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PL-14-1316 (2)Inspection Worksheet Miami Shores Village 10060 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-230535 Scheduled Inspection Date: March 31, 2015 Inspector: Diaz, Osvaldo Owner: LUND, KENNETH AND ALEXANDRA Job Address'. 1001 NE 96 Street Miami Shores, FL 33138- Project: <NONE> Permit Number: PL-6-14-1316 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition/Alteration Phone Number (714)721-2270 Parcel Number 1132060143740 Contractor: SKY SERVICE PLUMBING Phone: (954)655-1127 tsumunn Department comments REPLACE EXISTING PLUMBING IN KITCHEN, LAUNDRY ROOM 2 BATHROOM 03-11-15 Construction project is active. see inspections related under 14-744 INSPECTOR COMMENTS False Inspector Comments Passed ❑ CREATED AS REINSPECTION FOR INSP-214549. SECURE SHOWER HEAD CAP BAR OUTSIDE HAMMER ARRESTOR NEEDED Failed Correction Needed �/ 5 Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. March 30, 2015 For Inspections please call: (305)762-4949 Page 7 of 27 If Miami Shores Village M Fig BUILDING PERMIT APPLICATION Building Department JUN19 014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 7— INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 201 Master Permit No.v C I (A — k� Sub Permit No. (, I '"i — 1 Y0 ❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL ]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP J CONTRACTOR DRAWINGS JOB ADDRESS: /* r � o " City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Address: 1 �d / _ _ �� �O ��` City: C!l��1•i Tenant/Lessee Name: Email -PS State:( Zip: 32 /IL'i— Phone#: W %2 �r�ic �i �d ✓� C' r CONTRACTOR: Company Name: Address: Ag- l / City: ���/iG ✓� P� / ( Zip: 330 G Qualifier Name: �, / Phone#: State Certification or Registration M. CFc- / Ala- I all _Certificate of Competency #: DESIGNER: Architect/Engineer:: A�u l%-e_ 17� Ile- «d`'U Phone#: Address: �� I �/ i 1 / 3 �� City: Af,,44, State: Zip: Value of Work for this Permit: $ Ntt,() 0 0 - Jo Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑/ New Repair/Replace / /❑ Demolition Description of Work: �PII r/ CP � rl��a h�A.0 i�- ! 'iA 6ieC f, :- �i7cF /�`� ", ram^^ ve- e e Specify color color thru tile: Submittal Fee Permit Fee $ Z ZS• r CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ s TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) r Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 fter the building permit is issued. In the absence of such posted notice, the inspection will not be approt�ed and a rinspectigtyf# will be charged. Signatu OWNER or AGENT The foregoing instrument was acknowledged before me this 1, 2— day of 7S�- 20 19 by U-� , who i e nay n n to me or who has produced as Signature CONTRACTOR The foregoing instrument was acknowledged before me this day of /,��- 20 �� by -i-;?* A(0"O - who is personally known to me or who has produced 1x���� as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: ii�J \\\\Illlttlll///� `\\\\\\\11111111111/ ,/ ii Sign: 62� Xpi`•.�%� l Sign: z o Print: 1 = C� f'�9Y, � - Print: Seal: ;c `'F``��s'o /i. Seal: APPROVED BY 3y-f1* Plans Examiner Zoning Structural Review (Revised02/24/2014) Clerk It Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED. 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* IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT B. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. C. COPY OF LIABILITY INSURACE* D. COPY OF WORKERS COMPENSATION INSURANCE* *YOUR INS RAU CE COMPANY'MUST'ISSUE A CERTIFICATE-AS•FOLL'OW::D 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: BUSINESS ADDRESS: 10 ` �5�' CITY STATE( ZIP CODE D BUSINESS PHONE: ( ) FAX NUMBER ( ) CELL PHONE (�) �3� 7S?� QUALIFIER'S NAME: QUALIFIER'S LIC NUMBER: CFc-t (l 7 Fax: (305)756-8972 ACOIRbr CERTIFICATE OF LIABILITY INSURANCE °"'E`N�°°""""`' 06/12/2014 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 13Y THE POLCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT. If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies fray require an endorsement. A Statement on this certificate does not confer rights to the certificate holder in lieu of such endorsernent(s). PRODUCER Rivard Insurance Agency, Inc. 1014 Gateway Blvd Suite107 Boynton Beach, FL 33426 License #: A221221 CONCT NAME Teresa Hernandez PHONE (561)739-8348 Faz No (561)739-836D EMAIL o s- thernande rivardinsurance.net INSURERS AFFORDING COVERAGE NAIC:M WSURERA: R ai]Flrst Insurance Company INSURED SKY SERVICE PLUMBING INC 1410 NE 41 COURT POMPANO BEACH, FL 33064 INSURER B INSURERC: INSURER D: INSURER E: INSURER F : 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. ABC R TYPE OF tNSURANCE LT SL POLICY NUMBER POLICY EFF POIC LY EXP MMID X. LIMMS. — GENERAL LIABILITY EACH OCCURRENCE _ . S __- DAI:AAGE'TO REN'Y� COMMERCIALGF_NERAL LIAMUTY 5 - MED DIP (Any are person) $ CIAIMSMADc u OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATES GEN'LAGGREGATELIMIT APP_U_ESPER: PRODUCTS _COMPOPAGG 5 POLICY PRDr I LOC COMBINED SINGLE UMIT' S AUTOMOBILE LIABILITY Es accident BODI LY INJURY (Per person) S i AW AUTO BODILY INJURY (Per accident) S A. i CWNED SCHEDULED AUTOS NUN CVMED PROPERTY DAMAGE Peracdde rM $ HIREDAUTOS AUTOS UMBRELLAUA13 OCCUR EACH OCCURRENCE S —J EXCESS LIAR C:AIMS-MADE S DED RETENTION A WORKERS COMPENSATION 0520-47658 05/D6/2014 051D612015 WVC X oR STATU- O R E.L. EACH ACCIDENT S OO,ODO AND EMPLOYERS' UABILITY ANY PROPRIETORIPARTNEWEXECLTIVE YIN E.L. DISEASE - EA EMPLOYEE : 100,000 OFFICERRAEMBER EXCLUDED? NIA (Mandatory in NHI E.L. DISEASE- POLICY LIMIT $ 500,000 If yes, desaibe'xrder DESCRIPTION OF OPERAT,ONS below DESCRIPTION OF OPERATONSI LOCATIONS I VEHICLES (Attach ACORD 1e1. Additional Rsrna*s Sehedule. H ntere space Is required) OWNER: JOHN BREIGHNER PLUMBING LICENSE #- CFC1427263 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES BUILDING DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BEOF-LIVERED IN MIAMI SHORES VILLAGE ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 AVENUE AUTHOR2ED RE IVE MIAMI SHORES, FL 33136 �� TRFI i p 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Printed by TRH on June 12, 2014 at 04:46PM 9'd L9Z9-99L-t,96 6uigwnid eoi/ues Als 1 1 ' C A CERTIFICATE OF LIABILITY INSURANCE °"TE(a'M _ I 06112114 YY' f14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. if SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on ttl is cedtficate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Atlantica Insurance Agency 605 North State Rd 7 Margate, FL 33063 Phone (954)582-5800 Fax INSURED Sky Service Plumbing Inc C 1410 NE 41 Ct I _ INSURERiS)AFFORDINGCOVER_AGE_ _ NAIC# 1971-7307 hNSURERA: Scottsdale Insurance Company — j i POmpano Beach, FL 33054- (954) 235-7878 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. INSR! 'ADDLSUBRI I POLICYEFF P(x.ICYEXP LTRTYPE OF INSR VND� POLICY NUMBER LMMIDDIYYYY) WPMfDO )' LIMITS GENERAL LIABILITY EACH OCCURRENCE s 500,000.00 1 ! © COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100,000,00 PREMI§ES- Ea p(Zxunenca; _ $ ~S A G ❑ CLAIMS -MADE Q OCCUR I N CPS175154? i 03/25/2013 N 03/25/2014 HIED EXP An one arson 5,000.00 PERSONAL & ADV INJURY S 500,000.00 C I I GENERAL AGGREGATE S 1.000,00C.00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS • COMP/OP AGG $ 500,DOO.00 C POLICY ❑ jROT ❑ LOC -.._� '-- - --- ---._-- ! _ b-.- -------- � AUTOMOBILE LIABILITY OMngS�a D111NCsLE LIMIT S _— li (Es u ANY AUTO ! BODILY INJURY (Per person) If ❑oe ALL OWNED SCHEDULED i I ❑ AUTOS BODILY INJURY (Per aident' E I AUTOS NON OWNED ❑ HIRED AUTOS ❑ AUTOS I PROPERTY DAMAGE -(_P_accident) S l s ❑ UMBRELLA DAB ❑OCCUR i _EACF.00CURRENCE S I I ❑ EXCESS UAB ❑CLAIMS -MADE i 1 AGGREGATE_..-- i ❑ DED ❑ RETENTIONS $ �t WORKERS COMPENSATION I ! I V�'C STATU- OTH- . R AND EMPLOYERS' LIABILITY Y f N ANY PROPRETOR/PARTNERIEXECUTIVE E.L- EACH ACCIDENT S — OFFICERIMEMBEREXCLUDED? I—SINIA (Mande Tory In NH) E.L. CIS EASE - EA EMPLOYE S _ �9 yes, deserba under DESCRIPTION OFOPERATIONS be:ow ! ! I - EA- DISEASE-POLLCYL!M1-! S DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES (Attach ACORD 101, Additional Rornarks Schedule, If more space Is required) John Breighner licensed plumbing License No.: CFC1427263 CERTIFICATE HOLDER Miami Shores Building Department Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 ACORD 25 (2010105) OF 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 Denise Rivera ©1988-Z010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD L'd L8Z8-88L-t,56 6uigwnld eoiAJes kis s r- 00 cli C? co co rl, 't A(71%# 6363810 DzppaTx3N- co E a) co STATE , OF FLORIDA LONAL REGULATION JSINESS ;XD PROFESSING BOARD SEQ#L12091302121 3:01; $TRY r,ZN LAWSON sv,CRETARY Q r` CO N 00 00 OD r- v LD rn c Z) CL m U ro U) 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 954-831-4000 VALID OCTOBER 1, 2013 THROUGH SEPTEMBER 30, 2014 Receipt #:PLUMBING�JLWNT SPRXKL/COI` Business Nameme: D: sue, SERVICE PLtJI�BING INC Business Type: (py ut4BING CONTRACTOR) � Business Opened:oI/29/2007 Owner Name: BREIGHNER J011N D JR Business Location: 1.410POMPNo BEACH State/ mption Code: CFC 1427263 ` Business Phone: 954-492-9832 Seats Employees Machines Professionals II Rooms 1 For Vonuing euarness vmy Number of Machines: Vending Type: Penalty Pr"lor Years Collection Cost Total Paid Tax Amount Transfer Fee NSF Fee y 0.00 29.70 27.00 0.00 . 0.00 2.70 0.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for You must mof eett all County and/ong business within r Municipality ty and i� planning non regulatory in WHEN VALIDATED 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 I it is in compliance with State or local laws and regulations. i Mailing Address: BREIGHNER JOHN D JR 1410 NE 41 CT POMPANO BEACH, FL 33064 Receipt #03B-13-00000188 Paid 10/09/2013 29.70 2013 - 2014 _ i6 CERTIFICATE OF LIABILITY INSURANCE DATE IYYYY) 061191/19/14 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 HELOW. 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 certiflcate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGAtxCF IS WAIVED, subject to the tenns and conditions of the policy, certain policies may regWrs an endorsement. A statement on this certificate does not confer rights to the certificate holder In Ileu of such endorsement(s). PRODUCER cATACT Atlantica Insurance Agency INC- No Ertl- PHONE 954)582-5800 FAX Not:.---(954)971.7307 805 North State Rd 7 E-MAIL Margate, FL33063 INSURER AFFORDING COVERAGE NAIC0 j Phone (954)582-5800 Fax (954)971-7307 INSURER A : Scottsdale Insurance Company rINSURED ,u 11— e . Sky Service Plumbing Inc 1410 NE 41 Ct Pompano Beach, FL 33064- COVFRAIMFS (954)235.7678 CERTIFICATE NUMBER: D_ 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 MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRI8ED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPEOFINSURANCE IADD BR I POLICY EFF POLICY NUMBER ': MO POLICY ExP MJDDIYYYY LIMIT9 GENERAL LIABILITY COMMERCIAL GENERAL LIABILfrY A El ❑ CLAIVIS-MADE �V:] OCCUR GEN'LAGGREGATELW.ITAPPLESPER ❑ POLICY ❑ PRO ❑ LOC 1 N N CPS1941657 02/10/2014 EACH OCCURRENCE DAMAGE TO RENTED ' PREMISES o mencei 102/10/2D15 MED EXP (An one person PERSONAL d AOV INJURY GENERAL AGGREGATE PRODUCTS - CCMPIDPAGG -- --- — S 50O 000.00 $ 100,000.00 S 5,000.00 S 5D0,000.00 s 1,000,000.00_ _ $ 500,000.00 $ AUTOMOBILEUA61117Y ANY AUTO ❑ ALL ❑ AUTOS NON-0WNED ❑ HIREDAUTOS ❑ AUTOS - I-- F EOMaINEeDISINGLE LIMIT S BODILYINJURY (Per pw3w) S BODILY BODILYIN.'URY(Per accldent) S P e aadttent AMAGE $ S UMBRELLAUAS OCCUR EXCESS LIAB ❑ CLAMS -MADE EACH OCCURRENCE AGGREGATE 1 S t DED 0 RETENTION 4 S CQMPENSATON • AND EMPLOYERS' LIAINUTY Y I N ANY PROPRETOR/PARTNERJE%ECUTrVE OFFICERMEMBEREXCLUDEDZ L�—J� IKandmtory In NH) Effaayyeess descdbeunder dRIPTION OF OPERATIONS below NIA WC STATlJ-MrS 0TH- LIMrtNORI�RS ER E.LEACH ACCIDENT I E.L.DISEASE • EA EMPLOYE E.L DISEASE-POLICYLMn- $ S S i DESCRI PION OF OPERATIONS t LOCATIONS I VEHICLES {Attach ACORD 101, Addilional Remarks Schedule, if morn space is Tequiredl John Breighner licensed plumbing License No.. CFC1427263 ­V101^ATC uAI r'ICD CANCELLATION Miami Shores Building Department Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 ACORD 25 (2010105) OF 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 Denise Rivera The ACORD name and logo are registered marks of ACCIRD Z' d ZK9-99L-V96 6uigwnld eoiAies AC s