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DEMO-12-20-2874, 10635 NE 10th CtMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 10635 NE 10TH CT, Miami Shores, FL 33138 1122320280760 Contacts Francisco Gaviria Owner WISDOM ELECTRIC INC Contractor 10635 NE 10 CT IVAN MARTINEZ 2330 NW 35 ST, MIAMI, FL 33142 Business: 3059151983 Inspection Requests: Description: REMOVE (N) 2 POLE 60 AMP GFCI DISC, ALSO Valuation: $ 500.00 \ 3QS 76 REMOVE (N) (3) # 6 CU THW & IN 3/4" COND UNDERGROUND. \ Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 Building Demoloition Fee $50.00 CCF $0.60 DBPR Fee $3.75 DCA Fee $2.50 Education Surcharge $0.20 Scanning Fee $3.00 Technology Fee $6.25 Work Without Permit Fee $100.00 Total: $216.30 Payments Date Paid Amt Paid Total Fees $216.30 Credit Card 12/15/2020 $216.30 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 AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating con"ctXn and zoning. Futhermore, I authorize the above named contractor to do the work stated. , Authorized S gnituA Owner / Applicant / Contractor / Agent DO December 15, Page 2 of 2 Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit No.: DEMO-12-20-2874 Permit Type: Demolition r Work Classifacatior� Electric Expiration: 06/15/2021 Location Address Parcel Number 10635 NE 10TH CT, Miami Shores, FL 33138 1122320280760 Contacts Francisco Gaviria Owner WISDOM ELECTRIC INC Contractor 10635 NE 10 CT IVAN MARTINEZ 2330 NW 35 ST, MIAMI, FL 33142 Business: 3059151983 ..mm_.._. _._ _..-.._..... Inspection Requests: Description: REMOVE (N) 2 POLE 60 AMP GFCI DISC, ALSO Valuation: $ 500.00 305 762 4949 REMOVE (N) (3) # 6 CU THW & IN 3/4" COND UNDERGROUND. Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 Building Demoloition Fee $50.00 CCF $0.60 DBPR Fee $3.75 DCA Fee $2.50 Education Surcharge $0.20 Scanning Fee $3.00 Technology Fee $6.25 Work Without Permit Fee $100.00 Total: $216.30 Applicant Copy Payments Date Paid Amt Paid Total Fees $216.30 Credit Card 12/15/2020 $216.30 Amount Due: $0.00 For Inspections, Call (305) 762-4949 or Log on at https://bidg.miamishoresvillage.com/cap/. Requests must be received by 3pm for following day inspections. NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that maybe found in the GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, public records of this county. STATE AGENCIES, OR FEDERAL AGENCIES. December 15, 2020 Page 1 of 2 Miami Shores Village RECEIVED 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 DES; 11 ' U20 BY: A\ FBC 20n k� BUILDING Master Permit No:D6.r--"0 - 1 1- Z-(L4-7 PERMIT APPLICATION Sub Permit No.'Pti-mu -- I Z -2,�3 2- s74 5(BUILDING LECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP � y� CONTRACTOR DRAWINGS JOB ADDRESS: �,/ G°j 6 -5 5� I ��— /� C � /'�i 6 /,?7,. sk fl e S � PZ2 3 3 13 9 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: // -223 Z _02 9— Q'74 Q Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: �ff OWNER: Name (Fee Simple Titleholder): -r;Ai7 C i SCO V i rid► Phone#: 30-- y 7 1 �6�5 -y Address: %Q6 3 5 —/lie /y C/ City: 5-X,-,ye s State: `/dam- Zip: 3Ai3d Tenant/Lessee Name: f �� Phone#: Email: fh f' ����K� �F /G,r✓�1 ezC A� J14 �n%A-'! Cl 1 L Iec— /X i G M/C Phone#: CONTRACTOR: Company Name: a / Address: 150 S h/ z/ 4,1-e City: State: /—`CW 14 Zip: -3; :5 t/ Qualifier Name: Phone#: State Certification or Registration #:C- % _� 0 0 1 S 9 Y' Certificate of Competency #: _ DESIGNER: Architect/Engineer: Phone#: Address Value of Work for this Permit: $ 00, o o Type of Work: ❑ Addition ❑ Alteration escription of Work: l2PV►9G h{ Al Z. _ Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Technology Fee $. Structural Reviews $ Radon Fee $ City: State: Square/Linear Footage of Work: ❑ New ❑ Repair/Replace lP . G4 Amp Grc1" his" o /4" i� Un q/e �► rOV n < l Training/Education Fee $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ _ Zip: Demolition Xe M tiJ (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 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 "vN "U WNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of u en%&1' ,20 by �/ day of de c m, /'-Q-PL 120 2 C by )Wul fG ' J ' ? who is personally known to rt %tA -JeZ who is personally known to me or who has produced as me or who has produced Uc,`bs_ 71�� as identification and who did take an oath. identification and who did take a7bath-- f`-5— NOTARY PUBLIC:/ NOTARY P Sign: Sign: Ir Print: ��� Print: gPaYP(iB JEWELENE MENESES Seal: 2� �`� ommission #GG 119319 Seal: o Commission #GG 119319 Commission Expires 06.27-2021 Commission Expires 06.27-2021 y�OF�O�.O Bonded Through - Cynanotary Bonded Through - Cynanotary Florida - Notary Public OFFVO� Florida - Notary Public APPROVED- �L, l�� Plans Examiner Zoning Structural Review (Revised02/24/2014) Clerk - t2— za - A-34 / -.-i -- 7.c_�Iq AC"RhP CERTIFICATE OF LIABILITY INSURANCE `.i'' [__DATE (MMIDD/YYYY) 12/14/2020 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 CONTACT NAME: MANUEL GONZALEZ, CIC P"oNE (305) 220-0900 arc No: (305) 220-3029 All Nation Insurance E-MAIL ADDRESS: manuei@allnationinsurance.com 8520 SW 40th St INSURERS AFFORDING COVERAGE NAIC # INSURER A: NAUTILUS INSURANCE CO. 524210 Miami, FL33155 INSURED INSURERB: PROGRESSIVE 10193 INSURERC: WISDOM ELECTRIC INC INSURER D : 2332 NW 35 STREET INSURER E : INSURERF: MIAMI FL 33142 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 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 SUBR POLICY NUMBER POLICY EFF DDIY POLICY EXP MMI YYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 CLAIMS -MADE F OCCUR $ 100,000.00 NTE PREMISES EaEoccur re MED EXP (Any one person) $ 5,000.00 PERSONAL & ADV INJURY $ 1,000,000.00 A NN1136997 07/10/2020 03/03/2021 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000.00 POLICY � JE°T FX LOC PRODUCTS - COMP/OP AGG $ 2,000,000.00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident)$ 1,000,000.00 X BODILY INJURY (Per person) $ ANY AUTO 8 ALL OWNED SCHEDULED AUTOS AUTOS 48510569 04/27/2020 04/27/2021 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE PER OTH- STATUTE I I ER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA XXXXXXXXXXXXXXXXXXXXXXXXXXX) XXXXXXXXXXX XXXXXXXXX (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) STATE LICENSE EC13007574 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE 10050 NE 2ND AVE 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 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 7218932 BUSINESS NAMEq OCATION WISDOM ELECTRIC INC 130 SW 49TH AVE MIAMI FL 33134 OWNER MSDOM ELECTRIC INC C/O IVAN MARTINEZ PRES RECEIPT N0. RENEWAL 7503247 EXPIRES SEPTEMBER 30, 2021 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 PAYMENT RECEIVED 8Y TAX COLLECTOR Worker(s) 1 545.00 07121/2020 CHECK21-20-057553 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holders qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 6a-276. For more information, visit w�wmiamidadego9axcolleytor 1i; SEC. TYPE Of BUSINESS 196 ELECTRICAL CONTRACTOR EC13007574 A " NOT TRANSFERRABLE OR VALID AT ANOTHER ADDRESS ifU D cs Iiit�Iii UNLESS APPROVED BY THE FINANCE DEPARTMENT, DO NOT PAY CITY OF MIAMI 444 S.W.2 AVE 6' FLOOR, MIAMI, FL 33130, «. PHONE (305�416-1918. Effective Year Oct. 1 2020 Thru Sep. 30 2021 RECEIPT FOR WISDOM ELECTRIC INC ISSUED Oct 01, 2020 TOTAL FEE PAID 131.00 ACCOUNT NUMBER 158488 RECEIPT NUMBER 184619 NAME OF BUSINESS wisdom electric inc DBA LOCATION 130 SW 49 AV IS HEREBY IN COMPLIANCE TO ENGAGE IN OR MANAGE THE OPERATION OF: ADMINISTRATIVE OFFICE Adele Valencia Code Compliance Director This issuance of a business tax receipt does not permit the holder to violate any zoning laws of the City nor does it exempt the holder from any license or permits that may be required by law, This document does not constitute a certification that the holder is qualified to engage in the business, profession or occupation specified herein. The document indicates payment of the business tax receipt only. 2021 Florida DOW" LXCM .Aft36.400-"-21S-0' '- f STATE Of FLORWA DEPARTMj,,,Nj dOF BUSINESS AND PROFfSStONAt upr ,,UAT,,,, I c %)Wn7a OWAD WvXxx CUT010 RKWALCONIRACKW MART NAN j MAD Lft4*,A CHAPTtR 40, FtC*XM 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: MZ' S /tom ele- c e , / ivy BUSINESS ADDRESS: / 3U ,S'!-J Ave CITY STATE�(� ZIP 3 313 BUSINESS PHONE: (30�` ) y/S'- / 5 �13 FAX NUMBER ( ) CELL PHONE( ' M92 QUALIFIER'S NAME: 1 V,6t-7 MA � n e Z QUALIFIER'S LIC NUMBER: F C / 3oo7s-7 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to uwner — worKers' Lompensation 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: Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of am Notary: SEAL: 120 who is personally known to me or has produced as identification. A� 0® CERTIFICATE OF LIABILITY INSURANCE TE DA12/142020 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 CONTACT Automatic Data Processing Insurance Agency, Inc. Automatic Data Processing Insurance Agency, Inc. P"coNr o Ext : 1 800 524 7024 a No E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC a 1 Adp Boulevard INSURER A: Technology Insurance Company, Inc. 42376 Roseland NJ 07068 INSURED Wisdom Electric Inc INSURER B : INSURER C : INSURER D : 130 SW 49th Ave INSURER E : INSURER F : Coral Gables FL 33134 COVERAGES CERTIFICATE NUMBER: 1767215 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 UBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENT CLAIMS -MADE 17OCCUR -D PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑PRO ❑ LOC JECT PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SIN L LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A N TWC3881163 05/13/2020 05/13/2021 X I PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below 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) Contractor License: STATE LICENSE EC13007574 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 AV AUTHORIZED REPRESENTATIVE Miami Shores FL 33138 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD