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DEMO-17-1893 (3)Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address 1250 NE 91 Terrace Miami Shores, FL Owner Information Address Permit Parcel Number Permit tVO. DEMO-7-17-1893 Permit Type: Demolition Work Classification: Building Permit Status:. APPROVED Issue Date: 811612017 Phone Expiration: 02/12/2018 Applicant Cell GREG BAUMANN 1250 NE 91 MIAMI SHORES FL 33138- (305)467-8655 Contractor(s) Phone NEWMAN BROTHERS CONSTRUCTIC (305)933-2583 Cell Phone Valuation: Total Sq Fee Type of Demo: Building Additional Info: Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $3.60 $4.50 $4.50 $1.20 $300.00 $9.00 $4.80 $327.60 Pay Date Invoice # 08/16/2017 07/25/2017 Pay Type Amt Paid Amt Due QEMO-7-17-64673 Check #: 1516 $ 277.60 $ 50.00 Check #: 1496 $ 50.00 $ 0.00 $ 6,000.00 Available Inspect' Inspection Type: Final Review Electrical Review Plumbing Review Building Review Mechanical 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 e the above -named comer tcastert6—do`the work stated. August 16, 2017 Authorized Signature: Owt1 rl' Applicant / Contractor / Agent Date Building Department Copy August 16, 2017 1 Pa/I./lent & m, um p'rioiri4d Priority Permit Expeditors Leonardo Zelaya 2095 NE I 55th Street N. Miami Beach, FL 33162 Office: Cell: Efax: 786-320-6070 786-355-9937 305-503-7565 Email: leo@prioritypermit.com www.prioritypermitexpeditors.com BUILDING PERMIT APPLICATION OBUILDING ELECTRIC 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 FBC 2o1y Master Permit No Sub Permit No. ❑ ROOFING El REVISION El EXTENSION RENEWAL PLUMBING MECHANICAL PUBLIC WORKS JOB ADDRESS: 1250 N.E. 91 st Terrace City: Miami Shores Folto/Parcel#:11-3205-001-0550 Occupancy Type: ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR D INGS County: Miami Dade Is the Building Historically Designated: Yes NO Zip: 3�13s�CE[(fD Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Greg and Jennifer Baumann Address: 1800 N. Bayshore DR, Apt # 1005 city: Miami State: Florida Tenant/Lessee Name: Email: GEBaumann@gmail.com Phone#: 305-467-8655 Zip: 33132 Phone#: CONTRACTOR: Company Name: Newman Brothers Construction & Development, Inc Phone#: 305-933=2583 Address: 2079 N.E. 155 ST LEjj`i.1,4 i City: State: . North Miami Beach Florida zip: 33162 Qualifier Name: Joey Newman State Certification or Registration #: CGC1517330 DESIGNER: Architect/Engineer: Address: Phone#: Certificate of Competency #: Phone#: State: Zip: City: Value of Work for this Permit: $ 6,000.00 Type of Work: ❑ Addition ❑ Alteration Description of Work: Demo plaster ceiling and flooring, concrete porch and stairs. Square/Linear Footage of Work: 2,500 sq. ft ❑ New ❑ Repair/Replace 0 Demolition walls, plumbing fixtures, ductwork, insulation, casework, Specify color of color thru tile: r�-y1�� Submittal Fee $ Permit Fee $ 3 DZ • G7 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR :$ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ Z74\ ` 60 (Revlsed02/24/2014) Leo 2c I4/A ceTh 3(7"5 ”2- ‘77‘ LOr ; rrOrii-I ferfo%7L-,CP/)1 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) -CI) SE),:x1n4. Mortgage Lender's Address `lObS $\ ,,.e g\mod City -\ 5 v t-c. State Zip 33C3% 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 Signature The foregoing instrument was acknowledged before me this The fore oing instrumentmeJwas acknowledged before me this 1 Tfoday of S1 , 20 17- , by 2 / `S day of o y , 20 /9— , by /,t!Q QQ r 6radd itgianh , who is personally known tq c./61-1 N1G0t nan , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: APPROVED BY ichael Feltner Commission g GG044827 Expires: Nov. 3, 2020 i>F Bonded thru Aaron Notary j or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: Plans Examiner nateea y Oa -no cm `W`YlFf�, ••••• ,� Zany Jomolca y Commission # GG078728 �� Expires: March 2, 2021 * 1*Aa&AR otaiy* * *************** Zoning (Revised02/24/2014) Structural Review Clerk 7/21 /2017. - a. Miami -Dade Official Records - Print Document THIS INSTRUMENT PREPARED BY: Joseph S. Paglino, Esq. 2131 Hollywood Boulevard, Suite 307 Hollywood, Florida 33020 Folio No.: 11-3205-001-0550 11111111111111111111111311111111111111111111 CFH 2017R0222046 OR BK 30502 P9s 3594-3595 (2P9s) RECORDED 04/20/2017 11:15:47 DEED DOC TAX 31►845.00 HARVEY RUVIN, CLERK OF COURT MIAMI-DADE COUNTY, FLORIDA WARRANTY DEED (Statutory Form --Section 689.02, F.S.) THIS INDENTURE; made the /eh day of April, 2017, by Jacqueline Orcel, a single woman, and Schella Orcel, a single woman, whose address is 789 Saint Nicholas Avenue, Unit 2, New York, New York 10031, as Grantor, to Greg Baumann and Jennifer Baumann, husband and wife, whose address is 1250 N.E. 91' Terrace, Miami Shores, Florida 33138, as Grantees. Witnesseth, that said Grantor, for and in consideration of the sum of TEN & 00/100 DOLLARS ($10.00), and other good and valuable consideration to said Grantor in hand paid by said Grantees, the receipt whereof is hereby acknowledged, has granted, bargained and sold to said Grantees, and Grantees' heirs and assigns forever, the following described property in Miami - Dade County, Florida, to -wit: The Easterly 5 feet of Lot 30 and all of Lot 31 and Lot 32, less the Easterly 20 feet thereof, Block 2, Watersedge, according to the plat thereof as recorded in Plat Book 9, Page 141, Public Records of Miami -Dade County, Florida. a/k/a 1250 N.E. 91' Terrace, Miami Shores, Florida 33138. SUBJECT TO: (1) Restrictions, reservations, conditions and easements of record, if any, without intent to reimpose the same; (2) Zoning restrictions imposed by governmental authority; and (3) Real property taxes for the year 2017. TOGETHER with all tenements, hereditament and appurtenances thereto belonging or in any way appertaining. TO HAVE AND TO HOLD the same in fee simple forever. AND the Grantor hereby covenants with the said Grantees that the Grantor is lawfully seized of said land in fee simple; that the Grantor has good right and lawful authority to sell and convey said land, and hereby fully warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all encumbrances, except taxes accruing subsequent to December 31, 2016. rehittikTITLERAPID SERVICES CO. 1175 N.E. 125 FI.33161ST, 2 North Miami, Sc\-1` - P uuMar\n Book30502/Page3594 CFN#20170222046 Page 1 of 2 https://www2.miami-dadeclerk.com/OfficialRecords/PrintDocument.aspx?QS=YaoUfOzxry289YhXtmchAlYe7RN72UkVu5KVytuvW6VJ WE91 N 1 eYRXH... 1 /2 7/21 /2017, a -r Miami -Dade Official Records - Print Document OR BK 30502 PG 3595 LAST PAGE -2- IN WITNESS WHEREOF, Grantor has hereunto set Grantor's hand and seal the day and year first above written. Signed, sealed and delivered in the presence of: ac' Feline Orcel, Grantor Schella C. cel, Grantor STATE OF FLORIDA ) ) ss: COUNTY OF MIAMI-DADE ) The foregoing instrument was acknowledged before me this /011^ day of April, 2017, by Jacqueline Orcel and Schella Orcel, who [ ] are or [ Vare not personally known t me o(,oR_L who have provided identification in the form of ��t1 t Q.n /CQi WSe -1'v (driver's license, passport etc.), and who [ ] for [ did not take anoath. cosy My Commission Expires: ff ni P. KERRY DIIS MY COMMISSION N FF 016827 -i lirvl •. _ Fh EXPIRES: June 2017 Bonded Thfu Notary Public C UndEWTh rs Book30502/Page3595 CFN#20170222046 Page 2 of 2 https://www2.miami-dadeclerk.com/OfficialRecords/PrintDocument.aspx?QS=YaoUfOzxry289YhXtmchAlYe7RN72UkVu5KVytuvW6VJWE91 N1 eYRXH... 2/2 7/21/2017 Property Search Application - Miami -Dade County OFFICE OF THE PRTY APPRAI Summary Report Property Information Folio: 11-3205-001-0550 Property Address: 1250 NE 91 TER Miami Shores, FL 33138-3406 Owner GREG BAUMANN JENNIFER BAUMANN Mailing Address 1250 NE 91 TER MIAMI SHORES, FL 33138 USA PA Primary Zone 1100 SGL FAMILY - 2301-2500 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY : 1 UNIT Beds / Baths / Half 4/3/0 Floors 1 Living Units 1 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 2,592 Sq.Ft Lot Size 10,625 Sq.Ft Year Built 1950 Assessment Information Year 2017 2016 2015 Land Value $382,500 $356,150 $323,850 Building Value $162,363 $162,363 $162,363 XF Value $18,653 $18,809 $14,414 Market Value $563,516 $537,322 $500,627 Assessed Value $188,944 $185,058 $183,772 Benefits Information Benefit Type 2017 2016 2015 Save Our Homes Cap Assessment Reduction $374,572 $352,264 $316,855 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Senior Homestead Exemption $50,000 $50,000 $50,000 Widow Exemption $500 $500 $500 Note: Not all benefits are applicable to all Taxable Values (i.e. Coun y, School Board, City, Regional). Short Legal Description WATERSEDGE PB 9-141 ELY5FT LOT 30 & ALL LOTS 31 & 32 LESS ELY2OFT BLK 2 LOT SIZE IRREGULAR OR 17056-1499 1095 5 Generated On : 7/21/2017 Taxable Value Information 2017 2016 2015 County Exemption Value $100,500 $100,500 $100,500 Taxable Value $88,444 $84,558 $83,272 School Board Exemption Value $25,500 $25,500 $25,500 Taxable Value $163,444 $159,558 $158,272 City Exemption Value $50,500 $50,500 $50,500 Taxable Value $138,444 $134,558 $133,272 Regional Exemption Value $50,500 $50,500 $50,500 Taxable Value $138,444 $134,558 $133,272 Sales Information Previous Sale Price OR Book- Page Qualification Description 04/10/2017 $307,500 30502- 3594 Partial interest 04/06/2017 $307,500 30502- 3592 Partial interest 10/01/1995 $0 17056- 1499 Sales which are disqualified as a result of examination of the deed 12/01/1988 $137,000 13925 2930 Sales which are qualified 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: NEWMBRO-01 VJOHNSON ACORO" CERTIFICATE OF LIABILITY INSURANCE �� DATE 07/21/2017Y) 07/21 /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(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 CKP Insurance LLC 21845 Powerline Road Suite 205 Boca Raton, FL 33433 CONTACT NAME: (A/C,"N , Est): (561) 807-0900 FAX No):(561) 826-3782 n DRESS: Public@ckpinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: National Builders Insurance Company 16632 INSURED Newman Brothers Construction & Development, Inc. 2079 NE 155th St North Miami Beach, FL 33162 INSURER B : Progressive Express Insurance Company 10193 INSURER C :American Builders Insurance Company 11240 INSURER D : INSURER E : INSURER F : REVISION NUMBER: ------------------ THIS IS 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 WTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES 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 IMM/DDIYYYYI POLICY EXP IMM/DDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY X GLP-0202878-01 09/15/2016 09/15/2017 EACH OCCURRENCE $ 2,000,000 PAMAGES(RENTED PREMISES (Ea occurrence) $ 300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY ( OTHER: X LIMIT APPLIES jECT PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE _ LIABILITY ANY AUTO WNED v — SCHEDULED AUTOS ONLY 03911461-0 09/15/2016 09/15/2017 COMBIND Ea accidentSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILYOINJURY (Per accident) $ PROPERTY accident) 'DAMAGE $ $ C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE UMB-0205809-01 09/15/2016 09/15/2017 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 Per & Adver Agg $ 1,000,000 DED X RETENTION $ 10,000 C AND EMPLOYERS COMPENSATION ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y /" - N I A x WCV-0202866-01 09/15/2016 09/15/2017 X STATUTE R ERH 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 OPERATIC O� NS_/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required General Liability - Blanket Additional Insured On Going Operation On A Primary And Non -Contributory Basis and Waiver of Subrogation As Required By Written Contract Per Form (BIG GLECEF 04 13) Attached General Liability - Blanket Additional Insured Completed Operation As Required By Written Contract Per Form (CG 20 37) Attached Workers Compensation - Blanket Waiver of Subrogation As Required by Written Contract Per Form (WC 00 03 13) Attached L c 4 1 a c2 c7r r-Pz.�Z efL 1 y PI. - CERTIFICATE HOLDER CANCELLATION Miami Shores Village - Building Department 10050 NE 2nd Avenue Miami Shores, FL 33138 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 64,4._ /4,J-a ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD �a. Nanied'.below IS CERTIFIED; : : .Underthe provisions of4Chapter 489.FS: Expiration' date:;'AUG 3172018 .NEWMAN;:JOEY'BARRETTx«�',r!`„ ''`." /NEWMAN-BROTHERS CONSTRUCTION &DEVELOPMENT.: 2079. NE,155TH.;ST; w ,�..,_,, NORTH- MIAMIBEACH +,^FL'33162,.., ISSUED: 07/24/2016 STATE OF FLORIDA 1 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 NEWMAN, JOEY BARRETT NEWMAN BROTHERS CONSTRUCTION & DEVELOPMENT INC 2079 NE 155TH ST NORTH MIAMI BEACH FL 33162 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 learn 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 e STATE OF FLORIDA DEPARTMENT'OF, BUSINESS AND 'rPROFESSIONAL`REGULATION ," ~✓ CGC1517330� r(�� ISSUED:+.07/24/2016 /L` c CERTIFIED GENERAL CONTRACTOR . NEWMAN, JOEY,B'AfRRRETT�.4t„TV f NEWMAN BROTHERS^ 0" STRUUCT,ION & DEV ISICERTIFIED under the"provisions" ofCh'.489,FS.-. Expiration dite; AUG'31, 2018...- ---- .^L1607240002094 DETACH HERE STATE OF .FLORIDA • 5 . `DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ••.. ;_,CONSTRUCTION ;INDUSTRY LICENSING BOARD- - '• KEN LAWSON, SECRETARY LICENSE NUMBER "._, .._ • 71'.:4' ,'CGC1517330;" `" DISPLAY AS REQUIRED BY LAW SEQ # L1607240002094 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION 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: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: -Newman (7mf±ricMon BUSINESS ADDRESS: 203-q NE /55 St- CITY N •N1 • 5 STATE zIP331 1402 BUSINESS PHONE: (305 ) 33` -5 3 FAX NUMBER ( ) CELL PHONE (VD ) `g —9-I (A -QUALIFIER'S NAME: O' I JLL,t) MO lfl QUALIFIER'S LIC NUMBER: Cb C 15 (� J D NEWMBRO-01 VJOHNSON .=+41.—vrc1—. CERTIFICATE OF LIABILITY INSURANCE �'I DATE(MM/DD/YYYY) 07/28/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. 'THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POLICIES AUTHORIZED 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 CKP Insurance LLC 21845 Powerline Road Suite 205 Boca Raton, FL 33433 CONTACT NAME: PHONE AX (A/c, No, Ext): (561) 807-0900 1 (FA/c, No):(561) 826-3782 E-MAIL Public@ckpinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: National Builders Insurance Company 16632 INSURED Newman Brothers Construction & Development, Inc. 2079 NE 155th St North Miami Beach, FL 33162 INSURER B : Progressive Express Insurance Company 10193 INSURER C:American Builders Insurance Company 11240 INSURER D : INSURER E : INSURER F : • THIS INDICATED. CERTIFICATE EXCLUSIONS --'"" "'^"-'•"^"'�^ KtVISIUN NUMBER: IS TO CERTIFY TI-IAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 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 IMM/DD/YYYYI POLICY EXP (MMIDD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY OCCUR X GLP-0202878-01 09/15/2016 09/15/2017 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X DAMAGE TO RENTED PREMISES (Ea occurrence) 300,000 $ MED EXP (Any one person) $ 10,000 PERSONAL 8, ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES POLICY X PRO- OTHER: PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIREDTONLY X SCHEDULED AUTOS AUUTOS ONLYY 03911461-0 09/15/2016 09/15/2017 EOMaBI den SINGLE LIMITa t) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C X UMBRELLA LIAB EXCESS LIAB 1 X OCCUR CLAIMS -MADE UMB-0205809-01 09/15/2016 09/15/2017 EACH OCCURRENCE $ 1,000,000 f AGGREGATE $ 1,000,000 DED X RETENIION $ 10,000 Per & Adver Agg $ 1,000,000 C WORKERS.COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under Y/ N N / A X H/CiV-0202866-01 09/15/2016 09/15/2017 y PER _ X STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 below 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 If more space is required General Liability - Blanket Additional Insured On Going Operation On A Primary And Non -Contributory Basis and Waiver of Subrogation As Required By Written Contract Per Forrn (BIG GLECEF 04 13) Attached General Liability - Blanket Additional Insured Completed Operation As Required By Written Contract Per Form (CG 20 37) Attached Workers Compensation - Blanket Waiver of Subrogation As Required by Written Contract Per Form (WC 00 03 13) Attached GC License: CGC1517330 t Miami Shores Village - Building Department 10050 NE 2nd Avenue Miami Shores, FL 33138 ACORD 25 (2016/03) CANCELLATION 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 /44.-1-01 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD