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RF-18-1151 r a _ T a i I f e � I Permit No. RF-5-1 8-1151 Miami Shores Village Permit Type:Roof 10050 N.E.2nd Avenue NE r N,. Miami Shores,FL 33138-0000 Perit Wolk Classification Fiat Permit Status.APPROVED 'FN' ad` Phone: (305)795-2204 �OR1DA issue Date:511/2018 Expiration: 10/28/2018 Project Address Parcel Number Applicant 825 NE 92 Street 1132060050052 PROVINCIAL REALTY ASSOC IN Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell PROVINCIAL REALTY ASSOC INC 9401 BISCAYNE BLVD MIAMI SHORES FL 33138-2970 1 9401 BISCAYNE BLVD MIAMI SHORES FL 33138-2970 Coritractor(s) Phone Cell Phone Valuation: $ 6,098.00 INFINITY ROOFING AND SHEET METS (954)917-7107 � _,.... n _. Total Sq Feet: 80 Type;of Work:Re Roof Available Inspections: Additional Info:REPLACE 80 LF OF NEW FASCIA ALONG F Inspection Type: Classification:Residential Tin Cap Scanning:3 Final Roof Roof in Progress Renailing Affidavit Review Roof Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Contractors Bond $500.00 Invoice# RF-5-18-67364 CCF $4.20 DBPR Fee $3.75 05/01/2018 Check#:011980 $776.45 $0.00 DCA Fee $2.50 Bond#:3734 Education Surcharge $1.40 Permit Fee-New Roof $250.00 Scanning Fee $9.00 Technology Fee $5.60 Total: $776.45 k In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,'MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-named contractor to do the work stated. May 01, 2018 Author Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy May 01, 2018 1 h Inspection Worksheet Miami Shores Village r 10050 N.E.2nd Avenue Miami Shores,FL Phone.(305)795-2204 Fes:(305)75"972 Inspection Number: INSP-302976 Permit Number: RF-6-16-1161 Scheduled Inspection Date:June 08,2018 Permit Type: Roof Inspector Naranjo,Ismael Inspection Type: Final Roof Owner. , Work Classification: Flat Job Address:825 NE 92 Street Miami Shores,FL 33135. Phone Number Parcel Number 1132060060052 Project, <NONE> contractor INFINf7Y ROOFING AND SHEET METAL INC Phone:(9U)917-7107 Building Pepartnmint Comments REPLACE 80 LF OF NEW FASCIA ALONG FLAT ROOF Mn c o Passed U&n-manta AREA.THIS VALL ALSO INCWDE SOFFIT SEE INSPECTOR COMMENTS False ATTACHED DETA:1L 'bispector Comments Passed Failed Correction Needed Re4nspection, Fee .lame 07,2018 For InspecUons please calk(305)762-4949 Pegs 6 61 26 3 Miami Shores Village AY 2018 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 FBC 20 F? BUILDING Master Permit No. 1�_ I )S I PERMIT APPLICATION Sub Permit No. BUILDING [:j ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL i " ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS F_� CHANGE OF ❑CANCELLATION ❑ SHOP NCONTRAACTOR DRAWINGS JOB ADDRESS: � 1 fl) A' 1 ) S 4 P_E� City: Miami Shores County: Miami Dade _ ei Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: f Load: Construction Type: Flood Zone: BFE: . FFE: prokj m c,� t �alY �6 cS �G OWNER: Name(Fee Simple Titleholder i Phone#: Address. ,!5) , 315 c-AYA1E &VD, 2 ,City: 1)�� 1` 0 Q C­36State: Zip:J`J) i Tenant/Lessee Name:- Phone#: Email: (CONTRACTOR:Company Name: Phone#: -71477 Address: City:Pb ti p State: Zip: `�3d Qualifier Name: T �I J Phone#:4�� •`T`]�` State Certification or Registration A#: �- 14 4 --Certificate of Competency#: DESIGNER:Architect/Engineer: iii Phone#: ,Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition }}❑�1 Alteration' ❑ New Repair eplace Demolition -Desc iption of work: _ . T )5 wfLL -AL6Dj #•!' -atrf::.^-�i-a. Ttlit'r rFT'" IVv..�.•W.� - i i Specify color,of color thru 0� ... {� tirJti'HrF` F}flVtt`, +4V�tn41An� ' !�1� {t �`� Submittal Fee$'� ""`^ �"'4 i erm'it'Fee$ CCF$ 4..Z6-1,_.,. CO/CG$ _ Scanning Fee$ J Radon Fee$ 2.e-,50 DBP/�R$ :-2 �- Notary$_ Technology Fee$ 3 -10o Training/Education Fee$ . `t' o :' k "! Double Fee$ t &dP Structural Reviews$ Bond$ 5(3a •/�� TOTAL FEE NOW DUE$ -7 �O T .� iRevised02/24/2014) 9 ` Bonding'Company's Neme(if applicable) AM ' s Bonding Company's Address ' City t 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 on 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. y F Signature Signature r WNER or AGENT s CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day ofAA 0 20 �U by 301t/. day of APrjL 420 /9' ,by ''��tt �/.L�'�i'2•a.4, a,91 111gd4ei who is personally k n to J31 8, y�q44who is ppersonally known to me or who has produced as me or who has produced Ak• as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUB Sign: L ' Sign: Print: Q Print: ;—.•,,,,., * .�'., JAVIER M.MAR71NEZ Seal: ; , 's�: KATHLEEN M 8057 Seal: MY COMMISSION 000019 W MY COMMISSION#FF216826 EXPIRES:June 10,2021 Borated vu otary Pubfo lMM mkm �•','�'„•�;� EXPIRES April 02.2019 71 N -. iar.7 sa-0'55 FWrWgNotaryServita.' 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' .CC'C�aCCCC■C:CiaCCCiC6Ca CnCCC Cri° CCICCCC �a■iC mrCirCCC . ! a�rl■ rrr ■■Mae mCriamarKann ■a on . .. ■ a r . ts ■C■Cr aiirr .� i■ ■ iCr�amm■ ■riso ■iii■ ■■ O�r;l!i■ �C , Cs i�isiCC�ii . CaGi�C. C.am ■ar.lf10 ,H sR� isms 0 ■CGCG a ' ■CCCCCCCCCCraCaasaiCaiC' air • Ci aCCCCCCCaia°rC■CCe�i . . ' -|-��--`-----+---�------. - -- - - - - - i- - ---�------ --�----'�--�--�--��--'-- go 00000 0900 -71 ------------ - �` r - -T--�--r--'r- '- -' ---- ---'--�-----' --------r--�--�^ - - r--^ - i- - . . { Florida Building Code 6th Edition (2017) High-Velocity Hurricane Zone Uniform Permit Application Form INSTRUCTION PAGE COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING PERMIT APPLICATION FORM AND ATTACH THE REQUIRED DOCUMENTS AS NOTED BELOW: .••••. Roof System Required Sections of the Attachments Nagai •• • •••• Permit Application Form See List Bellow•• T 6 •••; Low Slope Application A,B,C 1,2.3,4.5,6,7. •'. ." '. • Prescriptive BUR-RAS 150 ABC 4,5,6,7 ..'..• ;•• •• . .... Asphaltic Shingles A,B,D 1,2,4,5,6,7 ..:. Concrete or Clay Tile A,B,D,E 1.2.3.4.5,6,7 •• • Metal Roofs A,B,D 1,2,3,4,5,6,7 Wood Shingles and A,B,D 1,2,4.5,6,7 Shakes Other As Applicable 1,2,3,4,5,6,7 R ATTACHMENTS REQUIRED: 1. Fire Directory Listing Page 2. From Notice of Acceptance: Front Page Specific System Description' Specific System Limitations General Limitations Applicable Detail Drawings a 3. Design Calculations per Chapter 16,or ff Applicable,RAS 127 or RAS 128 4. Other Component Notice of Acceptances 1' 5. Municipal Permit Application k 6. Owners Notification for Roofing Considerations(Re-Roofing On 7.1 Any Required Roof Testing/Calculation Documentation k k I INFINITY ROOFING & SHEET METAL, INC. 1150 SW 10T"AVE STE 201W, POMPANO BEACH, FLORIDA 33069. PHONE: 954-917-7107 PROPOSAL/CONTRACT AGREEMENT Date: March 7, 2018 To: ADOM 9401 Biscayne Blvd Miami Shores, Florida 33138 Re: House located at 45 NE 92nd Street, Miami Shores, Florida 33138 0.00 SCOPE OF WORK •• ••• • . . . . Furnishlabor, materials and supervision necessary to complete the follow..n.g.•mainten. ..ance on.....• the above referenced project per good roofing practices; ••••• • • .... .... ..... ...... . . ..... .. .. . ...... . .. ...... . . . . sees** .. . 00 L Subject Property �r Photos od rotted fascia 1 Photos od rotted fascia 9 • • • • • • • IIRI ti v 2 . r - r •••• •••• • • J _ Y Y 1. Provide necessary permits with Miami Shores Building Department before commencing roof work. 2. Remove the existing drip edge and the from around the perimeter of the roof. (80 linear feet) 3. Remove the existing rotted fascia board and 1x2 from the perimeter edge. (80 linear feet) 4. Remove and dispose of soffit from the area. 5. Install new 1"x10" fascia board and 1"x2" at the perimeter edge. 6. Install new white drip edge metal at the perimeter of the roof. Install two (2) plies of modified flashings to seal the flange of the drip edge metal. Drip edge metal to be fastened with 1 '/4" ring shank nails —two staggered rows. 7. Install new 1/4" plywood decking for the soffit area. 3 f I To be invoiced as follows: Labor $75.00 per hour Material $Cost plus 10 perecent Cost not to exceed $6,098.00 with-out prior approval from ADOM a Terms of Payment shall be: Progress billings based on percentage of,completion net 30 days — Any alteration or deviation from the above specifications involving extra cost of labor or material will only be executed upon written orders for same and will become an extra charge over the sum stated in this contract. All agreements must be made in writing according to the Conditions of Contract. Infinity Roofing and Sheet Metal, Inc. shall carry all workers compensation and liability insurance and shall also provide all licenses and permits necessary to complete this job. i t i John Mitala, Jr. . . a •••••• •• • ••••% r • --ACCEPTANCE- •""• • You are hereby authorized to furnish all materials and labor required JQ;po1npleje'fhe woV:O*• specified in the above proposal, for which the undersigned agrees to payAhabmotlrlf Vtated iq.••• said proposal, and according to the terms thereof. •••••• 0 •' . • • • • •••••• .00 :00060 • •• • •• • . • .•(Dote) I 4 L Property Search Application - Miami-Dade County Page 1 of 1 1 IS"R OFFICKE UK THE PROPE'RTY"" APPR AL '►. .., r Summary Report Generated On:5/1/2018 Property Information t " Folio: 11-3206-005-0052 Property Address: 825 NE 92 ST ` a, Miami Shores,FL 33138-2908 " Owner PROVINCIAL REALTY ASSOCIATES I INC 9401 BISC BLVD Mailing Address MIAMI SHORES, FL 33138-2970 PA Primary Zone 0900 SGL FAMILY-1901-2100 SQ 0101 RESIDENTIAL-SINGLE Primary Land Use FAMILY: 1 UNIT " Beds/Baths/Half 3/2/0 Floors 1 Living Units 1 -^-* Actual Area 3,275 Sq.Ft . Living Area 2,537 Sq.Ft Adjusted Area 2,906 Sq.Ft Taxable Value Information Lot Size 12,345.2 Sq.Ft 2017 2016 2015 Year Built 1955 County Exemption Value $512,015 $465,469 $423,154 Assessment Information , Taxable Value $0 $0 $0 Year, 2017 2016 2015 School Board Land Value $333,122 $271,974 $185,271 Exemption Value $569,030 $509,595 $425,954 Building Value $234,282 $235,967 $239,338 Taxable Value $0 $0 $0 XF Value $1,626 $1,654 r $1,345 City r Market Value $569,030 $509,595 $425,954 Exemption Value $512,015 $465;469 $423,154 Assessed Value $512,015 $465,469 $423,154 Taxable Value $0 $0 $0 Regional Benefits Information Exemption Value $512,015 $465,469 $423,154 Benefit Type 2017 2016 2015 ITaxableYalue $0 $0 $0 Non-Homestead Assessment Cap Reduction $57,015 $44,126 $2,800 Sales Information Parsonage Exemption $512,015 $465,469 $423,154 Previous Sale Price OR Book-Page Qualification Description Note`Not all benefits are applicable to all Taxable Values(i.e.County, 07/01/1981 $170,000 11154-0002 Other disqualified School Board,City,Regional). r Short Legal Description GOLDEN GATE PARK ADDN PB 6-130 E19.395FT M/L OF LOT 10&ALL LOT 9&W18.79FT M/L LOT 8 BLK 1 LOT SIZE 88.180 X 140 OR 11154-2 0781 6 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 hftp://www.miamidade.gov/info/disclaimer.asp Version: t https://www.miamidade.gov/propertysearch/ 5/1/2018 i 2018 FLORIDA NOT FOR PROFIT CORPORATION ANNUAL REPORT FILED DOCUMENT#720307 Jan 15, 2018 Entity Name: PROVINCIAL REALTY ASSOCIATES, INC. Secretary of State CC7179725238 Current Principal Place of Business! 9401 BISCAYNE BLVD { MIAMI SHORES, FL 33138 Current'Mailing Address: 9401 BISCAYNE BLVD MIAMI SHORES, FL 33138 FEI Number: 45-1470889 Certificate of Status Desired: No Name and Address of Current Registered Agent: FITZGERALD,J.PATRICK ESQ. 110 MERRICK WAY,SUITE 3-B CORAL GABLES,FL 33134 US The above named entity submits this statement for the purpose of changing its registered office or registered agent,or both,in the State of Florida. SIGNATURE: Electronic Signature of Registered Agent Date Officer/Director Detail Title PD Title VPSD Name JEANTY,CHANEL Name WORLEY,ELIZABETH Address 9401 BISCAYNE BLVD Address 9401 BISCAYNE BLVD City-State-Zip: MIAMI SHORES FL 33138 City-State-Zip: MIAMI SHORES FL 33138 I Title TD Title AS Name CASCIATO,MICHAEL A Name FITZGERALD,J.PATRICK Address 9401 BISCAYNE BLVD Address 110 MERRICK WAY,SUITE 3-B City-State-Zip: MIAMI SHORES FL 33138 City-State-Zip: CORAL GABLES FL 33134 I I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath;that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 617,Florida Statutes;and that my name appears above,or on an attachment with all other like empowered. SIGNATURE:SISTER ELIZABETH WORLEY, SSJ CHANCELLOR 01/15/2018 Electronic Signature of Signing Officer/Director Detail Date r i / 1 ® A�R o DATE(MM/DD/YYY`n CERTIFICATE OF LIABILITY INSURANCE 5/1/2018 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(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 Sandi Harrison I NAME: Frank H. Furman, Inc. PHONE (954)943-5050 FAXN0 : (954)942-6310 1314 East Atlantic Blvd. ADDRESS:sandi@furmaninsurance.com ` P. I O. BOX 1927 INSURERS AFFORDING COVERAGE NAIC# Pompano Beach FL 33061 INSURERA:Indian Harbor Insurance Co 36940 INSURED INSURERB:National Fire Ins Of Hartford 20478 Infinity Roofing And Sheet Metal Inc INSURERC:American Guarantee & Liabilit 'ins 26247 1150 S W 10th Ave, Suite #201W INSURER D:Brid efield Employers Ins Co 10701 INSURER E: Pompano Beach FL 33069-1326 INSURER F: COVERAGES CERTIFICATE NUMBER:Jan 2018 x prof/poll 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DD MM DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE FxI OCCUR DAMAGE TO RENTED $ 50,000 PREMISES Ea occurrence X $10,000 Ded Per Occ ESG300036503 5/25/2017 5/25/2018 MED EXP(Any one person) $ Excluded BI & PD Combined PERSONAL&ADV INJURY $ 1,000,000 GENIAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY F1 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 X OTHER:Contractual Included Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident B X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 2083041073 5/25/2017 5/25/2018 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS Ix AUTOS Per accident $ PIP 1 $ 10,000 , X UMBRELLA UAB X OCCUR AUC967203408 EACH OCCURRENCE $ 5,000,000 C EXCESS LIAB CLAIMS-MADE Follows form over AL, GL, AGGREGATE. $ 5,000,000 DED I X I RETENTION$ 0 and EL 5/25/2017 5/25/2018 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? FN] N/A D (Mandatory in NH) 0830-38636 1/1/2618 1/1/2019 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 (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) license number CCC057467 I f I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village Bldg Dept THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd Ave ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 I AUTHORIZED REPRESENTATIVE Dirk DeJong/TP ©1988-2014 ACORD CORPORATION: All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) ' I STATE OF FLORIDA ! ' ,dDEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION fq CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 i MITALA, JOHN B INFINITY ROOFING AND SHEET METALINC 11874 ISLAND LAKES LN. BOCA RATON FL 33498 Congratulations! With this license you become one of the nearly a=^ _:�.-..__.a_ one million Floridians licensed by the Department of Business and w Professional Regulation. Our professionals and businesses range h6 � « STATE OF FLORIDA DEPARTMENT OF BUSINESS AND from architects to yacht brokers,from boxers to barbeque i, restaurants,and they keep Florida's economy strong. PROFESSIONAL REGULATION I CCC057467 `'�?' ISSUED:e=;06/02/2016 Every day we work to improve the way we do business in order t . a to serve you better. For information about our services, please v log onto www.myfioridaticense.cam. There you can find more r CERTIFIED ROOFING CONTRACTOR` € 'information about our divisions and the regulations that impact MITAtA,�JOHN B ;. - G you,subscribe to department newsletters and learn more about I INFINITY-ROOFING{AN6S HEFT ETAL'I the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly.We constantly strive to serve you better so that you can �$ CERTIFIED unde-ihe'pi&isions of cn:4e9°Fs. A serve your customers. Thank you for doing business in Fonda, I I.,EX�atI �a;z'.,AUG 3,,_cue• L{60602o00j1� and congratulations on your new license! _ - _ . . ..._.._� r DETACH HERE ; . ................... .. .. ._ I . RIC _K SCO. TT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION - CONSTRUCTION INDUSTRY LICENSING BOARD' The ROOFING:CONTRACTOR Named below IS CERTIFIED, �`, � �, Under the:provison's of Chapter'489 FS: Expiration date AUG 31—,2018 '�. .. LU MITALA,:JOHN B - " TR ?OINAN° INFINI ID-SHE T METAL�INC ,111 50 SW-14THAVE^-,a ° STE=201 W POIVIPANOBEACH TFL 33069 c` '" �' d{ - ,d,'''� ^"" ��-.....'��w.. Y +:..� ua, �`� �..,� r his`^'.�.,,r.. °� w�5s�,. � t_' ,,�� ,.# a'° �t'�.. ❑ . y , '*�'.�.r''>✓"r�J r'` r"��i•'''.'""... .:, �. r:s.:-� "'I� �4. :''4 `�'r.�%'d� � y'..-.. ..! a�� ..5..` 'a� �'., \_S�x.,_�fr..�,__. :.:: i—:i.- .. - IssuEo. osrozrao�s DiSPLAYAS REQUIRED BY LAW sEQa L1606020001158 DATE(MM/DD/YYYY) A �® CERTIFICATE OF LIABILITY INSURANCE F12/13/2017 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 Sandi Harrison NAME: Frank H. Furman, Inc. PAHONN Ext: (954)943-5050 A/C No:(954)942-6310 1314 East Atlantic Blvd. E-MAIL ADDRESS:sandi@furmaninsurance.com t P. O. BOX 1927 INSURERS AFFORDING COVERAGE NAIC# Pompano Beach FL 33061 INSURERA:Indian Harbor Insurance Co 36940 INSURED INSURERB:National Fire Ins Of Hartford 20478 Infinity Roofing And Sheet Metal Inc INSURER C:Ameri can Guarantee & Liability Ins 26247 1150 S W 10th Ave, Suite #201W INSURER D:Brid efield Employers Ina Co 10701 INSURERE:Columbia Casualty 31127 Pompano Beach FL 33069-1326 1 INSURER F: COVERAGES CERTIFICATE NUMBER:Jan 2018 All Holders 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 INSURANCE ADDL 7ESG300036503 POLICY NUMBER POLICYEFF/YYYY FOLIC EXP LIMITS LTRINSD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DA AGE TO A CLAIMS-MADE ❑X OCCUR PREMISES Ea ocw encs $ 50,000 X $10,000 Ded Per OCC X 5/25/2017 5/25/2018 MED EXP(Any one person) $ Excluded BI & PD Combined PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO--JECT F]LOC PRODUCTS-COMP/OPAGG $ 2,000,000 l X OTHER:Contractual Included I Employee Benefits $ 1,000,000 + AUTOMOBILE LIABILITY COa acciMBIdent NED SINGLE LIMIT $ 1,000,000 E B Ix ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 2083041073 5/25/2017 5/25/2018 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS EX AUTOS Per accident plp , $ 10,000 { X UMBRELLA LIAB X OCCUR AUC967203408 EACH OCCURRENCE / $ 5,000,000 C EXCESS LIAB CLAIMS-MADE follows form over GL, AL AGGREGATE P $ 51000,000 DED I X I RETENTION$ 0 and EL 5/25/2017 5/25/2018 $ PERJ 1 WORKERS COMPENSATION X STATUTE I EERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 11000,000 D (Mandatory BER In NH EXCLUDED? 0830-38636 1/1/2018 1/1/2019 ( ry i ) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 11000,000 E Professional Liability & 6012744954 5/25/2017 5/25/2018 Each Claim 2,000,000 r Pollution (incl mold) Liab Aggregate 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Miami Shores Country Club and Professional Course Management II Ltd. are named as Additional Insureds in regards to General Liability as required by written contract. r t CERTIFICATE HOLDER CANCELLATION r apozzi@miamishoresgolf.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Country Club THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED' IN 10,000 Biscayne Boulevard ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 I AUTHORIZED REPRESENTATIVE Dirk DeJong/TP ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) r 1 .. BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S, Andrews Ave., Rm. A-100, Ft. Lauderdale,,FL 33301-1895—954-831-4000 VALID OCTOBER 1,2017 THROUGH SEPTEMBER 30,2018 -149 t DBA: T Receipt#'ROOFING/SHEET METAL CONTRA OR INFINITY ROOFING AND SHEEN,T META Business Name: INC Business Type: (ROOFING CONTRACTOR) � o y Owner Name:JOHN S MITALA / QUAL Business Opened:09/05/2006 Business Location:1150 sw to AVE tt2011w State/County/Cert/Reg:ccco57467 i POIMPANO.BEACH Exemption Code: Business Phone:954-91'1-7107 Rooms Seats Employees. Machines Professionals 16 For Vending Business Only Number of Machines: Vending Type; i Tax Amount Transfer Fee NSF Fee Penalty Prior Years CoAection Cost Total Paid w . . 9.0.:. .._.......... 0.... . 0.00 0.00 54.00 ; 1 t i t r E 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 I 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. i Mailing Address: INFINITY ROOFING AND SHEET METAL I: Receipt #1CP-16-00013438 LPOIMIPANO 5.0 SW 10 AVE ;{20Z d Paid 07/17/2017 54.00 BEACH, FL 33069 i �_.__.2017_ ._._2018 I ' t r 1 l f 'rW.ET}"r T. Y. ....� �.� °�-�"e � p E✓y.' �x �. ;� $!�' #T, :dam t, 1. �,. i t.4 �• x�..z�' a" ��y�m ,� t n u+�� J, l i 8 .�S �• _. .L ._Sa. .Xry: a .. ,,` rt r`M1f e `�E E ,�,p a'r - z ytk:.'�. •�r a.� ' A' °� c, x. i l• 11Q�Y ,r X`J. '!nom ,!4 r y S•x p ,j r. Y" .. - "„ },'�C �. ''f e-. a,_ �',y,4_-1• .Ja -. t:_.Fa { � �w z. _ v4 S•, � tt z n_ ,�i`1 'fi t Fi0rida's�Warmest CNelct7rne" 5 r t, 'v •�f.��� 'iia°4 � �; CITY`OFkPl.lMPANV,BEt' CH 'N .elBUSINES TAX-RECEIPT-,? �# 4 `.' =FISCAL-4'EAR:M 201`7==,•2415 s n ae t. y7 's.t .s '''� e�'.'* �4 fi.� w s• �.q1 � �r A� ;a ; "# THIS IS NQT`VBILL-" x �• ��, .,, " Business�Tax.Receipt Valid�fro :,33l ctoli'er 1, 2017 through Septem 'er`34,.2018 " �, ,f., A••s� 9/19/2017 rY.� °,� � - w �;. �}" dt .nh r• �r i w �� � tftvf:�. i '44�r M r f !:� � � in c, y_. i ! z 3 �"�"��� i ..� �• � '� °�' � �: �' ' u ti d',5 s'`�:s` � � ;,f , �-�ss,� '�• .�' �� � cox �� � 4449565 r INFINITY ROOFING AND SHEET METAL INC oaf II50StNiI0AVw201W 'Z a y1 �'•R_ POMPANO BEACH FL 33069 K • ti 4+'� •� e � .-- �i . � ?v.• *�R �°�krR,t "R' p` .p �.•, k' fi`,. �� ti_ THISIS YOUR BU9fNESS TAX RECEIPT .PLEASE POST IN A ONSPICtI0US5PLACE ATTH'E BUSINESS LbC'ATION: ' �. �. x e' _r ". a�`� «:�a� ,� s;: t�, t�f'T. �• `��"�? ""s.• r.�".r x. `'•ib >y5, is #'• � ,a r • BUSINESS.OWNER:, EINFINITLY ROOFING°AND,SHEET BUSINESS LOCATION: 1150 SW 1'0 AV 201W POMPANO BEACH Fl, r '.E "* N - � . � .°7,• ,cf`A T'sY 4 "�" �;� "�4n r p� � 4d '^s � +` r � �?, ,T '�" � -�.'_ �� �. to • ,rx, `"ai,:x a rt � ,f > ��. � r4z" ,�. �' "'2 RECEIPT NO: CLASSIFICATION q 18 0007372$ 4 K C .° tl1TIAC OR4SPEC 1200FIlG (�R) z E! I '�r s � �� � _. .. ,..� E�1s ..F `�-,� �y. R;t .{_�•;� � �:�� d< _p�i,�' L ���', '.�"�`� °*,�'Y' •,re '' ���'��,,� 5s P r r t .p S�r x ✓ X35 "�` r� « ,,A g 3K y�;-. ,r `; aX` Ca.R .,tet,., S�al�xp z- c,=S .z`.', R A.. a - 1.• t 's < X<' (�! I.,e< 53 # I a t TA �.t r•�� Z.. �� � E e x`a'R F.�� ^.i`w. .� ,..�� � i✓�"x' .,.4 � w. .- . c-4 - •r"a d` � '.3c b r _r, ` is °• -` '��. a iii "� s� ,,�.� air` � � +,� �,a •�d'' mr a f's� t �1 1 NOTICE: ANEW' PPLICATO'J.N4UST BE FILED IF THE BL`SINESS NAME,C7VJ\ERSHiP OR ADDRESS'35.CHA tiGED. ?HE ISSUANCE OF'A' r BUSINESS TAX,RECEIPT'SHALL NOT BE DEEMED A WAIVER OF ANY PROVISION OF THE CITY CODE NOR SHALL THE ISSUANCE OF A BUSINESS TAX RECEIPT BE CONSTRUED TO BE A JUDGEMENT OF THE CITY AS TO THE COMPETENCE OF THE APPLICANT TO TRANSACT' �1BUSINESS. TIHIS'DOCUNIENT CANNOT.BE ALTERTw.11: �» y P 'ti�`�5� v :3 a F 1,Y k'' , e i • y3 YSY�- rnf.�i X .. � jfi S' �' YT - rY _; a. �, 1. BUSINESS TAX RECEIPTS EXPIRE SEPTEMBER 30TH OF EACH Y>vAR' x� � � � 'yam. k �� 9� '� y`d. • � � ' E y r six " 5•L'` 5 : }a k "i ., ,r ar 4.�' Kv -.*at ... ¢�y ,e �' .'`, r