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MCC-06-23-1535
Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 1330 NE lOSTH ST 302, Miami Shores, FL 33138 Contacts - Permit NO.: MCC-06-23-1535 Permit Type: Mechanical - Commercial Work Classification: A/C Replacement Permit Status: Approved Issue Date:07/13/2023 I Expiration: 01/13/2023 Parcel Number 1122320580110 Reina Murray Owner CENTRAL COMFORTAIR CONDITIONING Contractor 1330 NE 105 ST 302, Miami Shores, FL 33138 ALEX ALBERT MARTINEZ 12310 SW 129 CT, Miami, FL 33186 Business:3055987575 centralcomfortacmiami@yahoo.com Ins e Description: TO REPLACE MCC-02-22-519 - EXACTA/C Valuation: $ 6,056.00 cuon Requests: REPLACEMENT 305-762 4949i fl l�r Total Sq Feet: 0.00 Fees Amount Payments Date Paid Amt Paid 100% Permit Renewal Fee $211.96 Total Fees $211.96 Total: $211.96 Credit Card 07/13/2023 $211.96 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 construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. Rle.� �fi,w�z Authorized Signature: Owner / Applicant / Contractor Agent Date July 13, 2023 Page 2 of 2 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑PLUMBING 0 MECHANICAL [:]PUBLICWORKS JOB ADDRESS: 1330 NE 105TH ST #302 Master Permit JUN 16 cJCJ L #01 FBC 20Z W-(--cam -22 -S(9 Sub Permit No. "(Sr -M-Z3 J ❑ REVISION ❑ EXTENSION QRENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: Foiio/Parcel#:11-2232-058-0110 Is the Building Historically Designated: Yes NO Occupancy Type:M Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Timothy Murry/ Phone#: Address:1330 NE 105TH ST #302 City: MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: Phone#: 305-331-3791 Email: SHORESHOMESERVICES@GMAIL.COM CONTRACTOR: Company Name: CENTRAL COMFORT AIR CONDITIONING Address: 12310 SW 129TH CT 305-598-7575 City: MIAMI State: FL Zip: 33186 Qualifier Name: ALEX MARTINEZ Ccw�r�l Cpr*��mligc minr�> QWb•CoWhone#: 305-598-7575 State Certification or Registration #: CAC057552 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: State: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace Description of work: EXACT AC CHANGE OUT Specify color of color thru Submittal Fee $ Permit Fee $ Scanning Fee $ Technology Fee Radon Fee $ Training/Education Fee $ Zip: ❑ Demolition CCF $ CO/CC $ _ DBPR $ Notary Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ Q TOTAL FEE NOW DUE $ z I • _` Bonding Company's Name (if applicable) Bonding Company's Address City S1 Mortgage Lender's Name (if applicable) Mortgage Lenders Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws re ulating 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: 1 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 ropy 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 nol ice, the inspection will not be approved and a reinspection fee will be charged. — % rNERorAGENT The foregoing instrument was acknowledged before me this day of 20 2 . by me or who has The foregoing instrument was acknowTedgtdJefore met is clay of TU IV 20 by _, who is personally knpwn to RUX VQO(fi E who is persor G Ys t_-1 v 41 V a s me or who has produced Identification and who did`taik an of NOTARY PUBLIC: Sign: r� V Print: J rl t Seal: 5i�i'� G c i dal APPROVED BY (Reviwd02/24/2014) �=}tZ3: s ,g�� identification and who did take an oath. Print Plans Examiner Structural Review PUBLIC: Notary Public • State of Florida Commission k GG 922453 My Comm. Expires Oct 14, 2023 ed through National Notary As,n to as JUN 16 2023 AIR CONDITIONING REPLACEMENT DATA Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax:(305) 756.8972 PERMIT NUMBER: MC C—O'2-V_ k 1 This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address (where the work is being done): l *�) "J C) N cC i05 lr S'r -4 3U2 City: Miami Shores Village County: Miami Dade Zip Code: 3300 6 ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means: YES[] NO P ARHI Sheet Attached: YES NO ❑ Contract Attached: YES ZI UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER Leonox AHU or PKG. UNIT MODEL# U "�J-01ko COND. UNIT MODEL # NL,��4X.C1$ d KW HEAT NOM TONS AHU CU PKG 1)M.C.A AHU CU PKGaj AHU CU PKG 2) M.O.P AHU Cu PKG AHU Cu PKG 3) VOLTS AHU Cu PKG PKG UNIT / / PKG UNIT EER/SEER 15� YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES CNO 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 54 3. Voltage of Circuit (208/240/480): ZD% 2-L1 c 4. Size Disconnecting Means: 35 s . p Contractor's Company Name.( ejwa 1 C.ornftcy Pt-% r ( Df)ekon[N�'AU Phone: State Certificate or Registration NoCP%C0595'SZ. Certificate of Competency No. Signature W-f %yLAi' Date: (Qualifiers sign (Revised02/24/2014) 1330 Northeast 105th Street #APT 302 Miami Shores, FL 33138 USA Central Comfort Air Conditioning Corp. Invoice 30594 12066 SW 117th Court, Miami, Florida 33186 Invoice Date 2/4/2022 United States Terms New AC System (305)504-8441 Completed Date 2/4/2022 Customer PO Job Address TIM MURRAY 1330 Northeast 105th Street #APT 302 Miami Shores, FL 33138 USA Description of Work Task # Description Quantity Your Price Your Total Crane Service Lowering old unit and raising new condensing unit 1.00 $500.00 $500.00 Mechanical Permit Permits are required to protect all people from the effects of repairs, replacements or 1.00 $450.00 $450.00 new construction. With proper permitting and inspections you can ensure that the work being performed inside your home are done correctly and that no shortcuts have been taken when it comes to building codes. If code enforcement see that work has been performed without a permit, you can expect to see a fine with VERY EXPENSIVE fees and penalties attached, and guess who is responsible for paying? The homeowner. Split System AC Split System Installation Includes: 1.00 $0.00 $0.00 Installation - Removal and Disposal of existing unit - Replace existing stand and install new Aluminum stand - New Digital Thermostat - New Water Leak Prevention Sensor - Reconnect to existing ductwork, electrical, plumbing - New digital thermostat - New vibration pads for noise control of unit - New Hurricane Approved Tie Downs - L Brackets - New Filter Dryer - Free filter "'Materials May Be Included in the Price, if not Representative will notify if there are additional cost*" Service & Repair Please enter Description of Service or Repair needed to get the unit cooling again: 1.00 $0.00 $0.00 NEED TO REMOVE THE AIR HANDLER FIRST, OWNER WILL THEN FIX UP AIR HANDLER CLOSET. ONCE COMPLETED WE WILL RETURN TO FINISH JOB III FEB 2 5 2022 D AIR CONDITIONING REPLACEMENT DATA Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax:(305) 756.8972 PERMIT NUMBER: MCC -1-3 `� " ti ( I This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet. Multiple units on single sheets are not acceptable. JJ, Job Address (where the work is being done): City: Miami Shores Village County: Miami Dade zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means: YES [I NO 0 ARHI Sheet Attached: YES ® NO ❑ Contract Attached: YES UNIT BEING REPLACED DATA NEW UNIT a el:% aL MANUFACTURER UNIV 017 oc. 0 J AHU or PKG. UNIT MODEL#t 2-S 03ty 3p o C 03 L'o COND. UNIT MODEL# rnL_ 10 ") • 5 1 .v KW HEAT .J ' '$U NOM TONS 3 tor-i AHU Cu PKG 1) M.C.A AHU Cu PKG AHU Cu PKG 2) M.O.P AHU Cu PKG AHU Cu PKG 3)VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER YES NO REPLACING DUCTS YES O ES NO REPLACING THERMOSTAT YES NO YES 14QJ NEW 4"CONCRETE SLAB YES NO NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES N 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 100 3. Voltage of Circuit (208/240/480): Zo 4. Size Disconnecting Means: N a ft � p Contractor's Company Name: LQ411 7 m (r � r Phone: State Certificate or Registration m- "No.pCI� Certificate of Copency No. Signature Q---y r rt'ozb. Date: 011-1, t 22. (Revised02/24/2014) Certificate of Product Ratin AHRI Certified Reference Number: 204289055 Date: 02-23-2022 Model Status: Active AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series: MERIT ML14XC1 SERIES Outdoor Unit Brand Name: LENNOX Outdoor Unit Model Number (Condenser or Single Package) : ML14XCl S036-230C'• Indoor Unit Model Number (Evaporator and/or Air Handier): CBA25UHV-036-23V* Region: Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SO, UT, VT, WA, WV, WI, WY, U.S. Territories) Region Note: Central air conditioners manufactured prior to January 1, 2015 are eligible to be installed In all regions unfil June 30, 2016. Beginning July 1, 2016 central air conditioners can only be installed in region(s) for which they meet the regional efficiency requirement. The manufacturer of this LENNOX product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of AHRI 210/240 - 2017 with Addendum 1, Performance Rating of Unitary Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (A2) - Single or High Stage (95F), btuh : 33800 SEER: 15.10 EER (A2) - Single or High Stage (95F) : 12.50 t'Active' Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offenng for sale; OR new models that are being marketed but are not yet being produced.°Production Stopped' Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering for sale. Ratings that are accomoanied by WAS indicate an involuntary re -rate. The new oublished rating is shown alono with the Drevious (i.e. WASI rating. DISCLAIMER AHRI does not endorse the product(s) listed on this certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed In the directory at www.ahrldirectory.org. TERMS AND CONDITIONS amm This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for Individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or In part, be reproduced; copied; disseminated; irmn entered Into a computer database; or otherwise utilized, in any form or manner or by any means, except for the users Individual, personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate- link Ne make lile better' and enter the AHRI Certified Reference Number and the date on which the certificate was Issued, which is listed above, and the Certificate No., which Is listed at bottom righL -- ©2022Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 1329OD990730454332 18C27 Efficient, durable air conditioner 1.00 $5,106.00 $5,106.00 Dimensions: 33.25 H X 28.25 W X 28.25 D Designed for efficient durability The ML14XC1 air conditioner is designed for smart energy use, and designed to last Efficiency ratings of up to 17.00 SEER mean the ML14XC1 can reduce utility bills without any compromise in comfort. It may also make you eligible for local utility rebates. Dependable performance, even in harsh conditions The coil inside an air conditioner helps keep your home cool by pulling the heat out of the air. The Lennox' Quantum? coil handles the heat like no other. It's constructed from fortified aluminum alloy, helping it resist corrosion in harsh conditions like coastal environments. Proven engineering The ML14XCl is built with a scroll compressor that's engineered to reliably deliver the cooling your home needs. Options for controlling contaminants The cool comfort and peace of mind you get from the ML14XC1 is enhanced when the unit is paired with indoor air quality (IAO) products, such as the Healthy° Climate whole -home dehumidifier. By helping control mold, mildew and other contaminants, an IAQ accessory can make your indoor air feel better. Unlike some portable units, these accessories improve the air without producing ozone, a known lung irritant. LENNOX ML14XCIS-036-230 CBA25UHV-036-230 Variable -speed air handler that delivers quiet and high -efficiency comfort. Dimensions: 1.00 53.63 H X 21.5 W X 22 D $0.00 $0.00 Never Settling For Less Welcome to the Lennox standard of excellence. Merit" Series is the introductory product line that raises the bar for heating and cooling equipment. Don't settle when it comes to the air inside your home ask for more. Ask for Merit. Ask More from Your Air. With years of rigorous testing under the most extreme conditions, our Quantum Coil featuring a proprietary aluminum alloy exclusive to Lennox is designed to weather the harshest elements. Comfort at Any Speed A variable -speed motor delivers consistent temperatures and steady, even airflow throughout the home. Quiet Operation Fully -insulated cabinet reduces sound for quiet operation and helps prevent cabinet sweating in hot and humid environments. I Optional electric back up heat Delivers an instant boost of hot air for added comfort when you need it most. Lennox CBA25UHV-036-230 ECBA25-10CB Heat Strip; Use with CBA25UHV-042 1.00 $0.00 $0.00 1 r\II. I^%I A11111 A\SMI rn PI IRHI r►A MMAf %1 PI r/-Vn6P- 1Ir ATr11 Paid On Type Memo Amount 2/4/2022 American Express $3,028.00 Potential Savings $605.60 Sub -Total $6,056.00 Tax $0.00 Total Due $6,056.00 Payment $3,028.00 Balance Due $3,028.00 Thank you for choosing Central Comfort Air Conditioning Corp. This invoice is agreed and acknowledged. Payment is due upon receipt. A service fee will be charged for any returned checks, and a financing charge of 1% per month shall be applied for overdue amounts. I find and agree that all work performed by Central Comfort Air Conditioning Corp. has been completed in a satisfactory and workmanlike manner. I have been given the opportunity to address concerns and/or discrepancies in the work provided, and I either have no such concerns or have found no discrepancies or they have been addressed to my satisfaction. My signature here signifies my full and final acceptance of all work performed by the contractor. Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: MCC-02-22-519 Permit Type: Mechanical - Commercial Work Classification: A/C Replacement Permit Status: Approved Issue Date:03/16/2022 Expiration:09/16/2022 Location Address Parcel Number 1330 NE 105TH ST 302, Miami Shores, FL 33138 1122320580110 Contacts Reina Murray Owner CENTRAL COMFORT AIR CONDITIONING Contractor 1330 NE 105 ST 302, Miami Shores, FL 33138 ALEX ALBERT MARTINEZ Description: EXACT A/C REPLACEMENT Valuation: $ 6,056.00 Ins ection Requests: 905-762-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $4.20 DBPR Fee $3.18 DCA Fee $2.12 Education Surcharge $1.40 Permit Fee $161.96 Scanning Fee $9.00 Technology Fee 55.30 Total: $7.37.16 Payments Date Paid Amt Paid Total Fees $237.16 Credit Card 02/25/2022 $50.00 Credit Card 03/16/2022 $187.16 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 construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. 3.93 lf-, 3\}(J'Iiz2 Authorized Signature: Owner / Applicant / Contractor I Agent Date March 16, 2022 Page 2 of 2 Miami,Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING Master Permit Sub Permit No. II I FEB 252022 FBC 20 Z09 ACC- �)Z-_ 2-2-' ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 133 «� �a� 3CZ City: Miami Shores County: Miami Dade Zia: 3313-8 Folio/Parcel#: I I -'rn—z-Mq�'- 0 \\ D Is the Building Historically Designated: Yes NO X Occupancy Type: I oad: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder) City: Yi m (Ze i nc, R") Phone#: C-2'43 A - ?q 91 State: V L 33 (3 Tenant/Lessee Name: /Q/It Phone#: W Email: 4rmc-0n5'Wnci`nc�clvnCai�.c�✓r, �ririVevttl}@gvno�I COVVN CONTRACTOR: Company Name: CW "i'b\ CUI\ICDI-N NL ( Qnr not\ .NC Phone#:?.O�-�'1`15-�1�1� Address: \Z�)\O SW \1Gh\Y\ Or City: ``A%?rMI State: 1-1� Zip: -;�-'S\4A`n Qualifier Name: r--- -r. pLa't Phone#:?�bC-S�lc? - �S State Certification or Registration M CAC Cf,--) SSZ Certificate of Competency #: DESIGNER: Architect/Engineer: State: Zip: Value of Work for this Permit: $ 1120'�JV Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: N \1 C Specify color of color thru Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Permit Fee $ Radon Fee $ Training/Education Fee $ CCF DBPR $ COAC $ Notary $ Double Fee $ Bond $ R TOTAL FEE NOW DUE $ I R (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 Z0 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. Signatur r WNERorAGENT The foregoing instrument was acknowledged before me this day of TP �p L GW . 20 ��, by who is personally known to me or who has produced L jA 4nilm-TS JjCtn<t as identification and who did take an oath. NOTARY PUBLIC: Notary Public State of Fkxft Zanja Marquez My commission GG 249005 Expires 08/15/2022 Signature 01 "X CONTRACTOR The foregoing instrument was acknowledged before me this i 6t day of reV.)(0zs(S4 20 ZZ , by pt9-X to e\-N A-e—t , who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Print: Seal: APPROVED BY J y y (tf// -Plans Examiner as CYNTHIA WSW GARRIDO Notary Public - State of Florida Commission # GG 922453 My Comm. Expires Oct 14, 2023 ed through National Notary Assn. Zoning Structural Review (Revised02/24/2014) Clerk r '_i. r.-,. :!' .. :'i ... ... ;'.''i .ls�t) 'i. ._ � i ..-,!_. .... 't ,!i:.._. ' i1;. .�. ., .,ii •. rt �.� .:11.. -. .. _ '�:. � t :li. t• • • �' t _.�: •''.. � i• - is r -' '''''•f-�'- _.i.. _ -.: �>�.., ,-_, _ .. 1. �i •�i7• ,ll .;,'t. - •. .t: - t ,., t'. � '. 1'�. .!�• , , -. • it • M l+ it l�il Sctcl &•I j.4 /l ila M:LI Ny�qJ'.�T�y �t.r)O:• '1i 11GT2 LT'I�L,O'. : , ,; ` f gC:�Lt i +t• q}fE.tGJ:::fw •�.:':.1'i rays y'C(tr r �=•1+r fl;i i iiUfl4{�1,T•i•� _• rI �- �ti � 1 :�i ti�)liiY� }.�!�rr.''� � �.(� �i '. ��iij T �:lti.'•.'.iTli:>.. fil.Til:.j i�� =i,: � t�}l7�'as 7.!':iiri.Rl!illf;f)1 �•.. !► ,'� _ _•l�1tjG•�Q13� �'�f '•rRe�b�'aFo4,,d�� • J :J.1' _ .r'r'0'x•'�• . . r OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-2232-058-0110 1330 NE 105 ST UNIT: 302 Property Address: Miami Shores, FL 33138-2100 TIMOTHY B MURRY Owner REINA MURRAY Mailing Address 1330 NE 105 ST #302 MIAMI SHORES, FL 33138-2148 PA Primary Zone 4900 MULTI -FAMILY - CONDOMINUM 0407 RESIDENTIAL -TOTAL VALUE Primary Land Use : CONDOMINIUM - RESIDENTIAL Beds I Baths I Half 2/2/0 Floors 0 Living Units 1 Actual Area Sq.Ft Living Area 1,465 Sq.Ft Adjusted Area 1,465 Sq.Ft Lot Size 0 Sq.R Year Built 1970 Assessment Information Year 2021 2020 2019 Land Value $0 $0 $0 Building Value $0 $0 $0 XF Value $0 $0 $0 Market Value $232,403 $232,403 $232,403 Assessed Value $120,222 $118,563 $115,898 Benefits Information Benefit Type 2021 2020 2019 Save Our Homes Cap Assessment Reduction $112 181 $113,840 $116,505 Homestead Exemption $26,000 $25,000 $25.000 Second Homestead Exemption a $25,000 $25,000 $25,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description BRYNWOOD CONDO UNIT 302 THIRD FLOOR UNDIV 7.53% INT IN COMMON ELEMENTS CLERKS FILE 71R-248315 OR 17998-3857 0298 1 Generated On: 2/4/2022 Taxable Value Information 2021 2020 2019 County Exemption Value $50,000 $50.000 $50,000 Taxable Value 1 $70,222 $68,563 $65,898 School Board Exemption Value $25.000 $25,000 $25,000 Taxable Value 1 $95.222 $93,563 $90,898 City Exemption Value 1 $50,000 $50,000 $50,000 Taxable Value 1 $70,2221 $68,563 $65,898 Regional Exemption Value 1 $50,000 $50,000 $50,000 Taxable Value $70,222 $68,563 $65,898 Sales Information Previous Sale Price OR Book -Page Qualification Description O6/01/2003 $146,950 21443-0844 Sales which are qualified 02/01/1998 $65,000 17998-3857 Sales which are qualified 04/01/1979 $68,000 10421-1456 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:/Av .Miamidade.gov/info/disclaimer.asp Miami, Florida February 11, 2022 ktipAg2101IN RZT,L\'IdiP►Ld 1 t►F We authorize, Central Comfort Air Conditioner, to perform service(s) in unit 302. They are authorized to remove/install the air handler in unit 302. Please provide a certificate of insurance. Cordially, Reina Murray - Br wood Condominium Treasurer Detail by Entity Name Page 1 of 3 Florida Department of State f s � s :>fXO 9 Denarlmenl of Stale / Division of Corporations / Search Records / Search by Entity Narne / Detail by Entity Name Florida Not For Profit Corporation BRYNWOOD CONDOMINIUM, INC. Filing Information Document Number 722215 FEIIEIN Number N/A Date Filed 12/06/1971 State FL Status ACTIVE Last Event REINSTATEMENT Event Date Filed 10/19/2005 Principal Address 1330 NE 105TH STREET MIAMI SHORES, FL 33138 Changed: 10/19/2005 Mailing Address 1330 NE 105TH STREET MIAMI SHORES, FL 33138 Changed: 10/19/2005 Reaistered Accent Name & Address Murray, Reina 1330 NE 105TH STREET 302 MIAMI SHORES, FL 33138 Name Changed: 05/10/2017 Address Changed: 05/10/2017 Officer/Director Detail Name & Address Title T MURRAY, REINA 1330 N.E. 105TH ST., SUITE 302 MIAMI SHORES, FL 33138 DIVISION OF CORPORATIONS http://search.sunbiz.org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 2/25/2022 Detail by Entity Name Page 2 of 3 Title VP MILLER, JONATHAN 1330 NE 105TH STREET, SUITE 203 MIAMI SHORES, FL 33138 Title Secretary Miller, Jessica 1 1330 NE 105th Street 103 Miami Shores, FL 33138 Title President Pink, Conrad 1 1330 NE 105th Street Apt 301 Miami Shores, FL 33138 Annual Reports Report Year Filed Date 2019 03/29/2019 2020 06/13/2020 2021 04/27/2021 Document Images 0412712021 --ANNUAL REPORT L View image at Put- format 06113/2020 • ANNUAL REPORT View image in F'DF format 03/29/2010 --ANNUAL REPOR View image in PDF format 0413012018 -- ANNUAL REPORT View image in PDF fon»at 05/101`2017._--ANNUAL II'2EPORT View image in PDF formal 01/08t2016 --ANNUAL REPORT View image in PDF format 05/02/2015 -- ANNUAL REPORT View image in PDF format 04/30/2014 -- ANNUAL aEPOR'r View image in PDF format 04/29/2013 - ANNUAL REPORT View image in PDF form 04128F2012 -- ANNUAL REPORT View image in PDF formal 07126/2011 -- ANNUAL REPORT View image in PDF format 04/30/2010 —ANNUAL REPORT View image in PDF format 04/30/2009 — ANNUAL REPORT View image in PDF format 04130/2008 -- ANNUAL. REPORT View image in PDF format 04/27/2007 -- ANNUAL KENQ_RT View image in PDF formal 09/25/2006 -- Reg. Anent Change) View image in PDF format I 09/25/2006 -- Off/Dir Resignation I View image in PDF format 04/10/2006 --ANNUAL REPORTView image in PDF format 10i19/2005 _REINSTATEMENT View image in PDF format http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 2/25/2022 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:ntYai BUSINESS ADDRESS: VLIAO SW 11c� hn (k CITY M ) MI STATE \ l— ZIP'�� f v BUSINESS PHONE: (2-)US FAX NUMBER ( ) CELL PHONE -L`-) � QUALIFIER'S NAME: �kk—' rv-:f— QUALIFIER'S LIC NUMBER: CFILCUSIS: 4� Z— ❑' Ron DeSantis, Governor Melanie S. Griffin, Secretary dbpr a STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD THE CLASS B AIR CONDITIONING CONTRACTOR HEREIN IS CERTIFIED UNDER THE • � 1 MARTINEZ, ALEX ALBERTO CENTRAL COMFORT AIR CONDITIONING CORP 9721 SW 102ND AVE RD * fiMIAMI FL 33176 r, : 7' LICENSE NUMBER: CAC057552 EXPIRATION DATE: AUGUST 31, 2024 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. Ron DeSantis, Governor Halsey Beshears, Secretary dbpr a STATE OF FLORIDA DEPARTMENT ne BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD THE CLASS B AIR CONDITIONING CONTRACTOR HEREIN IS CERTIFIED UNDER THE was • •WOMMMA191111 •kc"HiNIM9311NI CENTRAL COMFORT AIR CONDITIONING CORP 9721 SW 102ND AVE RD► MIAMI FL 33176 LICENSE NUMBER: CAC057552 EXPIRATION DATE: AUGUST 31, 2022 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. 006689 Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY 3870533 BUNNESSNANI&WCATIDN BECEl"NO. CENTRAL COMFORT AIR CONDITIONING CORFRENEWAL 12310 SW 129TH CT 4040861 MIAMI FL 33186-6500 LBT EXPIRES SEPTEMBER 30, 2023 Must be displayed at place of business Pursuant to County Code Chapter SA - Art 9 & 10 OVINIM SEC.TYPEDF BUNINBS PAYMMUCFIYED CENTRAL COMFORT AIR GONDTTIONINGCORP 196 SPEC MECHANICAL CONTRACTOR BYTAxwt 11 C/O ALEX MARTINEZ QUAUFIER CAC057552 V5.00 07/19/2022 Worker(s) 1 CHKK21-22-048803 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is note license, permit, era certification of the holder'squalifications, 0 do business. Holdermustoomply with anygovemmamel or nengovemmentel regulatory laws and mquiremants which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec ga-276. For more Information, visit wwwmiam dada mrcMaxcollmigr 004521 Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY 3870533 gUMNES NANFrLOfAnoR1 IECEaff NO. CENTRAL COMFORT AIR CONDITIONING CORRRENEWAL 12310 SW 129TH CT 4040861 MIAMI FL 33186 EXPIRES SEPTEMBER 30, 2022 Must be displayed at place of business _ Pursuant to County Code Chapter 8A - Art. 9 & 10 O OWNER REC.TYPEOFRmmm CENTRAL COMFORT AIR CONDITIONING CORP 196 SPEC MECHANICAL CONTRACTOR PAYMENTREQIYED C/O ALEX MARTINEZ QUALIRER CAC057552 $75.0OtI07/ $75.00 07/13/2021 Worker(s) 1 INT-21-337681 This Local Basis. Tax Receipt only confi.ms payment of the local Business Tax The Recelpt is note licenaa, permit are certification of the holdersquali0cadons,to do business. Holdermust comply with any gmemmental or nongovemmemal regulatorylaws end mguimnenmwhich apply to the business. The RECEIPT NO. above mud be displayed on all com emalal vehicles -Miami -Dade Code Sac 4-276. Ear more irdormafien,visH wwwmiamidade oovRexcolint, ---OW-64041 CENTCOM-01 BP P V KA DATE(MMIDD/YYYY) 7/11/2023 A4C RLY CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER C CT CIC Hotaling Insurance Services LLC 2301 NW 87th Ave Suite 401 PHONE FAX (AIC. No, Ext : 305 393-8981 AfC, No): 845 471-7494 E. certificatesMIA@hgfin.net Doral, FL 33172 INSURERIS) AFFORDING COVERAGE NAIC # INSURER A: Tokio Marine Specially 23850 INSURED INSURER B INSURER C : Central Comfort Air Conditioning Corporation INSURER D : 12310 SW 129 CT Miami, FL 33186 INSURER E INSURER F r.nVEROnFS 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 I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [X] OCCUR X X PPK2524634 2/23/2023 2/23/2024 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) 100,000 MED EXP (Anv one rson PERSONAL & ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY LOC OTHER: GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP/OP AGG 2,000,000 AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY Perperson) BOODILY INJURY Per acciderd BODILY PPS went AMAGE UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS• LIABILITY Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE OFJaEPWJry�M@�t2 EXCLUDED? (tYi a n) If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER OTH- E.L. EACH ACCIDENT E.L DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) License: CAC057552 Certificate Holder is included as an Additional Insured with respect to General Liability on a Primary and Non -Contributory basis when required by written contract. A Waiver of Subrogation applies where required by signed written contract. Miami Shore Village Building Department 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 .I-Ae - ACORD 25 (2016103) @ 1988 2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE 217/2o 2 Yam" 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 pollcy(les) 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 (305)220-2260 Eastern United Insurance JAIME CARLOS ORDONEZ A-196817 115 Fontainebleau Blvd. Suite 2A-1 Miami, FL 33172 CONTACT JAIME C. ORDONEZ PNONE FAX 0 305 220-2260 Ext. Arc Ne- 305 220-2263 E-MAIL ADORESe, JCORDONEZ®EASTERNUNITEDINS.COM INSURERS AFFORDING COVERAGE NAIC 0 INSURERA:NAUTILUS INSURANCE COMPANY 17370 INSURED CENTRAL COMFORT AIR CONDITIONING, CORP. 12310 SIN 129 CT. MIAMI, FL 33186 (305)281-7597 Ext. INSURER a: INSURERC: NSURER D: INEURERE: INSURER F: 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 TYPEOFINSURANCE POLICY NUMBER MMVD01YYYF MMT YT LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE REOCCUR X Y NN1284469 06/24/21 06/24/22 EACH OCCURRENCE S 1.000.000 PREMISES $ 100 OOO MED EXP (An oma arscn) $ 6,000 PERSONAL& ADV INJURY a 1.000.000 GENERAL AGGREGATE $ 2,000,000 GENLAGGREGATEUMITAPPLIES X POUCv PER: JECTPRC LOC PRODUCTS-COMP/OPAGG $ 2,000 000 S AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT lEa tl BODILY INJURY (Par person) S BODILY INJURY(Peraxidm) S PROP RTY DAMAGE Per accident S S B UMBRELLA LIAO EXCESS LIAB )( OCCUR CLAIMS -MADE X Y XBS0144307 09/28/21 00/01/22 EACH OCCURRENCE $ 11000,000 X AGGREGATE s 11000,000 DIEDRETENTIONS 0 PRODUCTS/COMP OPERA S 1 000 000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNEIVEXECURVE❑ OFFICEWMEMSER EXCLUDED? (Mandatory In NH) It yes, desonbs under DESCRIPTION OF OPERATIONS beWV, N/A I I WC STATUDRY LIM - I OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE E E L DISEASE - POLICY LIMIT I S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Afton ACORO 101, AddIllonel Remarks Schedule, it more space is required) AIR CONDITIONING CONTRACTOR. NO DEDUCTIBLE . WAIVER OF SUBROGATION APPLIES TO THE GENERAL LIABILITY POLICY, PRIMARY AND NON CONTRIBUTORY PROVISION. BLANKET ADDITIONAL INSURED. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS- COMPLETED COMMERCIAL OPERATIONS FORM L818(12/18). STATE LICENSE NUMBER CAC057552. CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2 AVE. ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES FL 33138 AUTHORIZED REPRESENTATIVE 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AC( khr CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) �,/' 07/11/2023 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 CONNAME: Marsh Affinity Marsh AffinityLA/C. PHONE FAX No Ext : 800.743$130 AIC, No): E-MAIL ADPTotalSource@marsh.com ADDRESS: �"c� a division of Marsh USA LLC. PO BOX 14404 INSURER(S)AFFORDING COVERAGE NAIC # Des Moines, IA 50306-9686 INSURER A: Illinois National Ins Co 23817 INSURED INSURER B: INSURER C : ADP TotalSourre I, Inc. INSURER D : 5800 Windward Parkway Alpharetta, GA 30005 Alternate Employer. INSURER E: INSURER F: Central Comfort Air Conditioning Corporation 12310 SW 129TH CT Miami, FL 331860000 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 TYPEOFINSURANCE ADDLSUBR INSD WVD POLICY NUMBER POLICYEFF (MMIDDIYYM POLICYEXP (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE ❑OCCUR DAMAGE TO RENTED PREMISES occurrence s MED EXP (Any one person) $ PERSONAL S ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO LOC JECT$ PRODUCTS - COMPIOP AGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY(Per $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESSLIAB CLAIMS -MADE DIED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN - X ISTATUTE ER E.L. EACH ACCIDENT $ 2,000.000 ANYPROPRIETORIPARTNERIEXECUTIVE A OFFICERIMEMBER EXCLUDED? F [Mandatory In NH)E.L. it yes, describe under DESCRIPTION OF OPERATIONS below NIA WC 034274994 FL 07/01/2023 07/01/2024 DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2 000 0W DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) All worksite e��oyees worldrtg for Central Comfort Air Conditioning Corporation paid under ADP TOTALSOURCE, tNC: s paynll, are covered under the above stated policy. Central Comfort Air Conditioning Corporation is an attemate employer under this policy. LICENSE# CAC057552 LICENSE# CAC057552 CERTIFICATE HOLDER CANCELLATION Miami Shores Village Bldg Department 10050 NE 2nd Ave SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores, FL 33138 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 26 (2016/03) ©1988.2016 ACORD CORPO ION. All rights reserved. The ACORD name and logo are registered marks of ACORD A� br CERTIFICATE OF LIABILITY INSURANCE oAoyl� 22 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 SUBROGA11ON IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statementon this certificate does notconfer rights to the certificate holder in lieu of such endorsements . PRODUCER Am RlskSaMces, Inc of Florida CONTACT NAME; ADn Risk Services,lncd Florida ACNoE:800.743-8130 NC No :800-522-7514 TOOT Bridal[DSu10M1100 Miami, FL 33 ADDRESS ADP.COI.Certer@Aon.mm INSURERS AFFORDINGCOVERAGE NAC A INSURER A: Illinois Naecnal Insurance, Cc 23817 INSURED ADP TotalSoace 1, Inc. INSURER B : INSURER C : 102DO Sumel Dn's Mind, FL 33173 ALTERNATE EMPLOYER INSURER D : Central Cmfod Air CondOcdng Corporation 12310 SW 129e1 CT INSURER E: INSURER F : Miami, FL33186 COVERAGES CERTIFICATE NUMBER: 3820099 REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE UST® 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 ANDCONDITIONS OFSUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCEDBY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED. INSF LTR TYPE OF INSURANCE DLSUB INSR WVD POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMDO LIMITS COMMERCIAL GENERAL LIABILITY CLNMS-MADE ❑ OCCUR I EACH OCCURRENCE $ DAMAGETORENTED PREMSES aaccunenor $ MED EXP ore $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPUES PER: POLICY [_]PROIECT❑LOC OTHER GENERALAGGREGATE $ PRODUCTS-OOMRADPAGG S $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOSONLY Ea accitlem $ BODILY INJURY PerPerim) $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ UMBRELLALIAB MESS LUB OCCUR CWMS.MADE EACH OCCURRENCE $ AGGREGATE 1 $ DEC I I RETENTION$ A WORKERS COMPENSATION AND EMPLOYERS'LIPBIUTY YIN ANY PRCPRIETCRIPARTNE (EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? (Mandatoryin NH) ere'. atom , DESCRIPTION OF OPERATIONS beIM NIA WC 038361533 FL 07101/2021 0710112022 X PER STATUTE OTH- ER EA- EACH ACCIDENT $ 2,000,000 EL DISEASE -EA EMPLOYEE $ 2,000,000 E.L DISEASE -POLICY LIMIT $ 2.000,000 DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORD 101. Additional Remaly Schedule, maybe attached if more space is required) AI vorksila artplo�ws vorHrg for CENTRAL COMFORTAIR CONDITIONING CORPORATION paid ulba ADP TOTALSOURCE, INC.S payoll, are co'.ered umler the oboe stak3d policy. CENTRAL COMFORT AIR CONDITIONING CORPORATION ism alternate ertplger under Ws policy. CERTIFICATE HOLDER CANCELLATION Mind Shores Village Bldg Deperamed SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10050 HE 2rd Ave THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores, FL 3313a ACCORDANCE WITH THE POLICYPROVISIONS. AUTHORIZED REPRESENTATIVE 0gon 0vk (fetvtne6, One o f (floaida ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD