MC-11-868__j
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
I ( _SS/(11---
nspection Number: INSP - 159755 Permit Number: MC -5 -11 -868 I
Inspection Date: August 08, 2011
Inspector: Perez, JanPierre
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Adrian Hall
Miami Shores, FL 33138 -0000
Project: BARRY UNIVERSITY
Contractor: EMERALD CONSTRUCTION CORPORATION
Permit Type: Mechanical - Commercial
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1121360010160 -07
Phone: (954)241 -2583
Building Department Comments
REPALCE EXISTING DUCTWORK
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Passed
Inspector Comments
' l
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
August 08, 2011
For Inspections please call: (305)762 -4949
Page 1 of 1
AC RO O®
PRODUCER I and B Insurance Associates
3250 NE 1st Ave. #305
Miami, FL 33137
Phone (786) 888 -4540
CERTIFICATE OF LIABILITY INSURANCE DATE ( DDJYY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
INSURER A: Tapco / NAUTILUS INSURANCE
INSURER B:
INSURER C'
INSURER D
INSURER E
COVERAGES INSURER F:
THE POLICIES OF INSURANCE LISTED 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, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MMIDDIYY) DATE (MMIDD/YY)
Fax (786) 787-3530
INSURED Chills Air Conditioning Svce Inc
12300 SW 105th St.
Miami, FL 33186-
INSR ADD'L
LTR INSRD
A
TYPE OF INSURANCE
GENERAL LIABILITY
./ COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER
V' POLICY PROJECT LOC
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
1 -TIRED AUTOS
NON OWNED AUTOS
GARAGE LIABILITY
ANY AUTO
EXCESS/UMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER / EXECUTIVE
OFFICER / MEMBER EXCLUDED?
It yes. describe under
SPECIAL PROVISIONS below
OTHER
POUCY NUMBER
NN005248
LIMITS
EACH OCCURRENCE
DAMAGE TO RENTED
05/05/11 05/05/12 PREMISES (Ea occurence)
MED EXP (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
(Per accident)
AUTO ONLY - EA ACCIDENT
OTHER THAN EA ACC
AUTO ONLY AGG
EACH OCCURRENCE
AGGREGATE
WC ER - Y mn'S
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
F
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
AIR CONDITIONING INSTALLATION AND REPAIRS
CERTIFICATE HOLDER
MIAMI SHORES VILLAGE
BUILDING DEPT
10050 NE 2 AVE
MIAMI, FL 33138
FAX 305 -756 -8972
ACORD 25 (2001108) QF
1,000,000.00
50,000.00
5,000.00
1 ,000 ,000 .00
2,000,000.00
1,000,000.00
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO
THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBUGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS . EPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
LETICIA C IRIGOYEN
CORD CORPORATION 1988