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MC-18-466§ttORnS h �oRiDA Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO. MC-2-18-466 Permit Type: Mechanical - Residential Per '' t Work Classification: A/C Replacement Permit Status: APPROVED Issue Date: 2/28/2018 1 Expiration: 08/27/2018 rroject Nooress Parcel Number Applicant 1111 NE 91 Terrace 1132050010120 Miami Shores, FL 33138- Block: Lot: ANDREA & UWE KREUTER Owner Information Address Phone Cell ANDREA & UWE KREUTER 1111 NE 91 Terrace MIAMI SHORES FL 33138- 5161 COLLINS Avenue MIAMI BEACH FL 33139- Contractor(s) Phone Cell Phone AIR X MD INC (305)620-8883 (786)285-9856 Valuation: $ 7,300.00 Total Sq Feet: 0 _j ional Info: CHANGE OUT 3 TON PACKAGE A/C UNIT + ;ification: Residential >ved: In Review nents: Date Approved:: In Review Denied: Type of Work: CHANGE OUT 3 TON PACKAGE A/C ling: 3 Fees Due Amount CCF $4.80 DBPR Fee $3.83 DCA Fee $2.56 Education Surcharge $1.60 Permit Fee $255.50 Scanning Fee $9.00 Technology Fee $6.40 Total: $283.69 Pay Date Pay Type Amt Paid Amt Due Invoice # MC-2-18-66545 02/28/2018 Credit Card $ 233.69 $ 50.00 02/22/2018 Credit Card $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final 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, I authorize the above -named contractor to do the work stated. 28,201 Authorized Signature: Owner / Applicant / Contra or / Building Department Copy -� 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 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING FEB 2 2018 FBC 20 11 """ Master Permit No. 66 Sub Permit No. 9 G - 6' 3z b ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: //Ne9/ Folio/Parcel#: [ / " 32-0S •4)0!' ©l 2 Q Is the Building Historically Designated: Yes NO y— Occupancy Type: e r Load: Construction Type: Flood Zone: BFE: FFEE: ' [� OWNER: Name (Fee Simple Titleholder)�7��a ��/�✓� k2e-14 T � 4 Phoned3 o527(,6 - 3"'Z7 Add 10. city: M /AM" SALOAr-es- State: FLO 2-/6 A— Zip: Tenant/Lessee Name: Phone#:_ Email: CONTRACTOR: Company Name: J/� r( f /-- �� i D �%1 C Phone#: 7 d 6 2-d J [ 0 S b `7 Address: 2 / © /V ZA /J / �eoelzace— City: Qualifier Name: F—Z- Zip: 33e, e#: State Certification or Registration #:0i CZ&-3 4 M Certificate of Competency #: DESIGNER: Architect/Engineer: Address: City: e#: Zip: Value of Work for this Permit: $ r�e 4pff- Square/Linear Footage of Work: Type of Work: ❑ Addition / �f❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: C._ 14X NG L- d0a T _OA� I-4A,-i 7 -mil— /3 00E =?Pp 11AAl'-r 4 A-N D . Specify color of color thru tile: Submittal Fee $ 5o G) Permit Fee $ CCF $ ^Z CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ 3 Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State 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 b approved and a reinspection ill be charged. Signature Signature�J OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this VY_ day of ran , 20 Zd$9 , by _ day of ���� 20 (A , by who is personally known to who is personally known to me or who has produced �e4il Xeaii ? ,7�3200 me or who has produced/ /C: Ref 1- u (G �p d p n, identification and who did take an oath. identification and who did take an oath. V NOTARY PUB Sign: Print: Seal: ww**ss*ssss •s APPROVED BY (Revised02/24/2014) •., '- RAYMOND SILAS Notary Public State . - of Florida Commission 0 GG 181657 a`'asa• Bonded through National Notary Assn. NOTARY PUBLIC: Sign: Print: r < Seal: : i>" + RAYMOND SILAS Notary Public -State of Florida . j COmMIfS10M N GG 181657 Structural Review Zoning Clerk yHORES h der • rag R 1�A. Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 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): //// ,y -` -(/ /'i?/eoe_ ` �7 City: Miami Shores Village County: Miami Dade Zip Code: R3/ 3 1f 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 ❑ NOt4 ARHI Sheet Attached: YES ® NO ❑ Contract Attached: YES ER UNIT BEING REPLACED DATA NEW UNIT _ QQf MANUFACTURER e 100A AHU or PKG. UNIT MODEL # e COND. UNIT MODEL # CkAj KW HEAT NOM TONS �p AHU CU PKG 1) M.C.A AHU CU PKG AHU Cu PKG 2) M.O.P SAMP AHU CU PKG AHU Cu PKG 3)VOLTS AHU CU PKG PKG UNIT / / PKG UNIT 2 EER/SEER , SQL g Y NO REPLACING DUCTS YES VN O ES NO REPLACING THERMOSTAT YE NO' 31. NO NEW 4"CONCRETE SLAB Y N YE NO NEW ROOF STAND NO ES NO NEW RETURN PLENUM BOX YES NO t__1 Q `,� 1. Minimum Circuit Ampacity (Wire Size): p p� k1 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3 L6' A'm P 3. Voltage of Circuit (208/240/480): Ac O ' Q 30 VA C 4. Size Disconnecting Means: Contractor's Company Name: State Certificate or Registratjo Signature (Qualifier's signature) (Revised02/24/2014) M V ILO C Phon4.5oUJ62V-a'��3 40 3a' Certificate J of Competency N . c Date: o� O L® i 0, 10% This combination qualifies for a Federal Energy Efficiency tax Credit when placed in service between Feb 17,2009 and Dec 31, 2016. Certificate of Product Ratings AHRI Certified Reference Number: 7180047 Date : 02-20-2018 Model Status Active w Y � Old AHRI Reference Number K' -`� � !r AHRI Type : HSP-A £` 1 Series : Platinum ZM Outdoor Unit Brand Name : AMERICAN STANDARD Outdoor Unit Model Number (Condenser or Single Package) : 4WCZ6036B1 `tLJj ` rph h is i[ 2 4 Indoor Unit Brand Name Indoor Unit Model Number (Evaporator and/or Air Handler) Furnace Model Number : The manufacturer of this AMERICAN STANDARD product is responsible for the rating of this system combination. 000 • • • ••• Rated as follows in accordance with thelatest eillfion of ANSIlAHRI 2i6/2Wwitti Ai)dehda 1 end 2: Pe`rformance`f2atirig of n ry r-Conditi:n?hy & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing. • • • •• • • • • *00000 Cooling Capacity,(A2) - Single or High Stage (95F),,btuh 36000 �- • •-¢ �1 • : • • SEER16.00 •sue••• •• EER (A2) - Sirigle or High Stage,(95F) 12.20 - • • •s • • 1y• r r •.••�•• • Heating Capacity (H12)- Single or High Stage (47F) : 31000 k: `i,, + t ! !' '• • HSPF (Region IV) : 8.30 n 1._r V. 1- �E " • • • • • r... _...� - . • i 00 • •• �r'`7FJ BY D4 -E a D F_ ,T 10 PI.P1`,CE WI `H All FFI)E9A_ t"Active" Model Status are those that an AHRI Certification Program Participant is crur(egtly ppducing AND selling or,o_ eV,,9g, for;�sole;.9R new modbls that are being marketed but are not yet being produced: Production Stopped' Model"Status are those that an AHRI Certificationldr6gra Parts ant is nolonger p+oducing BUT is still selling or offering for sale. _ l DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on which the certificate was Issued, which is listed above, and the Certificate No., which is listed at bottom right. -- -- - ©2018Air-Conditioning, Heating, and Refrigeration Institute CPRTIFiCATE NO.: 131636297643889825 f '`` PRODUCT INFORMATION PAGE miami tech inc. ,oF, AS14S (Standard duty) STANCE RANGES FROM 20" TO 30" AS14H (Heavy duty) STANCE RANGES FROM 36" TO 42" AS 14CAB Aluminum cross mounting angle - when the condensing unit is too narrow to sit on the required stand, a set ASI4CAB's allow for unit installation. • Part No. Description •FraL Size: AS14S18 Aluminum stand leg assembly, 2014 FBC 20-30" spread, 18" tall • 18" AS14S24 Aluminum stand leg assembly, 2014 FBC 20-30" spread, 24" tall .•.24" • AS14S30 Aluminum stand leg assembly, 2014 FBC 20-30" spread, 30" tall • • • 30" • AS14H18 Aluminum stand leg assembly, 2014 FBC 36-42" spread, 18" tall* : • • 48" AS14H24 Aluminum stand leg assembly, 2014 FBC 36-42" spread, 24" tall• • • • 24" AS14H30 Aluminum stand leg assembly, 2014 FBC 36-42" spread, 30" tall• g0" • Part No. Description • • • tize AS141-3 Aluminum Stand I —Beam, 2014 FBC, 3' 3' AS141-6 Aluminum Stand I —Beam, 2014 FBC, 6' 6' AS141-9 Aluminum Stand I —Beam, 2014 FBC, 9' 9' AS141-12 Aluminum Stand I —Beam, 2014 FBC, 12' 12' AS141-15 Aluminum Stand I —Beam, 2014 FBC, 15' 15' AS141-18 Aluminum Stand I —Beam, 2014 FBC, 18' 18, Part No. Description Length ASI4CAB-30 3"0%1/8" In —Beam Cross Mount Angle for 30" spread 30" ASI4CAB-36 3"x3"x1/8" In —Beam Cross Mount Angle for 36" spread 36" ASI4CAB-42 3"x3"x1/8" In —Beam Cross Mount Angle for 42" spread 42" AS14S/AS14H ALUMINUM CONDENSING UNIT STAND PRODUCT INFORMATION SHEET miami tech inc. CG .'• 10/13/15 lMT TO SCALE AS14—INFO ,,� � m, IV— 1 Property Search Application - Miami -Dade County Page 1 of 1 O.F.FICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-3205-001-0120 Property Address: 1111 NE 91 TER Miami Shores, FL 33138-3403 Owner ANDREA KREUTER UWE KREUTER Mailing Address 5161 COLLINS AVE 1017 MIAMI BEACH, FL 33139 USA ....... ___.... ......._.....____- PA Primary Zone 1100 SGL FAMILY - 2301-2500 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY: 1 UNIT Beds / Baths / Half 3/3/0 Floors 1 Living Units 1 Actual Area 2,717 Sq.Ft Living Area 1,838 Sq.Ft Adjusted Area 2,309 Sq.Ft Lot Size 12,500 Sq.Ft Year Built 1959 Assessment Information Year 2017 2016 2015 Land Value $450,000 $419,000 $381,000 Building Value $160,706 $160,706 $160,706 XF Value $33,299 $33,668 $21,784 Market Value $644,005 $613,374 $563,490 Assessed Value $644,005 $613,374 $563,490 Benefits Information Benefit Type 2017 2016 2015 _ _.._..._...._.._..____ . __.... _... _...___...__.... _ _....._ __.._........... ....... Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description 5 53 42 WATERSEDGE PB 9-141 LOTS 14 & 15 BLK 1 LOT SIZE IRREGULAR OR 21148-4136 03 2003 1 Generated On : 2/22/2018 Taxable Value Information 2017 2016 2015 County Exemption Value $0 $0 $0 Taxable Value $644,005 $613,374 $563,490 School Board Exemption Value $0 $0 $0 Taxable Value $644,0051 $613,374 $563,490 City Exemption Value $0 $0 $0 Taxable Value $644,00 1 3,3741 $563,490 Regional Exemption Value $0 $0, $0 ....... _._._..__._... .._........ s......_ Taxable Value $644,005 _.._.__...._.___.__........_.....__......_........ $613,374 $563,490 Sales Information Previous Price OR Book - Qualification Description Sale Page 03/08/2016 $775,000 29999-2309 Qual by exam of deed Financial inst or "in Lieu of 01/27/2015 $584,300 29502-4936 Forclosure" stated Financial inst or "in Lieu of 10/23/2014 $550,100 29367-4804 Forclosure" stated 03/01/2006 $765,000 24378-4103 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 hftp://www.miamidade.gov/info/disclaimer.asp Version: http://www.miamidade.gov/propertysearch/ 2/22/2018 --STAT..E dF FLORIDA. `1 -' DRP,ARJTMEKIT OF BUSINESS AND--, rPROF,F-.SSIONAL,REGULAT,ION- J808038 I WED: 08 0_4f201 ItE).--U.QbND dONT9 - P„MLC AEL HOUNRREA�, SFt ;F a ad' ,�uiuis�� as s_ —�•. sosoao3ooae, A� "IF CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 04/21/2017 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 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 NAME: Maximo Dopazo CPIA PHONE (3O5) 470-8500 NO: (a 6fi)647-9673 Dopazo & Associates Inc 8725 NW 18th Terr Ste 300 E-MAIL ADDRESS: max@dopazo.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Associated Industries Ins Co Inc 23140 Miami FL 33172 INSURED INSURER B INSURER C : Air X MD Inc INSURERD: 2910 NW 157 Terrace INSURER E : INSURER F: Miami Gardens FL 33054 COVERAGES CERTIFICATE NUMBER:CL1742116756 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 SUER POLICY NUMBER MMIDDY EFF POLICY EXP MM/DD LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR 1$ EACH OCCURRENCE $ DAMAGES Ea TO RENTED PREMISEoccurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: JECT POLICY ❑ PRO ❑ LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS 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 I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? —1 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A AWC1062325 04/21/2017 04/21/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 I E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) HVAC contractor. CERTIFICATE HOLDER CANCELLATION (305)756-8972 Miami Shores Village 10050 NE 2 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 exander Dopazo/AD © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) INS025 (201401) The ACORD name and logo are registered marks of ACORD AC4RD® CERTIFICATE OF LIABILITY INSURANCE MID DATE DmYY) 2/22/2018 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 endorsements . PRODUCER CONTANAME: CT Edward S Collins Construction Pros Insurance LLC PHONE 800-685-0027 F4X 813-659-5480 PO BOX 186 E-MAIL . office@constructionprosins.com San Antonio FL 33576 INSURERS AFFORDING COVERAGE NA_IC_# INSURERA:Wesco Insurance Company 25011 INSURED AIRXMDI-01 INSURER B : Air X MD Inc INSURER C : 2910 NW 157 Terrace Miami Gardens FL 33054 INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMRFR- 1219836799 RFVISION Nt1MRFR- 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 INSD WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y WPP1432758-02 1/12/2018 1/12/2019 EACH OCCURRENCE $1,000,000 CLAIMS -MADE lxl OCCUR DAMAGE PREMISES TO Ea occuRENTED rrence $100,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 GEN'L X POLICY DPRO JECT ❑ LOC PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: AUTOMOBILE LIABILITY Ea aBINEDt SINGLEL $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident _ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE EXCESS LIAB CLAIMS -MADE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. DISEASE - EA EMPLOYE -- $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) Michael H Dunlap - Florida Certified Air Conditioning Contractor per License CAC1818038. Please review named insured's policies referenced in this document for complete list of all applicable coverages, limits, endorsements, exclusions, deductibles, and their respective terms and conditions. MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVENUE MIAMI SHORES FL 33138 I IUN 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ..- — - - --------------- ...... .............. . „asT Local Business Tax Rece t Miami -I Ad6C-6uMW,.State.ef-F1o'ri.d — 7HISfSN&ABJLL NOT PAY . BUSir¢Lad>i'jtg7tll/iff _-girl ` ""�• i C JffTi.va. - . - AIR X.MD ]IBC REN lIItAL 2910 NW 157 TER 7$$0B39 �'SEPTE MIAMI GARDENS A 33054 =Must be disAiayed.at pipea of business Pursuant to GoU6IV Code. . Chaptar m - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS AIR UY INC 196 SPEC MEM- AgICAL CONTRACTOR PAYMENT -RECEIVED C/O MIL1-iAEL "bUNLAP SR PRES CAC181B0 a,.,- • SYTAXCOLLECTOR K ores Thia Locsl Nosiness TeK RsceiplonlyeDnl�rmspayment of_Ihe local BusitiessTax. The Rscelpf Isnata Ilcerue, pertri]! uis certFfication:ofthe Goidsr's�ualillcationa to do•6usiness. }ialdermusl compFYtivilh anygovarnsrrantal m noagovemmerltal iepuletory lawaeri 7aquireroenlsxrCtFcp spplyta Ihshu�osas, The RECE07f10,ahove must he displayed an sitrsmemsre9al vehieies'_jAjami-DrldkCade seaas-27& Fnrmoreenfstmetion visilvnmty.mlaroldedaQyy�x6oliampr -