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EL-16-2943Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address ermii Parcel Number Permit NO. EL-1 i 16-2943 Permit Type: Electrical - Residential Work Classification: Addition/Alteration Permit Status: APPROVED 2016 Expiration: 07130/2018 Applicant 440 GRAND CONCOURSE Miami Shores, FL 33138- 1132060170030 Block: Lot: EDUARDO & XIMENA CALLE Owner Information Address Phone Cell EDUARDO & XIMENA CALLE 440 GRAND Concourse MIAMI SHORES FL 33138 (305)751-2707 440 GRAND Concourse MIAMI SHORES FL 33138 Contractor(s) Phone Cell Phone POWER TECHNOLOGY SERVICES LL (305)803-9216 Valuation: Total Sq Feet: $ 3,800.00 0 Type of Work: ADDITION WITH UPGRADES, ROUGH ELECT Additional Info: ADDITION WITH UPGRADES, ROUGH ELECT Classification: Residential Scanning: 1 Fees Due CCF Change of Contractor Fee DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $2.40 $110.00 $3.38 $3.38 $0.80 $225.00 $3.00 $3.20 $351.16 Pay Date Pay Type Invoice # EL-10-16-61824 11/02/2016 Credit Card 10/28/2016 Credit Card Amt Paid Amt Due $ 191.16 $ 50.00 $ 50.00 $ 0.00 Invoice # EL-1-18-66292 02/02/2018 Credit Card $ 110.00 $ 0.00 Available Inspections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Review Electrical W. W. Underground 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 constructio Futhermore, I authorize the above -named contractor to do the work stated. Aut or¢e• ignature: Owner / Applicant / Contractor / Agent February 02, 2018 Date Building Department Copy February 02, 2018 1 6Qrsoi, o) \?A\(6 Miami Shores Village Budding 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 BUILDING PERMIT APPLICATION ❑BUILDING "ELECTRIC ❑ ROOFING PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: 17 ‘10 61244140 CoX CoL77 ' City: Miami Shores RECEIVED JAN31 2018 FBC 2diQ Master Permit No. /2C - )3 — 25 ' 7 Sub Permit No.EL -(0 /.6-- 29y3 ❑ REVISION ❑ EXTENSION ❑ RENEWAL CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS County: Miami Dade Folio/Parcel#: 11-5 20Lo6/-9003d Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: Flood Zone: OWNER: Name (Fee Simple Titleholder): EDU)4)Z D d XfAlig/1(A e-PLL E BFE: zip: 331 38' NO, FFE: Phone#: 305- 7S1-2707Z Address: 4/4/0 fq t) ,wt City: /V1 i AAA t s',10.R. State: AL Zip: 3 3(38 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: SeYVicpS Address: / 2 3V Sc&) 8' Phone#: 3c — 803 --72(6 City: Ai1Ai-ic State: FZ. Qualifier Name: Cel" Sot•-t // r'Pivt c%i i tc, Phone#: State Certification or Registration #: EC' /3 300 L72, 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: a Addition ❑ Alteration Description of Work: ADD I / () 'X.; ilk ❑ New OCSra.JeS ❑ Repair/Replace Zip: 3 3 / 305- 8cj-7?, ❑ Demolition Specify "color of color thru ;tile: Submittal Fee $ Permit Fee $ /it c962- CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ _ (Revised02/24/2014) TOTAL FEE NOW DUE$ 6 )fo : O 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 OWNER or AGENT The foregoing instru nt was acknowledged before me this /sf dayof ,20 i a .by x% kr? ia_ C.'..I •• p , who is personally known to me or who has produced as identification and who did take an oath. Sign: ,(jf Print: Seal: LUIS FFRNANDEZ MY COMMISSION # GG 041161 Q EXPIRES: November 7, 2020 14-oF p - Bonded Thru Budget Notary Services ************************ APPROVED B CONTRACTOR The foregoing instru t was acknowledged before me this r'day of , 20 I , by e fJo i e.X i:41 who is personally known to me or who has produced as identification and who did take an oath. Sign: Print: Seal: NJ reo t_uiS FERNANDEZ MY COMMISSION # GG 041161 a EXPIRES: November 7, 2020 e.°P Bonded Thru Budget Notary Services *********************************************************************************** P-7%, -/glans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT L-/0-6 1 tt Permit N. - - 1 — � Owner's Name (Fee Simple Title Holder):&Loci Owner's Address: (�. j 6/`a ✓► of City: (lit Cd yfl )' S/ O rGS 6t/ /J(;fr?e/u>1 ncvv' Se State : F-L Phone #: Job Address (Of where work is being done): 4(4 6 Croyi CcmGOcxs c' FL, City: Miami Shores State: Florida Contractor's Company Name: R Address: I .760 Nb-) /5:th City: PoPil (ctr a C tru"t Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: 365 75/- 7,0 Zip Code: 3S / 38' Zip Code: 3 5 / 3' / 4uc. 4434S State: FL Qualifier's Name : Cf ieG l G Phone#: 75.4 -9�3 57:'7 Zip Code: 33 669 Lic. Number: 1 ' C /,3 v / 8v5 Describe Work: hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the con `act. Miami Shores harmless of Signature Ectroarr-n 6112_ Owner or Agent The foregoing instrument was aknowledged before me �+ this LC day of re? ru..45/20 12,by 6 L •rAnc ctto,_ this Who is personally known to me or who has produced r -Y,aGl y e4iLtviel., 4o VY.•. as indentification. Notary Publi -Sign: r A, ee, Seal: Notary Public State of Florida Maria P Miller My Commission GG 172426 Expires 01/03/2022 Signature h. d th - uilding Official and the �� • Ive��- � t. Contractor or chitect The foregoing instrument was aknowledged before me f` ,( 4 !- .It i,b3iO day of `'a rnt, c,(c.t 201( by nown to me or who has produced Notary PybJic: Sign: ( Seal: as indentification. EVELYN ROMERO Notary Public - State of Florida Commission • FF 929239 My Comm. Expires Oct 20. 2019 Satdidthoual Ninon.' Notary Assn. Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address ermil Permit NO. E L-10-16-2943 Permit Type: Electrical - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date:11/2/2016 Expiration: 05/01/2017 Parcel Number Applicant 440 GRAND CONCOURSE Miami Shores, FL 33138- 1132060170030 Block: Lot: EDUARDO & XIMENA CALLE ti Owner Information Address Phone Cell EDUARDO & XIMENA CALLE 440 GRAND Concourse MIAMI SHORES FL 33138 (305)751-2707 440 GRAND Concourse MIAMI SHORES FL 33138 Contractor(s) R & R ELECTRIC COMPANY INC Phone (954)968-5907 Cell Phone Valuation: Total Sq Feet: $ 3,800.00 0 Type of Work: ADDITION WITH UPGRADES, ROUGH ELECT Additional Info: ADDITION WITH UPGRADES, ROUGH ELECT Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Amount $2.40 $3.38 $3.38 $0.80 $225.00 $3.00 $3.20 Total: $241.16 Pay Date Pay Type Invoice # EL-10-16-61824 11/02/2016 Credit Card 10/28/2016 Credit Card Amt Paid Amt Due $ 191.16 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Underground W. W. 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 a SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing info construction and zoning. Futhermore, I authorize the abov rcX a on is accurat Fro tractor 'rk will be done in compliance with all applicable laws regulating stated. Authorized Signature: Owner / Applicant / Contractor / Agent November 02, 2016 Date Building Department Copy November 02, 2016 1 BUILDING PERMIT APPLI ❑BUILDING ❑ PLUMBING JOB ADDRESS: City: Folio/Parcel#: Occupancy Type: Miami Shores Village 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 RECEIVEb OCTT8 2016 BY. FBC 20 1 4 Master Permit No. - 28 ( /j TION Sub Permit No. EL t 0 - (6 -Z-t 13 aryl \ LECTRIC ❑ ROOFING ❑ MECHANICAL ❑ PUBLIC WORKS GraAA.a 1/40 ❑ REVISION El EXTENSION El RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS M& C Miami Shores County: Miami Dade . Zip: J Jl 5g Is the Building Historically Designated: Yes NO X Load: OWNER: Name (Fee Simple Titleholder): Construction Type: l�5 Flood Zon : BFE: FFE: v` Phone#: Address: %' City: 10/111. j. 5/7T/►` Tenant/Lessee Name: Email: State: Phone#: CONTRACTOR: Company Name: i (90 �N/N) Address: City: l9'h Qualifier Name:. State Certification or Registration #: DESIGNER: Architect/Engineer: Address: Value of Work for this Permit: $ ?7 gn0 Stay g /Voo/ Type of Work: L! Additiop ❑ ,,Alteration Description of Work, ' /` L o/d ► 7: C vv\ 'MOH rn 9!( ;:,t C x.a.Us+ Pa Specify C010r of coldr thru tile: +rtoi iP 1 7 tt♦ F i .1t g f .�y�a"tif P L �$ul r�t�tt•F>I'e $ ' 0 Scanning Fee $ Zip: Phone#: C- "-0- / 68 ?o) 3L5 layk J— Phone#: Zip: 7j Certificate of Coy etency #: / 'e0/ `''' Phone#: (5o /f b / - ©V O ( State: rr r� Zip:�U � �D Square/Linear Footage of Work: coc New City: ❑ epair/Replace (city00cA 3Lt ofz..."09 F 4:sr-td n Demolition Permit Fee $ O6 Radon Fee $ 3. 3a Technology Fee $ J Training/Education Fee $ Structural Reviews $ CCF CO/CG$ ''� DB PR'$4s+j'OP r338 Noary • 8 CD Double Fee $ • Bond $ TOTAL FEE NOW DUE$ tCt (Revised02/24/2014) r Bonding Company's Name (if applicable) Bonding Company's Address City, • r. 4 State Zip Mortgage Lender's Name (if applicable)�- Mortgage Lender's Address • City "t-, ` i / 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 Qermit is issued. In the abs ce of such posted notice, the' inspection will not be approved and a reinspection fee will be charged. Signature £ oldaTV 1az Signature' OWNER or AGENT CONTRACTOR The foregoing/'_instrum wa ck wledged before me this Theforregoing instrument wasYacknowledged beforerm_e this r�•�� day of 20 20 %,b , by 1,18.. day o e tr:Ait ._ , 20 `P , by C..thOLCS.J-Vb �IS,N , who is personally known to 11.. ci-• - \4 .) , who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. NOTARY PUBLIC: identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: 1'- aa".2 *************** ** APPROVED BY Sign: Print: Seal: 1:11(1, .., .,; Amy Osborne • COMMISSION IFF905740 ' �c g+e** * 1*ill%*s******************************* �r 1WWINAARONNOTARY.COM z Z _ ,-0Plans Examiner Structural Review o a v a ,,, EVELYN ROMERO ,, -t Notary Public • sate a Florida `• ConmNaeba 0 'el 929239 My Comm. Expires Oct 20, 2019 4 t , Banded - Netloa 110U ry Assn. Zoning Clerk (Revised02/24/2014) _..__- ,..ram' -.a--a.,��'a".^t"'%"'.rsx.,� - ak.;rR•.•Sa?��'.x:'x:d':=y"'C+".?,c..........i.��......."�..�'R'`.€:iz;.�a,,d4rr..cc^,="�,,,„ C�.._';si"'`�.3;: BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2016 THROUGH SEPTEMBER 30, 2017 DBA: Business Name: R & R ELECTRIC CO INC Owner Name: REX A HAMILTON Business Location: 1700 NW 15 AVE STE 345 POMPANO BEACH Business Phone: 954-968-5907 Rooms Seats Employees 14 LWN SPRNKL/CONTRA C+.OR Business Type: (ELECTRICAL CONTRACTOR) Receipt #: P 8UMB NG/ Business Opened:09/01/1989 State/County/Cert/Reg:EC 13 0 018 6 5 Exemption Code: Machines Professionals For Vending Business Only • Vending Type: Tax Amount • Transfer Fee NSF Fee ,Penalty Prior Years Collection Cost Total Paid 54.00 0.00 0.00 0.00 0.00 0.00 54.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: R & R ELECTRIC CO INC 1700 NW 15 AVE STE 345 POMPANO BEACH, FL 33069 This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning 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. 2016 - 2017 Receipt #1CP-15-00018736 Paid 08/12/2016 54.00 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 HAMILTON, REX A R & R ELECTRIC COMPANY INC 1700 NW 15 AVE SUITE 345 POMPANO BEACH FL 33069 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and leam more about 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 serve your customers. Thank you for doing business in Florida, and congratulations on your new license! RICK SCOTT, GOVERNOR LICENSE rEC1;3001865 The -ELECTRICAL CONTRACTOR-----:.:��; =Named"beloww:IS CERTIFIED =- 'Under"theprovisions;ofChapter 489-FS. Expiration date. AUG:731-20'18 �: ;�. CERTII D:ELEEE .HA1V11L-TON, REXr_µ f &•R'ELEGTRIC)-COMP,A ;STATE..OF FLORIDA " . DEPARTMENTrOF BUSINESS AND ---PROFESSI01 AbUL'ATION .. .r EC 13001865 a ..;y ' SSUE 'D07/31 /2016 7 -t=.0 TRACTOR-,.M:`��.. Y.IN IS C€RTOEJED,.under-the=provisions of`Ch^488 FS. 7 Exp'rration.daie, A G 31 2018� L1607310004223 DETACH HERE KEN LAWSON, SECRETARY - _� STATE-ORFLORIDA- --4 ,' ` a a .-�. --� -DEPARTMENT OF_BUSINESS AND.P„ROFESSIONAL:REGULATION`,b --ELECTRICAL-CONTRACTORS LICENSINGBOARD - +, A f,.�.�;RAMILT.ON;_REX ; _ :& R-ELECTRIC"SUICOMTE 3�4PA;N. `f-1700.NW 1'S,AVE ''POMPANO BEACki` 030 t•" �'`/l/yam �yi"' ISSUED: 07/31/2016 DISPLAY AS REQUIRED BY LAW SEO # L1607310004223 — Florida's-WarmeW st elcome CITXOF POMPANO BEACH BUSINESS TAXRECEIPT: FISCAL YEAR: 2016-2017 Business iTax-ReceiptAralid!from•Petober 1 2016,thrnaughSepteiiiiiii430- 2017 .8/10/2016 4449366 R & R ELECTRIC CO INC 170041'W1 577AV ?rii-345 • '7 ' POMPANO BEACH FL 33069 I /N THIS IS YOUR BUSINESS TAX RECEIPT PLEASE POST IN Ap CONSPICObti&AT THE PLACEp BUSINESS LO6ATioN: BUS1NESSWNER R & RELECTRIC COMPANYINC BUSINESS LOCATION: 1700 NW 15 AV 345 POMPANO BEACH FL RECEIPT NO: i/77•1'. 1 "' 11 1. ;:';' ; • CLASSIFICATION 17-00081738 ; ' CONTRACTOktLECTRICALI(CMt), • ' = • I , Fr • 4 3 ; __ NOTICE: ANEW APPLICATON MUST BE FILED IF THE BUSINESS NAME, OWNERSHIP OR ADDRESS IS CHANGED. THE ISSUANCE OF A 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 JO THE COMPETENCE OF THE APPLICANT TO TRANSACT BUSINESS. THISbOaNENT CANNOT BEAfTEED: <4') ' ' / -: ''. fi''t ' .-- ' ' 1 , - I , . • , . , ! 1 ' ' BUSINESS TAX RECEIPTS EXPIRE SEPTEMBER 30'H OF EACH YEAR OP ID: HP TNSR LTR A A A Aco v' CERTIFICATE OF LIABILITY INSURANCE THIS IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND EXTEND OR ALTER RIGHTS THS UPON N THE AFFORDED BY HOLDER. POLICIES THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER INNOVATIVE INSURANCE CONSULTANTS, INC. 6461 UNIVERSITY CORAL SPRINGS, FL 33067 03 BRIAN J. MAMO INSURED R & R ELECTRIC COMPANY, INC. 1700 NW 15TH AVE SUITE 345 POMPANO BEACH, FL 33069 COVERAGES CERTIFICATE NUMBER: THIS IS TO ERIFY NDICATED.CNOTTWIT STANDINGOANY REQUIREMENT, TERM OR CONDITION OFBANY CONTRACT OR OTHEREPOLICYEEN ISSUED TO THE INSURD NAMED ABOVE FOR THE 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 REDUCEDMS. PCBY PAIFF D JMM/D CONTACT NAME: PHONE FAX (NC, No): IA/C. No, Ext): E-MAIL ADDRESS: PRODUCER R$(REL-1 CUSTOMER ID e, INSURERS) AFFORDING COVERAGE INSURER A : FCCI COMMERCIAL INSURANCE CO. INSURER B DATE (MNDD/YYYY) 10/24/2016 NAIC # 33472 INSURER C : INSURER O : INSURER E : INSURER F : TYPE OP INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X GENT AGGREGATEGALIMIT APPLIES PER: 7 POLICY 11L I JF C 1 PLI LOC AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS X NON -OWNED AUTOS X 5500 DED COMP UMBRELLA LIAB EXCESS LIAR DEDUCTIBLE RETENTION $ ADDL MGR X OCCUR CLAIMS -MADE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERR'IEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below SUBIC WVD NIA POUCY NUMBER GL0011387 6 CA0017700 6 UMB0015458 4 CP0009266 4 5% DED WIND & HAIL 02/01/2016 02/01 /2016 02/01/2016 02/01/2017 02/01/2016 REVISION NUMBER: 02/01/2017 0210112017 EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MEO EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 300,000 10,000 $ 1,000,000 $ 2,000,000 $ 2,000,000( $ $ 1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (PER ACCIDENT) $ $ 02/01/2017 A PROPERTY $1,000 DED AOP RCV DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) EACH OCCURRENCE AGGREGATE $ 1,000,000 $ 1,000,000 $ $ 1 TORY LIMITS I TU- I ER E.L. EACH ACCIDENT E.L DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT PERS PROP BUS INCOM $ 65,000 192,000 CERTIFICATE HOLDER MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVENUE MIAMI SHORES, FL 33132 ACORD 25 (2009/09) MIAMI-6 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACCORD CERTIFICATE OF LIABILITY INSURANCE `.---- DATE(MM/DD/YYYY) 10/24/2016 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 Libertate Insurance LLC 707 East Washington Street Orlando, FL 3281 WWW.libertateins.com CONT NAMEACT Libertate Insurance LLC PHONE FAX E-MAILc 1: 844-571-0810 (NC, No): 407-613-5477 ADDRESS: info@libertateins.com INSURER(S) AFFORDING COVERAGE NAIC it INSURER A: Technology Insurance Co 42376 INSURED The S2 HR Group, LLC dba Engage PEO 3001 Executive Drive, Suite 340 St. Petersburg FL 33762 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 32522805 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MDD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO PREMISES (EaENTED occurrence) $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below , / N N/A TWC3524477 12/31/2015 12/31/2016 �/ PER STATUTE OTH ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space is required) PEO Client: R & R Electric Company, Inc. #131026 Effective: 12/31/2015 Coverage is extended to the leased employees of alternate employer in all states except in monopolistic states. CERTIFICATE HOLDER CANCELLATION 131026 Miami Shores BuildingDept. P 10050 NE 2nd Ave Miami Shores FL 33138 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ��.,.4+ IP Paul R. Hughes ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 32522805 I ENGAPEO-01 I WC PEO Master I Amy MacDonald 110/24/2016 4:28:34 PM (EDT) I Page 1 of 1 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD LICENSE NUMBER The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 ARENCIBIA, GERSON _ 'f•Aer, POWER TECHNOLOGYaSERVICES LLC 515 SW .41-0,7 • " ,eA,01 4,61 ISSUED: 07/10/2016 DISPLAY AS REQUIRED BY LAW • SEQ # L1607100001844 ACCORD 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 POUCIES 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 poiicy(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). CERTIFICATE OF LIABILITY INSURANCE PRODUCER Mayor Insurance LLC 175 Fontainebleau Blvd. Suite 2-G8A Miami FL 33172 INSURED Power Technology Services LLC 9234 SW 8 Terrace Miami FL 33174 1 DATE (MMIDDIYYYY) 01/12/2018 NAME: Jorge Rumayor PHONE e Fac(l; 305313-4074 I FAX 305-513-4075 ADDRESS: _y roAmse,poin INSUREAFFORDING COVERAGE HMO RS) x INSURER A : Granada Insurance Company INSURER B : Berkshire Hathaway Guard INSURER C: INSURER 0 : INSURER E : INSURER F : COVERAGES CERTIFICATE 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 EE 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 ADM. St7BR POUCY EFF POUCY E ILTRO,R TYPE OF INSURANCE INSO WVD POLICY NUMBER IMMIDYYYYI (MMIDD/YYYYT LT X 1 COMMERCIAL GENERAL UABIUTY 1i CLAIMS -MADE lam OCCUR 1 1 GEL AGGREGATE LIMIT APPLIES PER: j POLICY r� 1 JECT 1 1 LOC i OTHER: AUTOMOBILE UABILtTY ANY AUTO ALL OWNED AUTOS HIRED AUTOS A TSOS ULED NON -OWNED AUTOS 0185FL00075641 10/12/17 10/12/18 REVISION NUMBER: LIMITS EACH OCCURRENCE S 1.000,000 rb'AWUrrOlk€NTED -Fi;W$ ,(E.� 4.n 0}._. s_,00 000 MED EXP (Any one person) $ LOW PERSONAL ADV INJURY s 1.000 000 GENERAL AGGREGATE S 2,000,000 PRODUCTS - COMP/OP AGG 1COMBINED SINGLE LIMi (Ee aaideltt} s 2.000,000 S S BODILY INJURY (Per person) BODILY INJURY (Per accident} $ PROPERTY DAMAGE (D4 &&inert/ S S B UMBRELLA UAB EXCESS UAB. IOCCUR CLAIMS -MADE DED l RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) it yes, describe under DESCRIPTION OF OPERATIONS below YIN I I N/A POWC829244 02/08/17 02/08/18 EACH OCCURRENCE AGGREGATE S X 3 STA PERTUTE ER OTH- E.L EACH ACCIDENT S 1,000,000. E L 04SEASE - EA EMPLOYE S 1, 000,000. EL DISEASE - POLICY UMIT S 1,000,000. DESCRIPTION OF OPERATIONS' LOCATIONS! VEHICLES (ACORO 104, Add UO4 ai Remarks Schedute. may Electrical Contractor attached it more space is required) CERTIFICATE HOLDER Miami Shores Village Building Department 10050 NE 2nd ave Miami Shores FL 33138 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNEREO IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Mayor Insurance LLC ACORD 25 (2014/01) 01988-2thORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 004653 Loca1; { ' ss Tax Receipt p Miami -Dade County, State of Florida -THIS IS NOT A BILL — DO NOT. PAY 7190599 BUSINESSNAME/LOCAT.ION' POWER TECHNOLOGY SERVICES LLC 515 SW 102 AVE -MIAMI FL 33174 RECEIPT NO. EXPIRES' RENEWAL : SEPTEMBER 30, 2018 7472124 OWNER SEC. TYPE OF BUSINESS POWER TECHNOLOGY SERVICES LLC 196 ELECTRICAL CONTRACTOR C/O GERSON ARENCIBIA EC13006726 Worker(s) 1 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 PAYMENT RECEIVED BY TAX COLLECTOR $75.00 08/16/2017 CREDITCARD--17-05449(3'' This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles.-Ataittt3,a For more information, visit www.miamidade.gov i'iijcfs r Oeofte' ec. a 27