 PROPERTY ( e s 50 , 000 $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/NEMER EXCLUDED? ❑ (Msndnory In NH) tt yes. describe under DESCRIPTION OF OPERATIONS below NIA PER OTH- • STATUTE ER _ E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required) Electrical Service Contractor CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2 Ave Miami Shores, FL 33138 fax 305-756-8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD25(2014/01) The ACORD name and logo are registered marks of ACORD Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. EL -3-15-566 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: APPROVED Issue Date: 312'512015 Expiration: 09/2112015 Parcel Number Applicant 1680 NE 104 Street Miami Shores, FL 1122320320440 Block: Lot: AMIR KERMANI Owner Information Address Phone Cell AMIR KERMANI 3180 S OCEAN DRIVE HALLANDALE BEACH FL 33009- (305)965-0170 Contractor(s) VOLTECH ELECTRIC CO INC Phone (305)218-6166 Cell Phone Valuation: Total Sq Feet: $ 15,000.00 0 Type of Work: REMODEL - ELECTRICAL WORK REPAIR. Additional Info: Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $9.00 $7.88 $7.88 $3.00 $525.00 $3.00 $12.00 $567.76 Pay Date Pay Type Invoice # EL -3-15-54804 03/16/2015 Credit Card 03/25/2015 Check #: 1262 Amt Paid Amt Due $ 50.00 $ 517.76 $ 517.76 $ 0.00 Available Inspections: Inspection Type: Review Electrical 1 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 AFFIDA . certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an — . i• uthermore, I authorize the above-named contractor to do the work stated. March 25, 2015 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date March 25, 2015 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972. INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING Ig ELECTRIC ❑ ROOFING PLUMBING D MECHANICAL El PUBLIC WORKS JOB ADDRESS: Act RECEIVED MAR :. 6 2015 B FBC20I6 Master Permit No?O— (9- 223' Sub Permit No- - t ( - % G ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: .3/ 98 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Address: City: Phone#: State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR a•77yr Name: /4; �1 /G G 7Z�/i���ZD ,Z Address: City: ante l /(1/>9 l State: �G ,6lsL ,de./ci-" 4// - 6 '/953 Qualifier Name: State Certification or Registration #: Phone#:2/P��67v r Zip: z / * W. Certificate of Competency #: 9,SU' ©e'© DESIGNER: Architect/Engineer: Phone#: Address: O. City: State: Zip: Value of Work for this Permit: $ 1 53� IyTh • CD Square/Linear Footage of Work: Type of Work: ❑ Addition 12I Alteration ❑ New E Repair/Replace ❑ Demolition Description of Work: /C, /y0 cZ -- .61G76.el C Specify color of color thru tile: Submittal Fee $ -V " G3 Permit Fee $ 5 �J / dc, CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE$ 51R • (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 even (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approv , aa reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this le day of Com♦ , 20 'S , by Z day of AW 611 , 20 /—S by The foregoing instrument was acknowledged before me this 1 \:%N. VW1IV<% , who is personally known to /[v'N!- 'L , We /)l, who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Prin Sea identification and who did take an oath. NOTARY PUB Sign: rint: eal: :+: .MY COMMISSION # EE 171626 :V EXPIRES: May 7, 2016 Bonded Thru Nota P .Jf f,��•'� Notary blit Underwriter_ EXPIRES: JUN 14, 2016 Bonded through 1st State Insurance iii*f*tft**tt**f*t********t**t****************eft*****tete nt*****iiia*************************lett*****i*****•*•* 2 Q, /SAM -A Plans Examiner Zoning APPROVED B (Revised02/24/2014) Structural Review Clerk Ai lot CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 98E000031 VOLTECH ELECTRIC CO INC D.B.A.: BOLOIX RAUL Is certified under the provisions of Chapter 10 of Miami -Dade County VALID FOR CONTRACTING UNTIL 09/30/2015 RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD The ELECTRICAL CONTRACTOR Named below HAS REGISTERED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 (INDIVIDUAL MUST MEET ALL LOCAL_ LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) BOLOIX, RAUL BIBIAN VOLTECH ELECTRIC CO INC' 13725 SW 170 TERRACE MIAMI FL 33177 ISSUED: 07/24/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1407240001966 Iy II. 111I1 11.,11., ILH1 I IhH fl IiI Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY 3866077 BUSINESS NAME/LOCATION VOLTECH ELECTRIC CO INC 6979 NW 53 TERR MIAMI, FL 33166 OWNER VOLTECH ELECTRIC CO INC Worker(s) MIAMFOADE 2 RECEIPT NO. RENEWAL 4036612 SEC. TYPE OF BUSINESS 196 ELECTRICAL CONTRACTOR 98E000031 LBT EXPIRES SEPTEMBER 30, 2015 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 PAYMENT RECEIVED BY TAX COLLECTOR 75.00 09/29/2014 0245-14-004530 This Local Business Tax Receipt only confines payment of the Local Business Tax. The Receipt is net a license, permit, ora certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles -Miami -Dade Code Sec 8a-276. For more information, visit www.miamida!de,..gwjtaxegllecter Municipal Contractor's Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY CC NO: 98E000031 BUSINESS NAME/LOCATION VOLTECH ELECTRIC CO INC 6979 NW 53 TERR MIAMI, FL 33166 OWNER VOLTECH ELECTRIC CO INC MIAMMADE RECEIPT NO. NEW BUSINESS 7455519 TYPE OF BUSINESS ELECTRICAL CONTRACTOR MC EXPIRES SEPTEMBER 30, 2015 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 For more information,visit www.miamidade.govltextellector PAYMENT RECEIVED BY TAX COLLECTOR 20000 09/29/2014 0245-14-004530 2015-03-03 11:33 Eguino & Associates 7863133738 » 1 800 685 7530 P 1/1 A Rt7 f DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 13/3/2015 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 tho corUflcato holdor Is an ADDITIONAL INSURED, tho pO1Icy(los) must bo ondorsod. If SUBROGATION IS WAIVED, subJoct to the terms and condklons of tho policy, cortaln pollclos may roqulre an ondoraomont A atatomont on this cortlflcato doos not confor rights to tho cortlficato holdor In Ilou of such ondorsomont(s). PRODUCER A QUICK & EASY ASSURANCE GROUP Insurance Professionals of S. FL 7229 Coral Way Miami, FL 33155 A106088 INSURED VOLTECH ELECTRIC COMPANY, INC. 6979 NW 53 Street MIAMI, FL 33166 305-218-6166 CONTACT NAME-: vu&Ne"5t tet). (305) 662-7030 Ism ra ell@gmail .coat A,c,No);(305) 6627168 INSURERI$) ANPORDINO COVCRAOd NNCN INSURER A; Ascendant Underwriters INSURER D : Progressive Inuaranco Company INSURER C ; INSURER D INSURER E ; INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 1S 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. d ADL SUER MR WV') TR TYPE OF INSURANCE X COMMERCIAL GENERAL LI/MALIN CLAIMS -MADE OCCUR A B POLICY NUMBER GENT. AGGREGATE LIMIT X IPRo- J POLICY � ECT l ECT OTHER: AUTOMOOILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS APPLIES PER; ELOC GL -52252.6 POLICY -EFF (MM/ DmYY) 9/29/14 (MrOGY Ex!. MM/0 )NYV YY) 9/29/15 EACH OCCURRENCE LIMITS DAMAGE TO RtN rtU PREMISES (Ea aceurroncn) MED FafP (Any Ono preen) PERSONAL & ADV INJURY S 1,000,000 $ 50,000 a 5,000 s 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIQp AGG s 1,000,000 3 _ SCHEDULED x AUTOS NON•OWNED _ AUTOS UMBRELLA LIAO j___ EXCESS LIAB 02090779-2 3/1/15 3/1/16 GOMF)INtD SINGLE LIMIT (En (accident) 3 BODILY INJURY (Per porson) BODILY INJURY (Pot occident) F'kOYEHIY DAMAUE (Per occident) $ 100,000 OCCUR CLAIMS•MADE DEO RETENT ON $ WORKENS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIUTOR/PARTNEWEXECUTIVE OPFICIRMEMOER EXCLUDED> (Mend io,1, In NMI If yes, describe under DEScruPTION OF OPERATIONS below EACH OCCURRENCE 300,000 $ 50,000 3 S AGGREGATE 3 Y/N NIA YtR STATUTE; GTN. ER s E.L. EACH ACCIDENT S E.L, DISEASE • EA EMPLOYEE S E.L DISEASE • POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES (ACORD 101, Adalllorlol Remarke SChodulo, may bo attached It mord space Is rgqulred) Electrical Service Contractor CERTIFICATE HOLDER 3 CANCELLATION Miami Shores Village Building Department 10050 NE 2 Ave Miami Shores, FL 33138 fax 305-756-8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE ©1988.2014 ACORD CORPORATION, All rights reserved. ACORD25(2014/01) The ACORD name and logo are registered marks of ACORD 03/03/2015 TUE 12:12 FAX 121001/001 VOLTE-1 OP ID: GS '`__O OA CERTIFICATE OF LIABILITY INSURANCE DATE(MMf/D/TYYY) 03/03/15 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 pollcy(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 thls certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER 305-442-9507NAME Insurance Marketers Inc 2600 Douglas Road Suite 712 306.,447-5627 Coral Gables, FL 33134 Marla Iglesias CT Marla Iglesias PHONE FAX No): ac- No. 15><n:306-442-9507 E-MAIL POLICY -EXP IMM/DD/YYYYI ADDRESS: INSURER(SI AFFORDING COVERAGE NAIC # INSURER A : Technology Insurance Co. INBURSR a : INSURER C: 42376 INSURED VOLTECH ELECTRIC CO INC. 6979 NW 63 TERRACE MIAMI, FL 33166 INSURER 0 : INSURER 5 : EACH OCCURRENCE INSURER F : • 1\V V banal• n\V,euO R: 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 SHAWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR LTR TYPE OF INSURANCE ADDL. INSR SUBR WVD POLICY NUMDER POLICY EFF IMM/PO/YYYY) POLICY -EXP IMM/DD/YYYYI LIMITS GENERAL UABILITY EACH OCCURRENCE COMMERCIAL GENERAL PREMEB( occ zrDenge) 5 I CLAIMS.MADE L—I OCCUR El MEP EXP (Anyone person) 5 PERSONAL &ADV INJURY GENERAL AGGREGATE 5 5 GEN'L AGGREGATE LIMIT APPLIES PER 7 PRODUCTS - COMP/OP AGO $ POLICY n JPEC 17 LOC E AUTOMOBILE — LIABILITY COMBINED SINGLE LIMIT (E I1) 5 ANY AUTO ALL OWNED — SCHEDULED BODILY INJURY (Per person) $ ....... AUTOS AUTOS PION -OWNED BODILY INJURY (Per ec Iden/) 5 HIRED AUTOS _ AUTOS PROPERTY DAMAGE IPer accident) 5 $ UMBRELLA LIAR_ EXCESS OCCUR EACH OCCURRENCE $ LIAR CLAIMS -MADE AGGREGATE 5 DED RETENTIONS 5 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN WC gTAT1J- I TORY millX DER ANYPROPRIETOR/PARTNERIEXECUTNE OFFICERIMEYBER EXCLUDED? Y N /A TWC3459571. 01/21/15 01/21/16 EL EACH ACCIDENT $ 1,000000 , (MrewletorY In NN) If yyeese deealbe under E,L DISEASE • EA EMPLOYEE - s 1,000,000 DE8LIRIPTION OF OPERATIONS below E.L. OISEABE - POLICY LIMIT $ 1,000,000 OEBCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule If more space is required) Electrical contractors,COVERAGES ARE SUBJECT TO THE TERMS, CONDITIONS, DEDUC AND EXCLUSIONS LISTED ON THE POLICY. Ql=SSTIGICeTG "JAI rimmo ION MIAMISV MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORES, FL 33136 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE IX ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD