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MC-10-2180Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: I N S P- 165418 Permit Number: MC -12 -10 -2180 Inspection Date: October 12, 2011 Inspector: Perez, JanPierre Owner: BALL, MONA Job Address: 800 NE 97 Street Miami Shores, FL Project: <NONE> Contractor: SUNAIR COOLING CORPORATION Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060142770 Phone: (954)456 -2274 Building Department Comments AC CHANGE OUT 2 UNIT OF 2 TON EACH (\------)Q 0 I it Passed Inspector Comments fro Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until fIrtnhar 19 9A11 For Inspections please call: (305)762 -4949 Penn 11 of 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No. PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: MECHANICAL Owner's Name (Fee Simple Titleholder) Mok1 Fit bAL . Phone # Owner's Address 20o 2 City 1- `VIM 1 rStLO State Zip 2 3/313 ty FL p Tenant/Lessee Name Email Phone # Job Address (where the work is being done) Soo f V 2, 2 q� City Miami Shores Village County Miami -Dade Zip 3•51 J v FOLIO / PARCEL # L I `01 � 2 Is Building Historically Designated YES NO Q/ FloUd Zone Contractor's Company Name Su OAR, WO L106, " RS Phone # 954- 45b -22914 Contractor's Address Lt-C) At Si'hI 5L />, City VkALLANDfci,E3 (650sat State L Zip '33058 Qualifier Name DA L) CIO IA Phone # / 5 rpp`i� ° 4 2p State Certificate or Registration No. CACI % t� A 0 Certificate of Competency No. 1 U 3- -' I ,2318 C) Contact Phone l5 q - 456-2,2/7q E -mail COY C CTU.S UYI E�1 tr(� 001; l X15 . cAj Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ toq i 0 -3 Square / Linear Footage Of Work: Type of Work: ❑Addition 1 ['Alteration ❑New .(Repair/Replace ❑ Demolition Describe Work: A/C OA VT 011 2. r T;/ T L * * * * * * * * * * * * * * * * * * ** r *, * * * * *: * * * * *: Fees * * * * * * *** ** * * * * * * * * * ** * * * * *:* * * * * *** * * * * * ** Submittal Fee $ +13 Permit Fee $ CCF $ CO! /CC $ Notary $ Training/Education Fee $ Scanning $ Radon $ DPBR $ Double Fee $ Violation date: Structural Review. $ Technology Fee $ Bond $ Total Fee Now Due $ 2 it See Revere side -› Tt ilt t Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's 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 regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 o such posted notice, the inspection will not be approved and a reispection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this `')0 day of lilt%v ,20(cD,by MONA (ALL who is personally known to me or who has produced tett As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: 4ikz€p 6 6 My Commission Expires: NATHANIEL B. COX Commission # DD 695160 *E My Commission Expires 07-15.2011 I' Bonded Through Atlantic Bonding Co., Inc. Signature Contractor The foregoingpstrument was acknowledged before mete his `' 3 day of Aib" ,20(o,by, Jn113 CA W who is personally known to me or who has produced as identification and who did take an oath. ***** * * * *** * * ** *** * ****** * * ***** **** APPROVED BY NOTARY PUBLIC: Sign: Print: ?I 6 My Commission Ex - NATHANIEL B. COX Ta Commission # DD 695160 My Commission Expires 07.15.2011 Bonded Through Atlantic Bonding Co., Inc. ********************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** lans Examiner Engineer (Revised 07 /10 /07)(Revised 06/10/2009) Zoning Clerk checked i Y Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC 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): (Roo E- 14' L ET City: Miami Shores Village County: Miami Dade Zip Code: '33 i37:) 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 ARI (AHRI) DATA SHEET REQUIRED Change Disconnecting means: YES ❑ NO ❑ ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES ❑ UNIT BEING REPLACED DATA NEW UNIT 00 \r.C\ MANUFACTURER 931'0 AHU or PKG. UNIT MODEL # A50 E.� tA)K‘i COND. UNIT MODEL# A00 2 KW HEAT NOM TONS 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 2.0b/ 2,30 AHU CU PKG PKG UNIT / / PKG UNIT I / EER/SEER ie4,N 5 YES NO REPLACING DUCTS YES (110-3' YES NO REPLACING THERMOSTAT (S NO YES NO NEW 4"CONCRETE SLAB NO YES NO NEW ROOF STAND Y S + • YES NO NEW RETURN PLENUM BOX YES 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse /Breaker Size): 3. Voltage of Circuit (208/240/480): 20%/ 2O 4. Size Disconnecting Means: � A �� �zz� Contractor's Company Name: 30�t (� //�'0L l O O19°tV Phone:: ?Sit-- State Certificate or Registration N. � . l lb ®) Certificate of Competency N. I g J �'� g GtI Signature - Date: IV 30P°13 SJ'Li.&_ signature only) Submitted ' ''^='`--`_' - '.,``~' • .''' - - •:/c��. date AHU:: ^�'``�`~=```^,^^ • _ P ARM Certified Reference Number: 3018316 Product Variable Speed Mufti-Split Heat Pump Date: 11/23/2010 Outdoor UnitM •Number: AOU24RML indi:or tioiiTYpe INOn4Iiit •htdo rr Units • . Niantrfacturer:: FUJrTSU:GENERALAMERICA, INC. Trade/Brand name:' FUJITSU Manufacturer responsible for the rating of this system combination is FUJITSU.GENERAL AMERICA, INC. Rated:asfailowtin accordance ► A#iR# Standard :2101240-2M* #or hinary•Air -Ctin coning and•Air= Swords • Heat :Pump_ Equipment and subject to verification of rating -.accuracy by AHRI - sponsor d, independent, third party testing: Cajoling Capacity. (Btuh): 24000 EER Rating (Cooling): 10.40 SEER Rating (Ching): 16.50 Heating Ca} iji(Btith) @ 447 F: 28800 Region:IV "HSPF Rating (Heating): 8.00 Heating Capac ity(Btuh) @ 17 F: 16900 • CERTIFIED RATINGS'. FOR VARIAl SPE MINI- AND a1LTESPUT SYSTEMS -ARE VALID FOR AU t 8 NA11ON OF-INDCORUNrrS - (BASED:ON COMBINATION TYPES) WITH THE SPECIFIC OUTDOOR UNIT LISTED ABOVE AND IN THE AHRI-DIRECTORY-OF CERTIFIED EQUIPMENT. VISIT WWW AHRIDIRECTORY.ORG TO VERIFY THAT THIS COMBINATION IS AN ACTIVE LISTING AND THE DATA LISTED ON • THISCERTIRCA E IS ACCURATE.- SEARCH ON THE AHRI REFERENCE # TO QUICKLY LOCATE THIS COMBINATION IN THE DIRECTORY. Ratings followed by an asterisk () ind catea voluntary rends of pretiously published data unless accompanied with a WAS. which indicates an involntarY'relate. DISCLAIMER AHRI doles not etrdo set a prodnet s) hided ea this Cie and makes no tee..earramfies or guarantees ast. end assumes no mareelsrlahttell • . the prodtro2(s) listed on this Certificate. AMU ewes* &schism all for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alt+eralton of dale listed as this Cam. Certified rafinor, we veld only for models and configurations hit ®rifle directory at nrww.aiukyrecfory org. TERMS AND•CCONDiTIONS:. - •.......... .. This C.erfsiica teand its contents are proprfastary products. of ARM. This Certificate shalt only be used forbefinklual. perscaral and cordiderdial reference purposes. The contents-of this Cow may not. in whole Orin per. be wed: copied: disseminated; entered into a comma database or ogmrNise utilized, in any tanner manner or by airy means. except for the riser's hrdividual, personal and confidential reference. CERTIFIC.ATE.VERIFIOATION- .. . The hdormlation for the model cited on this certfficataman be verified at v r.atit rectory.org. click on "VersiyCerfi icate" ink and enterfire ARM Certified Reference Number and the date an which the cer was (stated, which is famed abtnre. and the Cetz a No., which is fisted helmet ©2010 Air- Conditioning; Heating, and Refrigeration Institute ondi g, #!elting, ii_s Irr�titilit3 - CERTURCATE 1 1263:416 )28553149603 .. 6/15/11 04:04PM EDT SunAir Green Solutions -> Miami Shores Building Dept 3057568972 2/2 IC, '® CERTIFICATE OF LIABILITY INSURANCE �'' DATE (IVI/DD ) 06115!2011 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 Moody Insurance 1939 Tyler Street Hollywood, FL 33020 NAM ALr Monica Gomez PHO ran_ (954)256- 7700,N.): (954)475 -8821 ADDRESS: mgomezemoodyinsurance.co INS(B) AFFORDING COVERAGE NAIC II INEURERA : Bridgefield Employers Insurance Company INSURED Sun Air Green Solutions Corp; Sunair Cooling Car Solar Power Copr. 730 W Hallandale Beach Blvd., #102 Hallandale Beach, FL 33009 �r pN� EACH OCCURRENCE INSURERD INSURER E. DAMAtiETO REN reu PREMISES INSURER F : CERTIFICA 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. 66 'PR TYPE OF INSURANCE ADD INAR SUER WW1 POLICY NUMBER POLICY OFF IMfaSDOrcYYY1 FFOLICYE%P niaanaIYYYY1 UAITS GENERALLIABILrrY — EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAtiETO REN reu PREMISES $ CLAIMS-MADE OCCUR Meoccurrencel MED E)P (Any one $ Person) PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEML AGGREGATE U MIT APPLIES PER 7POUCY75V,W I— LCD PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE — — LIABILITY ANY ALTO OS ® (EC0 ��Nde t) NGLE UMIT $ BODILY INJURY (Per person) $ �o HIR HIRED — — S OS 1L® NON.OWNED AUTOS BODILY INJURY (Per occident) $ PROPERTY DAMAGE fPer accident $ $ _ UMBRELLA LAB EXCESS UAB — OCCUR CLAIMSMADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ ORA AHEPLO COMPENSATION UABIU Y Y1 N 0830 -47542 03/08/2011 03/08/2012 X I'tYcY Mfrs I IGETR� ANY PROPRIETORIPARTNER/DCECUTIVE OFFICER/MEMBER �R EXCLUDED? NIA E L. EACH ACCIDENT $ 100 100,000 (�fl�MyendetorynNH} DESCRIPTION OF OPERATIONS be E.L. DISEASE -EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS !LOCATIONS 1 VB•SCLES (AESCII ACORD 107, Additional Remarks Schedule If mere space Is required) EVIDENCE OF INSURANCE wCDT, l,wi �r ..w• ��� CANCELLATION Miami Shores Village Building 10050 NE 2nd Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE "77/ (MJG) 0 198 010 At D CORPO . All rights reserved. The ACORD name and logo are registered marks of ACORD Printed by MJG on June 15, 2011 at 03:43PM ACORD 25 (2010/05) NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. {` -1 a -to -cal B)TAX FOLIO NO.- 3a6to -61-k a770 STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1111111 11111 11111 11111 11111 11111 111111111E C F N 2r011W:1392159 OR Ek 27723 Ps 0683► (leas) RECORDED 06/15/2011 15 :37 :12 HARVEY RUVIHr CLERK OF COURT MIAMI-DADE COUNTY? FLORIDA LAST PAGE Space above reserved for use of recording office 1. Legal description of property and street/address: 1416.Mu SC re Se( ? i'? \© •- 3-7 W 113 er \_r,+ 1 . t S 1. :; . a be o GA- t). - iL No © i 2. Description of improvement: A- t 6Acn5t c t- 3. Owner(s) name and address: Interest in property: Name and address of fee simple titleholder. 4. Contractor's name, address and phone number: S%Jr141r- Cc t COT :or> - 7.'0 .16 s4 38c.4) 5. Surety: (Payment bond required by own r from cunt ctor, if y) -ri Name, address and phone number: {LW r Vdi\a5 e I #ACCASIVI Amount of bond $ 1,001 c 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name, address and phone number: 9. Expiration date of this Notice of Commencement (the expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signature(s) of bner(s)or Cane - Prepared By 'MOW/ .4 Print Name H 6144 (a g Title /Office oWiaEQ_ STATE OF FLORIDA COUNTY OF MIAMI -DADE s)' Authorized Officer /Director/Partner /Manager Prepared By Print Name Title/Office The foregoing instrument was ackqowledged before me this 1 5 day of BY DA k ' ❑ Individually, or ❑ as _/ for ID Personally known, or WI produced the following type of identificatio Signature of Notary Public: Print Name: (SEAL) VERIFICATION PURSUANT TO SECTION 92.525, FLORIDA STATUTES Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true, to the best of my knowledge and belief. utne, 91x11 Signature(s) of Own (s) or By• ,"7O/ 123.01 -52 PAGE 3 3/10 wner(s)'s Authorized Officer/Director /Partner /Manager who signed above: By Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. V COPY OF QUALIFIER'S STATE LIC CARD B. V COPY OF LOCAL BUSINESS TAX RECEIPT C. ✓ COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) a ►/ COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: 5 QV A( it C®© Li to 6 cog fD/ATION BUSINESS ADDRESS: 4453 M 61-0 CITY C' L 4OALE aAcif STATE FL. ZIP CODE 33Oe1 BUSINESS PHONE: ( /54 ) 45(0 FAX FAX NUMBER (1cs'C ) 2x10— C43,�S CELL PHONE ( ) QUALIFIER'S NAME: 91)L a: 021 QUALIFIER'S UC NUMBER: CAC t t(a [o3 E -MAIL ADDRESS (IF APPLICABLE): CoadOS S‘t\ o%1r(Oc) li Created on 3119109 BY MLDN 1 RV MN ELM f'> Pil8l1w 15 S. Andreoris.Ave4:Rrn; A-100„ FL. Laudeatki•FL -.33301-A895- EP5441 314000 • • • . . VALID OCTOBER1-,2010.:. 'THROUGH SEPTEMBER:30;2011.... .4 SUNAIR COOLING CORPORATION PaitakkeS: 27 00 0 00 0 SPICUOUSLY IN YOUR :P DINU CIORA •. :1173dOLDER-IgLi..4 DR STE 202 FMISANNIALIC; FL - ”009 Receipt.:*1111k-; 09 -00030054 Paid 09/27/2010 27.00 - -...-. --,..--- - -- - - 4 ..... ::-...5:1.: ...:, y11.: :....:::,......,..,...i.:6 .., tiiy. ,r.-.:j.-.•,-.:..-.,-......,:-:.:,.....:;::3,-:::::, ...:,,,,,,, 0 ...ao .: 27 00 27 00 0 00 0 SPICUOUSLY IN YOUR :P DINU CIORA •. :1173dOLDER-IgLi..4 DR STE 202 FMISANNIALIC; FL - ”009 Receipt.:*1111k-; 09 -00030054 Paid 09/27/2010 27.00 po NOT OR AR SUNAXR COOLING CORPORATION JAMES M THECKSTON `.PRES 430 ANSIN BLVD STE `;M HALLANDALE BCH FL :33009,: 1,,11,,, 1„111,1,�,d OTHER ;SID From:Chuck Hahn FaxlD Page 2 of 2 Date:10/11201012:58 PM Page:2 of 2 d'E.°11 CERTIFICATE OF LIABILITY INSURANCE PRODUCER Al Malins Insurance 3801 Bee Ridge Road, Suite #6 Sarasota FL 34233 phone:941- 377 -7283 Fax:941- 927 -8461 DATE(MMIDDJYYYY) OP ID LIMN sums-1 I 10/11/10 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 POIJCiES BELOW. INSURERS AFFORDING COVERAGE NAIL # INSURED Sunair Cooling Corporation 473 Golden Island Dr Hollandale FL 33009 INSURER A Guarantee Insurance CO INSURER E. INSURER C: MEURE 2 D: INSURER E THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 PAD CAMS LTR T4SRD TYPE OF INTAXIANCE POUCY MAKER DATE ATE odwrowrm MOTS GENERAL LIABB_ITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAprtAt,E lo HEN 1 to PREMISES (Ea CVTSBCe) $ CLAIMS MADE OCCUR MED EXP (My one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENL AGGREGATE LIMIT APPLIES PER —I POLICY ,EC LOC PRODUCTS- COMP /OP AGG $ ASE UABLITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) $ BODILYlILERY (Per accident) $ TTY DAMAGE (Per accident) GARAGE UABIUTY ANY AUTO AUTO ONLY - EAACCIDENT $ EA ACC OTHER THAN $ AUTO ONLY: AGG $ EXCESS 1 UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EAO-I OCCURRENCE $ AGGREGATE $ $ $ $ A WOE COMPENSATION AMI EMPLOYERS' LIABLITY ANY PROPRIETOR/PARTYIEREXECUTIVE YIN OFFICER/Ntt EXCLUDED? [ (Mandatory In NH) If yes, describe under SPECIAL PROVISIONS below 8Cj000947 02/04/10 02/04/13. ITG WC STAID- I ((MI- E.L.IACHACCIDENT $100,000 Et DISEASE- EA EMPLOYEE $ 100,400 E.L. DISEASE - POLICY LIMIT $ 500 , 000 OTHER DEW-RUMOR OF OPERATIONS 1 LOCATE, VENUES 1 EXCLUSKINS ADS BY RMIORSEMENT 1 »L PROVEMINS CERTIFICATE HOLDER CANCELLATION MIMI SNORES VTLLAOE BUThDING DEFT 10050 NE 2nd Wined SHORES FL 33138 ACORD 25 (2009101) S1 SrSTUAD ANY OF TEE ABOVE LESCRI3ED POLICIES BE WORE THEECPINA -RON DATE THEREOF, THE =RFS OFFURBMIU. ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO TIE LEFT, BUT FALURE TO DO SO SHALL orasE NO OIMIGATION OR LIABILITY OF ANY IM WON TIE INSUREER, ITS AGENTS OR REPRESENTAMIES. RE366TATF/E ,, L C 619118-2009 ACORD CORPORATION. Al fights reserved. The ACORD name and logo are registered maths of ACORD ACORD ,� CERTIFICATE OF LIABILITY INSURANCE ATE teN/DDmrY1 D11/09/2010 PRODUCER Phone: (9 5444$78.090T Pinkerton, Olson & Moody Insurance 4901 NW 17th Way Suite 100 Fort Lauderdale, FL 33309 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Sunair Cooling Corporation 473 Golden Isles Drive Hallandale Beach, FL 33009 I INSURER A: Cypress P &C INSURER HL INSURER C- INSUltER D INSURER E COVERAGES - THE POLICIES OF INSURANCE LISTEDBELOWHAVE BEEN ISSUEDTOTHE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICI-I THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SU POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILNTR SR f- 4± t, POLICY � Y EFFf POUCY EXPIRATION GFL 1009119 01 81 11102/2010 LIMITS GERI AGGREGATE LIMIT APPLIES PER: MED EXP(Any are Person) PERSONAL 16 AD/ INJURY GENERAL AGGREGATE PRODUCTS- COMP$OPAGG 1 000 000 s 100 000 s 000 $ 1 000 000 GARAGE LIABILITY ANY AUTO EXCESSIIMBRELLA LIABILITY OCCUR n CLAIMS MACE DEDUCTIBLE RETENTION S El. EACH ACCIDENT S E.L. - EA E PL • S EL DI - POLICY LIMIT S DESCRIPTION OF OPERATIONS /LOCATIONS 1 VIDOCLES i SONS ADS BY 1 SPECULL PIONS CERTIFICATE HOLDER City of Miami Shores Village Bldg Dept 10050 NE 2 Avenue Miami Shores, FL 33138 SHOW.D ANY OF THE ABOVE DESCMBED POL.N:ESIO CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE 4581510 INSURER MILL ENDEAVOR TO A4Ai1. DAYS WRITTEN NOTICE TO THE C32RFIOATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL. WIPDSE NO OBLIGATION OR uasanv OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHOR/ZED REPRESENTATIVE ACORD 23 (2001108) (JLF) ® ACORD CORPORATION 1988 Printed by JLF on November 09, 2010 at 03:38PM