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PL-18-1184 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-303255 Permit Number: PL-5-18-1184 Scheduled inspection Date: July 10,2018 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: , Work Classification: Sprinkler System Job Address: 10101 NW MIAMI Court Miami Shores, FL Phone Number Parcel Number 1131010210080 Project: <NONE> Contractor: THE BIG ONES PLUMBING INC Phone: (786)302-2801 Building Department Comments REPAIR OF ONE LINE AND SPRINKLER LEADS Infractio gassed comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re-Inspection Fee ,No Additional Inspections can be scheduled until re-inspection fee is paid. r July 09,20118 For Inspections please call: (305)762-4949 Page 10 of 46 Permit NO. RL-5-18-1'1'$A Miami Shores Village Nt Permit Type:Plumbing-Residential 10050 N.E.2nd Avenue NW I Work Classification:Sprinkler System Miami Shores,FL 33138-0000 Pen a Permit Status;APPROVED FHa,�g Phone: (305)795-2204 CORtDp` Issue Date:612412018 f Expiration: 11/20/2018 Project Address Parcel Number Applicant 10101 NW MIAMI Court 1131010210080 ! Miami Shores, FL Block: Lot: HNL REAL ESTATE LLC Owner Information Address Phone Cell HNL REAL ESTATE LLC 680 NE MIAMI Street MIAMI FL 33138- 680 NE MIAMI Street MIAMI FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 400.00 THE BIG ONES PLUMBING INC (786)302-2801 _..._., .�.. Total Sq Feet: 0 Type of Work:REPAIR OF ONE LINE AND SPRINKLER LE Available Inspections: Type of Piping:REPAIR OF ONE LINE AND SPRINKLER LE Inspection,Type: Additional Info:REPAIR OF ONE LINE AND SPRINKLER LE Final Bond Return: Underground Sprinkler Classification:Residential Scanning:3 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoice# PL-5-18-67408 $2.00 05/24/2018 Credit Card $64.60 $50.00 DCA Fee $2.00 Education Surcharge $0 20 05/03/2018 Check#: 1073 $50.00 $0.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.60 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. f OWNERS AFFIDAVIT: I c rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoni uthermore, I authorize the above-named contractor to do the work stated. I N-PV 0 R-3S-O�Z- I May 24, 2018 horized Signat .Owner / Applicant / Contractor / Agent Date Building D artment Copy May 24, 2018 1 t A0 RECEIVEb Miami Shores Village g MAY 0 3 2018 u Building Department 10050 N.E.2nd Avenue Miami Shores,Florida 33138 a (� Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762.4949 FnBC 20 BUILDING Master,Permit Na k�L ^112-q PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL ❑PLUMBING ❑MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 10101 NW M AJ 1 CT City: Miami Shores County Miami Dade Zip 3 1 $c7 Folio/Parcel#: w - Is the Building Historically Designated:Yes NO "X I ' Occupancy Type: o Load: Construction Type: Flood Zone: BFE:' . FFE: OWNER:Name(Fee Simple Titleholder): Q( �C-}Q�° _ phone#: - a -Address:- 1680 NE 6q 9T A�'A SO y K , City: i•l�t-ft _ u`' _ �ff nn WAS Ap State: Tenant/Lessee Name:_ L10 A Iy A S S't Phone#: �k(o • 6 6-S��2 X72-,0 E _- 1'1G SSe cP S XPi ��` Email: RU(k( •.. �-. m _.tom. _�„ -�§ ! `C� CONTRACTOR:Company Name: Vd/�3 ,� iu/ Phone#: •; .. ..' Address: City: Zj��}—4117 State: L p Zip: ip: �J� \.-4,;' 06 � .w 'I.,,_,_•Q:..+'�"'xi+r+•:,•'g,' � a .._ �` .M yp-.•„c:«.:�".+. � �� .. Qualifier Name: u P / Phone# �) k State Certification or Re istratlo~ #:"""/ 'p 0� g �' Certificate of Competency#: (..Z' 406 2S`'�w"" ,• DESIGNER:Architect/Engineer. Phonal►: ^ ' p • Address: "_ _ * ~ , City. State Zip Value of Work for this Permit: Square/Linear Footage of Work Type of Work: ❑ Addition ❑ Alteration ❑ Newv • ® Repair/Replace i ❑^Demoiition, Description of Work: (Le Pal ia of O N\O— U, txc- r i.,(\ 1�.1- L7e ,:k. .p " `'�`Aw-r' _ °�.• �h �°, re�lia'SYI:�•� ..h�° "♦:.S �.�`$41P';�Ft` �..s:f+4+' A'aty_ `'ry"s'milrl�' "�•',.t+G�"a. "i#,aa'°c.i,' �Sr"y�.'..a,..�iza,.�'.�"P""'°w-t ., ,, ��.,,+�tr r;d.r—r—�i": ,da�"'�s:'-"�STydN�+H' ' Specify color of color thru tile: �- • �.__ ,,a,__ . .�� ._.. _ ._ ;�� .Aa Submittal Fee$ .Permlt Fee p". CCF$; +SCO/eC Scanning Fee$ K Radon Fee$ "tea 'C Aga. _.DBPR$ w.~rW 1. Nr1►$ a g ,. }r cal � :.,,.�. -,_• .� �._ �.. "-.,r'✓r� ""„'�� -.r...-, ..,y�-c-.�'roq�� w.+' Technology Fee$F "�'"° * ~~^"^` "�* Training/EducaN n Fe �•' Doub'Ie Fee `} i Structural Reviews$ Bond gg '�yE. ..-, h —s i�r� ...,..,. _,,.;war.+ •b.. •`' ""�9.n �,.,i;"'°„"y j, �i '"' E k4,.TOTAL'FEE NOW DUE IRevlsed02/24/2014) 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 on estimated volue'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 o�'AGENT S – _.. ,. ... AONITRA OR The foregoing instru ent was acknowledged before me this The foregoing ins111111nt`was acknowledged before me thisay . by day of «.r ZO , _ .. by. M. ._,0- ,�»,d of 1"� •l 20 ,'�� Q_� low ,who is personally known `?';personally known to�: me or who-has roduced: ..��•� ��, ...�-w�. . ... , „w� • "r"u,.r�.�. P as me or who has produced as c a ` '?lpfw.j, a. '.'WW�+,.,:.w.. WR..w ,,.., • .raM''"'” - :..,,ci• r " .., rr'„+ Identification and who"did take ainn oath., .identification and who did take an oath.: s „ NOTARY PUBLIC. "' t �,. .;` {4rNOTARY PUBUC r , ,• i> � ' all, -..�; -^I. ,,,,� � ..•�.�=•�-r�~�Asa�'�5= �. y U.�••a .. -icy.,;:. `�.. _��, -�f- •,,,t, .d �.,v�..-_. Sign: J10!"I LZMAUUMIr + Print n � "`-- '��"' .Print:,��-•�!r C.f' _! � 7r '�"�� "�^�t t.. MY COMM_ISSI ON#FF 224345 .,Py .., .,� .s>•�,� ,e o* r.-GABRIEL MOMERO a o i, ISeal MY COMMISSION�FF 184292 EXPIR •A nl 26 20 • .�---� ES 19 x ondedThruNotaryPubGcUnde,"n; �a XPIR .E ES:February 15,2019° °TF0,ncpzz Bonded Thru fiudget Notaiy Serncec int''*:y....iwr.�...+wKii+,._,....': - �' ,.s�sstiititisiittaii��♦t�d��ts+•�t� t�r��r��ssst� �iRii�ss��,is�i��s�s��'.:�f��ss��iiiiii��i��+ei�%i�� v ,..mZbnth ' :d t �. —...A;>,,,t� ., �;..�. ,.� li" •„ .°t�. �.;`•'""� ' N ,.; ` -S' ` -y•-' .• �-.�N. :,:�—,r- ., •! rldF ; Clerk Structural Reviews u ,. •._ n. M _ ,_. +�• l e St —_ _ ,. ' �.�sP'h > �-:5,��•7 �"1.� : -� - 1 lJ �e'e .. ylf�Rnmew--�—Y..r.ti�vy,,. -Vf•.^ . .. -.0 -1•i .. (RevIs&0Z/24/2014)1 e ,rt.. Y. c.. .: 41 n I, 4 •� 5/3/2018 Property Search Application-Miami-Dade County "Y A'P_"PR AMSER OFFICE OF THE PROh"ERgi Summary Report Generated On:5/3/2018 Property Information ' Folio: 11-3101-021-0080 T t I 10101 NW MIAMI CT ' Property Address: 71Ae t Miami Shores,FL 33150-1261 t ' Owner HNL REAL ESTATE LLC 680 NE 64 ST A304 Mailing Address MIAMI,FL 33138 USA ` PA Primary Zone 1000 SGL FAMILY-2101-2300 SQ Primary Land Use 0101 RESIDENTIAL-SINGLE I FAMILY: 1 UNIT Beds/Baths/Half 3/2/0 - Floors 1 Living Units 1 Actual Area 2,365 Sq.Ft Living Area 1,853 Sq.Ft Adjusted Area 2,022 Sq.Ft " Lot Size 7,704 Sq.Ft Taxable Value Information Year Built 1958 2017 2016 2015 County Assessment Information Exemption Value $50,000 $50,000 $50,000 Year 2017 2016 2015 Taxable Value $206,476 $201,201 $199,455 Land Value $169,477 $169,477 $125,014 School Board Building Value $168,877 $171,223 $173,568 Exemption Value $25,000 $25,000 $25,000 XF Value $682 $682 $556 ,�•,� �_,._.,,.,.,._,_-,�� __.� .-.- Taxable Value 1 $231,476 $226,201 $224,455, Market Value $339,036 $341,382 $299,138 City Assessed Value $256,476 $251,201 $249,455 Exemption Value 1 $50,000 $50,000 $50,000 Benefits Information Taxable Value 1 $206,476 $201,201 $199,455 Regional Benefit Type 2017 2016 2015 Exemption Value 1 $50,000 $50,000 $50,000 Save Our Homes Cap Assessment Reduction $82,560 $90,181 $49,683 Taxable Value 1 $206,4761 $201,201 $199,455 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead I Exemption J$25,000 $25,0001 $25,000 Sales Information Note:Not all benefits are applicable to all Taxable Values(i.e.County,School Previous OR Book- Board,City,Regional).Re Sale Page Price Qualification Description ). Short Legal Description 02/15/2018 $500,000 30873-2638 Qual by exam of deed 12/03/2014 $100 29429-4528 Corrective,tax or QCD;min 1 5341 consideration HAMILTON TERR A SUB PB 15-75 11/04/2011 $299,900 27894-4784 Qual by exam of deed W1/2 OF LOTS 10&11 BILK 1 LOT SIZE 72.000 X 107 07/30/2010 $200,500 27384-3049 Financial inst or"In Lieu of Forclosure" OR 15904-3644 0493 1 stated 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 Version: ' t r ACTION OF THE MEMBERS OF LNH REAL ESTATE, LLC ADOPTED BY UNANIMOUS WRITTEN CONSENT - t. The undersigned, LARS NAGEL-HEYER, being the one and only Member of HNL rte. t REAL ESTATE, LLC, a Florida Limited Liability Company(the "Company"), do hereby waive c� any and all requirements,for notice of,the time and place of a special meeting of the Company ' and do hereby agree, declare and consent, pursuant to the provisions of the Florida Limited Liability Company Act (the "Act") and the Operating Agreement of the Company, as,amended, to the adoption of, and do hereby adopt, the following resolutions and the actions specified herein: WHEREAS, the Company desires to enter into a purchase and sale agreement with Joshua Alain Ground and Lindsey Michelle Hemphill (the "Seller"), whereby the Company will purchase certain real property of the Seller (the "Purchase Agreement"), located at 10101 NW Miami Ct., Miami Shores, Florida 33150, and further described as: THE WEST % OF LOTS 10 AND 11, BLOCK 1, OF HAMILTON TERRACE, ACCORDING TO THE PLAT THEREOF AS REOCRDED IN PLAT BOOK 15, PAGE 75, OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA. P NOW THEREFORE,be it RESOLVED, that the Company is hereby authorized to execute and deliver to the Seller the Purchase Agreement along with any other assignments, closing statements and such other agreements, instruments and any ancillary documents as may be deemed necessary or required to consummate the transactions contemplated by the Purchase Agreement which shall contain such terms and conditions as the members of the Company shall determine to be in the best interest of the Company, with the signature of any such member to be conclusive evidence of such determination and of the authority of such managing member.to execute and deliver the same; FURTHER RESOLVED, that all that such member(s) have done or may do in pursuance of any of the foregoing or to facilitate transactions thereunder is hereby ratified and approved; and FURTHER RESOLVED, that Lars Nagel-Heyer, Sole Member,is hereby authorized to execute and deliver, and to affix the seal of the Company to and attest the same upon the Purchase and Sale Documents but with such modifications and additional provisions as they may deem advisable, and any and all other documents and instruments required by the Company's attorney, the Seller's attorney, the Settlement Agent in connection with the sale and purchase and all supplements and amendments to the same or to any of the same as they may deem advisable, all of which documents and instruments executed and delivered as aforesaid to be and constitute the acts and obligations of the Company; the Company hereby ratifying and confirming the acts of its officer executing and delivering all of such documents and instruments, irrespective of whether such acts were performed before or subsequent to the ate of the adoption hereof, and directing the 15585785.2 officers and employees of the Company to perform all of the Company's obligations and undertakings under each and all such documents and instruments. FURTHER RESOLVED, that Roxana Mirabal, Esq., as authorized agent/attorney, is hereby authorized to execute and deliver, and to affix the seal of the Company to and attest the same upon the Purchase Documents but with such modifications and additional provisions as they may deem advisable, and any and all other documents and instruments required by the Company's attorney, the Seller's attorney, the Settlement Agent in connection with the purchase and all supplements and amendments to the same or to any of the same as they may deem advisable, all of which documents and instruments executed and delivered as aforesaid to be and constitute the acts and obligations of the Company; the Company hereby ratifying and confirming the acts of its officer executing and delivering all of such documents and instruments, irrespective of whether such acts were performed-before or subsequent to the ate of the adoption hereof, and directing the officers and employees of the Company to perform all of the Company obligations and undertakings under each and all such documents and instruments; and This Unanimous Written Consent may be signed in counterparts and each signed counterpart shall constitute a part of the whole. A faxed signature shall be accepted and , considered the same as an original signature. i IN WITNESS WHEREOF, the undersigned ave executed this Unanimous Written Consent of the Members effective as of the 30 day of , 2018. MEMBER: Print Name: LARS NAGEL-HEYER STATE OF COUNTRY: Sworn to and subscribed before me this_day of , 2018, by LARS NAGEL- HEYER, who personally appeared before me, and who are [ ]personally known to me or [X] have produced as identification. (seal) NOTARY PUBLIC My Commission Expires: 2 15585785.2 Roll of Deeds No. 185/2018 This is to certify that before me, Dr. Alexander Schmidt, Notary Public in and for the Free and Hanseatic City of Hamburg, Veritaskai 1, 21079 Hamburg, Federal Republic of Germany Mr. Lars Nagel — Heyer, born on October 27th, 1968, address: Heimhuder Strage 31, 20148 Hamburg/Germany, /II , identified by: German passport No. L1VJTC7ZY, has acknowledged in my presence the foregoing signature as his free act and deed. Witness my hand and seal. Hag, January 30th, 2018 �a Dr. Schmidt Notary Public Lu ip o Wu �NCE 44". ipCa• S3 t� Q W [C '�1� ' 1--{•ear• IC)CP t:t'j N� I 3'!•5a ------------- dW�ClrW 3V • ' ' n, r Ft W�jY J LEo _ 14 _ Ior- LOT a 10 � J-Qd ' Yf 'W J21Y • / I .J . - T1C - •� a.sem. � m _ � • r seas ma • • • N .�' 1�1� 1� 0� C 00 S1V 31 �q J Y i • • • • �J �� 'rltk ?�_2 t S,]StW • ••.••• •� + TN.E �� 114' Wed �► . . ra 1 �_'�✓-.ate OJ13S 7I I l•� z Op 't Q I N. 05 Sh-.res Village r' �> W -• i ��Qe; C1-�i�"( APPROVED BY D. = ZONING DEPT GTJBJECT.TO COMPLIANCE Vll l 1 ALL FL-DERAL STATE AND COUNTY RULES'AND RMUL.ATIONS " LEGAL DESCRIPTION u 'Z Nam LEGAL DESCRIPTIC OF HAMILTON E n DRIVER L; R 3 6 2-7'2.' 0 1 -2 9 2-0 RELDY CHADO ;# 16776 ;u MIS #, F alp HGF -2020 S c A F`E `l R I -a � CT �rV1Construction Trades ualifying Board BUSINESS CERTIFICATE OF COMPETENCY �d 12P000257 THE BIG CINES PLUMBING INC D.B.A. : RO RI U Z RELDY Is certified under the provisions of Chapter 10 of Miami-Dade County i r t Muni ci-pal Contractor's Tax= Receipt 4 p M iam i-Dade-County,,'Stpte..of'Florida -THIS IS NOT A BILL-DO NOT P.AY t CC NO: 12P000257 ]RES BUSINESS.NA t:E!LOCA TION RECEIP_i-NO. EXP ]R E S THE BIG ONES PLUMBING INC 15776.SN 76IEZ SEPTEMBER 3Q, 2.018 .MIAMI,R_ 331.93. 7.5'25.3=1;1 Pursuant to County Code Sec 10-24, TYPE OF BUSINESS Ot„�tER PAN MENT RECEIVED iNEBIG ONES PLUMBING INC PLUMBINGCONTRPOTOR BY T.Az COLLECTOR 50.00 .01/18/2018;. 0203-18-002223 Restricted W City of=North Miami Beach Miarta For moreintorrration visityyj w:rri fti s�1�g9v/taxcotlecior r { I. T. r r { Local Busi ness Tax Receipt M`iami.-DadeCounty, State of Florida THIS IS NOT A BILL-DO NOT PAY 7016827 _ pp 4 B U SIN ESS NA M E/LOCA TION RECEIPT N'O'. E X P I RE'S THE BIG ONES PLUMBING INC RENEWAL SEPTEMBER 30, 2018 15.776 SW 76 TER 7292667 MIAMI, FL: 33193 Must be displayed at place of business- Pursuantto County Code C Chapter 8A-Art.9& 10; CS1rNER SEC •TYPE OF BUSINESS• PAYN1 ENT..RECEWED THE BIG ONES PLUMBING INC 196 PLUMBING BY TAX COLLECTOR CONTRACTOR $2;50 10!19!2017 Vlorker(s) 1 12P000257 0223-.1 8-000229 { This Local Business Tax Receipt only con"mos payment of the Local Business Tax.The Receipt is not a license, permit,or a certi"cation of the holder's qua!i"cations,to do business.Holder.r ust comply with any governmental or nongovernmental•regulatory.lawsand requi rements w hi ch apply to the business. �- The SPT NO.above must be displ ayed on all commercial vehicles-Miam-Dade Code Sec Ba-ZrS. "� For more information,visit www,mfamidade ov/taxcollector ria ROW t , f Y k { t f A� CERTIFICATE OF LIABILITY INSURANCE °A�'M2/2018 Y' 05/02/2018 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 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 rightsto the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT LISSETTE AVILEZ NAME: Continental P&c A No Ell: (305)207-7889 ac No): (305)207-0565 12955 SW 42 St Ste 5 EMAIL LAVILEZ@CONTINENTALPAC.COM Miami,FL 33175 INSURERS AFFORDING COVERAGE NAIC# Phone (305)207-7889 Fax (305)207-0565 INSURER A: ARCH SPECIALTY INSURANCE 21199 INSURED INSURER B: COMMERCE&INDUSTRY INS COM 19410 The Big Ones Plumbing,Inc INSURER C: 15776 SW 76 Terrace INSURER D: INSURER E: Miami FL 33193 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 TYPE OF INSURANCE ADD UBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY F COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 DA AGE 0 RNTED ❑ CLAIMS-MADE OCCUR PREM SES EaEoccurrence) $ 100,000.00 MED EXP(Any one person $ 10,000.00 A F1N N AGL0044128-01 12/30/2017 12/30/2018 PERSONAL&ADV INJURY $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000.00 G POLICY ❑ JECT ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000.00 ❑ OTHER $ AUTOMOBILE LIABILITY EOM�NdentSINGLE LIMB $ ❑ ANY AUTO BODILY INJURY(Per person) $ E] ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ❑ AUTOS F-1 HIRED AUTOS ElADN-0WNED PP OUT ( rP�EGRd DAMAGE $ ❑ ❑ $ ❑ UMBRELLA LIAB ❑OCCUR EACH OCCURRENCE $ 1,000,000.00 B a EXCESS LIAB ❑CLAIMS-MADE N N EBU 019083718 12/30/2017 12/30/2018 AGGREGATE $ 1,000,000.00 ❑ DED ❑ RETENTION$ $ WORKERS COMPENSATION ❑PEAR ❑OH AND EMPLOYERS'LIABILITY Y/N T ER ANY PROPRIETOR/PARTNER/EXECUTIVF[:] N/A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Contractor Plumbing License#12P000257 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 AUTHORIZED REPRESENTATNE i ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101)QF The ACORD name and logo are registered marks of ACORD