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ELC-18-612 Inspection Worksheet i Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-299004 Permit Number: ELC-3-18-612 Scheduled Inspection Date: April 27, 2018 Permit Type: Electrical Commercial Inspector: Devaney, Michael Inspection Type: Final Owner: CHURCH, Work Classification: Addition/Alteration Job Address:602 NE 96 Street Miami Shores, FL Phone Number (305)754-9541 Parcel Number 1132060141410 Project: CHURCH Contractor: RED HAWK FIRE &SECURITY, LLC Phone: (954)791-1313 Building Department Comments INSTALL DEVICES TO FIRE ALARM Infractio Passed Comments INSPECTOR COMMENTS False 09/14/2016 TO REPLACE PERMIT#ELC-9-16-2534 t i Inspector Comments Passed Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. t i April 26,2018 For Inspections please call: (305)762-4949 Page 9 of 28 y Permit NES. ELC-3-18-612 Miami Shores Village Permit Type:Electrical-Commercial 10050 N.E.2nd Avenue NE & Work Classification:Addition/Alteration Miami Shores,FL 33138-0000 r i y,— -g ;aPhone: (305)795-2204 Permit Status:APPROVED FtorcioA ration: 10/23/2018 I Issue Date:4/26/2018 Ex p� Project Address Parcel Number Applicant 602 NE 96 Street' 1132060141410 Miami Shores, FL Block: Lot: MIAMI SHORES PRESBYTERIAL Owner Information Address Phone Cell MIAMI SHORES PRESBYTERIAN 602 NE 96 ST (305)754-9541 - -- MIAMI FL 33138-2742 Contractor(s) Phone Cell Phone Valuation: $ 14,970.00 RED HAWK FIRE&SECURITY, LLC (954)791-1313 Total Sq Feet: 0 Type of Work:INSTALL DEVICES TO FIRE ALARM Available Inspections: Additional Info: Classification:Commercial Inspection Type: Final Scanning:6 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical W.W. Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $9.00 Invoice# ELC-3-18-66731 DBPR Fee $6.74 04/26/2018 Credit Card $437.33 $50.00 DCA Fee $4.49 Education Surcharge $3.00 03/21/2018 Check#: 1161 $50.00 $0.00 Permit Fee $449.10 Scanning Fee $3.00 Technology Fee $12.00 Total: $487.33 f r 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 wor tated. �,7 April 26, 2018 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy April 26, 2018 1 MIX zMiami Shores Village A - M R21 18 1� ' Building Department artmentHL - 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 l `} BUILDING Master Permit No. y — 2, PERMIT APPLICATION Sub Permit ❑BUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION [jjAENEWAL ❑PLUMBING ❑MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: 33/3 9 Folio/Parcel#: 1l 3;�'0(06 I Li i i� 1 is the Building Historically Designated:Yes NO Occupancy Type: load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): ! /! )Ora I 5w< Ih►-TCo oy) Phone#: '65-254 ^'2541 Address: LI)a /v E q6 S- ' City: M[L1-rn i State:- Zip: -31 3 g Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: k F[ir•(- li _5eWrt±y Phone#: Addre�sss► City:V� i rwat - n r State: i L zip: 330 r Qualifier Name: Ebl� n"I°� t' 1 e44 f2e,0" Phone#: State Certification or Registration#: C 13L i 7 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: i Address: City State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑Demolition Description of Work: IT* SLC ( -C �3� Specify color of color thru tile: Submittal Fee$c :�D' C'71 Permit Fee$ /31 �i l CCF$ CO/CC$ Scanning Fee$ ' a3Radon Fee$ -9- 149 DBPRR$$ - Notary$ Technology Fee$ t2 Training/Education Fee$ .� Double Fee$ Structural Reviews$ Bond$ , TOTAL FEE NOW DUE$ `"7 J, (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 absence of such posted notice, the i spection will not be anproved and a reinspection fel will be charged. t� ,,Tla•dLQ/�J�21Lcct�r. Signa pre Signature M""" OWNE AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _ ,_day of 20 l8 by a��`lr dayfoof ��'('� 20 L� by lkmas Latina rd- ,who is personally known to � !r5 !' l e P7679who is personally known to .� b _ �.. . .... me or who has produced 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: /Q-�.�.�O. ►/D��d� Prin Print: _ MY COMMISSION N FF 915218 i�PY P✓ . DORINDA Seal: :�a•••...°4:: LELLO Seal EXPIRES:December 20,2019 MY COMMISSION#GG 158196 e,E:•• Bonded Thru Notary Public UMerwrilers y oma; EXPIRES:November 15,2021 y., oF!;;•••` BondedThruNoteryPubllcUnderwrhers APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 3/8/2018 Property Search Application-Miami-Dade County 'HE PRO"PERTRY0 APPRAISER OFFICE ff SummaryReport Generated On:3/8/2018 't... e Property Information � �" .; •k • Folio: 11-3206-014-1410 Property Address: 602 NE 96 ST Miami Shores, FL 33138-2742 , Owner NORTHEAST PRESBYTERIAN i. CHURCH 602 NE 96 ST Mailing Address * ' - r" MIAMI,FL 33138 USA PA Primary Zone 6800 COMMERCIAL-PROFESS 915, OFFI 7144 RELIGIOUS-EXEMPT: Primary Land Use RELIGIOUS Beds/Baths/Half 0/0/0 ? _ Floors 1 'Nov Living Units 0 t r p Actual Area Sq.Ft Living Area Sq.Ft Taxable Value Information Adjusted Area 47,457 Sq.Ft 2017 2016 2015 Lot Size 85,167 Sq.Ft Year Built 1958 County Exemption Value $3,957,766 $3,663,598 $3,330,544 Assessment Information Taxable Value $0 $0 $0 Year 2017 2016 2015 School Board Land Value $1,192,338 $1,192,338 $936,837 Exemption Value $3,957,766 $3,834,585 $3,330,544 Building Value $2,638,731 $2,513,618 $2,263,248 Taxable Value $0 $0 $0 XF Value $126,697 $128,629 $130,459 City _,. ..................._._....... _... Exemption Value $3,957,766 $3,663,598 $3,330,544 Market Value $3,957,766 $3,834,585 $3,330,544 Assessed Value $3,957,766 $3,663,598 $3,330,544 Taxable Value $0 $0 $0 Regional r Benefits Information Exemption Value $3,957,766 $3,663,598 $3,330,544 Benefit Type 2017 2016 2015 1 Taxable Value $0 $0 $0 Non-Homestead Assessment Cap Reduction $170,987 Sales Information Religious Exemption $3,957,766 $3,663,598 $3,330,544 Previous Sale Price OR Book-Page Qualification Description Note:Not all benefits are applicable to all Taxable Values(i.e.County,School Board,City,Regional). i Short Legal Description r MIAMI SHORES SEC 2 PB 10-37 LOTS 1 TO 10 INC BLK 61 LOT SIZE IRREGULAR The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp I Version: r Detail by Entity Name Page 1 of 2 l , oritla Depaitnaent of Stata DivfsiaU?J OF (:O'tPb7E;.;';ONS f t g r :l y1 Department of State / Division of Corporations / Search Records / Detail By Document Number/ Detail by Entity Name Florida Not For Profit Corporation NORTHEAST PRESBYTERIAN CHURCH, INC. Filing Information Document Number 712497 FEI/EIN Number 59-1196196 Date Filed 03/28/1967 State FL Status ACTIVE Last Event AMENDMENT Event Date Filed 03/25/1988 � r Event Effective Date NONE Principal Address 4400 SHORE ACRES BOULEVARD NORTHEAST ST PETERSBURG, FL 33703 Changed: 05/24/2000 ' Mailing Address 4400 SHORE ACRES BOULEVARD NORTHEAST ST PETERSBURG, FL 33703 Changed:05/24/2000 Registered Agent Name&Address , Zoellin, Steven R 4400 SHORE ACRES BLVD NE ST.PETERSBURG, FL 33703 Name Changed: 03/27/2017 Address Changed:07/18/2007 1 Officer/Director Detail Name&Address i Title PD STEVE, FISHER i 1 4640 SHORT LEAF LANE NE ST. PETERSBURG, FL 33703 F http://search.sunbiz.org/Inquiry/CorporationSearch/SearchRe sultDetail?inquirytype=Entity... 3/8/2018 Detail by Entity Name Page 2 of 2 Title SD JOHNSON,JERRIANN 2226 37TH AVENUE NORTH SAINT PETERSBURG, FL 33713 Title TD Zoellin, Steven R 142 NE Madison Circle North SAINT PETERSBURG, FL 33702 Annual Reports { Report Year Filed Date 2016 03/31/2016 2017 03/27/2017 2018 03/08/2018 i I Document Images 03/08/2018--ANNUAL REPORT View imago,in PDF formai 03127/2017--ANNUAE..REPORT View image in PDF format 03.13112016...ANNUAL REPORT View image inPDF format 01/12/2015--..ANNUAL REPORT View Image in PDF format Q:!iUM14...-.-._.NMI).;.REP.QRT View image in PDI format 01/2812013--ANNUAL REPORT View image in PDF format 03!06/2012--ANNUAL.REPORT View image in PDF format 02.!16/2011 --ANNUAL REPORT View image in PDF format 05!13.12010--ANNUAL REPORT View image irr PDF for€mat g)1122!213Q9_.,-.A NU�1l;REPORT View image in PDF format 042412006--ANNUAL REPORT View irnage m PDF fwmat 0,!1812007--ANNUAL REPORT View image in PDF format 04/1012006--ANNUAL REPORT View image in PDF format 03/1612005--ANNUAL REPORT View image in PDF format n t?3120()4._-_ANNUAC;;_[tFGQRT View image in PD1 tarrrat� 03i1312003--ANNUAL REPORT View image in PDF fornat 05/01!2002--ANNUAL.REPORT View image in PDF format 03!0812001 -ANNUAL REPORT View image in PDF format 1 05!24.!2000--ANNUAL REPORT View image in PDF format (l4l2311,99Q„_--.ANNUI UA:REP image in PDI format 03/10/1998--ANNUAL REPORT View irnage in PDF fornat 01i24/1997--ANNUAL.REPORT View image in PDF formate 04(24/14Jo,__.-,4NNU L,_REF QRT View image in PDF format rin'i;;a r.%e.iii r+; E'.!�:('.':;�t_.�,Civ:sirn i I http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 3/8/2018 Detail by FEI/EIN Number Page 1 of 3 Florida Division of Corporations • I.)e"partment of State • Division of Corporations • Search Records • Detail 1:3v Document Number Previous On List Next On I.,ist Return to I..,i.st Events No Namb History Detail by FEUEIN Number Florida Not For Profit Corporation MIAMI SHORES PRESBYTERIAN CHURCH r Filing Information Document Number713938FEI/EIN Number59-0689708Date Filed0l/15/1968StateFLStatusACTIVELast EventAMENDMENTEvent Date Filed04/11/2016Event Effective DateNONE Principal Address 602 N E 96 ST MIAMI, FL 33138 1 Changed: 05/04/2001 i Mailing Address 602 N E 96 ST MIAMI, FL 33138 F a Changed: 05/04/2001 Registered Agent Name & AddressMIDDLETON, J. LANE, III 2121 PONCE DE LEON BLVD - STE 600 ' CORAL GABLES, FL 33134 Name Changed: 04/28/2003 Address Changed: 01/10/2014 Officer/Director DetailName & Address r i Title PT ROSE, DEBORAH ,.. 18151 NE 31 st Ct. APT. # 205 AVENTURA, FL 33160 file:///C:/Users/dorinda.lello/AppData/Local/Microsoft/W iridows/Temporary%20lntemet%... 3/16/2018 h Detail by FEI/EIN Number Page-2 of 3 1 e Title VT LEONARD, THOMAS A 9300 N.E. 4TH AVENUE MIAMI SHORES, FL 33138 Title ST g t TIMKO, THOMAS M 700 N.E. 96TH STREET MIAMI SHORES, FL 33138 Annual Reports Report Year Filed Date E 2016 04/04/2016 ` 2017 04/25/2017 2018 02/26/2018 i Document Images F 02/26/2018 -- ANNUAL REPORT'View imizge in PDF format 04/125/2017 -- ANNUAL REPORT View image irl PDF format 04/11/2016 -- Amendment View ii-nage in PDF format 04/04/2016 -- ANNUAL REPORT View image in PDF format I 04/20/2015 -- ANNUAL REPORT Vier- image in PDF format 04/114/2014 -- ANNUAL REPORT View image in PDF format 01/10%2014 -- Reg. Arent Change View image in PDF format 04/15/12013 -- ANNUAL REPORT Vievv image in PDF format - 02/21/2012 -- ANNUAL REPORT View image in PDF format 031114/2011'-- ANNUAL REPORT View image in PDF format } 04/20/2010 -- ANNUAL REPORT View image in PDF format 03/10/2009`-- ANNUAI..; RI: PORT View image in PDF format 03/27/2008 -- ANNL AI., Rl:;POR'IView image in PI)F format a 0'/19/2007 -- ANNUAI... R1 PORT View image in 1'L)l,' format 04/13/2006 -- ANNLiAI:., Rl."POR'1 View irnage in PDF format 02/10/2005 -- ANNUAL.; R.I: POKh View image in PD format 04/29/2004 -- ANNUM., R1:PORT View image in PI)I- format 04/28/2003 -- ANN i_)AI... R.f PORI' View image in l'D:I format 05/16/2002 -- ANNUAL RI.:POR 1'View image in PDL" format Y. 05/04/2001 -- ANNUAL, R.1 PORT View image in:Pb:F format 03%31/2000 -- ANNt AL, ZEPOR 1' VjOW image in_PDF fortnat 03/09/1999 -- ANNUAL, REPOR.'I' Vlew image in P )F format 08/26/1998 -- ANN[ AL 1ZEP01Z:I View image in PI)F format i f file:///C:/Users/dorinda.lello/AppData/Local/Microsoft/Windows/Temporary%201nternet%... `3/16/2018' 1 { SNORES a � " Miami shores Village Building Department OR ID , 10050-N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305)795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF.CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. ✓ PY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. '` '� COPY OF LIABILITY INSURANCE* 3 D. JCOPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. ` COPY OF LIABILITY INSURACE* { .E.. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW:` Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT I 10050 NE 2ND AVE MIAMI SHORES,FL 33138 Certificate must specify'the description of operations or contractor license number. BUSINESS NAME: rF BUSINESS ADDRESS: 33 Lr�&%Y�E' f TCITY Nl6C1PO' STATE ZIP 3361, BUSINESS PHONE: 054 ) �x'13 i 3 FAX NUMBER q I— 6 CELL PHONE(7,��) Jamba —�61�5 QUALIFIER'S NAME: ��Lt arb QUALIFIER'S LIC NUMBER: ��r— s RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD .4 EC13004155 F The ELECTRICAL CONTRACTOR x Named below IS CERTIFIED Under the provisions of Chapter 489 FS. •�Qa,W"s Expiration date: AUG 31, 2018 PLEFFNER, EDWARD F RED HAWK FIRE&SECURITY,"LL'C �R* ' 5100`TOWN CENTER CIR7 TE 3504,,,.. TOWER II r MIRAMAR ' FL733025 y ` �P.r'` .+'^' 'r, .„ a •:'" -" ,,,5`,,.,,, �' �,,n., �„�t v^s _`�t` 1°r. 4•-� � " y, �`. L; '"• '�' .� ", +- _..s'."'r"_�x.`�-.' `"'^'•'.� �'`':*,... � ''.. •. tat �''t v.M r`� "'*'h 1�j� �' �4.� � i�..i �,,. ��_�'t;. „4 SL1802010001075 ISSUED: 02/01/2018 DISPLAY AS REQUIRED BY LAW EQ# K 4 r ^f , 115,S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895— 954-831-4000 VALID OCTOBER 1,2017 THROUGH SEPTEMBER 30,2018 1, DBA: Receipt#:181-289129 ELECTRICAL/ALARMS/CONT OR RED HAWK FIRE & SECURITY LLC Type: (CERT ELECTRICAL CONTRA R) Business Name: Business T e: Owner Name:EDWARD F PLEFFNER/ QUAL Business Opened:02/16/2018 Business Location:3375 COMMERCE PKWY State/County/Cert/Reg:Ec13004155 MIRAMAR Exemption Code: Business Phone: Rooms Seats Employees Machines Professionals 28 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: ,0.00 0.-00.:. 0.00 81.00 I 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 business location.This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: RED HAWK FIRE & SECURITY LLC Receipt #05B-17-00000244 3375 COMMERCE PKWY Paid 02/16/2018 81.00 MIRAMAR, FL 33025 all i - 2 .17- 2Q1R r " ^ i Page 1 of 1 ACORQ® I DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE F03/16/2018 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 have ADDITIONAL INSURED provisions or 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). I PRODUCER CONTACT Willis Towers Watson Certificate Center NAME: Willis of New York, Inc. c/o 26 Century Blvd PHONE 1-877-945-7378 FAX 1-888-467-2378 WC, /C No Ext): (A/C.No E-MAIL certificates@willis.com P.O. Box 305191 ADDRESS: i Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: First Specialty Insurance Corporation 34916 INSURED INSURER B: Liberty Mutual Insurance Company 23043 Red Hawk Fire 6 Security, LLC , 3375 Commerce Parkway INSURERC: Scottsdale Insurance Company 41297 Miramar, FL 33025 INSURER D: t INSURER E: x INSURER F: COVERAGES CERTIFICATE NUMBER:W5520333 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. , 1 INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LTR POLICY NUMBER MM DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 3,000,000 I DAMAGE TO RENTED CLAIMS-MADE Fx_1 OCCUR PREMISES Ea occurrence $ 100,0010 A MED EXP(Any one person)' $ ,10,000 E IRG 2001021 04 04/10/2017 04/10/2018 PERSONAL&ADV INJURY $ 3,000,000 L GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY F_x1 jECT F] LOC PRODUCTS-COMP/OPAGG $ 3,000,000 OTHER: $ AUTOMOBILE LIABILITY CMBINED SINGLE LIMIT $ 2,000,000 (EO accident X' ANY AUTO BODILY INJURY(Per person) $ r. B OWNED SCHEDULED AS2621094871027 04/10/2017 04/10/2018 BODILY INJURY Per accident $ AUTOS ONLY AUTOS , ( ) HIRED NON-OWNED PROPERTY DAMAGE' X AUTOS ONLY X AUTOS ONLY Per accident $ $ l C X UMBRELLA LIAB X OCCUR, EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE - NXS0003059 04/10/2017 04/10/2018 AGGREGATE $' 2,000,000 DED I X I RETENTION$0 $` WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE B ANYPROPRIETOR/PARTNER/EXECUTIVE Y/NE.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? No N/A WA762D094871017 ' 04/10/2017 04/10/2018 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000;000 If yes,describe under I1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 9' DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Contractor # EC13004155 I , i 7 I t 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.,. Village of Miami Shores AUTHORIZED REPRESENTATIVE Building and Zoning 10050 NE 2nd Ave Miami Shores, FL 33138 C 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 15781825 BATCH: 637304 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 � .� 2601 BLAIR STONE ROAD " TALLAHASSEE FL 32399-0783 Y GOMEZ, CARLOS RED HAWK FIRE&SECURITY, LLC 2423 SW 147TH AVENUE SUITE 213 MIAMI FL 33185 Congratulations! With this license you become one of the nearly Q I one million Floridians licensed by the Department of Business and STATE OF FLORIDA Professional Regulation. Our professionals and businesses range f DEPARTMENT OF BUSINESS AND ;, from architects to yacht brokers,from boxers to barbeque �•�' PROFESSIONAL REGULATION restaurants,and they keep Florida's economy strong. EF20001380 , ISSUED` 07/27/2016 Every day we work to improve the way we do business in order ---. to serve you better. For information about our services,please r CERTALARM SYSTEM'CONTRACTOR I to onto www.myfloridalicense.com. There you can find more l GOMEZ,CARGOS"= information about our divisions and the regulations that impact I RFD HAWK FIRE 8�SECURITY-LLC you, subscribe to department newsletters and learn more about F the Department's initiatives. • s Our mission at the Department is: License Efficiently, Regulate IS CERTIFIED under the Fairly.We constantly strive to serve you better so that you can E.-plrai date•AUG 31.2M8 provisions of Ch.489 F5, serveand con ratulati ns on our nour customers. Thankew license!ou ibr ng business m Florida, uso7z700003na a 9 Y " DETACH HERE RICK SCOTT;GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD EF20001380 ADDITIONAL BUSINESS QUALIFICATION '� The ALARM SYSTEM CONTRACTOR I Named below IS CERTIFIED W ` Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 GOMEZ, CARLOS RED HAWK FIRE &SECURITY'-.LLC 3375 COMMERCE PARKWAY"��""" r.' MIRAMAR" FL'`33025 r .. 1' W ISSUED: 07/27/2016 DISPLAY AS REQUIRED BY LAW SEQ# L1607270000344 DROWARD-COUNTY-EOC-AEESS TAX RECEtPT t 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2016 THROUGH SEPTEMBER 30,2017 DBA: Receipt#:EVECTR1acAi ALARMS/CONTRA' OR Business Name:RED HAWK FIRE AND SECURITY LLC Business Type: (ALARM SYSTEM CONTRACTOR) Owner Name:CARLOS GOMEZ Business Opened:o8/23/2016 Business Location:3375 COMMERCE PKWY State/County/Cert/Reg:EF20001380 MIRAMAR Exemption Code: Business Phone: Rooms Seats Employees Machines Professionals 5 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 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 the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: RED HAWK FIRE AND SECURITY LLC Receipt #30A-15-00006738 i 5100 TOWN CENTER CIR STE 350 Paid 08/23/2016 27.00 BOCA RATON, FL 33486 2016 - 2017 DATE CERTIFICATE OF LIABILITY INSURANCE page 1 of 1 09/(13/20 6) 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 Willis of New York, Inc. PHONE 877-945-7378 FW- c/o N() 888-467-2378 c/o 26 Century Blvd. )' P. C4 O. Box 305191 E-MAIL certificateswillis.com Nashville, TN 37230-5191 I NSU R E R(S)AFFORDI NG COVERAGE NAIC# INSURERA: First Specialty Insurance Corporation 34916-001 INSURED Red Hawk Fire & Security, LLC INSURERB: Liberty Mutual Insurance Company 23043-002 3375 Commerce Parkway t INSURERC: Scottsdale Insurance Company 41297- Miramar, FL 33025 INSURER D: INSURER E: INSURER R COVERAGES CERTIFICATE NUMBER:24646626 REVISION NUMBER:See Remarks 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. I R DDL SUB POLICY EFF POLICY EXP TTYPEOFINSURANCE POLICYNUMBER LIMITS A X COMMERCIAL GENERAL LIABILITY IRG200102103 4/10/2016 4/10/2017 EACHOCCURRENCE $ 2 000 OQO 000AAnngqcc;;EE 7?pJ.R�ENTED CLAIMS-MADE ][ OCCUR PNEMISES(taoccurence) $ 100,000_ I MED EXP(Anyone person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 000 000 POLICY PRO- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 PRO OTHER: $ B AUTOMOBILE LIABILITY AS2-621-094871-026 4/10/2016 4/10/2017 COMBINEDSINGLELIMIT (Ea accident $ 2,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Peracddent) $ X HIREDAUTOS X AONOSWNED PROPERTY DAMAGE $ C X UMBRELLALIABX OCCUR NXS0002524 4/10/2016 4/10/2017 EACH OCCURRENCE $ 2_0 001_0.00 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 2,000,000 DED I RETENTION$ $ B WORKERS COMPENSATION WA7-62D-094871-016 4/10/2016 4/10/2017 X AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEYN/A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? FMandatory,in NH) E.L.DISEASE-EA EMPLOYEE $ 11000,000 f yes,descri DESCbe under RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additonal Remarks Schedule,may be attached if more space is required) THIS VOIDS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE DATED: 4/8/2016 WITH ID: 24332744 Re: EF20001380 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. AUTHORI DR ESENT Miami Shores Village 10050 NE 2nd Ave Miami Shores, FL 33138 '4 Coll:4959256 Tpl:2049791 Cert:24646626 V88-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered markACORD I l