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EL-10-19-2605, 9425 N Miami AveMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 9425 N MIAMI AVE, Miami Shores, FL 33150 1132060130510 Contacts RAMON TOLEDO Owner CARIBE ELECTRICAL CONTRACTOR INC Contractor 9425 N MIAMI AVE, MIAMI SHORES, FL 33150 ELIGIO FIGUEROA Home: 3054691290 floridainsurancequote@gmail.com 261 W 27 ST, HIALEAH, FL 33010 Business: 7864120067 Inspection Requests: Description: INSTALLATION OF GFI OUTLET Valuation: $ 600.00 Total Sq Feet: 135.00 ..j Fees Amount 100% Permit Renewal Fee $50.00 Application Fee - Other $50.00 Total: $100.00 Payments Date Paid Amt Paid Total Fees $100.00 Credit Card 10/30/2019 $50.00 Credit Card 11/08/2019 $50.00 Amount Due: $0.00 Building Department Copy 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 AF AVIT: I j;drtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulati co truction ionin Futhermore, I authorize the above named contractor to do the work stated. Owner / Applicant / Contractor / Agent Date November 08, 2019 Page 2 of 2 Miami Shores Village RECEIVED Building Department OCT 4 0. 2019 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 I LFBC 201�. BUILDING t Permit No. PERMIT APPLICPermit No. EL -1 Q l 9 -at�bG- ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ PLUMBING ❑ MECHANICAL [-]PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ! qa< 4--c l City: Miami Shores County: Miami Dade Zip: Folio/P8 Occupancy Type: Load: Is the Building Historically Designated: Yes NO Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): / illL Phone#: Address: ^A)Ir- +4' /V14-A--j. City: fyly-�1''"l; State: Tenant/Lessee Na Email one#: CONTRACTOR: Company Name: 6! z LE �-)( Phone#: Address: —'Z/ . -7 IS City: t-r'tf�iC State: ff-1 Qualifier Name: [... 4 i' iO 0 Phone#: State Certification or Registration #:G I Certificate of Competency #: _ DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ j%Z� w Squire/Linear'Footage'of,Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition n Description of Work: Specify color of color thru the: Submittal Fee $ Scanning Fee $ Permit Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ O� (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address Zip 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 ofall 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 charqed. 0e, Signature / OWNER or AGENT The foregoing instrument as acknowledged befo a me this C'.� t day of 20 (� , by �s _74-44yF449 }}who is personally known to me r ho has produced J as 1111111 111///j� ide tifica ion nd w did take an oath. NNy PRfEpO NO ARY OUB IC: `�\'L`; SS1ON Pp ip Si ' Print: ..� • pro, Bp �� p; Seal: ANN���``\•► Signature 61 CONTRACTOR The foregoing instrument, WA" acknowledged before me this rpkh day of lsc" , 20J by who is personally known to me or who has proPuced as identification and who did take an oath. NOTARY PUBLIC: Print: Seal: ^ l� APPROVED � i� /I/ /gym// Plans Examiner Structural Review Chddne Puzon Caslmlgion;ie 66300011 Expires: Minh 12, 2023 BOWW Thru Aaron Notary Zoning Clerk (Revised02/24/2014) �sKORES .� Miami Shores Village 10050 N.E. 2nd Avenue N Miami Shores, FL 33138-0000 Phone: (305)795-2204 �taxtaA Project Address 9425 N MIAMI Avenue Miami Shores, FL 33150- 9425 N MIAMI AVE LLC Parcel Number Applicant 1132060130510 Block: Lot: 9425 N MIAMI Avenue MIAMI SHORES FL 33150- 9425 N MIAMI Avenue MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone E & S ELECTRICAL SOLUTIONS INC (786)250-8836 of Work: KITCHEN REMODELING ELECTRICAL WORK onal Info: KITCHEN REMODELING ELECTRICAL WORK ification: Residential iinq: 1 Fees Due Amount CCF $0.60 DBPR Fee $2.25 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee - Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $158.85 9425 N MIAMI AVE LLC Phone Valuation: $ 500.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # EL-4-18-67336 05/04/2018 Credit Card $ 108.85 $ 60.00 04/27/2018 Credit Card $ 50.00 $ 0.00 Available Inspections: Inspection Type: Review Electrical 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 AFF�: I geiag iufarn is accurate and that all work will be done in compliance with all applicable laws regulating construction an i p. Futh rmore, I authorize the aboxe-named contractor to do the work stated. / Contractor / Agent May 04, 2018 Building 'A Copy 1 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 P ELECTRIC ❑ ROOFING PR 2 201 FBC 20't+SMA Master Permit No. IR C 1 1 — 3,50 Sub Permit No. ,1. �a ti Z6 ❑ REVISION ❑ EXTENSION [:]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ` 4�s N© �'r' 1 M 1 r'M I, Avc City: Miami Shores County: Miami Dade Zip: 33 / Sd Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: ' ,rFlood Zone: d � BFE: FFE: OWNER: Name (Fee Simple Titleholder): /� zi LC A 0A / i ��m� � PKo�� '3oS— Address: e7z/ ZS /UOA /V i",I'! IhC'<- city: A4)a M'1 slwra State: nn Zip: 33 Tenant/Lessee Name: &✓oArje✓g/enf .1jWr= C� G^'` ^'I ��' Phone#: Email: CONTRACTOR: Company Name: �7 `S G /Y�-� S `L7 "J '4�-CPhone# Address: 16.30eJ'4U —7-7 Aw City: %/% <AA , State: Qualifier Name: 45;fe-� 4 • lzi"cZ- Phone#: State Certification or Registration #: E%L / 3 o / 4A 9 Ze) Certificate of Competency #: _ DESIGNER: Architect/Engineer: Phone#: -�84. _ zTo - 8s3` !ip: 3 3 / i } 3 e DDp q6 C/ Address: City: State: Value of Work for this Permit: $ �0O`�� Square/Linear Footage of Work: Type of Work: ❑ Ad,ci Tn ❑ Alteration ❑New ® Repair/Replace Description of Work: Zip: ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ _ Scanning Fee $ Radon Fee $ 0� DBPR $ 025 Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ _ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) 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 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature OWNER or AGENT The foregoing instrument was acknowledged before me this day of y 4Z 20 Ir by r9Y,t��P�Ywho is personally known to me or who has produced6.�l� identification and who did take an oath. NOTARY PUBLIC: Sign atu CONTRACTOR The foregoing instrument was acknowledged before me this �T day of /lJd�� 20 XP by who is personally known to me or who has produced - �r7Z �/�—/Was identification and who did take an oath. NOTARY PUBLIC: Print: Print: Seal:=�,:+"'"y►�I OLGA PEDRAZA Seal: MY COMMISSION 0 FF2105J** a?o.rj? EXPIRES March 16.2019 ********** " ****#!�M**1dNPwrr "*****************a APPROVED BY 91o4�A/T/L l iY Y l&� Plans Examiner Structural Review :$�';;: OLGA PEDRAZA � MY COMMISSION # FF210571 ,''+d n?EXPIRES March 16, 2019 *** Zoning Clerk (Revised02/24/2014) Al Scanned by CamScanner PICK�f:C)1�T�_ E�CiVI���•1C�rt Kf N L.AM:;0 N SF ('R[ f APY STATE OF FLORIDA DEPAR`I f: Lit- 13USINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD The ESL TR[CAL (,(')N-f A(, f C NarrjHd below HAS REGISTE"PED Under the provisions of Gf`t;apt(,, 4j (; f Expitation date AUCJ 'i1, 20,1 t 1INUIVIIJ Al ICI if3T I„ AL 1. IC FN,;JNG H OUIREI'Af. 14 T'' I IRIOP '1 O (,0N-r A(:'J INN IN ANY Af„,f:A) ELECT 16300 Sw 9 MIAMI h E`iE 411 AY A.`a t AVV' ;J 1) ff 1 4i01; 000;),17() Scanned by CamScanner Scanned by CamScanner ESELECT OP ID: JB CERTIFICATE OF LIABILITY INSURANCEFOC27'102018 DATE(MMDIY 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 endorsements . PRODUCER NAMEACT Nestor Rivero _ Tropical Insurance Agency PHONE FAX 8700 West. Flagler St. Ste 401 Arc No Ext : 305-221-2400 A/c No : 305-552-5360 Miami, FL 33174 E-MAIL Nestor G. Rivero, CIC ADDREss: nestor @tropicalinsurance.com INSURER(S) AFFORDING COVERAGE NAIC M INSURER A: Ascendant Underwriters LLC INSURED E & S Electrical Solutions,lnc INSURER B : Edel -- 16300 SW 99 Avenue INSURERC: Miami, FL 33157 INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NLIMRER- REVISION NLIMRER! 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 A L POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY GL43116-4 10/11/2017 10/11/2018 DAMAGE TO RENTED DAMAGE Ea occurrence $ 100,00 CLAIMS -MADE IK OCCUR MED EXP (Any one person) $ 6,00( PERSONAL & ADV INJURY _$ 1,000,00 ( - _ _ GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER* PRODUCTS - COMP/OP AGG $ 11000100 POLICY PRO 7 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ _ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ I PERACCIDROPERTY DN MA $ HIRED AUTOS AONo-OWNED UT UMBRELLA LIAB OCCUR EACH OCCURRENCE _ _$ EXCESS LIAB_ CLAIMS -MADE AGGREGATE $ DED-71 RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE WC STATU- OTH- TORY LIMIT ER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N / A --- _ _-- (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Electrical operations MIAMISH Miami Shores Building Department 10050 N.E 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 Ne4t-arr RLvfw- ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Scanned by CarnScanner Proof of Coverage Page 1 of 1 WC Mobile App WC 110111e Search Our Data CFO Home Employer List Page This database was last updated Wednesday, May 02, 2018 12:09 AM. Return to Search Page Federal Employer ID Number Information 1 records found for federal employer id number 463485650. Click the links below the Employer Name column for more detailed information. Record Employer Name.Employer Address __...........................__............................_.............._._.............. ...... ...._...._....... _....... --- ................................. _... _......, E & S ELECTRICAL SOLUTIONS INC 16300 SW 99 AVE, MIAMI, FL 33157 1 records found for federal employer id number 463485660, Return to Search Page Cov lExem .......... _....... .........._............ . Exem https:Happs8.fldfs.com/proofofcoverage/EmployerList.aspx 5/2/2018 Proof of Coverage Page 1 of 1 WC Mobile App WC Horne Scare.li Our Data CF0 11olne Exemption Detail Page 'Phis database was last updated Wednesday, May 02, 2018 12:09 AM. Return to Previous Page Exemption Details Name Title Effective Date `Termination Date Exemption Type i"Business Activities Employer Name 1 EDEL A Click Here to View E & S RODRIGUEZ SR Oct 21 2017 Oct 21 2019 Construction Activities Listed on ELECTRICAL Exemption SOLUTIONS INC EDEL A Click Here to View E & S RODRIGUEZ SR PR Oct 22 2015 Oct 21 2017 Construction Activities Listed on ELECTRICAL ........... __ ..................... __._._.... _................ ........................... _................ .............. ......... _.__._............................;_...__......_..........._........._..._........._......_......___....................................._.__.............. Exemption SOLUTIONS INC .......... ..._.............._._....._... EDEL A Click Here to View E & S RODRIGUEZ SR PR Oct 22 2013 Oct 22 2015 Construction Activities Listed on ELECTRICAL Exemption SOLUTIONS INC "Termination maybe through the revocation of the exemption, or expiration of the exemption. ""The exemption only applies to the business activities listed on the exemption. Return to Search Page I https:Happs8.fldfs.com/proofofcoveragelExemptionDetail.aspx?pr_person_id=X00038910 5/2/2018 Proof of Coverage Page I of I WC Mobile App WC Home Search Our Data CFO 11orne Business Activities Detail Page This database was last updated Wednesday, May 02, 2018 12:09 AM. L Return to Exemption Detail Page I Business Activities on Exemption for EDEL A RODRIGUEZ SR Burglar and Fire Alarm Installation or Repair & Drivers ...................... . . ..... . ... -. .1 ....................... . . . .................................. . .. . . I ........................................... .. . . ......... . . . ...................................... . .. . . .................... Electric Light or Power Line Construction & Drivers ......................... . .. . . . . ..... ....................... . .... . I . . ..... . ....... . ............ ...... . . . .............. . ... -1 . .... . .............. . ..................................................... Electrical Wiring Within Buildings and Drivers ........... . ......... . ..... . .............. . ............................ . ----... ............. .............. .... -- .. . ............. -- ......... . . ........... . . ............................ . . ............ . . ............ . .............. - Licensed Electrical Contractor .................... . ....... ......................... - .. . . ..................................... . . .. . . . ........................................... . . . ........... . ..... . ................................ . ....... -- ........... . . Return to Search Page https:Happs8.fldfs.comlproofofcoveragelBusinessActivitiesDetail.aspx?EffectDate=l0/21/2... 5/2/2018 E & E Electrical Contractor Lic. # 13E000464 CC # 15CME19647B Edel Rodriguez 786 2508836 May 3rd. 2018 State of R o ► d q County of Mcl ryi1 _ 1_X-Zd c Before me this day personaly appeared d� (G Uf- Z. who, being duly sworn, Deposes and says. That he or she will be the only person working on the project at: 01 W 5 /1 Vit, a w" A u e, Koa Vl i ' 2 4v k'-e s> fib -33 l 5 o Contrator Signature td Sworn to (or affirmed) and subscribe before me this day of 20 Personally Know OR Produced Identification ✓ Type of I p14i9iji,?Wduced rloodo U fye,S Print, Typ Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner —Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: I . The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. a Signature: State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of 1 20 By AgisA � 3:i > _j UV Pa2-�jwvho is personally known to me or has produced U C"�� as identification. Notary: y V"W'r a y •s , Notary Public State of Florida t SEAL: } ; Sindia Alvarez { +� . My Commission FF 156750 4 } �p Expires0910312018 , tisKO1 Miami Shores Village r 10050 N.E. 2nd Avenue N Miami Shores, FL 33138-0000 Phone: (305)795-2204 CffRtW" Project Address 9425 N MIAMI Avenue Miami Shores, FL 33150- Owner Information 9425 N MIAMI AVE LLC Parcel Number 1132060130510 Block: Lot: Address 9425 N MIAMI Avenue MIAMI SHORES FL 33150- 9425 N MIAMI Avenue MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone CITY CABINETS CORP (786)735-7459 In Review ments: Approved:: In Review Denied: of Construction: KITCHEN CABINETS AND VANITY Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Yes Certificate Date: Fees Due Amount CCF $3.00 DBPR Fee $2.21 DCA Fee $2.00 Education Surcharge $1.00 Permit Fee $147.00 Scanning Fee $9.00 Technology Fee $4.00 Total: $168.21 9425 N MIAMI AVE LLC Cell Valuation: $ 4,900.00 Total Sq Feet: 135 Occupancy: Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: KITCHEN CABINETS AND VANITY Classification: Residential Pay Date Pay Type Amt Paid Amt Due Invoice # RC-10-17-66207 10/02/2017 Credit Card $ 50.00 $ 118.21 01/10/2018 Credit Card $ 118.21 $ 0.00 Available Inspection Type: Final PE Certification Window Door Attachment Framing Insulation Drywall Screw Fill Cells Columns Review Plumbing Review Planning Review Structural Review Mechanical Review Building Review Electrical Review Electrical Review Electrical 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 narget!' tira� do the work stated. January 10, 2018 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy January 10, 2018 Miami Shores Village 1X_r-dk_; rwil V t9CTA 2017 Building Department l/ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY' Tel: (305) 795-2204 Fax: (305) 756-8972 v1' C INSPECTION LINE PHONE NUMBER: (30S) 762-4949 sty) FBC 201 �" BUILDING Master Permit No. P)C. 1-1-235cD PERMIT APPLICATION Sub Permit No. ABUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: � �` ' V lwof 4 ( 4 ✓ �e_ City: Miami Shores County: Miami Dade Zip:.3315*0 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Type: BFE: FFE:L� OWNER: Name (Fee Simple Titleholder): QConstruction / / Z� �V � �Flood /Zone: ��"'! ! t� �1 Phone#: �✓ ? (�7 Z Address: Z AA y `e 4 // City: /411AP 15,4cw e5 State: -f— Zip: 33 N Tenant/Lessee Name: Phone#: 0 Email: � CONTRACTOR: Company Name: Phone#: �- 0UAddress: City: } 4 &S 4 State: e� Zip: 3.3� Qualifier Name: �Q��O!/ �CV� Phone#: 3010 ✓ T� Q¢'ff 3 State Certification or Registration #: Certificate of Competency #: eTQ� I �,�5 effe�fi -� DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $X % / dd Square/Linear Footage of Work( (-); S , Type of Work: ❑ Addition Alteration New ® Repair Replace ElDemolition Description of Work- e U 6ilie 'q & NO QA ikAer Specify color of color thru tile: Submittal Fee $ Permit Fee $ 1 ' l J CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ f� j TOTAL FEE NOW DUE $ I v I (Revised02/24/2014) 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 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 Signature OWNER or AGENT CONTRACTOR The foregoi g instrumentwasacknowledged before me this The foregoing instru 7 ent was acknowledged before me this �ay of f3�C�7 Y1J[JL 20 by L-VV day of ��tLh— 20 by ho ist personally known to jFw - � &6�who is personally known to me or who has produce�AAiiozu &a4e -lt-e �a me or who has producedaRI& 4"ek �LqAg s identification and who did take an oath. NOTARY PUBLIC: Print/If Gt ;f**�.ru� 14'su 10410 Seal: State of Florida OF F`o �q My Commission Expres 12/16/2019 Commission No. FF 944254 identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: State of Florida "a,�of M1 My Commission Expires 12/16/2019 Commission No. FF 944254 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 1'"I"Y PPRAISER Summary Report Property Information Folio: Property Address: 11-3206-013-0510 9425 N MIAMI AVE Miami Shores, FL 33150-2245 Owner 9425 N MIAMI AVE LLC Mailing Address 9425 N MIAMI AVE MIAMI, FL 33150 USA PA Primary Zone 1000 SGL FAMILY - 2101-2300 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY: 1 UNIT Beds / Baths / Half 3/1/0 Floors 1 Living Units 1 Actual Area 1,997 Sq.Ft Living Area 1,508 Sq.Ft Adjusted Area 1,746 Sq.Ft Lot Size Year Built 9,360 Sq.Ft 1938 Assessment Information Year 12017 2016 15 f$1 Land Value $210,504 $210,50409 Building Value $121,522 $121,522 $121,522 XF Value $1,969 $2,001 $1,271 Market Value Assessed Value $333,9951 $333,995 $334,027 $311,0821 $282,802 $282,802 Benefits Information Benefit Type 2017 2016> 2015 Non -Homestead Cap Assessment Reduction $22,945' _._. Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description MIAMI SHORES SEC 1 AMD PB 10-70 LOT 11 i£ N18FT LOT 12 BILK 4 LOT SIZE 72.000 X 130 OR 15512-4566 0592 4 Generated On : 10/2/2017 Taxable Value Information 20171 2016 2015 County Exemption Value $0 $0 $0 Taxable Value $333,995 $311,082 $282,802 School Board Exemption Value $0 $0 $0 Taxable Value $333,995 $334,027 $282,802 City Exemption Value $0 $0 $0 Taxable Value Regional $333,995 $311,082 $282,802 Exemption Value Taxable Value $0 5333,995 $0 $311,082 $0 $282,802 Sales Information Previous Price OR Book - Qualification Description Sale Page 05/04/2017 $348,600 30533-2191 Qual by exam of deed Corrective, tax or QCD; min 11/13/2014 $0 29451-0853 consideration Financial inst or "In Lieu of 10/17/2012 $251,100 28347-1863 Forclosure" stated 01/01/2008 $535,000 26342-4564 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 http://www.miamidade.gov/propertysearch/ 10/2/2017 COVER LET TER TO: New Filing Section Division of Corporations SUBJECT: 9425 N Miami Ave LLC (Nairte of Resulting Florida Limited Company) The enclosed Articles of Conversion, Articles of Organization, and Ices arc submitted to convert an "Other Business Entity' into a "Florida Limited Liability Company" in accordance with s. 605.1045, F.S. Please return all correspondence concerning; this matter to: Alejandra Warner (Contact Person) (r irm/Conipany) 12460 SW 123 Street ( Address) Miami, FL 33186 (City. State and Zip Code) warnerateiandra@gmaii.com L-mail Address: (to he used for future annual report notifications) For further information concerning this matter, please call: Alejandra Warner at(3O5 1439-4742 (Nance of Contact Person) (Area Code) (Daytime "Telephone Number) Enclosed is a check for the following amount: (All checks processed by this office must be payable in US dollars and drawn on a bank located in the United States) N S150.00 I-iling Pecs (525 for Conversion & $125 for Articles of Organization) ❑$155.00 k i1ing fees and Certificate of Status STREET ADDRESS: New Filing Section Division of Corporations Clifton Building 2661 l"xecutive Center Circle Tallahassee, FL 32301 MI 80.00 Filing Fees OS185.00 filing FceS, and Certified Copy Certified Copy. and Certificate of status MAILING ADDRESS: New Filing Section I )ivision of Corporations P. 0. Rox 6327 Tallahassee, 1'L 32314 INtiS11 (2/17) Articles of Conversion For "Other Business Entity" Into Florida Limited Liability Companl The Articles of Conversion and attached Articles of Organization arc submitted to convert the following "Other Business Entity" into a Florida Limited Liability Company in accordance with s.645_ I045, Florida Statutes. 1. The name of the "Other Eiusir�� 11 .t� y" i 9425 N MIAMI AVE LLC ] �� to the filing of the Articles of Conversion is: (tinter Name of Other B3 siness l-;ntity) 2. The "Other Business Entity" is a Florida Profit Corporation (Enter entity type. Example: corporation, limited partnership, general partnership, common law or business trust, etc ) First organized, fomled or incorporated under the laws of Florida on March 13, 2017 (Enter state, or ifa non-U.S. entity, the name of the cauntry) (date of organization, formation or incorporation) s. The name of the Florida Limited Liability Company as set Ivrth in the attached Articles of Organization: 9425 N MIAMI AVE LLC (Enter Name of Florida Limited Liability Company) 4, If nut effective on the date of filing, enter the effective date: March 10, 2017 {The effective date: 1) cannot be prior to date of receipt or filed date nor more than 90 calendar days after the date this document is filed by the Florida Department of State, AND 2) must be the same as the effective date listed in the attached Articles of Organization, if an effective date is listed therein.) Note: If the dale inserted in this block does not meet the applicable statutory filing requirements, this date will no[ he listed as the document's effective date on the I)epartment of State's records. 5_ The plan of conversion has been approved in accordance with all applicable statutes. 6. 'Fhe "Converted or Other Business Entity'- has agreed to pay any members having appraisal rights the amount to which such members are entitled under ss. 605.1006 and 605.1061-605.1072, 1'.S. Signed this 5 day of April 2017 Signature of -Authorized Representative: tt Printed Name:Aleiandra warner '[']tic_ Manager -Agent Signature(s) on behalf yof Other Business Entity: [See below for required signature(s)l Signature: 9L�t )"C c i1f7- ------ ---- - - Printed Name: Signature: _ Printed Name: Signature: _ Printed Name: Signature: _ !Tinted Name: Title: Title: Signature: Printed game: 'Title: Signature: _ Printed Name: Title: If Florida Corporation: Signature of Chairman, Vice Chairman, Director. or Officer. If Directors or Officers have not been selected, an Incorporator must sign. If Florida General Partnership or Limited Liabilitv Partnershi Signature ol'one General Partner_ If Florida Limited Partnership or Limited Liabilitv Limited Partnership: Signatures of ALL General Partners All others: Signature ofan authorized person. I"C s: Articles of Conversion: S25.00 f"ees for l'lorida Articles of Organization: $125.00 ARTICLES OF ORGANIZATION FOR FLORIDA LIMI` ED LIABLLI7Y COMPANY ARTICLE I - Name: The name of the Limited Liability Company is: 9425 N MIAMI AVE LLC (Mull contain the cords -'I,imitcd l,tahihry Company, " 1, L, u.." nr "I.I.0 "} ARTica, If - Address: 'I he mailing address and street address ofthe principal oilice ol'the Limited Liability Company is: Principal 0111ce Address: Mailing Address: 9425 N MIAMI AVENUE MIAMI, FL 33150 9425 N MIAMI AVENUE MIAMI, FL 33150 ARTICLE III - Registered Agent, Registered Office, & Registered Agent's Signature: fl he Limited LmNjai Company cattnoi sem: cu its own Registered Al en1. Vuu must desipmto aj) iriditAlu,tl or,in„ther hu,rncsti entity wah r,n acure Florida rcgislratiott.} "l he name and the I' lorida street address of the registered agent arc: ALEJAN DRA WARNER Name 12460 SW 123 STREET Florida street address (P.O. Box NOT acc:eptahlc) MIAMI F t , 33186 City Zip Having been named as registered agent and to accept .service of process 1vr the above stated htnircd liuhility c•ompam! at the place designated in this certifirute, I hereby accept the appointment a.s registered agew and agree to act in this capacity. I further agree to complt- wish the provi.siont n/ ail statutes relating to the proper and complete per/nrtnance t fmy dutie�N, and I um /umiliar with and accept the obligations of r,t•,v po silk+n as registered agent as provided fvr in Chupter 605, F..S'.. Registe ec1 gent's Signature (REQI11RP[)) ARTICLE JV- The name and address of each person authorized to manage and control the Limited Liability Company: Title: "AMBR" = Authorized Member "MOR" = Manager MGR AMBR (Use attachment if necessary) Name and Address: Alejandra Warner 12460 SW 123 Street Miami, FL 33186 Lisa M Bartlett 50 Booth Hill Road Shelton, CT 06484 ARTICLE V: Effective date, [father than the date offilingMarch 10, 2017 . (OPTIONAL) (If an effective date is listed, the date must be specific and cannot be more than five business days prior to or 90 calendar days after the date of filing.) Now. If the date inserted in this block does not meet the applicable statutory filing requirements, this date will not be listed as the dOClnnetlt S effective date on the Department of State's records. ARTICLE VI: Other provisions, If any. REQUIRED SIC NATURE Signature of a member or an authorized representative of a member. This document is executed in accordance with section 605.0203 (1) (b), Florida Statutes. 1 am aware that any false information submitted in a document to the Department of state constitutes a third degree felony as provided for in s_817.155, t=.S Alejandra Warner l'ypcd or printed name of signet: Filing Fees T CTConstruction Trados uallf-y-ing Bcmrd �pllllllllli� gillillill M uni ci pal Contractor's Tax Fbcei pt M iam i-Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY CC NO: 11 BS00346 BUSINESS NAM E/LOCATION CITY CABINETS CORD 2280 W 80 ST 6 HIALEAH, FL 33016 OWNER CITY CABINETS COPP RECEIPT NO. EXPIRES 7517196 SEPTEMBER 30, 2018 Pursuant to County Code Sec 10-24 TYPE OF BUSINESS PAYMENT RECEIVED _ SPECIALTY BUILDING CONTRACTOR BY TAX COLLECTOR 37.50 09/20/2017 0223-17-007637 Restricted to City of Miami Shores MIMI®� For more information, visit www.rniamidade.00v/taxcdlector % *'�g' CERTIFICATE ` E O LIABILITY K � ANO i3�iE :it Y'll'YY'l'-?z cIs _ �� 7 THIS ,A.-RT,Fl,A, IS UL x_�A MATTER OF INFi'�RMATiOV CTNL. , AFL (;ONFE,s;L Lut t.l}«� I " ;: (.,E t FzI€.ATE HOLDER. THIS i� El ? • ;F;;a : "E ),�ES NO t AFFI,*MATb°ELY OR NEGATIVELY ANAUND, EXTEND OR Al c--N "C;tRV-- Y THE POLICIES `'E-FIC.ATE G_ INSURANCE DOES NOT €,OR _ _,', IJT : A (,,ONTRA;.'f IN` I RER.(S(, AUTHORIZED I EFF t i PRODUCER, R, ANO THE CERTIFICATE HO C WP'-, = I,,"N $° r j I ,;a€ ,.ertlticsate holdor Is an ADDITIONAL JNSUR , th( FwlF are mus - -tx � AUX' . , # v- I I.F are:= sions or e -- n4orsed. . Ili« I ,. it fit, .F s ,' : T:•3! i , WAIVED, subject to the teens and C3' xne poicy, e rtam -F• A statement on 01k, 3tf I r x, contf.r 0-�Ets to the certificate holder in Poo et satcis a� �I��rserne€att::� IYI r 0d "AVE S,,,ii -b l%fEW4 W (.,ERTIFILATE NUMBER: .'Ak, W JMSEW f.lINSURANCE )F_ €Jt THE', li PE#tsGC l I:;CY1JIIt MFN , i# 3 ,fJ €. " v � ? #tk,SPF " I 'AHICH THIS THE IN CEi I.L.-f,t BE N ;. v3i �'? C I/,f 'ERTAIN, .x(�IZrWI- A- A— !: 1, ;W` I( 'C?:. ' ! l TO xi..d t�:i. TERMS "x"t'V It:PJs C .>3,1, H P;LICES, LIMITSb#fc_31,m419A EGf#= :d�F•� -. o-73}� Hi81t ... GI Y E :F F # __-_ _ :17 �r ��Tiy��YG'?7 I00.0A.f } 5000 7 411t<` E-' T 500.000 p F : }z'' Y f £A,C >ftt J ,F CER T F r: i I Y . OER ATION CANCELLATION SWMILD ANY 0# 9 C E ;r � CIi S E GANGEL}"GF18EFiJI�F ' J fir: FXPIRA`tt: ?d fi `: _ # : i )Tf "E WILL. aE OcA-IVERED IN �. L(( S r i� r•F;.ah ..i� , kEa�Fri... , i'"' '•1:' i1 Ah f _ AATIGN. All rights reserved, A(,CAI- i 2.> t." 0' The ACORD name o-t. 4s Io(;€a Ler� rr,16 s --------------------------------------------------------------------------------------IMPORTANT----------------------- ' STATE OF FLORIDA Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from chaptercertificate of DEPARTMENT OF FINANCIAL SERVICES mahisy election under this section ma f recoberfbenefits DIVISION OF WORKERS' COMPENSATION F compensation under this chapter. ; *► A,¢ 0 Pursuant to Chapter 440.05(12h F.S., Certificates of election to ; be the the business trade CONSTRUCTION INDUSTRY EXEMPTION , exempt.. apply only within scope of or L listed on the notice of election to be exempt. CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW i D Pt to Chapter 440.05() , F.S., Notices of election to be ' p13ursuan EFFECTIVE DATE: 112$l2016 EXPIRATION DATE: 1 %27i201 B i H exempt and certificates of election to be exempt shah be ; subject to revocation if, at anytime after the filing of the notice the issuance the the the PERSON: CABRERA SANCOR : s ; E or of certificate, person named on notice or certificate no longer meets the requirements of this ; section for issuance of a certificate. The department shall revoke time for the the FEIN: 263470296 R a certificate at any failure of person named on certificate to meet the requirements of this section. E , BUSINESS NAME AND ADDRESS: CITY CABINETS CORP ' 6181 EAST 4TH AVE ; HIALEAH FL ' SCOPES OF BUSINESS OR TRA ' CARPENTRY INSTALLATION OF CA Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Comoensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: wner State of Florida County of Miami -Dade The foregoing w_as` acknowledge 1b nef`ore me this / - day of W, 20� By �`� �� 7S . k� �� ` whRis personally known to me or has produced 1 U b0s id n�tifieati . Notary: SEAL: No COON, i l March 12% 2021 Ciy cabinets corp 2280 west 801h st ste 6 January 10, 2018 State of Florida Miami Dade County Before me this day personally appeared candor j Cabrera who, being duly sworn, That he be the only person working on the project located at: 9525 n Miami ave Miami shores, fl 33150 Contractor signature STATE OF FLORIDA MIAMI DADE COUNTY The foregoing was acknowledged before me this kQ) day of v c, , 20 lS By �P.ry 1✓SvS�=c , who is personally known to me or who has producedas identification Notary Signature: Seal: �y01+Y"� Notary RugliCStatoofP1064d { r„ SindiaAlva r6t• { `,:Y '%—V ff My Commission FF 156750 4 ,"sr Expires09/0312018 A • .16 4, . A. A. 4 A . A A ,A4 A, .A A , .0