Loading...
RF-03-22-709Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 1225 NE 93RD ST, Miami Shores, FL 33138 1132050270030 Contacts Zachary Berger Owner PIONEER ROOFING COMPANY, LLC Contractor 1225 NE 93 ST, Miami Shores, FL 33138 NATHAN L DAPEER 2026 GRANT ST, HOLLYWOOD, FL 33020 Inspection Requests Description: ROOF REPAIR - REPLACE BROKEN TILE AND p Valuation: $ 5,480.00 ? RUSTED VENT Sq Feet: 30.00 Ei _ Total E r.,,. Fees Amount Application Fee - Other $50.00 CCF $3.60 Copies Fee (Manual) $3.45 DBPR Fee $3.75 DCA Fee $2.50 Education Surcharge $1.20 Roofing Fee $114.40 Scanning Fee (Manual) $12.00 Technology Fee $4.11 Total: $195.01 Building Department Copy Payments Date PaidLAmtPa]idTotalFees Credit Card 03/21/2022Credit Card 03/24/2022Amount Due: 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 authoiize the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / J UTTractor / Agent Date March 24, 2022 Page 2 of 2 Miami Shores Village D T C� T 2 2_� Building Department MAR 21 ( 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 rBc Zo � T BUILDING Master Permit No�`43` PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC 0 ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1225 NE 93rd St City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3205-027-0030 Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Zachary Berger Phone#:305-992-4513 Address:1225 NE 93rd St city: Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: �CZCE-� lL� L ���1.(�GZ.V�DDF1t�l�nCG�P �AIY Uu.� CONTRACTOR: Company Name: Pioneer Roofing CO LLC Address: 2026 Grant St City: Hollywood State: FL Qualifier Name: Nathan Dapeer State Certification or Registration #: CCC1332507 DESIGNER: Architect/Engineer: hone#: 954-920-7688 Zip: 33020 hone#: 954-920-7688 Certificate of Competency #: Phone#: Address. City: State: Zip: Value of Work for this Permit: $ 5,480 Square/linear Footage of Work: � 6 Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of work: Roof repair - replace broken tile and rusted vent Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $_ Scanning Fee $ Radon Fee $ DBPR $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 2- ' 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 0 NER or AGENT The foregoing instrument was acknowledged before me this • S day of20 �, by I ersonally �knoto me or who has produced as identification and who did take an oath. NOTARY PUBLIC: i Signature CONTRACTOR The foregoing instrument was acknowledged before me this `1\ day of �i..e� 20 by wh 'taersonally < n to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Print: Seal: ::?`dPy,.. ANDREWWHARTON aJP Seal: <" ANDREW WHARTON MY COMMISSION # GG 917166 ;=a° ' ' �t EXPIRES: January 26, 2024 `• �: NY COMMISSION # GG 917166 bonded Thru Notary Public Underwriters =9; • P EXPIRES: January 26, 2024 t3onded Th, Notary Public Underwriters (� 7S t APPROVED BY T-- Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 1 OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-3205-027-0030 1225 NE 93 ST Property Address: Miami Shores, FL 33138-2940 ZACHARY BERGER Owner AMBER BERGER 1225 NE 93 ST Mailing Address MIAMI SHORES, FL 33138 USA PA Primary Zone ______...... ................. ....... 1300 SGL FAMILY - 2801-3000 SQ ___._----- __..___..__......... __- ....... ____.... ...... __......... ...... 0101 RESIDENTIAL -SINGLE Primary Land Use FAMILY: 1 UNIT Beds / Baths / Half 4/3/1 Floors 1 Living Units 1 Actual Area 3,128 Sq.Ft Living Area 2,414 Sq.Ft Adjusted Area 2,732 Sq.Ft Lot Size 9,825 Sq.Ft Year Built Multiple (See Building Info.) Assessment Information Year 2021 2020 2019 Land Value $371,197 $371,197 $371,197 Building Value $678,696 $206,415 $144,690 XF Value - $54,846 a $55,400 $0 .._.. ..........._ ....$515,887 Market Value $1,104,739 $633,012 Assessed Value $1,104,739 $622,875 $515,887 Benefits Information Benefit Type 2021 2020 2019 Non -Homestead Cap Assessment Reduction $10,137 _ Homestead Exemption $25,000 Second Homestead Exemption $25,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description BAY LURE PB 44-63 E50FT LOT 3 & W25FT OF LOT 4 BILK 1 LOT SIZE 75.000 X 131 Generated On : 3/21/2022 Taxable Value Information 20211 2019 County Exemption Value $50,000 $0 $0 Taxable Value $1,054,7391 $622,8751 $515,887 School Board Exemption Value $25,000 $0 $0 Taxable Value $1,079,739 $633,012 $515,887 _-_---_-_.._ City Exemption Value $50,000 $0 $0 Taxable Value $1,054,739 $622,875 $515,887 Regional Exemption Value $50,000 $0 $0 Taxable Value $1,054,739 $622,875 $515,887 Sales Information Previous Book- Oale Price Qualification Description S Page 03/18/2020 $1,530,000 31882-4965 Qua] by exam of deed 10/27/2017 $635,000 30745-4540 Qual by exam of deed Corrective, tax or QCD; min 09/27/2017 $100 30699-1035 consideration 05/24/2017 1 $615,000 30550-2475 Qua[ by exam of deed 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 https://www.miamidade.gov/Apps/PA/propertysearch/ 3/21/2022 Florida Building Code 7th Edition (2020) High Velocity Hurricane Zone Uniform Roofing Application Form for Miami -[fade County Section A (General Information) Master Permit Number: Process NumbD Contractor's Name: Pioneer Roofing Co LLC Job Address: 1225 NE 93rd St - Miami Shores, FL 33138 ROOF CATEGORY ❑ Low Slope ❑ Mechanically Fastened Tile ❑ Mortar / Adhes;vc Sot Tile ❑ Asphaltic Shingles ❑ Metal Panel/ Shingles ❑ Wood Shingles ; S�3kes ROOF TYPE ❑ New Roof RJ Repair ❑ Maintenance ❑ Reroofing ROOF SYSTEM INFORMATION Low Slope Roof Area (ft2) Steep Sloped Roof Area (ft2) ❑ Recoverml; Tota I (ft2) 30 Are there gas vents on the roof? ® Yes 0 No If Yes what type? ®Natural 0 LPX Is there an existing roof top Solar System? 0 Yes C) No If yes will it be reinstalled? 0 Yes 0 No Section B (Roof Plan) Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. Include dimensions of sections and levels, clearly identify dimensions of elevated pressure zones and location of parapets. TZ T-_ _ate- -�>-2_ _:�9 Miami Shores Village Building Departme- Zoning Dept. Date Building Dept. t Subject to complia ith all . State and County rules and rec, Permit# n non n n n n nano nononn n n n n nn n n o n n n n n nnnnnn r nn nn onnoon nnnnnn n n n nnnnnn n n n n n n 0 n n n n n o 0 noon 0 n n n o n O O n n O o n 0 0 0 n n o n n o o O 0 0 0 0 n 0 0 0 0 O o 0 0 0 0 0 00 0 000000 0 o O 0 0 0 O O 00 O 000000 O O O 0 r O o0 0 0 0 000000 Miami Shores Village - BUILDING DEPARTMENT 10050 NE 2 Ave Miami Shores, FL 33133 305-795-2204 www.msvfl.qov SECTION R4402.13 HIGH VELOCITY HURRICANE ZONES — REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS R4402.13.1 Scope. As it pertains to the section, it is the responsibility of roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of the section. The provisions of Section R4402 govern the minimum reGuirEments Gr.d standards of the industry for roofing system installations. Additionally, the following ;toms ; should be addressed as part of the agreement between the owner ant thZ contractor. The owner's initial in the designated space indicates that the item has been oxola,ned. 1. Aesthetics -Workmanship: the workmanship provisions of SPr_tion R4402 are for t e purpose of providing that the roof system meets the wind res;stan,:e anc water instruction performance standards. Aesthetics (appearance) are not d con3ideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the agreement between the owner and the contractor. Z1 2. Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Section R4403. (The roof deck is usually concealed prior to removing the existing roof system). 3. ! Common roofs: Common roofs are those which have no visible delineation between neighboring units (i.e., townhouses, condominiums, etc.) In buildings with common roofs, the roofing contractor and/or owner should notify the occupants of =Exposed ts of roofing to be performed. 4. Ceiling: Exposed, open beam ceilings are where the underside of the roof decking can be viewed from below. The owner may wish to maintain the architectural appearance; therefore, roofing nail penetration of the underside of the decking may not be ac ptable. This provides the option of maintaining the appearance. 5 Ponding water: The current roof system and/or deck of the building may not drain well and may cause water to pond (accumulate) in low-lying areas of the roof. Pounding can be an indication of structural distress and may require the review of a professional structural engineer. Pounding may shorten the life expectancy and performance of the new roofing system. Pounding conditions may not be evident until the original roofing system is removed. Pounding conditions should be corrected. Rev01 142021 Owners roofing consideration Page 1 of 2 i Miami Shores Tillage - BUILDING DEPARTMENT 10050 NE 2 Ave Miami Shores, FL 33138 305-795-2204 www.msvfl.gov rflow scuppers (wall outlets): It is required that rainwater flows off so that the roof is not overloaded from a buildup of water. Perimeter/edge wall or other roof extension may block this discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance with the requirements of Sec o s R4402, R4403 and R4413. 7. Ventilation: Most roof structures should have some abilit'I to vent na'-ural airflow through the interior of the structure assembly (the building itselt). The ex`sting amount of attic ventilation shall not be reduced. It may be beneficial t;, e:.nsidcr additiorc.l v nting which can result in extending the service life of the roof. i� ®w er/�g t s Signature ®ate Contractor Signature Date For Forms and Applications click here: http://bldg.miamishoresvillage.com/WebLink/Browse.aspx?id=118080&dbid=0&repo=Mia miShoresVillage Rev01 142021 Owners roofing consideration Page 2 of 2 Florida Building Code 7th Edition (2020) High Velocity Hurricane Zone Uniform Roofing Application Form for Miami -Dade County Section D (Steep Sloped Roof System) Roof System Manufacturer: Crown Product Control Number: 21-0420.11 Minimum Design Wind Pressures, From Applicable RAS 127 Table or Calculations: ; Zone1: 74 Zone 2e: 74 Zone2n: 108 Zone 2r: 108 Zone 3e: 108 7.one 3r: 1`28 Slope Range:>_ 2:12 to 5 4:12 ®> 4:12 to <_ 6:12 ®> 6:12 to,< 12`:12 Roof Shape: ® All Hip Roof Q) Gable Roof or Partial Gabieji ip Roo', Deck Type: Wood Underlayment Type: ASTM 30# Roof Slope: 3 . 12 NA Insulation: Fire Barrier: NA Ridge Ventilation? Fastener Type & Spacing: 1 1/4 rs w/ 1 5/8 tin caps NA Cap Sheet Type: ASTM 90# Mean Roof Height: 12' Cap Sheet Attachment: Cold adhesive Roof Covering: Concrete tile Drip Edge Type & Size: 30 galvained Florida Building Code 7th Edition (2020) High Velocity Hurricane Zone Uniform Roofing Application Form for Miami -Dade County Section E (Tile Calculations) For Moment based tile systems, choose Method 1. Compare the values for M,with the values from Mf. If the Mf values are greater than or equal to the Mr values for each area of the roof, then the tile attachment method is acceptable. Method 1* " Moment Based Tile Calculations per RAS 127" Enter positive uplift pressures when using this table ( Zone 1: 74 x x .313 = 23.2 8.17 14.99 63 — Mg: = Mri Product Approval Mf: ( Zone 2e: 74 x x .313 = 23.2 8.17 14 — Mg: = Mrze 99 Product Approval Mf: 63 ( Zone 2n: 108 x x .313 = 33.8 ) _ Mg: 8.17 = Mrzn 25.6 63 Product Approval P_1f: ( Zone 2r: 108 x A 313 _ 33.8 ) — Mg: 8.17 = Mr2r 25.6 Product Apprdvdl Hr: 63 ' ( Zone 3e: 108 x x .313 = 33.8 8.17 25.6 63 — Mg: = Mr3e Product Approval PA':, ( Zone 3r: 128 x 313 = 40.0 8.17 31.9 ` ` ` 63 — Mg: = Mr3, Product Appro>im W:, Tile attachment method: Tile bond medium patty Alternate Tile attachment method For Uplift Based tile systems use Method 3. Compare the values for F' with the values for Fr. If tFie F'�✓a(aes are greater thamor equal to the Fr values for each area of the roof, then the tile attachment method is acceptable. Method 3* "Uplift Based Tile Calculations per RAS 127" (Zone 1: x L = x W = ) — (w) x cos A ) = Fri Product Approval F': (Zone 2e: x L = x W = ) — (w ) x cos 0 ) = Frze Product Approval F': (Zone 2n: x L = x W = ) — (w) x cos 0 ) = Frzn Product Approval F': (Zone 2r: x L = x W = ) — (w) x cos 0 ) = Frzr Product Approval F: (Zone 3e: x L = x W = ) — (w) x cos 0 ) = Fr3e Product Approval F': (Zone 3r: x L = x W = ) — (w) x cos 0 ) = Fr3r Product Approval F': *Method 2 "Simplified Tile Calculations" only applicable in Broward County. Where to obtain information Description Symbol Where to Find Design Pressure Zones 1, 2e, 2n, 2r,3e, 3r From the applicable Table in RAS-127 or be an engineering analysis prepared by a PE based upon ASCE 7 Mean Roof Height H Job Site Roof Slope 0 Job Site Aerodynamic Multiplier A Product Approval / Notice of Acceptance Restoring Moment due to Gravity Mg Product Approval / Notice of Acceptance Attachment Resistance Mf Product Approval / Notice of Acceptance Required Moment Resistance Mr Calculated Minimum Attachment Resistance F' Product Approval /Notice of Acceptance Required Uplift Resistance Fr Calculated Average Tile Weight w Product Approval / Notice of Acceptance Tile Dimensions L=Length W= Width Product Approval / Notice of Acceptance All calculations must be submitted to the Building Official at the time of permit application. MIAMI-DADE COUNTY MIAMI•GADE PRODUCT CONTROL SECTION MAWALIM 11805 SW 26 Street, Room 208 DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) Miami, Florida 33175-2474 BOARD AND CODE ADMINISTRATION DIVISION T (786)315-2590 F (786) 315-2599 NOTICE OF ACCEPTANCE (NOA) www.miamidade.gov/economy Crown Building Products of Florida LLC 6018 HWY 72 Arcadia, FL. 34266 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of :,3nstruction mate-ials. The documentation submitted has been reviewed and accepted by Miami -Dade County RER-Fr,)daz, Control Scclion to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisd;ct;or, k'AHJ). This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Section Qr. Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the :igh' .o have this product_ a- material tested for quality assurance purposes. If this product or material fails to perform in I,e accepted manner, V.w manufacturer will incur the expense of such testing and the AHJ may immediately revoke, *nooiiy, or suspend the use of such product or material within their jurisdiction. RER reserves the right to revoke this acceptance, if it s determined by Miami -Dade County Product Control Section that this product or material fails to meet the n,quirements of the appliczhlc building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Windsor Roof Tile LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA revises NOA 20-1105.08 and consists of pages 1 through 8. The submitted documentation was reviewed by Alex Tigera. NOA No.: 21-0420.11 Expiration Date: 01/29/25 Approval Date: 09/02/21 Page 1 of 9 ROOFING ASSEMBLY APPROVAL Category: Roofing Sub -Category: Roofing Tiles Material: Concrete 1. SCOPE This approves a roofing system using Windsor Tiles, manufactured by Crown Building Products of Florida LLC in Arcadia, Fl., as described in Section 2 of this Notice of Acceptance. For locations where the pressure requirements, as determined by applicable Building Code does not exceed the design pressure values obtained by calculations in compliance with RAS 127 using the values listed in section 4 herein. The attachment calculations shall hP done - s i moment based system. 2. PRODUCT DESCRIPTION Manufactured by Dimensions Test P oduct Applicant Specifications Dc,sc,(.ktlon Windsor Shake L = 17." TAS 112 Flat, interlocking, concrete tile equipped with two W = 13." Type 3a nail holes. For direct neck or battened npil-on, H = 1.2" Class III mortar or adhesive set applications. Thickness: 0.59" Windsor Split Shake L = IT" TAS 112 Flat, interlocking, concrete tile equipped with two W = 13." Type 3a nail holes. For direct deck or battened nail -on, H = 1.2" Class III mortar or adhesive set applications. Thickness: 0.59" Windsor Slate L = 17." TAS 112 Flat, interlocking, concrete tile equipped with two W = 13." Type 3a nail holes. For direct deck or battened nail -on, H = 1.2" Class III mortar or adhesive set applications. Thickness: 0.59" Trim Pieces L= varies TAS 112 Accessory trim, concrete roof pieces for use at hips, W = varies rakes, ridges and valley terminations. Varying thickness Manufactured for each tile profile. NOA No.: 21-0420.11 Q I•DAD' COUNTY Expiration Date: 01/29/25 ®- Approval Date: 09/02/21 Page 2 of 9 2.1 PRODUCTS MANUFACTURED BY OTHERS Product Name Polyset AH-160 TILE BONDTm Roof Tile Adhesive Product Description Two component polyurethane foam adhesive. Single component polyurethane foam roof tile adhesive. Touch `N Seal StormBondo One One component polyurethane Component Polyurethane Roof Tile foam adhesive. Adhesive "Tile Tite" Roof Tile Mortar Bonsai Roof Tile Mortar Premixed, pre -bagged roof tile mortar. Premixed, pre -bagged roof tile mortar. "Quikrete" Roof Tile Mortar, FL-15 Premixed, pre -bagged gray roof tile mortar. 2.2 MANUFACTURING LOCATION I . Arcadia, FL. 2.3 SUBMITTED EVIDENCE: Manufacturer (With Current NOA) ICP Adhesives and Sealants, Inc. DuPont de Nemours, Inc. DAP Foam, Inc. Bennutt Roof Co. Inc. Bonsai American, Inc. The Qu4ieo "— mpanies, Inc. Test Agency Test Identifier Test Name/Report Date Redland Technologies 7161-03 Appendix III PA 102 & PA 102(A) Dec. 1991 7161-03 Appendix II PA 108 (Nail -On) Dec. 1991 Letter PA 108 (Nail -On) Aug. 1994 P0631-01 PA 108 (Mortar Set) July 1994 P0402 Withdrawal Resistance Testing of screw vs. Sept. 1993 smooth shank nails The Center for Applied 94-060A PA 101 (Mortar Set) March, 1994 Engineering, Inc. 94-084 PA 101 (Adhesive Set) May 1994 25-7094-2 PA 102 Oct. 1994 (4" Headlap, Nails, Direct Deck, New Construction) 25-7094-8 PA 102 (4" Headlap, Nails, Battens) Oct. 1994 25-7094-5 PA 102 (4" Headlap, Nails, Direct Deck, Oct. 1994 Recover/Reroof) 25-7183-6 PA 102 (2 Quik-Drive Screws, Direct Feb. 1995 Deck) 25-7183-5 PA 102 (2 Quik-Drive Screws, Battens) Feb. 1995 25-7214-1 PA 102 (1 Quik-Drive Screw, Direct Deck) March, 1995 25-7214-5 PA 102 (1 Quik-Drive Screw, Battens) March, 1995 Project No. 307025 PA 100 Oct. 1994 Test #MDC-77 NOA No.: 21-0420.11 Expiration Date: 01/29/25 Approval Date: 09/02/21 Page 3 of 9 2.3 SUBMITTED EVIDENCE: Test Agency Test Identifier Celotex Corporation 520109-1 Testing Service 520111-4 520191-1 Walker Engineering, Inc. American Test Lab of South Florida NEMO ETC, LLC PRI Construction Materials Technologies Calculations Calculations Calculations Calculations Calculations Calculations Calculations Calculations Calculations Calculations Calculations Test Name/RCDort PA 101 PA 101 PA 101 Aerodynamic Multiplier Moment of Gravity 25-7094 25-7496 25-7584 25-7804b-8 25-7804-4 & 5 25-7848-6 25-7183 Aerodynamic Multiplier.; Two Patty Adhesive Set System RT1021.02-15 TAS 112 RT1211.02-15 Restoring Moment RT1211.02-15 Aerodynamic Multiplier RT0908.01-14 TAS 112 RT0923.01-14 TAS 112 RT0923.02-14 TAS 112 RT0912.01-14 Restoring Moment /Aerodynamic Multiplier RT1203.03-18 TAS 112 RT0819.03-19 TAS 112 4c-DPBS-20-LSOTM-Ol.A-RI TAS 101 2002T0003.10 TAS 101 Date Dec. 1998 March 1999 March 1999 October 2007 August 2007 February 1996 Ap-i 1 1996 Dec^mber 1996 D;.cember 1996 Dec%nnber 1936 ThP,�Pmber 1996 March 199-') April 1999 Anril 1999 12/10/15 04/16/16 12/11/15 09/18/14 09/30/14 09/30/14 09/18/14 12/11/18 08/29/19 12/17/20 10/05/20 MIAMI•DADE COUNTY NOA No.: 21-0420.11 • Expiration Date: 01/29/25 Approval Date: 09/02/21 Page 4 of 9 3. LIMITATIONS 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile applications, a static field uplift test shall be performed in accordance with TAS 106. 3.3 Applicant shall retain the services of a Miami -Dade County Certified Laboratory to perform quarterly test in accordance with TAS 112, appendix 'A'. Such testing shall be submitted to the Miami -Dade Product Control office for review. 3.4 Minimum underlayment shall be in compliance with the applicable Roofing applications Standards listed section 4.1 herein. 3.5 4/12 minimum slope for mechanically attached tiles. 3.6 30/90 hot mopped underlayment applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayment material manufacturers published literature. 3.7 This acceptance is for wood deck applications. Minimum deck requirements shad he in compliance v,i+.h applicable building code. 3.8 All products listed herein shall have a quality assurance audit in accordance wi'L 1L F lorida Building Code and Rule 61 G20-3 of the Florida Administrative Code. 4. INSTALLATION 4.1 Crown Windsor Roof Tile and its components shall be installed in strict compliance with Roofing Application Standard RAS 118, RAS 119, and RAS 120. 4.2 Data For Attachment Calculations Table 1: Average Weight (W) and Dimensions (I x w ) Tile Profile Weight-W (lbf) Length-1 (ft) Width-w (ft) Windsor Shake, Windsor Split Shake, 11.7 1.42 1.08 Windsor Slate Table 2: Aerodynamic Multipliers - A (ft) Tile Profile A (ft3) A (ft) Batten Application Direct Deck Application Windsor Shake, Windsor Split Shake, 0.289 0.313 Windsor Slate Table 3: Restoring Moments due to Gravity - Mg (ftAbf) Tile 2":12" 3":12" 4":12" VAT' VAT' 7"•12" or Profile greater Windsor Battens Direct Battens Direct Battens Direct Battens Direct Battens Direct Battens Direct Shake, Deck Deck Deck Deck Deck Deck Windsor Split N/A 8.26 N/A 8.17 8.07 8.04 7.91 7.87 7.72 7.67 7.50 7.46 Shake, Windsor Slate NOA No.: 21-0420.11 QIMLAMM•DADE COUNTY j • , l , Expiration Date: 01/29/25 Approval Date: 09/02/21 Page 5 of 9 Table 4: Attachment Resistance Expressed as a Moment - Mf (ft-lbf) for Mechanically Attached Systems Tile Profile Fastener Type Direct Deck (min 15/32" plywood) Direct Deck (min. 19/32" plywood) Battens Windsor Shake, Windsor Split Shake, Windsor Slate 2-10d Ring Shank Nails 30.9 38.1 17.2 1-10d Smooth or Screw Shank Nail 7.3 9.8 4.9 2-10d Smooth or Screw Shank Nails 14.0 18.8 7.4 1 #8 Screw 2 #8 Screw 30.8 51.7 �0.8 61. 7 _ .8.2 i 24.4 1-10d Smooth or Screw Shank Nail Field Clip) 24.3 24.3 24.2 1-10d Smooth or Screw Shank Nail Eave Clip) 19.0 19.0 22.1 __j 34.8 32.2 2-10d Smooth or Screw Shank Nails Field Clip) 35.5 T,35.5 lee", 2-10d Smooth or Screw Shank Nails (Eave Clip) 31.9 31.9 2-10d Ring Shank Nails' 50.3 65.5 48.3 1 Installation with a 4" the headlap and fasteners are located a min. of 2'/2" from head of tile. Table 5: Attachment Resistance Expressed as a Moment Mf (ft.-Ibf) for Two Patty Adhesive' Set Systems Tile Tile Application Minimum Attachment Profile Resistance Windsor Shake, TILE BONDTm Roof Tile Adhesive 632 TILE BOND rm Roof Tile Adhesive 653 Windsor Split Shake, Windsor Slate ICP Adhesives Pol set® AH-160 31.34 Touch 'N Seal StormBond® (one component) 985 1 See manufactures component approval for installation requirements. 2 Medium paddy weight of 8 grams between tile and underlayment, paddy weight of 8 grams on overlap of tile of TILE BONDTm Roof Tile Adhesive. 3 Medium paddy weight of 8 grams between tile and underlayment, and a second paddy weight of 8 grams next to first paddy between tile and underlayment of TILE BOND' Roof Tile Adhesive. 4 Medium paddy weight of 8 grams per paddy of Polyset® AH-160. 5 Medium paddy weight of 18 grams between tile and underlayment, paddy weight of 10 grams on overlap of tile of Touch 'N Seal StormBond ® one component) Table 6: Attachment Resistance Expressed as a Moment - Mf (ft-lbf) for Single Patty Adhesive6 Set Systems Tile Profile Tile Application Minimum Attachment Resistance Windsor Shake, Windsor Split Shake, Windsor Slate ICP Adhesives Pol set® AH-160 118.97 ICP Adhesives Polyset® AH-160 40.46 6 See manufactures component approval for installation requirements 7 Large paddy weight of 45 grams of Pol set® AH-160. 8 Medium paddy weight of 24 grams of Pol set®AH-160. NOA No.: 21-0420.11 Mu►rn•naoecouNrr Expiration Date: 01/29/25 Approval Date: 09/02/21 Page 6 of 9 Table 7: Attachment Resistance Expressed as a Moment - Mr(ft-lbf) for Mortar Set Systems Tile Tile Attachment Profile Application Resistance Windsor Shake, Mortar Set9 39.0 Windsor Split Shake, Windsor Slate 9 Seespecific mortar manufacturers Notice of Acceptance 5. LABELING All tiles shall bear the imprint or identifiable marking of the manufacturer's name cr logo (Sen. Det-til Below), or following statement: "Miami -Dade County Product Control Approved". VSHMIDEOM �Yq IGIpfCi)mm CROWN WINDSOR ROOF TILE (LOCATED ON UNDERSIDE OF TILE) 6. BUILDING PERMIT REQUIREMENTS: 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Any other documents required by Building Official or Applicable building code in order to properly evaluate the installation of this system. NOA No.: 21-0420.11 Expiration Date: 01/29/25 Approval Date: 09/02/21 Page 7 of 9 4 13" PROFILE DRAWINGS WINDSOR SHAKE FASTENER HOLES FASTENER MOLES NOA No.: 21-0420.11 Expiration Date: 01/29/25 Approval Date: 09/02/21 Page 8 of 9 13' WINDSOR SPLIT SHAKE END OF THIS ACCEPTANCE MIAMI•DADE COUNTY � uma NOA No.: 21-0420.11 Expiration Date: 01/29/25 Approval Date: 09/02/21 Page 9 of 9 �M IA�M;rI�-aw MIAMI-DADE COUNTY PRODUCT CONTROL SECTION DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) 11805 SW 26 Street, Room 208 BOARD AND CODE ADMINISTRATION DIVISION Miami, Florida 33175-2474 T (786) 315-2590 F (786) 315-2599 NOTICE OF ACCEPTANCE (NOA) www.miamidade.gov/economy The Dow Chemical Company 1605 Joseph Drive 200 Larkin Center Midland, MI 48674 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction matPria?s. The documentation submitted has been reviewed and accepted by Miami -Dade County RER - Product Control Section to be used in Miami -Dade County and other areas where allowed by the Authority Having Jurisdiction ,;AHJ). This NOA shall not be valid after the expiration date stated below. The Miami -Dade Count-i Pr.)dact Control Section (in Miami -Dade County) and/or the AHJ (in areas other than Miami -Dade County) reserve the right to h4vv this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, me manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. RER reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: TILE BOND' Roof Tile Adhesive LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA renews NOA No.14-0820.08 and consists of pages 1 through 8. The submitted documentation was reviewed by Gaspar J Rodriguez. 4jA- NOA No.: 16-0222.01 Expiration Date: 08/23/21 Approval Date: 04/14/16 Page 1 of 8 ROOFING COMPONENT APPROVAL Category: Roofing Sub Category: Roof Tile Adhesive Material: Polyurethane SCOPE: This approves TILE BOND' Roof Tile Adhesive as manufactured by The Dow Chemical Company as described in this Notice of Acceptance. For the locations where the pressure requirements, as determined by applicable building code, do not exceed the design pressure values; as obtained by calculations in compliance with Roofing Application Standard RAS 127. For use with approved flat, low, and high profile roof tile systems using TILE BONO " Roof Ti'e Adhesive. PRODUCTS MANUFACTURED BY APPLICANT: Product Dimensions Test Specifications TILE BOND' Roof Tile N/A TAS 101 Adhesive PRODUCTS MANUFACTURED BY OTHERS: Produe. Lcscripth n Single component polyurethane fiain roof tile adhesive Any Miami -Dade County Product Control Accepted Roof Tile Assembly having a current NOA which list attachment resistance values with the use of TILE BOND roof tile adhesive. MANUFACTURING LOCATION: Wilmington, IL PHYSICAL PROPERTIES: Property Test Density ASTM D 1622 Compressive Strength ASTM D 1621 Tensile Strength ASTM D 1623 Water Absorption ASTM D 2842 Moisture Vapor Transmission ASTM E 96 Dimensional Stability ASTM D 2126 Closed Cell Content ASTM D 2856 Results 1.83 lbs./ft.3 14.31 psi 31.21bf @ 180°F, 65% RH for 120 days, concrete to concrete 2.21% absorbed by Volume 3.00 Perm / Inch -0.47% Volume Change @-40°C., 2 weeks -4.05% Volume Change @70°C., 100% Humidity, 2 weeks 86.3% Note: The physical properties listed above are presented as typical average values as determined by accepted ASTM test methods and are subject to normal manufacturing variation NOA No.: 16-0222.01 Expiration Date: 08/23/21 Approval Date: 04/14/16 Page 2 of 8 EVIDENCE SUBMITTED: Test Azeney Test Identifier Test Name/Report Date IBA Consultants Inc. 4848-8 TAS 101 05/19/08 4848-7 TAS 101 05/19/08 4848-6 TAS 101 05/19/08 4848-5 TAS 101 05/19/08 4848-4 TAS 101 P5/19/08 4848-3 TAS 101 ('-`/19/08 4848-2 TAS 101 C5/19;08 4848-1 TAS 101 65/19108 Trinity ERD D9840.09.09 TAS 110 W/111,109 INSTALLATION: 1. TILE BOND' Roof Tile Adhesive may be used with any roof tile assembly having a cniTent NOA that lists attachment resistance values with the use of TILE BONDTM Roof Tile Adhesive. 2. TILE BOND' Roof Tile Adhesive shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof tile assembly's adhesive attachment with the use of TILE BOND' Roof Tile Adhesive shall provide sufficient attachment resistance to meet or exceed the resistance value determined in compliance with Miami -Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA. 3. TILE BOND' Roof Tile Adhesive and its components shall be installed in accordance with Roofing Application Standard RAS 120, and The Dow Chemical Company TILE BOND' Roof Tile Adhesive Operating Instruction and Maintenance Booklet. 4. Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by The Dow Chemical Company. 5. Pressure treated wood filler block shall be required on all eave course of all tile profiles, except on two piece barrel tile 6. Tiles must be adhered in freshly applied adhesive. Tile must be set within 4 minutes after TILE BOND" Roof Tile Adhesive has been dispensed. 7. TILE BONDTM Roof Tile Adhesive placement and minimum patty weight shall be in accordance with the 'Placement Details' herein. Each generic tile profile requires the specific placement noted herein. NOA No.: 16-0222.01 Mia Fjm a gi Expiration Date: 08/23/21 Approval Date: 04/14/16 Page 3 of 8 LIMITATIONS: 1. Fire classification is not part of this acceptance. 2. TILE BONDTM Roof Tile Adhesive can be used with flat, low, medium and high tile profiles. 3. Minimum underlayment shall be in compliance with the Roofing Application Standard RAS 120. 4. Roof Tile manufactures acquiring acceptance for the use of TILE BOND' Roof Tile Adhesive roof tile adhesive with their tile assemblies shall test in accordance with TAS 101 with section 10.4 as modified her,Jn. F W 2 F'= MS 5. All products listed herein shall have a quality assurance audit in accordance with the Flori�i3 Building Code and Rule 61G20-3 of the Florida Administrative Code. LABELING: All approved products listed herein shall be labeled and shall bear the imprint or identifiable marking of the manufacturer's name or logo and following statement: "Miami -Dade County Product Control Approved" or the Miami - Dade County Product Control Seal as shown below. ' kPP�7YH1 BUILDING PERMIT REQUIREMENTS: As required by the Building Official or applicable building code in order to properly evaluate the installation of this system. TABLE 1: ADHESIVE PLACEMENT FOR EACH GENERIC TILE PROFILE Tile Profile Placement Detail Minimum patty Weight per tile (grams) Contact Area (Square inches) Flat / Low Profile #1 11.1 19.5 Medium Profile #2 11.0 19.5 High Profile ( Head) High Profile (Nose) #3 22.0 11.0 39 19.5 Two Piece Barrel #4 11.6 20 NOA No.: 16-0222.01 Expiration Date: 08/23/21 Approval Date: 04/14/16 Page 4 of 8 ADHESIVE PLACEMNT DETAIL LOW (FLAT) PROFILE DETAIL #1 NOA No.: 16-0222.01 Expiration Date: 08/23/21 Approval Date: 04/14/16 Page 5 of 8 MEDIUM PROFILE DETAIL #2 NOA No.: 16-0222.01 Expiration Date: 08/23/21 Approval Date: 04/14/16 Page 6 of 8 HIGH PROFILE DETAIL #3 NOA No.: 16-0222.01 Expiration Date: 08/23/21 Approval Date: 04/14/16 Page 7 of 8 BARREL PROFILE DETAIL #4 END OF THIS ACCEPTANCE NOA No.: 16-0222.01 Expiration Date: 08/23/21 Approval Date: 04/14/16 Page 8 of 8 Cu O Z 0 E u a) D Q w O t W v w w co...I H Q m z D o = Z t7 o Q N D 0 Z w U N u c u. Q J J p O N c O N V� .� Z � � } N �f1 � �+- Fti N IW W w �ii'4 Z Q�MM� — V N O �fi. a a w O a a O F' V = L.L c i w �j• ►,a V Z W c�a u O O U. Z _ L Z z90 m I— c -0 c Q � Q N ' �O QO V) o H OtO �O °W O"oZaZ = Lu ENZ W W c WNWZ Z u c z p Z = U 3 O 0 O : a m V U Z `; a W Ln LL O CC x L ~ O > Q Leio N Q > W Z a 0 0 w c ~ V ~ i) Q v► � N o W F- � 0 R► 0 m 0 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2021 THROUGH SEPTEMBER 30, 2022 D BA: Business Name: PIONEER ROOFING COMPANY LLC Owner Name: NATHAN DAPEER Business Location: 2026 GRANT ST HOLLYWOOD Business Phone: 920-8880 Rooms Seats Employees 10 Number of Machines: Receipt #:ROOFING/SHEET METAL CONTRACTOR Business Type: (ROOFING CONTR) Business Opened:11/17/1982 State/County/Cert/Reg:CCC 13 3 2 5 0 7 Exemption Code: ng Business Only Machines Vendina Tvoe: Professionals Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 1 0.00 1 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning 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 it is in compliance with State or local laws and regulations. Mailing Address: NATHAN DAPEER Receipt #01C-20-00002353 2026 GRANT ST Paid 09/17/2021 27.00 HOLLYWOOD, FL 33020 2021 - 2022 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2021 THROUGH SEPTEMBER 30, 2022 DBA:PIONEER ROOFING COMPANY LLC Business Name: Owner Name: NATHAN DAPEER Business Location: 2026 GRANT ST HOLLYWOOD Business Phone: 920-8880 Receipt#: 185-125064 Business Type: ROOFING/ SHEET METAL CONTRACTOR (ROOFING CONTR) Business Opened:11/17/1982 State/County/Cert/Reg: CCC1332507 Exemption Code: Rooms Seats Employees Machines Professionals 10 Signature For Vending Business Only Numher of MachinPc� Vanrlinn Tuna- Tax Amount I Transfer Fee I NSF Fee I Penalty I Prior Years I Collection Cost I Total Paid 27 .001 0.001 0.001 0.001 0.001 0.00 27.00 Receipt #01C-20-00002353 Paid 09/17/2021 27.00 A� �® CERTIFICATE OF LIABILITY INSURANCE DA3 (..IDD�) 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: PHOIAIC_NENo. (954) 943-5050 FAX No: (954)942-6310 Frank H. Furman, Inc. 1314 East Atlantic Blvd. E-MAIL Lexie@furmaninsurance.com ADDRESS: INSURERS AFFORDING COVERAGE NAIC # P. O. BOX 1927 INSURERA:Great American E & S Insurance Company 37532 Pompano Beach FL 33061 INSURED INSURER B: Obsidian Specialty Insurance Company 16871 INSURER C: American Insterstate Insurance Company 31895 Pioneer Roofing Company, LLC INSURERD: 2026 Grant Street INSURER E : INSURERF: Hollywood FL 33020 COVERAGES CERTIFICATE NUMBER:21-22 GL XS we 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 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICYNUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X� OCCUR E766560 11/13/2021 11/13/2022 EACH OCCURRENCE $ 1,000,000 DAMAGE(RENTED PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: POLICY a jEO LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS AUTOS COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ J BODILY INJURY (Per accident) $ FIR PE tlenDAMAGE $ $ B UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE EAE000D062-00 11/13/2021 11/23/2022 EACH OCCURRENCE $ 2,000,000 X AGGREGATE $ 2,000,000 DED I X I RETENTION $ 0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA AVWCFL3039932021 11/13/2021 11/13/2022 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) License number is CCC1332507 re: Nathan Dapeer CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Building Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd Ave ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Dirk DeJong/EF � AIV ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD