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MC-18-1531 Inspection Worksheet Miami Shores Village C10050 N.E. 2nd Avenue Miami Shores, FIL L/ Phone: (305)795-2204 Fax: (305)756-8972 inspection Number: INSP-305791 Permit Number: MC-6-18-1531 Inspection Date: July 05, 2018 Permit Type: Mechanical - Commercial Inspector: Perez,JanPierre Inspection Type: Final Owner: , Work Classification: A/C Replacement Job Address:9601 NE 2 Avenue Miami Shores, FL 33138-2721 Phone Number (954)348-0479 Parcel Number 1132060134060 Project: <NONE> F Contractor: AIR& HEAT DOCTORS INC Phone: (305)446-0940 Building Department Comments EXACT CHANGE OUT OF A 6 TONS CENTRAL AIR Infractio Passed Comments CONDITIONING SYSTEM INSPECTOR COMMENTS False jj I � 1b Inspector Comments Passed Failed El Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. t For Inspections please call: (305)762-4949 F July 03, 2018 Page 1 of 1 Per/7?&NO. MC-6-1$-1531 %sNO1 s L,� Miami Shores Village t Pent Type:Mechanical-Commercial 10050 N.E.2nd Avenue NE ' r � n I I I Work Classification:A/C Replacement " Miami Shores,FL 33138-0000 Pennit`Status:APPROVED Phone: (305)795-2204 ZORIDp' Issue Date:6/8/2018 F Expiration: 12/05/2018 Project Address Parcel Number Applicant 9601 NE 2 Avenue 1132060134060 Miami Shores, FL 33138-2721 Block: Lot: Atlantic Oil Incorporated I Owner Information Address Phone Cell Atlantic Oil Incorporated 1308 E Atlantic Boulevard (954)348-0479 Pompano Beach FL 33060- 1308 E Atlantic Boulevard Pompano Beach FL 33060- Contractor(s) Phone Cell Phone Valuation: $ 8,200.00 AIR&HEAT DOCTORS INC (305)446-0940 Total Sq Feet: 0 I Tons: Available Inspections: Additional Info:EXACT CHANGE OUT OF A 6 TONS CENTRA Inspection Type: Classification:Commercial Final i Approved: In Review Review Mechanical Comments: Date Approved: :In Review Date Denied: Type of Work:EXACT CHANGE OUT OF A 6 TONS Scanning:2 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $5.40 DBPR Fee DCA Fee $2.4466 Invoice# MC-6-18-67802 $3. 06/08/2018 Check#: 1478 $222.55 $50.00 Education Surcharge $1.80 06/05/2018 Check#: 1474 $50.00 $0.00 Permit Fee $246.00 Scanning Fee $6.00 Technology Fee $7.20 Total: $272.55 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 resp sibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL .M G, ECHANICAL,WINDOWS,DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAV 1 ify II a foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction a zonin j authorize the above-named contractor to do the work stated. ' June 08, 2018 Au rized ignature:Owner / Applicant / Contractor / Agent Date Building Department Copy i June 08, 2018 1 Miami Shores Village REcF� �.CA� Building Department o zoo �w` 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 VtV% FBC 20 111 BUILDING Master Permit No.M(1CtB �3 PERMIT APPLICATION sub Permit No. ❑BUILDING E] ELECTRIC E] ROOFING REVISION ❑ EXTENSION MRENEWAL PLUMBING MN MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS 'JOB ADDRESS: 9601 NE 2 AVE City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3206-013-4060 Is the Building Historically Designated:Yes NO x Occupancy Type: Commercial Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):ATLANTIC OIL INC. Phone#:5612481239 Address:1308 E. ATLANTIC BLVD City: POMPANO BEACH, state: FL Zip: 33060 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Air& Heat Doctors Inc. Phone#: 7864864436 Address: 1276 SW 143 PL City: Miami State: FL Zip: 33184 Qualifier Name: Agustin Alvarez Phone#: 3052181798 State Certification or Registration#: CAC 1819172 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$8,200 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New M Repair/Replace ❑ Demolition Description of Work: Exact Chenge out of a 6 Tons central air Conditioning system. Specify color of color thru tile: , Submittal Fee$ So��►I Permit Fee$ (. $ CO/CC$ IF Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) t 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 approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this .3� day of_/� 20 A� by 51 day ofV 20 l by ho is personally known to h `V( y-c?-, .who is personally known to 7MAr who has produced as 6Pr who has produced as identification andi identification and whuiu ARAM E AMADOR �e ��,,,,,,�� , ,•,arP�., ; BRAHAM E AMADOR NOTARY PUBLIC: ••'►"""''s', NOTARY PUBLIC: :+°, `'� r Public-State of Florida Public State of Florida . ` Commission#FF 922362 Commission#F FF 922362 • My Comm.Expires Sep 29,2019 My Comm.Expires Sep 29,2019 Sign: �°f bonded ftough National Notary Assn. Sign: Bonded Mm*National Notary Ann. Print: /`� /'� iZ Print: �� �'�''� /�i`'��✓�af2 Seal: Seal: **r*******r****sr*******s*�**s*r r *s***s* sss* *�r:�**#**ss*•s*»r*s*:srss**s*rye*sass*s*�*ss**res*r*•r***sr APPROVED BY ans Examiner Zoning Structural Review Clerk l(Revised 02/24/2014) °R„ Miami.Shores Village Building Department "sell" 10050 N.E.2nd Avenue Miami Shores, Florida 33138 OR Tel:(305)795.2204 Fax:(305)756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change-out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address(where the work is being done): 9601 NE 2 AVE City: Miami Shores Village County: Miami Dade Zip Code: 33138 ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means:YES(] NO 0 ARHI Sheet Attached:YES ❑ NO N Contract Attached:YES UNIT BEING REPLACED DATA NEW UNIT Trane/Allegiance MANUFACTURER American Standard TWE065E13FB0 AHU or PKG.UNIT MODEL# TWE09043AAAP004 7C0072A300A0 COND. UNIT MODEL# TTA07243AAAE001 10KW KW HEAT 10KW 6 NOM TONS 6 AHU CU PKG 1)M.C.A AHU Cu PKG AHU CU PKG 2)M.O.P AHU CU PKG AHU CU PKG-3PH2O0/230-1PH 3)VOLTS AHU Cu PKGaP+2o�1m PKG UNIT / / ARI#201930663 PKG UNIT / UNKNOWN EER/SEER 12.90 EER YES NO N/A REPLACING DUCTS YES NO N/A YES NO YES REPLACING THERMOSTAT YES"� NO YES YES NO N/A NEW 4"CONCRETE SLAB YES NO N/A YES NO N/A NEW ROOF STAND YES NO N/A YES NO N/A NEW RETURN PLENUM BOX YES NO N/A 1. Minimum Circuit Ampacity(Wire Size): # 6 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 60 AMPS 3. Voltage of Circuit(208/240/480): C/U 3PH 208/230 A/H 1 PH 208/230 4. Size Disconnecting Means: 60 AMPS Contractor's Company Name: Air & Heat Doctors Inc. Phone: 7864864436 CAC 819172 I State Certificate or RegisIZ2= Certificate of Competency No. Signature Date: 06/03/18 Qualifi s signature) (Revised02/24/2014) { 1276 SW 143rd Place Miami, FL 33184 h CON D QVI®N I NG 305-446-0940 abraham@airdoctor.us CAC1819172 Air & Meat Doctors nc. Date Estimate# ATLANTIC OIL INC. 5/30/2018 1009 1308 E.Atlantic Blvd Pompano Beach,FL 33301 Estimate P.O.No. Terms Project EXPREZO 9601 NE 2 AVE MIAMI SHORES Description Item- Total. REPLACEMENT OF CENTRAL AIR CONDITIONING SYSTEM. 15 HVAC 8,200.00 BRYAN COMMERCIAL 6 TONS SPLIT UNIT. 3 PHASE 208/230 VOLTS. REMOVAL AND PROPER DISPOSAL OF OLD SYSTEM. FLUSH REFRIGERATION LINES SYSTEM WITH NITROGEN. INSTALLATION OF NEW FILTER DRYER. RECONNECT NEW SYSTEM TO EXISTING DUCTWORK,ELECTRICAL, SMOCK DETECTOR,DRAIN LINE SYSTEM AND CONCRETE SLAB. 5 YEARS WARRANTY BY MANUFACTURE(REGISTRATION IS REQUIRE) 1 FULL WARRANTY ON LABOR BY US. I CITY OF MIAMI SHORES PERMITS FEES ARE NOT INCLUDED IN THIS PROPOSAL. / �Cf/d�' CSC you have any questions please call me at 305 446 0940. Thank you. Abraham Amador Accepted By Accepted Date Total $8,200.00 r 5/30/2018 Detail by Entity Name '-� DIVISION OF CORPORATIONS e--, I I Jazm ON uu vjfirird&Wr rjf evlitrl w izsu� pgoartment of State / Division of corporations / Search Records / Detail By Document Number / Detail by Entity Name Florida Profit Corporation ATLANTIC OIL INCORPORATED fiUng Information Document Number P15000003250 FEI/EIN Number 47-3112517 Date Filed 01/09/2015 State FL Status ACTIVE Principal Address 1308 E. ATLANTIC BLVD. POMPANO BEACH, FL 33060 Mailing Address 1308 E. ATLANTIC BLVD. POMPANO BEACH, FL 33060 Registered Agent Name&Address OSHINSKY, LEONARD 350 E. LAS OLAS BLVD. SUITE 970 , FORT LAUDERDALE, FL 33301 I Officer/Director Detail Name&Address Title D,P SHEHADEH, MAHMOUD 1308 E. ATLANTIC BLVD. POMPANO BEACH, FL 33301 Title D,S rSHEHADEH,AHMAD 1308 E. ATLANTIC BLVD. POMPANO BEACH, FL 33301 Title D/T Hamed, Taher 8044 Kaliko Lane http://search.sun biz.org/Inquiry/CorporationSearch/Search ResultDetail?inqu irytype=EntityName&di rectionType=ln itial&search NameOrder=ATLANTICOIL%20P 150 5/30/2018 Detail by Entity Name Wellinaton, FL 33414 Annual Repo s Report Year Filed Date 2016 01/14/2016 2017 01/16/2017 2018 04/03/2018 Document Images 04/03/2018--ANNUAL REPORT: View image in PDF format 01/16/2017--ANNUAL REPORT! View image in PDF format 011/14/2016--ANNUAL REPORT View image in PDF format 01/09/2015--Domestic Profit View image in PDF format r Florida Department of State,Division of Corporations http://search.sun biz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EnUtyName&directionType=ln itial&search Namebrder-ATLANTICOI L%2OP 150 Property Search Application - Miami-Dade County Page 1 of 1 OFFlut UF 21"OHE PROPERVY APPRAISERr Summary Report Generated On :6/5/2018 Property Information .r Folio: 11-3206-013-4060 9601 NE 2 AVE Property Address: Miami Shores,FL 33138-2721 Owner ATLANTIC OIL INC , t 1308 E ATLANTIC BLVD �" 7 Mailing Address. W, -^-- POMPANO BEACH,FL 33060 USA PA Primary Zone 6400 COMMERCIAL-CENTRAL Primary Land Use 2626 SERVICE STATION :SERVICE STATION-AUTOMOTIVE Beds/Baths I Half 0/0/0 Floors Living Units 1 0 Actual Area Sq.Ft Living Area Sq.Ft " �,4 Aerz .. IlrhY 2W! Adjusted Area 4,276 Sq.Ft Taxable Value Information Lot Size 26,000 Sq.Ft 2017 2016 2015 Year Built 1964 County Assessment Information'. Exemption Value $0 $0 $0 Year 2017 2016 2015 Taxable Value $922,378 '$845,982 $769,075 Land Value $642,200 $642,200 $543,400 School Board Building Value $222,816 $214,782 $172,648 Exemption Value $0 $0 $0 XF Value $57,362 $58,062 $53,027 Taxable Value $922,378 $915,044 $769,075 City Market Value $922,378 $915,044 $769,075 $0 Assessed Value $922,378 $845,982 $769,075 Exemption Value $0 $0 Taxable Value $922,378 "$845,982 $769,075 Benefits Information Regional Benefit Type 2017 2016 2015 Exemption Value $0 $0 $0 Non-Homestead Cap Assessment Reduction $69,062 Taxable Value $922,378 $845,982 $769,075 Note:Not all benefits are applicable to all Taxable Values(i.e.County, School Board,City,Regional). Sales Information Previous OR Book- E Short Legal Description Sale Price Page Qualification Description MIAMI SHORES SEC 1 AMD PB 10-70 02/04/2016 $3,200,000 29954-2113 Involving non-typical personal LOTS 11-14 INC BLK 30 property" LOT SIZE IRREGULAR 10/01/1999 $410,100 18852-4133 Sales which are qualified OR 18852-4133 1099 1 The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at hfp://www.miamidade.gov/info/disclaimer.asp Version: t https://www.miamidade.gov/propertysearch/ 6/5/2018 h � a S L'. SNORATIC.1-93 Eggs ES G�! C� J ..,..v" Miami shores Village ° �� Building Department ORIDp 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION i IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: t Certificate Holder: ` MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE ' MIAMI SHORES,FL 33138 r Certificate must specify the description of operations or contractor license number. ...........2500......0 0 0 0 0....0 0 0 0 0 0\0008...0 0.0 0 0 0.110....0.............\0 11 0 0.000...IS...0 BUSINESS NAME: BUSINESS ADDRESS: /�27?� �•Gc� A/0 fieCITY/11i9�.z STATE�ZIP BUSINESS PHONE:{J��) �y6 a9fiD FAX NUMBER( ) CELL PHONE) yBG yy3� QUALIFIER'S NAME: ����� ��V1--eez QUALIFIER'S LIC NUMBER: 1 AIR&H-1 QP ID: AP ACORD$ DATE(MM'DD;YYWy CERTIFICATE OF LIABILITY INSURANCE F0610s/2oi8 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. f IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. I If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on i.this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 305-842-3600 CONTACT Luis Gazitua JAG Insurance Group-MIA —...........--'—............._._........._—........ " ............_.._..._ 2151 LeJeune Road,Suite 308 c"c°.No,Ext):305-842-3600 FAXto-c,Na):305-842-3574 Coral Gables,FL 33134 E-MAIL cert) Icates jaglnsgroup.com LuisGazitua Iztf.ES :__..__....--- ----._....------........_...._.._ ---.....—..._.._..__.._.....—._...._.. -- INSUREIRM AFFORDING CQVERAGE._................._._—..............___... _.____LAIC N__—. —..........._..._ —_.. ........_..__ INSURER A_ASSOCIATED INDUSTRIES OFLA 23140 ____........_—. _.............—_...........—_...--�----.. ......---... s INSURED Air&Heat Doctors,Inc,Co. INSURER B 1276 Sw 143rd Place -----------.__._..._—....._._.._....._._...---- .--.._...---.._—...._..._ Miami,FL 33184 -INSURER 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 .......... REDUCED_ 3LIBNSR I TYPE OF INSURANCE jADDL SUBR WVQPOLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL.LIABILITY EACH OCCURRENCE CLAIMS-MADE C. OCCUR ._DAMAGE TO.REN_r.`.✓..........._..... ..............................._................................. ....... ............. .........._ .._'l..E..Mi.SE.S.:Ea..r.7.t:.gt.rrenci<J............._5..................... .........._........ I � I ........i...................._............................................................................._._................ ME!D..:=.Y). ..iArY_Gnt..Hc,rSLill............._u......................................... ..._.................�..... I \ i PERSONAL&ADV INJURY $ __ .. .....:........... ............................ ......... GEN'L AGGREGATE LIMIT APPLIES PER: I.............. .. GENERALAGGRE„GATE. ..5................. POLICYPao- IOC ...................-................................ �............�JEcr I PRODUCTS-COMP!OP .................................. .... .................................................................... ..... .........._AGG, 5 OTHER: AUTOMOBILE LIABILITY COMBIN,D SINGLE LIMIT j , �igntl $ ANY AUTO BODILY INJURY i?erarson $ OWNED j SCHEDULED - AUTOS ONLY AUTOS j BODILY INJURY Per a_rcident S HIRED NON-QWNED F'ROFERTY RfJR±:3E $ ._;AUTOS ONLY ,__AUTOS ONLY Pei accident I S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE` AGGREGATE S DED RETENTIONS A WORKERS COMPENSATION PF..R 0TH- V. AND EMPLOYERS'LIABILITY TATUTE E(3 _ Y=N AWC1106685 03,!29,!2018 0312912019 100,000 :ANY P ROFRIETOR!FARTNER!EXECUTVE E.L.EACH ACC DEN $ I OFFICEMMEMBER EXCLUDED? IN/A .- --- (Mandatory in NH) EL.DISEASE,EA EMPLOYEE $ 100,000 If yes.describe;;rider 600,000 DESCRIPTION OF OPERATIONS bel�rr E.L.DISEASE-POLICY LIPAIT i I I DESCRIPTION OF OPERATIONS r LOCATIONS:VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Contractor License#CAC1819172 t CERTIFICATE HOLDER CANCELLATION MIAMISV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village Bldg Dept THE EXPIRATION IO DAT POLICY PRF. NOTICE WILL BE DELIVERED IN 10050 NE 2nd AVE S. Miami Shores, FL 33138 y AUTHORIZED REPRESENTATIVE { �6 ACORD 25(2016/03) tj.1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD t AIR&H-1 .A`CORO' 02 10- CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/05/2018 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 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). PRODUCER 305-842-3600 CINTACT Luis Gazitua ' JAG Insurance Group MIA PHONE 305-842-3600 FAX 305-842-3574 2151 LeJeune Road,Suite 308 A/C,No,Ext): A/C,No): Coral Gables,FL 33134 E-MAILcertl icates jaglnsgroup.com I Luis Gazitua , INSURERS AFFORDING COVERAGE NAIC# INSUReRA:ASSOCIATED INDUSTRIES OF FLA' 23140 INSURED Air&Heat Doctors,Inc,Co. INSURER B: 1276 Sw 143rd Place Miami,FL 33184 INSURER C, I 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 I LTR TYPE OF INSURANCE DDL UBR POLICY NUMBER POLICY EFF YYY1 POLICY EXP LIMITS WVDCOMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE ❑OCCUR DAMAGE TO RENTED 'PREMISES(Ea occurrence) $ MED EXP(Any one ersor PERSONAL&ADV INJURY GEN'LAGGREGATE LIMITAPPLIESPER : GENERAL AGGREGATE R POLICY JECT F LOC PRODUCTS-COMP OP AGG OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ AUTOS ONLY ATOS C perOacciRdent AMAGE $ UMBRELLA LAB' OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ _ A WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY AWC1106685 03/29/2018 03/29/2019 TATLITE ER 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y� E.L.EACH ACCIDENT $ (Mandatory in BER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 1��'��� If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION'OFOPERATIONS[LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space Is required) CERTIFICATE HOLDER CANCELLATION MIAMISH 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. Building Department 10050 NE 2nd Ave Miami Shores, FL 33138 (s'AUTHORIZED REPRESENTATIVE .yD"""_ ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD I F ' 1 1 4 STATE OF.FL'ORIDA �.i"'w DEPARTMENT°OF.BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTIODUSTRY LICENSING BOARD,,. OARD " g CAC1819172 The AIR,CONDITIONING;CONTRACTOR-,,-.. -Named below IS-CERTIFIED .., Under=the'provlslons of Chapter 489 ._=.py, ;J h.�0 '3W •'}f y"t y m`t .__Wy n S' Expiration date AUG 31 LE 2018 ax ` , 1276,SWF143RDFPLACE f �• ;" 4�}" •, R ,= ,` ,• N FL 33184w >,� �.' � ` r `a. `'Nzs �, ..; «�• . ( 5 .. """ we w�i � 01 .„ �. .( �,�;,•.m�"«"°'�,,,,w✓,,,,....r' .«� ^°-° ,.,�!.�.� ,f,,��¢{{{k F �:1^'�, ral�at +�, ��''�,1,��� �.(�'l ,}t�« �,,a N _ ISSUED: 08/14/2017 DISPLAYAS REQUIRED BY LAW SEQ# L1 7 08 1 400004 31 w I ' a { k Scanned by CamScanner f t t i 1 Local Business 'Tax %ceipt Miami-Dade County, State of Florida -THIS IS NOT A BILL-DONOT PAY i 7196651 BUSINESS NAM EILOCATION 'RECEIPT NO, EXPIRES < AIR & HEAT DOCTORS INC RENEWAL SEPTEMBER 30, 2018 1276`SW 143 PL 7478954 MIAMI, FL 33184- Must be displayed at place of business Pursuant to County Code Chapter 8A -•Art.9& 1,0 OWNERSEC TYPE OF BUSINESS ' - PA YM ENT RECEIVED AIR&HEAT,DOCTORS'INC 196 SPEC MECHANICAL BY TAX COLLECTOR C/O ALVAREZ AGUSTINE, CONTRACT©R 75:00 08/24/2017 Clt IAl IPIFR Worker(s) 1 CAC 1819172 0200-17-005155 This local Business Tax Receipt only con',ims payment of the Local Business Tax.The Receipt is not alio, permit,ora cert"cation of the holder's quail"cations,to do business.Holder mist comply with any gm ernmentai or nongovernmental regulatory laws and requirements which apply to the business. s The FeMPTNO above must be displayed on all commercial vehicles-Miami-Dade Code Sec 8a 216. +SMI® F'or more information,visit www.miamidadeawAaxcdlet for ' 6 t l y , i Scanned by CamScanner ACC)RO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 44..� 06/05/2018 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). PRODUCER CONTACT NAME: Marcia C.Alvarez Pinnacle Insurance Group Inc. PHONE . (305)854-9898 FAC No: (305)854-9899 950 SW 57th Ave E-MAIDRLESS: pinnacleins@comcast.net AD APT 102 INSURERS AFFORDING COVERAGE NAIC H WEST MIAMI FL 33144 INSURER A: UNITED SPECIALTY INS CO INSURED INSURER B Air&Heat Doctors, Inc INSURER C: 1276 SW 143 PL INSURER D: INSURER E: Miami FL 33184 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INqn WVD POLICY NUMBER MM DD MM DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE F OCCUR DAMAGETO1,000,000 PREMISES SEa occurrence $ MED EXP(Any one person) $ 5,000 A S111027622534 01/25/2018 01/25/2019 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑ PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE h $ EXCESS LIAB CLAIMS-MADE AGGREGATE k $ DED RETENTION $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ I OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L'DISEASE-POLICY LIMIT $ + DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Air Conditioning Contractor CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave AUTHORIZED REPRESENTATIVE Miami Shores FL 33138 _f @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD I k 1