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EL-17-1145 ri APR 26 2017 LAUNDRY� BY u No. DESCRIPTION ....PERMLIS... SWIMMING MAID KITCHEN POOL 1000000 BATH F1 0-11 FAMILY/BREAKFAST ROOM I -XI i CLOSET oo*:: L3 vy •jk .... Z DINING • 8 • 0 L3 .......... m ui L :3 U.J z W z < > 0 TERRACE M L' ENTRY LIVING = G y w H In LL E3 C3 NO < z J^[7 Oil W VI Is Eq < Z z_j 0 L3In LL 0 0 M In ti < W.I.C. POWDER1! < Licence 0.ES1 Qualffier:SAMUEL N RMAN R 1;3, LitT A&ature: CORRIDOR F1-q BEDROOM 3 -7 vv W.I.C. STORAGE 3 7 BRUNO 4 j MBAM W.I.0TERRACE E eh ALMEIDA i BEDROOM 2 PATH#1 BEDROOM I r MASTER 9879 NE 13TH AVE BEDROOM BATH#3 BATH#2' MIAMI SHORES, FL 331 38 SP 0 DATE (M.17.2017 SCALE: 3M'-1'4r DROM BY'. PROPOSED FIRST FLOOR PLAN PERMITS Video(RGk R=WWm%HX Wffor Bdm)-RED kw be hb*mmddm sluaEsykj&v MINMOMU DATA AM MVHK Cmu mz coo 0%I=UK W LOCAVIII 11:93 =w 0m LOW VOLTAGE Audio(RGS,Stereo Pot.Cats for ad^Sped /Ire)-on CtkTjp lmm)mm-mu bw Vftm "IN N Cmw WEN= IMMMEL W311111111IRT CNIIIII)IL Doan CTO 0151 Cont /Dota/Phone(Cate D*6 Cath Control,Cate Sme)-a= mum Sp-(Any Si—Win)-RMI &N="w 111113"n AaRN WIL WAM AM=w Iiiwiit 04*ft.Rob v MMM MZ ga I C41B To m FM DDIX man OCTV(CO3 RG59)-WM T:dI- am Pow(Any Pow CabW)YMN Ramustan ph=.JIM PROPOSED 311111 WW mwwff am 0 cc=ow Fq- PAD AUM KEVPN au RIPE Norm pm-bn wArbw p to be and b bbdhd 0 mulm IV 0 LV i *W(*-4 Ub-Light Oft Lubar,$110110 Cd)k Aft MA OW-%naft d ft cdb Im to�(b be and b Mdkd W-z"Nim"Fbm vam cwmwmmmw 0 CDC C"m mw a wd NOWAT 0 Permit No. EL-4-17-1145 `SHORES t�� Miami Shores Village Permit Type:Electrical -Residential 10050 N.E.2nd Avenue NE Per Work Classification. Low Voltage Miami Shores,FL 3313&0000 "tea` Phone: (305)795-2204 Permit Status:APPROVED E.ytEg N� F[ORiDp' Issue`Date:4127/2017 Expiration: 10/2412017 Project Address Parcel Number Applicant 9879 NE 13 Avenue 1132050090490 Miami Shores, FL Block: Lot: JACQUELINE BARRANTES Owner Information Address Phone Cell JACQUELINE BARRANTES 9879 NE 13 Avenue (917)698-2863 MIAMI SHORES FL 33138- 9879 NE 13 Avenue MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 6,500.00 MAXICON LLC (305)479-2679 Total Sq Feet: 0 Type of Work:LOW VOLTAGE-PRE-WIRE AS PER PLANS. Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:3 Fees DLL$M254.52 unt Pay Date Pay Type Amt Paid Amt Due CCF $4.20 Invoice# EL-4-17-63814 DBPR Fee $3.41 DCA Fee $3 41 04/26/2017 Check#: 1733 $50.00 $204.52 Education $1.40 04/27/2017 Credit Card $204.52 $0.00 Permit Fe227.50 Scanning $9.00 Technolog $5.60 Total: 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 d zoni . F ther re,I aut ze a above-named contractor to do the work stated. April 27, 2017 ut orized ignature:Owner / Applicant / Contractor / Agent Date Building Department Copy April 27, 2017 1 C- 95 q- \\A V Miami Shores Village 2 6 2017 Building Department r 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 [� FBC 20��' J BUILDING Master Permit No. — t,�T 7 PERMIT APPLICATION Sub Permit No. DI�1 4 :T ❑BUILDING ,'ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION 7RENEWAL ❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS 1 JOB ADDRESS: O J 1 V `3 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: I � 3 �)0,�'4 O� q9 n Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): 43 Q,4�0 4 LW—E�0 FI- Phone#: Address: 7� 1 ( a -DEQ City: _ H It 4 f-t i State: A- Zip:33 1 ,-? Tenant/Lessee Name: Phone#: Email: IvAPD w1_t� CONTRACTOR:Company Name: A�( 1 C_O(") LCc Phone#��0� 7 T� Address: I S� iq j C-- 1 City: - ` State: (_ Zip: 3 3 D ft Qualifier Name: S A�` U E L ,y A � 1FC-M R rj Phone#:,30-Y1 State Certification or Registration#: E S , 6y l `� O Certificate of Competency#: � DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration/ ID New F-1 Repair/Replace E] Demolition Description of Work: L so (� dLJ-AG� — \ (2 l.J l e A5 Specify color of color thru tile: Submittal Fee$ �� _�)• 0�3 Permit Fee$ �y ?`b CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$�0 Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ �Q •S (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. the absence of such posted notice, the inspection will not be(77 pection fwill be charged. ;V� 'd ignature--=> Signature 74 O NER or ENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this Z.S- day of 20 1 —7- by c, day of �1' L 20 �� by N QR &J 9" -0- (1�url(�= ho is personally known to �9'�Wl - 1 � ,who is personally known to me or who has C 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: Print: Print: YP MARY D. VISPO Seal: 2°' ��� MY COMMISSION#FF242221 Seal: IEB A JAV EXPIRES:JUN 21,2019 NOT RK P11Bt.IC,STATE OF FLORIDA * Bonded through 1st state Insurance �pMMiSS;f!iy N0.FF 146537 MY((1hE'J1 $ICIN EXPIRES JULY 30,2018 �y APPROVED BY Plans Examiner _ Zoning Structural Review Clerk (Revised02/24/2014) iLOFFICE OF THE PROPERTY A Summary Report Generated On:4/25/2017 Property Informations Folio: 01-3207-031-0580 Property Address: 839 NE 72 TER { Miami,FL 33138-5262 BRUNO ALMEIDA&W Owner JACQUELINE BARRANTES Mailing NE 72 TERR" ailing Address MIAMI,FL 33138-5262 PA Primary Zone 0100 SINGLE FAMILY-GENERAL -T, rr Primary Land Use 0101 RESIDENTIAL-SINGLE ' +/r" 1T. . " � '"`�' FAMILY: 1 UNIT � .. ' Ilk Beds/Baths/Half 3/4/0 Floors 1 r ID n , Living Units - 1 Actual Area 2,643 Sq.Ft y ,. . q. 0 �? r 4200 Living Area 2,579 Sq.Ft Adjusted Area 2,355 Sq.Ft Taxable Value Information Lot Size 10,620 Sq.Ft 2016 2015 2014 Year Built 1940 County Exemption Value $0 $0 $50,000 Assessment Information Taxable Value 1 $566,628 $515,1171 $314,612 Year 2016 2015 2014 School Board Land Value $339,840 $245,430 $228,330 Exemption Value $0 $0 $25,000 Building Value $250,145 $269,687 $241,916 Taxable Value 1 $626,552 $515,117 $339,612 XF Value $36,567 $0 $24,478 City Market Value $626,552 $515,117 $494,724 Exemption Value $0 $0 $50,000 Assessed Value $566,628 $515,117 $364,612 Taxable Value $566,628 $515,117 $314,612 Regional BenefitsInformation Exemption Value $0 $0 $50,000 Benefit Type 2016 2015 , 2014 Taxable Value 1 $566,628 $515,117 $314,612 Save Our Homes Assessment $130,112 Cap Reduction Sales Information Non-Homestead Cap Assessment $59,924 Previous Price . Book- Qualification Description Reduction Sale Page Homestead Exemption $25,000 26426- 06/01/2008 $505,000 Sales which are qualified Second Homestead Exemption $25,000 2789 Note:Not all benefits are applicable to all Taxable Values(i.e.County, 02/01/2008 $0 26197- Sales which are disqualified as a result School Board,City,Regional). 4367 of examination of the deed 07/01/2007 $450,000 25794 Other disqualified Short Legal Description 1057 NEW BELLE MEADE PB 40-45 25289-` Sales which are disqualified as a result 03/01/2006 $0 LOT 30&E1/2 LOT 32 BLK 4 3839 of examination of the deed LOT SIZE 90.000 X 118 COC 26426-2789 06 2008 1 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:/twww.miamidade.govrinfo/disclaimer.asp Version: I r ' uuSS��" ,}. { y b _lis' ! 'a. 71 F. STATE 'OFFLO R. ID g -S ANO A PRO MCMABAREGULATION" FES 4Z 0-241 _ fwt 36 TR � U� `. - ,MA-XJ ON lC --I �, �' 6, 1154- Sm, 1S x' 9a�gqc�--e��,» -"{��r► r IEM is;s IS ER, ,If# t me rryti 'prt�v s tin i Ch` # SFS �Kf�*��g,��� 3'�c t j, 3', y L� � r'� 'kms � �. ntci a•ar y, "`'R i s. r DBPR-NAIERMAN, SAMUEL; Doing Business As: MAXICON LLC, Certified Specia... Page 1 of 1 9:28:25 AM 412612017 Licensee Details Licensee Information Name: NAIERMAN, SAMUEL (Primary Name) MAXICON LLC (DBA Name) Main Address: 19595 NE 10TH AVENUE BAY D NORTH MIAMI Florida 33179 County: DADE License Mailing: License Location: License Information License Type: Certified Specialty Contractor Rank: Cert Specialty License Number: ES12001350 Status: Current,Active Licensure Date: 09/22/2015 Expires: 08/31/2018 Special Qualifications Qualification Effective Limited Energy Systems 04/22/2015 Specialty , Alternate Names View Related License Information View License Complaint 2601 Blair Stone Road,Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer.Coovriaht 2407-2419 State of Florida.Privacy Statement Under Florida law,email addresses are public records. If you do riot want your ernail address released in response to a public-records request,do not send electronic mail to this entity.Instead,contact the office by phone or by traditional mail. If you have any questions,please contact 850.487.1395. "Pursuant to Section 455.275(1),Florida Statutes,effective October 1,2012,licensees licensed under Chapter 455,F.S. must provide the Department with an email address if they have one.The emails provided may be used for official communication with the licensee. However email addresses are public record.If you do not wish to supply a personal address,please provide the Department with an email address which can be made available to the public. Blease see our Chapter 455 page to determine if you are affected by this change. https://www.myfloridalicense.com/LicenseDetail.asp?SID=&id=DA22E520782F2E06DOF... 4/26/2017 C252017 Local Business Tax 2017(2).JPG Local Business Tax Receipt Migrr -Dade Courrry,State of Florfda -HIa OO MO T FO LBT �ts�pr 1ns.+ew Maweewcw, Rrc...no. EXPIRES, 19MNF r SEPTEMBER 30,2017 M1 MU .FL U179 Mew 06 wMrNA0 .1wO WOW* AW000rsCOWWCO► C�ra..nasa ie i orw+ew sso.rrri a w�wasw �rvwar rmonues MAXMM LLC 220 TAME PER30MAL ax xwx oeuec PROPOW rwTHO CSM a�arsr�a�socriee { Iw}YrA*�w14a M SMI/ 14�1t Af ftedoYUw.WAM% i «wtf.�� M►rww,wM 1+M tMII 0olm"Iftwoi.....wr ��nlr4niwa M�TYM.��wr�Iriw4AiwNw�tW�iMs-1i�iitl�OMt�wIR+ . rrw+YYw�ii��i https://maiI.googie.com/mail/u10/Mnboxtl5ba6e58b5f2adfe?projector=1 1/1 . MIAMI•DADE MIAMI-DADE COUNTY- STATE OF FLORIDA N/A April 26,2017 ME LOCAL BUSINESS TAX RENEWAL 7167837 2016 -2017 APPLICATION RECEIPT:7446412 STATE# DBA/BUSINESS NAME: BUS.COMMENCEMENT DATE:03/12/2014 MAXICON LLC SEC TYPE OF BUSINESS BUSINESS LOCATION: DLR-WHO TANGIBLE PERSONAL PROP DLR 19595 NE 10 AVE#D 5 MIAMI,FL 33179 OWNER/CORP. APPLICATION DETAILS MAXICON LLC FEE AMOUNT PHONE# Receipt Fee 30.00 UMSA Fee 30.00 19595 NE 10 AVE#D Beacon Council Fee 15.00 MIAMI,FL 33179 Bingo Permit Fee 0.00 Nightclub Permit Fee 0.00 Multi-Municipal Contractor Fee 0.00 Restricted Contractor Fee 0.00 Library Fee 0.00 NAICS CODE: 423990 Transfer Fee 0.00 Doing Business without a License Penalty 0.00 Late Penalty 0.00 Collection Cost 0.00 NSF Fee 0.00 Prior Years Due 0.00 Amount Recently Paid - 75.00 TOTAL AMOUNT DUE: 0.00 ................................................................................................................................................................................................................................................................................................................. If no longer in business,please notify us in writing. To pay online go to www.miamidade.goy/taxcollector Review and correct the information shown on this application. To pay by mail, make check payable to: Miami-Dade County Tax Collector A 25% penalty will be assessed to anyone found operating Business Tax without a paid local business tax, in addition to any other 200 NW 2nd Avenue penalty provided by law or ordinance (Sec 8A-176(2)). , Miami FL 33128 To pay in person go to: A Certificate of Use and/or City Business Tax 200 NW 2nd Avenue Receipt may also be required. (305)270-4949,fax(305)372-6368 A service fee of not less than$25.00 up to a minimum of 5% will be charged for all returned checks. t RETAIN FOR YOUR RECORDS t ................................................................................................................................................................................................................................................................................................................. MIAMI-DADE COUNTY- + DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT + N/A April 26,2017 STATE OF FLORIDA LOCAL BUSINESS TAX RENEWAL 20s 8372017 APPLICATION I I II I VIII IIII I III VIII I I III I II RECEIPT.7446412 STATE# BUSINESS LOCATION: 19595 NE 10 AVE#D MIAMI,FL 33179 BUS.COMMENCEMENT DATE:03/12/2014 SEC TYPE OF BUSINESS OWNER/CORP. DLR-WHO TANGIBLE PERSONAL PROP DLR MAXICON LLC 5 APPLICATION IS HEREBY MADE FOR A LOCAL BUSINESS TAX RECEIPT OR PERMIT FOR THE BUSINESS PROFESSION OR OCCUPATION DESCRIBED HEREON.I HAVE BEEN INFORMED OF ALL ZONING RESTRICTIONS IMPOSED ON THIS RECEIPT. I SWEAR THAT THE INFORMATION IS TRUE AND CORRECT. MAXICON LLC 19595 NE 10 AVE#D MIAMI,FL 33179 SIGNATURE REQUIRED SEE INSTRUCTIONS ABOVE Please pay only one amount.The amounts due after Sept 30th include penalties per FS 205.053. If Received By Apr 30,2017 May 31,2017 Jun 30,2017 Jul 31,2017 Please Pay $0.00 $0.00 $0.00 $0.00 7000000000000000000000007446412201700000007500000000000007 f 8n r r�T• �� '�°`�" $ f,' '�'+ �� �•'4 ' � ice! `�' "" �9*,�y £, a YA.'f� s� 'e- i�- �3 � e� "� �#e2~.a.. 3�`" � '� `g i� k� j'�^q ;. t ,7'6 r'�'� fir, °' 1 s. �' c:�v , ',%x � °,,,,�. �ys, -�'C.,'�, `��• 3 ��� r.' '�+^�- 'D�R *^�. a ` ,.. 'a�'�"' i ��-. °`�y{y� •��' .F '.' ��. '� � � '..� � y,e:.4t 5,f"�'k k�^,� �r .x.r �,_�� s��.,�: y:. f ", .f 94 �s f r�? y z �t zs r ti ff '" ,,L,�. a '�,�+ "" � t� 05 "IN } P.v �Y,' l r ' \ v € (� e' 2�• fir: �i�4 } # y + fit 4�`1 '<t 9 �' r '" S # :" "�R -.�. Rd°�fY * a ,r i- .. � •,3#6�r'•e _ ��� aa�,f°t��r 7"Yl A '�- �ry��_ r y tai & Bo , i jam , ,. , •Rr. ^� '"5 �+. w �fll M I t:#��OUROW R, J i7 y e p w, Sit IM G Re.T4' M1 i;�«`,,9 �'' C. •,i' r3 p n :1 .r +., yt xf ' r,'°°# Q•.. fg Rµ% R+t" ''�4 Y # ref i xf �i � » f s* +# � •.}._ ���Mwi#I:• � - j t ''3N ` .h`.. a #RTY.0 t '-J'+lk�k' ► Y .." f ! <a #''w: .}�" •f eTX` C?" t' �y s.. ~w #.. ""' • r' *9"�°`!-fi °` •*aid ..4's r'�'-. Y- r.' �.'}' n* a,6�, ,`4� 'd[' :: �, A.;.,C� .. " +� �1►iRiF},!`A�9R+`' � d��� ., y�y7 �`' ���� ,'s2 .. f k I{r r 4,7M4Fba7A `j :` p, +'•yT * . w # illtkq �,' Ail �` � r `i f�,. � q,�•`�' j j � fir, R r' k E a �i� ¢, � �4. � k dL� s �+,•�p."�a� �$ 'j'� .' ,'*.i � 7a� >ti,p � -^_f i�� ! a # r MIAMNDADE `' MIAMI-DADE COUNTY- STATE OF FLORIDA N/A April 26,2017 LOCAL BUSINESS TAX RENEWAL 7167837 2016 -2017 APPLICATION RECEIPT:7469287 STATE# DBA/BUSINESS NAME: BUS.COMMENCEMENT DATE:03/12/2014 MAXICON LLC SEC TYPE OF BUSINESS BUSINESS LOCATION: SER-INS SERVICE BUSINESS 19595 NE 10 AVE#D 1 MIAMI, FL 33179 OWNER/CORP. APPLICATION DETAILS MAXICON LLC FEE AMOUNT PHONE# Receipt Fee 30.00 UMSA Fee 30.00 19595 NE 10 AVE#D Beacon Council Fee 15.00 MIAMI,FL 33179 _ Bingo Permit Fee 0.00 Nightclub Permit Fee 0.00 Multi-Municipal Contractor Fee 0.00 Restricted Contractor Fee 0.00 Library Fee 0.00 t Transfer Fee 0.00 NAICS CODE: 561790 Doing Business without a License Penalty 0.00 Late Penalty 0.00 Collection Cost 0.00 NSF Fee 0.00 Prior Years Due 0.00 Amount Recently Paid - 75.00 TOTAL AMOUNT DUE:, 0.00 ................................................................................................................................................................................................................................................................................................................. If no longer in business,please notify us in writing. To pay online go to www.miamidade.gov/taxcollector Review and correct the information shown on this application. To pay by mail, make check payable to: Miami-Dade County Tax Collector A 25% penalty will be assessed to anyone found operating Business Tax without a paid local business tax, in addition to any other 200 NW 2nd Avenue penalty provided by law or ordinance (Sec 8A-176(2)). Miami FL 33128 To pay in person go to: A Certificate of Use and/or City Business Tax 200 NW 2nd Avenue Receipt may also be required. (305)270-4949,fax(305)372-6368 A service fee of not less than$25.00 up to a minimum of 5% wi;l be charged for all returned checks. t RETAIN FOR YOUR RECORDS t 3•................................................................................................................................................................................................................................................................................................................. MIAMI-DADE COUNTY- + DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT 1 N/A April 26,2017 STATE OF FLORIDA ' LOCAL BUSINESS TAX RENEWAL 206 8RECEIPT.7469287 372017 APPLICATION IIIIIiI III IIIIIIII VIII IIIIIIII IIIIII III IIIIII II STATE# BUSINESS LOCATION: 19595 NE 10 AVE#D MIAMI,FL 33179 BUS.COMMENCEMENT DATE:03/12/2014 SEC TYPE OF BUSINESS OWNER/CORP. SER-INS SERVICE BUSINESS MAXICON LLC 1 APPLICATION IS HEREBY MADE FOR A LOCAL BUSINESS TAX RECEIPT OR PERMIT FOR THE BUSINESS PROFESSION OR OCCUPAI ION DESCRIBED HEREON.I HAVE BEEN INFORMED OF ALL ZONING RESTRICTIONS IMPOSED ON THIS RECEIPT, I SWEAR THAT TIE INFORMATION IS TRUE AND CORRECT. MAXICON LLC 19595 NE 10 AVE#D MIAMI,FL 33179 SIGNATURE REQUIRED SEE INSTRUCTIONS ABOVE Please pay only one amount.The amounts due after Sept 30th include penalties per FS 205.053. If Received By Apr 30,2017 May 31,2017 Jun 30,2017 Jul 31,2017 Please Pay $0.00 $0.00 $0.00 $0.00 7000000000000000000000007469287201700000007500000000000002 MAXIG2 OP ID:PALI AcoRoP CERTIFICATE OF LIABILITY INSURANCE DATE 1 o4/25//2�z017 �—� 17 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 i 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 Rosie Gomez Golden Global Insurance NAME: 19950 W.Country Club Dr#902 PA/CNNo E,1:305-899-5125 F N,:305-899-5135 Aventura,FL 33180 E-MAIL JACKELINE ORTIZ ADDRESS,Rosie@goglo.net INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Catlin Specialty Insurance Co 15989 INSURED MAXICON LLC INSURER a:National Liability&Fire 19595 NE 10th Ave INSURER C North Miami Beach,FL 33179 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 I 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 POLICY EFF POLICY EXP LIMBS y LTR D POLICY NUMBER MM/DD MM/D A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE , $ 1,000,00( I CLAIMS-MADE ❑X OCCUR 0901102017 07/01/2016 07/01/2017 GE�6RER 100,00( I � PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,0 GEN'L AGGREGATE LIMIT APPLIES PER2. GENERAL AGGREGATE $ 2,000,00 X POLICY❑JE P LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea acddem ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS er accident $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION XP OTH- AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETORIPARTNER/EXECUTIVE Y/N VSWC717528 12/28/2016 12/28/2017 E.L.EACH ACCIDENT $ 1,000,00 F' OFFICERIMEMBEREXCLUDED? ❑N/A I I (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is mgWraQ Qualifier: SAMUEL NAIERMAN FL LICENSE: ES12001350 CERTIFICATE HOLDER CANCELLATION MIASHIR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue Miami SHores,FL 33138 AUTHORIZED REPRESENTATIVE Jam' ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD a