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ELC-13-82 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-200917 Permit Number: ELC-1-13-82 Scheduled Inspection Date: October 10, 2013 Permit Type: Electrical - Commercial Inspector: Devaney, Michael Inspection Type: Final Owner: COUNTY, MIAMI DADE Work Classification: Addition/Alteration Job Address:9500 NE 2 Avenue Miami Shores, FL Phone Number (786)331-4509 Parcel Number 1132060132660 Project: <NONE> Contractor: CHARLES D. BELCHER ELECTRICAL SERVICES INC Phone: (561)963-7773 Building Department Comments ELECTRICAL WORK TO INSTALL THE AIR CLEANING Infractio Passed Comments DEVICE IN THE FIRE STATION APPARATUS BAY INSPECTOR COMMENTS False Inspector Comments Passed Ea / Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. October 09,2013 For Inspections please call: (305)762-4949 Page 22 of 2 Miami Shores Village Building Department J 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: o ----------------- Tel:(305)795.2204 Fag:(305)756.8972 INSPECTION'S PHONE NUMBER: (305)762.4949 FBC 20 BUILDING Permit No. PERMIT APPLICATION Master Permit No. Permit Type:Electrical JOB ADDRESS: 9500 NE 2nd Avenue (Fire Station#30) City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: 11-3206-013-2660 Is the Building Historically Designated:Yes NO X Flood Zone: OWNER:Name(Fee Simple Titleholder):Miami-Dade Fire Rescue Department Pho e#:786.331.4500 Address:9300 NW 41 Street r U I6( , � M1.4 S City: Dora[ State: Florida Zip: 33178 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name. Phone#: 1? &-3°-7 7 Address: 2�-7 L{ �. �� V_i z Q it AA��. GW State Zip: %�6 Co Qualifier Name: 0, Z t?(E5 L.e_"q A-- Phone#:!Rg I ef q Jam\ State Certification or Registration#: 6 C- (If 00 3 b Certificate of Competency#: Contact Phone#:6r (4L( &.5,4 Email Address: AJ I;® 2-1�r t o 40 1 g C d DESIGNER:Architect/Engineer: Ernesto Rodriguez Phone#: 786.331.4532 Value of Work for this Permit:$2000 Square/Linear Footage of Work: 1 000 'S-F Type of Work: ❑Address 29Alteration ONew ❑Repair/Replace ODemolition Description of Work: Electrical work to install the Air Cleaning Device in the Fire Station Apparatus Bay. t Submittal Fee$ Permit Fee$ 11 e-°4f li CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ bro. q 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which ccurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approv and a reinspection fee will be charged. Signature Signature t P', Owner or Agent Contractor //'q'���{ The foregoing instrument was acknowledged before me thisl� The fore oin Instrument was ackn dged f rc gthis day ot'Decembex,20�,by der n artlea F e �a n c, z, day of 1 20 3,by Y U �lyd' who is rsonally known to me r who has produced ho is rsonally mown t me or who has produced As identification and who did take an oath. ® . itification and who did take an oath. NOTARY PUBLIC: TARY PUBLIC: r Sign: . Sign: r,UBiL�OS �n o1 Florida �'\ � e Print:�eV�'r' �totary Public- .aSeP 23.2015 �oaN;,ue4c BBEE'VE�RLY M.HECKMAPI Print: A: y if es EE 128810 My Commission Expires: MYCpMMISSION t EE444483 My Commission Expires: \ o Commissio Na ro�a��etary Assn. * EXPIRES:March 6,2015 %''F «;' Bonded Through ee..��..�� ////iii • �19I ow,11e CwlwvT1wu - kzkkkIssKk�kokkkk����kk�k �slafak%kkkkk8akslskakk���$�ksk��k8a�z.�zgsRk�ikk��kk'n'abekakkkkhbk8ak%a%R�S�.$akskkkkAskkkkI t�kkkkk�sk[akkkkkkk m 17 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/1212012)(Revised 07/10/07)(Revised 06/1=009)(Revised 3/15/09) e Edward Villareal Construction Manager Facilities and Construction Division MiamipDade Fire Rescue Department 9300 N.W.41 st Street Miami,Florida 33178 T 786-331-4509 F 786-331-4501 edward.villareal@miamidade.gov �E 7belnerheExtellewe bj, miarrmidade.govArerescue -wiles am awniami Shores village Building Department tOR'l�' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 5T--n 0 Q $--36 Tel: (305) 795.2204 ��►►++ ppi�pp�+ //±ii�+Tp Fax: (305) 756.8972 CONTRA TORS' REGIS 1 RATION 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. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE(CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION(EITHER CERTIFICATE OR EXEMPTION) IF CONTRACTOR HAS A NMI BADE 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 jCERTMATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE LEITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: SHORES VILLAGE BLDG DEPT 14M NE 2ND AVE MIAMI SHORES,FL 33138 ■■rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrsrrrrrrrrrrrrsrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: 'CHARLES D.BELCHEREWTCAL SERVICES,INC- BUSINESS ADDRESS: 2874 CHERONEE RD CITY VVEST NUM BEACH STATE ZIP CODE 33406 BUSINESS PHONE-L i 963-n73 FAX NUMBER( 7?4-9417 CELL PHONE( 61 l 644-N33 QUALIFIER'S NAME: CHARLES D.BELCHER QUALIFIER'S LIC NUMBER: EC13001638 E-MAIL ADDRESS JIF APPLJCABLE): crud on Y190 BY A N IRV30M KDV i. i ' �'!•11-201� *WE STATE OF FLORIDA ° =t� DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION `.of..ELgPw TO 'BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW .: .�. €t el:[€sled below has elected to be exempt from Florida Wotkers' Compensation law. �ECTI. EXPIRATION DATE: 011/112015 CHARLES D :,: Ewe::.:...'. :...•.:..,... ,:;..::;••.. 'I`r •s�[�ll�'t�J... 13% . ..•; : .: ;•: : ., .. CES Inc -• .' .` ::: i •`..` ,aE_f ?;: '. „ ' '. ¢f a�s'.:&f•.8;•L iatn`& ::5saa. stiou ir¢m ffids C#raDEei Ly €i€iR9 a certificate of election under th€s ' w^^+t+ c.rit'. elk tss�er,t? 'rka c,i'�fsaaag:;w:Chapwr:44A.055;f3.�,•.F4 tetifticates at etactiaa to he exempt.. apply only within the satiPa aF I e;3Yas gy d a8e. Dm:> ;aa se ,al�effeo:d{'fie ;. ,Fws?ot to'tlregter{4t1.©8ft3fr F.&, Notices of election to be exempt and certificates of : .• tC tn3n: :' :E? h; ; •' a `t? .4#;:as: ny"atteat;o#ter.�ta'fREfag•,o� the Autice-oF the issuance of the-certificate. the parson named as the notice or > ::tsi�tica .sq-apu er;sa ;.st�.a::r erpet&is. f;;t4i :' cast far:;s�e lace z�€-a.;rertificate,• The department shall revoke a certificate at any time for fatlare of the Person mastei oa:the:cer{t#ic#to p ';tma.se9 a®aats.ef:tbfg sert;rin' OEM= (850) 413-1609 owc-Z52'CERT1FiCA3E'QF,QEGT!#}N;10 BE EXEC.T REVCSZ pATE(MMtDDAfYYY) CERTIFICATE OF LIABILITY INSURANCE 4/2/2013 PRODUCER TIM CERTIFICATE Is ISSUED AS A MATTER OF INFORMATION JOAN JACO88 INSURANCE Ate» ONLY � CONFERS NO RIGHTS UPON THE CERTIFICATE 213 5 S Congress Ayes Suits 4B HOLDER. THIS CERTB=ICATE DOES NOT AMEND, EXTEND OR gre s ALTER THE COVERAGE AFFORDED By THE POLICIES BELOW. west Palm Beam, LPL 33406 (561)967-8400 RMRERS AFFORDING COVERAEE NAICB MsuRED CHARLES D BEICHER ELECTRICAL a RA: AbMRICAN VEHICLE SERVICES INC g4mAux e: Titan Ins 2874 CHEROKEE ROAD MAIRERC: WEST FArm B , FL 33406 Msb D: 561-963-7773 MBE: COVERAGES 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 VVrTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBE)HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND COMMONS OF SUCH POLICIES.AGGREGATEUMITSSHOWN MAYHAVEBEENREDUCEDBYPAIIDCLAIMS. 0"ADM LTR POUCY NUMBER bdMITB GEMIAL L AMM EACH OCCURRENCE $ 1,000,000 g COtAfiI9tCftGEm bps ER s„ s 100 f000 nOCCUR MEDEKP(Anyom ) $ 5,000 A GL-0504008943-00 03117/13 03/17/14 PummL&ADVSjmy s 1,000.1000 onmL AGATE s 2,000,000 GOft AGGREGATE LW APPLIES PROMfCTS-COMROPAGG $ 1,000,000 -x-1 PoucY Loc AUTOMOBILEUASHAY COUMNEDS04GLELMT $ 300,000 ANYAUTO � ) ALLOYYNWAUTUS d I SODLYRWRY B11 R SCHEDULED AMOS $ 8 mRmAums 8903356 03/08/13 03/08/14 BODLYINJURY 1 $ R NON*WNWAUTOs FROFOM GE s GARAGEUAI#UTY AUTDONLY-EAACCWEW S ANYAWO OTb1ERTHAN EAAOC $ AUTOONLY: AGG $ t 1 „Y €ACN OCCURRENCE $ OCGR FI CLAMeS mm AGGREGATE 5 S DEDUCTMLE $ RETENTM $ $ QTH- WORKERSCOMPEIMATIONAND TO AITS EMPLOYERS'L1mL1Ty Ei FApI ACYNT S arry OFFMArdafflER W(CUK=7 E.L.DMEASE-EA EMPL. $ $PE-42 SfONSb E.L DMEASE-POUGYUWT S OTHER DE-ICRFnONOFOPEPATOMILOrATIOMIVBOCLMIE)CLUSMMADDWSYENMOEMOfftSPUXALPMrOONS CERTIFICATE HOLDER CANCELLATION Miami Shores Village SHO"AWOFTMABOVEDESCPAMPOUCIES BE CANCEI.LED OWWW THE ExPIRAWN Building Department DATE TWREOF.THE MUNG DASURFR WILL ENW AVOR TO N"-30 DAYs WmTrEN 10050 NE 2nd Avenue t TO THE Tb=HOLIER NAMED TO THE LEFT.BUT FALURE TO 00 SO SHAD Niami Shores, FL 33138 ND OBUGATM OR UABIUTY OF ANY KMD UPON THE MSURER.ITS AGENTS OR XFax: 305-756-8972 REPr: erAT�' Aug ACORD250MM) M ®ACORDCORPORATION 1988 Ar4xE M. _GA.NNON "LOCATED AT'`* - ° «^« •P.O.Box 3353,West Palm Beach,FL 33402-3353 , b ;f, cbxsni�ltsatikt<Utz.dacLeol'bxytaxcollectorpbc.com Tel:(561}355 2272 s�r,:1,iFQ:�1r�rxclir(»tx 2960 MELALEUCA DR ' WEST PALM BEACH,FL 33406- 0000 TYPE OF.Bus1NEss 'owNER' CERTIFICATION# RECEIPT#/DATE PAIO AMT PAIQ BILL# 23-0106 CW ELECTRICAL CONTRACTOR BELCHER CHARLES D EC13001638 013.5771-10!02112 5284.60 140018455 This document is valid only when receipted by the Tax Collector's Office, STATE OF FLORIDA PALM BEACH COUNTY ' 2012/2013 LOCAL BUSINESS TAX RECEIPT CHARLES D.BELCHER ELECTRICAL SERVICES INC LBTR Number.'200321348 CHARLES D BELCHER ELECTRICAL SERVICES INC EXPIRES: SEPTEMBER 30a 2013 2960 MELALEUCA DR This receipt does not constitute a franchise, WEST PALM BEACH, FL 33406-5161 agreement,permission of authority to perform the c 1.�1itl�tr�l1���1ui��ct:�.c�tl.ti[�1�rtc:cl�� services or.operate the business described herein when a franchise,agreement or other county commission,state or federal permission of authority Is required by county,state of federal law. I A t„t N l IG A N T i f f .P,O,Box 3353,West Palm Beach,FL 33402-3353 `"LOCATED AT- CYisrrviS.pg1A4TAX'OCvv?jf1 www•taxcollectorpbc,00mTel: 561)355-2272 '• SrrniKq Fciru 8,rur>ar Cortntrr � 2960 MELALEUCA DR WEST.PALM BEACH,FL 33406- 0000 TYPE OF BUSINESS' gWNER CERECEIPT&DATE PAID AMT PAID BILL# 21.0169 ELECTRICAL CONTRACTOR BELCHER CHARLES O EC13001838 U13.5771^10=12 $30.50 64001&!58 This document Is valid only when receipted by the Tait Collector's Office. STATE OF FLORIDA PALM.BEACH COUNTY 2012/2013 LOCAL BUSINESS TAX RECEIPT CHARLES.D BELCHER ELECTRICAL SERVICES INC LBTR Number; 200321347 ' CHARLES D BELCHER ELECTRICAL SERVICES INC 2960 MELALEUCA DR EXPIRES: SEPTEMBER 30. 2013 WEST PALM BEACH,FL 33406-5161 This receipt does not constitute a franchise, j, ( r agreement,permission of authority to perform the ruEE11IuIIIirisI1iI!III!iNiIlI`�sill1 services or operate the business described herein when a franchise,.agreement or other county commission,state or federal permission of authority is required by.c aunty,state of federal law. 'r: i„• -:,i:: '0�+'7 °+:.'i,i.x :i. n•Xir•:I,: ''-Ji t`• .it.r < ,!` .'1. .i' .2} ,t: ..z � •t• ."er � l�;r: • -,5i _t ,•.. '.�-• '�(,;�• ,fir'+: `;�\; 'r.. �'• k :�'- :t,..i� �A \y:aY;!•�;;i. \.: I i•.:Y;\': r '�::i::-':.r•:1 Il!/1.jjJ[✓ flY t: t': •r e!'\, <1 ,lf h hY. ..1 ' \7....J :1'i/,::WH. }"•.' ;I:24.t/sh'',•'• .�•,r'� �.( s, lit..r, }'/4.. 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'�6,.:ti::....,:�1'r`:;.. r .,s,;r,;:. r��.7rr .t.,-.f...., oi•SFrCRETA.R.Y. - . C315(?CAY'AS`<•REQIJIRED"B1`LA1N`-`�^• :n; • . Inspection Worksheet Miami Shores Village 10054 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-184200 Permit Number: MC-1-13-81 Scheduled Inspection Date: November 13, 2013 Permit Type: Mechanical - Commercial Inspector: Perez,JanPierre Inspection Type: Final Owner: COUNTY, MIAMI DADE Work Classification: Addition/Alteration Job Address:9500 NE 2 Avenue Miami Shores, FL Phone Number (786)331-4509 Parcel Number 1132060132660 Project: <NONE> Contractor: GARRISON MECHANICAL Phone: (954)441-7000 Building Department Comments INSTALLATION OF MECHANICAL AIR CLEANING Infractio Passed Comments DEVICES IN THE FIRE STATION APPARATUS BAY INSPECTOR COMMENTS False I I Inspector Comments Passed R1 Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. I� November 12,2013 For Inspections please call: (305)762-4949 Page 1 of 38 II November 4,2013 Miami-Dade Fire Rescue Department 9300 N.W.41"Street ' Building&Zoning Department Doral,Florida 33178-2414 a T 786-331-4500 Mechanical Division Project: Exhaust System for Station#30 fl , L FL, 3, To:Whom it may concern y' Please be informed that the following clarifications to the design are approved and hereby incorporated to the construction documents by Ernesto Rodriguez,P.E.engineer of record: I -Air Cleaning Devices(ACD's)and Exhaust Fans(EF) sequence of operation is as follows: Condition ACD's EF's EF's Yellow Red 94db Low Speed) (High Speed) LED LED Alarm Doors Closed COIN02<10 ppm OFF ON OFF OFF OFF OFF Doors Open or Closed COIN02 10-24 ppm ON OFF ON ON OFF OFF Doors Open or Closed CO/NO2>25 ppm ON OFF ON OFF ON ON Doors Open(First 20 minutes) OFF ON OFF OFF OFF OFF Doors Closed(First 20 minutes) ON OFF ON OFF OFF OFF Filter pressure drop above mfgr recommendation to replace filter Light on at Airhawk unit and indication at control panel -CO2 devices are set to be tripped at over l Oppm,at which time the exhaust fans will engage their high speed setting until the concentration falls below acceptable levels. MDFRD has contracted an independent test and balance company,to test all air filtration rates and sequence of operation. i Testing of sensors: All gas sensors are factory calibrated. Set points have been configured and verified at Test and balance. Air Cleaning Devices(ACDs) Manufacturer AirHawk Model 3000XL Total Air(CFM) 2000 Location Apparatus Bay If there are any questions please do not hesitate to call me at(786)331-4500. rnesto Rodriguez, P.E. FL P.E.# 58155 Note:Corrections or comments made by herein do not relieve the contractor from compliance with the requirements of the plans, specifications, and applicable building codes. Contractor is responsible for: dimensions to be confirmed and correlated at the jobsite; information that pertains solely to the fabrication processes or to the means, methods, techniques, sequences and procedures of construction; coordination of the Work with that of all other trades and performing all Work in a safe and satisfactory manner. q A r B al, a c e, e:il;i `j`t and n Diagnostic CERTIFIED TEST, ADJUST, ALANCE REPORT DATE: 10/2312013 PROJECT NAME: STATION No.30 (MIAMI SHORES/El- PORTAL). ADDRESS: 9500 NE 2 AVENUE MIAMI SHORES, FL 33138 DESIGN ENGINEER NAME: ERNESTO RODRIGUEZ P.E. HVAC CONTRACTOR NAME: GARRISON MECHANICAL NEBB TAB FIRM NAME: AIR BALANCE & DIAGNOSTIC COMPANY. ADDRESS: 702 NW 87 AVE UNIT # 403 MIAMI, FL 33172 INLEBB TAB CERTIFICATION NUMBER: 3499 PAGE 1 Certification Nt- Air balance and any t Diagnostic r t uomp PROJECT: STATIC .3 THE DATA PRESENTED IN THIS REPORT IS A RECORD OF SYSTEM MEASUREMENTS AND FINAL ADJUSTMENTS THAT ' HAVE BEEN OBTAINED IN ACCORDANCE WITH THE CURRENT EDITION OF THE NEBB PROCEDURAL STANDARDS FOR TESTING,ADJUSTING,AND BALANCING OF ENVIRONMENTAL SYSTEMS. ANY VARIANCES FROM DESIGN QUANTITIES,WHICH EXCEED NEBB TOLERANCES,ARE NOTED IN THE TEST-ADJUST-BALANCE REPORT PROJECT SUMMARY, SUBMITTED&CERTIFIED NEBB CERTIFIED TAB FIRM NAME- AIR BALANCE AND DIAGNQSTIC C . NEBB CERTIFICATION NUMBER:- 3499 CERTIFICATION EXPI ATE: MARCH 31, 2014 REPORT ATE: 1012312 13 ' G�a0d Diagnos�'� tLIMNS.PAYAN m d C1:�iTfF1�4'110N 3499 Exp.3/31J14 y d��yYdroni+~ NEBB QUALIFIED SUPERVISOR NAME: LE EL P . NEBB QUALIFIED SUPERVISOR SIGNATURE: t PAGE 2 ra I-to Air B alance Diag- nostic ' TABLE OF CONTENTS ' REPORT COVER SHEET .................................Page 1 REPORT CERTIFICATION SHEET.....................Page 2 ' TABLE OF CONTENTS....................................Page 3 INSTRUMENT CALIBRATION REPORT.............Page 4 AIR CLEANER DEVICES TEST REPORTS............Page 5 ' EXHAUSTFAN TEST REPORTS..........................Page 6 ABREVIATION SHEET REPORT........................Page 7 PAGE 3 Instruments Calibration Report Air Balance and � Diagnostic Company t PROJECT:STATION No.30 Instrument Type Fmanufactureril Model No. Serial No. Date of Use Calibration Date Air Capture Hood ALNOR EBT721 90846056 10/23/2013 1/3/2013 Hot wire anemometer ALNOR AVM440 AVM440903009 10/23/2013 12/31/2012 Micromanometer ALNOR EBT720 90846056 10/23/2013 1/3/2013 Pitot Tubes Dwyer 181, 3611,4811 None 10/23/2013 N/A Rotating Vane Anem. ALNOR RVA501 RVA500929005 10/23/2013 2/13/2013 Electrical Meter FLUKE Model 902 94860302 10/23/2013 12/12/2012 Environmental Meter Gray Wolf Advancesense 1155 10/23/2013 4/4/2013 I! NEBB TAB FIRM: AIR BALANCE & DIAGNOSTIC COMPANY. NEBB TAB SUPERVISOR: LEONEL PAYAN PAGE 4 AIR CLEANER DEVICE TEST REPORT ire Driers> 1 hp /fir Balance and Diagnostic Company PROJECT:STATION No.30 FAN DATA FAN No. FAN No. FAN No UNIT DESIGNATION ACD 4 1 AREA SERVED APPARATUS BAY MANUFACTURER AIR14AWK MODEL NUMBER 3000XL SERIAL NUMBER 062090 TEST DATA ®ESIGN ACTUAL DESIGN ACTUAL THAI. RESIGN ACTUAL TOTAL AIRFLOW CFM(L/S) 2000 2156 TOTAL SP or ESP m. (Pa) DNA N/AP MOTOR HP(Kw) 1 I 1 MOTOR RPM DDR DDR MOTOR RATED VOLTS 230 208/230 MOTOR RATED AMPS 9 5.8 MOTOR PHASE 1 I MOTOR OPERATING HERTZ 60 60 MOTOR SERVICE FACTOR DNA OPERATING VOLTS 204 OPERATING AMPS 4.3 CO&NO2 ENTERING 18/5.92 CO&NO2 LEAVING 15/4.47 REMARKS: TEST DATE:10/23/2013 READINGS BY: RICARDO VARONA PAGE 5 FAN TEST REPORT ( Direct Drive > 1x'8 hp) Air Balance and Diagnostic Company PROJECT:STATION No.30 FAN DATA FAN No. FAN No. FAN No. UNIT DESIGNATION EF- 1 AREA SERVED APPARATUS BAY MANUFACTURER GREENHECK MODEL NUMBER CW- 180-VG-7-X SERIAL NUMBER 13240633 TEST DATA DESIG1eT ACT[IAI. DESIGN ACTUAL TOTAL AIRFLOW CFM(L/S) 2400 2291 TOTAL OUTLET AIRFLOW CFM(L/S) 2400 2291 TOTAL SP or ESP in. a 0.50 0.44 MOTOR HP(Kw) 1/2 3/4 MOTOR RPM DDR DDR MOTOR RATED VOLTS 120 120 MOTOR RATED AMPS DNA 10.1 MOTOR PHASE 1 I 1 MOTOR OPERATING HERTZ 60 60 MOTOR SERVICE FACTOR DNA OPERATING VOLTS 121 OPERATING AMPS 4.8 REMARKS: TEST DATE:10/23/12 READINGS BY: RICARDO VARONA PAGE 6 Abbreviations Air Balance a andi Diagnostic Company CFM Cubic Feet ner Minute ADDR Address F decrees of Fahrenheit MUA Makeup Air fpm feet ner minute O/A Outside Air ft.HZO feet of water E.S.P External Static Pressure in. inches T.S.P Total Static Pressure in.H2O inches of water SW Sidewall Supply ms multi speed SWR Sidewall Return ' No. number CD Ceiling Diffusser psi pounds per square HP Horsepower rpm revolutions per minutes FLA Full Load Amps sq. ft. square feet SF Service factor # number BHP Brake Horsepower % porcentage DNA Data Not Available AHU Air Handling Unit DNL Data Not Listed RTU Roof Top Unit N/A Not Accessible CF Correction Factor NIT Not Taken 1 MAX Maximum M.V.D Manual volume damper MIN Minimum N/S Not Specified V.F.D Variable Frequency Drive DDR Direct Drive T.D.V Triple Duty Valve N/AP Not Applicable PAGE 7 r w Miami Shores Village - Building Department 90050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax:(305)756.8972 °1 f $•�� 4 E_CTON'S PHONE NUMBER: (305)762.4949 � - 9 FBC 20 BUILDING Permit No. PERMIT APPLICATION Master Permit No. Permit Type:MECHANICAL JOB ADDRESS: 9500 NE 2nd Avenue (Fire Station#30) City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: 11-3206-013-2660 Is the Building Historically Designated:Yes NO X Flood Zone: OWNER:Name(Fee Simple Titleholder):Miami-Dade Fire Rescue Department Phone#:786.331.4500 Address:9300 NW 41 Street IE J&LA0:4C L1509 City: Doral State: Florida Zip: 33178 Tenant/Lessee Name: Phone#: Email: 1 CONTRACTOR:Co y Name: ��`�°� t � X11 Phone#: `���" Llgl 1Vo A wk e,�t t� � i n� �. a e: � Zip: ) Qualifier Name: lk� Phone#: 6V -6-4,-S UP State Certification or Registration#: CA C i + 2 Certificate of Competency#: N�� Contact Phone#:��`�'� �M Email Address: �'�'�S'�t�f���,� ��c�d ei •���� 1 dcc''t, c; �l DESIGNER:Architect/Engineer: E� sto Rodriguez Phone#: 786.331.4532 Value of Work for thisPe t:$9000 Square/Linear Footage of Work: 1800 Type of Work: ❑Address XMAS on ONew ❑Repair/Replace ODemolition Description of Work: Instil ' echanical Air Cleaning Devices in the Fire Station Apparatus Bay. Submittal Fee$ Permit Fee$ 2— ( CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which ccurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection wiand a reinspection fee will be charged. Signature Signatur 6R,er or Agent Contractor The foreg ' instrument was acknowledged before me this!'A-- The foregoing instrument was acknowledged before me this, day of© cesn�o SL 20 by FQX' 1,V-1 Ve-v n Qvin li�7_, day of 9 ,20 ,by �` � kYs,� who isljersonally known tom or who has produced who is personally known to me or who has produced -t C> As identification and who did take an oath. as identification and wl�g%diid1t8lk+a� oath: NOTARY PUBLIC: NOTARY PUBLIC: a>'� � Q°t��n . +§'%%>''o> Sign: Sign: Print:��'�`E)r �v . Print: 0 My Commission Expires: iot4;:::°�.� BEMLYM.WCf h%N My Commission Expires: � '••....... * * My COMMISSION E 0� P,� � EXPIRES.March 6, Bonded Ttn Badge Notsy SrAw skk�ak�XskI sokkkkk%kk�skk�ssfa:isik�ark� hk�kjk�:k�k k�s1�sAeikkXaskl sgskkk�k�K�kIs�xXakBs�eRakkk# I sga��BaXs�gssla�ah=kkk�ik�k��ikk�kk�khkk�k�Is$skKaXsBaSa APPROVED BY ' Plans Examiner Zoning Structural Review Clerk Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Fire Rescue MIAMI, E 9300NW41 Street ran Miami,FL 33178 Carlos A.Gimenez,Mayor 10 3-53 ATTACHMENT 1 B February 13,2013 Robert Garrison CERTIFIED MAIL_No: GARRISON MECHANICAL SERVICE CARP DBA GARRISON MECHANICAL FACSIMILE:(954)441-7200 20851 Johnson St TELEPHONE:(954)441-7000 Pembroke Pines, FL 33029 Re: Notice To Proceed for MCC 7360 Plan-RPQ NO:MDFRD-VEHEX-R Furnishing and installation of Vehicle Exhaust System at various MDFR Stations Various MDFR Stations Dear Robert Garrison: This letter will serve as your notification that you are to proceed with the work described in RPQ #MDFRD-VEHEX-R starting Thursday. February 14, 2013, and that all work must be completed on schedule in accordance with the contract documents. The time allotted for the contract is 180 consecutive calendar days which results in a scheduled completion date of Tuesday.August 13,2013. The complete execution of this notice to proceed shall constitute a contract for the work described in the Request for Price Quotation(RPQ)under the MCC 7360 Plan.The terms and conditions applicable to this contract are in the 7360 Contract dated 611/2003.which can be found on w ww.mlamidade.gov loci and the totality of the contract documents(including but not limited to the RPQ including any specisi provisions contained therein,drawings and specifications,addenda,and any contract modifications or change orders etc). This letter will also serve as a reminder that all work must be performed in accordance with the contract documents and in accordance with all applicable Federal.State and local laws,codes and regulations. In accordance with the contract procedure,the Miami-Dade County Purchase Order Release Number is PCFR1300020. Should you nave any questions regarding this notification,please contact Edward Villareal at 786-331- 4W9. II Sincerely, Sylvia Novela Special Projects Administrator s CC:Edward Villareal,MDFR Construction Manager i i I } i Fire Rescue MIAM 9300 NW 41 Street i �Dw Wiaml,FL 33178 Carlos A.Gimenez,Mayor NOTARY FORM February 13,2013 Robert Garrison CERTIFIFO MAIL No, GARRISON MECHANICAL.SERVICE CORP DBA GARRISON MECHANICAL FACSIMILE:(954)441-720x} 20851 Johnson St TELEPHONE:(%4)441-7000 Pembroke Pines. FL 33029 Re: Notice To Proceed for MCC 7360 Plan-RPQ NO.MDFRD-VEHEX-R Fumishing and Installation of Vehicle Exhaust System at various MDFR Stations Various MDFR Stations TO BE COMPLETED BY THE CONTRACTING FIRM I understand and accept the terms and condillora for the 73W RPQ#MDFRD-VEHFX-R referenced above. Accepted by.Company Name: Garrison Mechanical Service Corporation DRA Garrison Mechardcal Authorized Representative Name: Authorized Representative Sig M4 o February i$,2013 The foregoing was sworn and subscribed before me this is day of February,2043 by Robed Garrison a is =a—Vy—kno, 10 who has n Produced as Identification who being duty swam.deposes and sop that the above is true to the best of his knowledge,information and belief, 2 4 May CornrnissiDn expires: NOTARY?UH1jC4TAT9 OF FLOP= Tim Yodw NOTARY PUBLIC Expires: JAN.14,2014 STATE OF FLORIDA Expires: 50%DVFGC0�W- Note:Whoever Is signing above Is authorized to blind the corporation and must be an officer of the corporation as Verified through the ftride Olviston of Corporations. r ..: .I. y - -- i S MIA DARE COUNTY : ._ -:: ... PURCHASE:-.ORDER PAGE' :. ..... - -. ! DATE , 02/13/2413 PO..NUMBER PCFR130:0020 ** ORIGINAL ** . ... ._; - _ _ -. -. .. .....: VENDOR .... .: ..REOUESTTNG DEPARTMENT OR AGENCY .. - GARF2ISON MECHANICAL.SERVICE..CORP MIAIwII-pADE :FIRE=PAC & CONST ,DBA..GARR...$ MECHANIC IL '. - ` . - .....: 4851 JOHNSQN :STREE' , -#1`0$ :FA.. .. . .ZES . CQAFSTRUCTZON: °PEMBROKE PINESi: FI, 33029 . !' -9;300 N W 41 STREET, MIAMI> FL :3317$. ... VENDOR ZD x42143992 _ 01 VENDOR . 'EL (954)-441 -7000 _ - -- ---: FI,EASE:..REFER ALL: QUESTIONS - TEL {`-06)331 449$ CONCERN NG,T HIS:: ORDER TQ .YT NOVELA . .: - _... _ ._ CASH I)ISCOUNT FRE GH T CARRIER __-­MT. - — . ... .._._ . ... ._ _: { .... ?OB I? T P -- .:- t F{)B_DESTINATION, FREIGHT PREPAID -THE SELLER=FAY$'AND :BEARS THE FREIGHT :.CHARGE$. - _ _ _ AGENT-:CONTACT FLORES, ZRASELA'' DEI,TVERY REQUIRED :DEPT : NO REQ NQ: {305).3'75 5.$ 1 02:./.01/2013 .FRCC PCFRl3£3002Q 1. _, _. _ISSUED:.UNDER CONTRACT NO MCC-;P12OG�tAM 7360 FED - - BPO .ID: . _AHCW1 tIQ0675''. . _ SHIP TO BILL TO Nt A I ..,..., F RE.;.:RESCT3 T?EPT/k`iNNANCE, MIA DAAF _' E-_RESCUE DEPT/F`IN.. C. 9;300.:.NW 4! STREET ___ 9. Ot? NW. STREET MZAMZ,_ FL 3317$:. _: i�iIAMI, ' EIs 3378 1. .. .. .. . . .. .. . . _..._. ... .. ::. .: ..... .. :_ .. - .. _, : :ITEM .:COMMODITY ID . _ . QUANTITY U/M UNIT PRICE TOTBL PRICE COMMODITY.NAME/SPECIFICATIONS` ,_.,z, ` ...:. .. ._ ._. 001 907 99 1 00 �,C7 1,084,659 2400 1./084,669 24 ft: .. .. ... . - -- MZBCELLANEOU$ CONST,RUC..IQN,E'EI7)3RAL - .... < , . _ ... . s :...1, --._..._-- _.. _ . -.. . . .. . {CO�TTZNUED ON; NEXT RAGE) .,_ .. . . . . . , ; .. ._... . -. : - I . I : .: . ,.. .. :.. - . . . , - - < .: : f MX ?T DAE E OUNTy PURCHASE.-ORDER PAGE: 2: . RATE :a2 j13/2013 !­­`-:-t­. ; PO ;NUMBER PCF'R13f�:002a . I I I *k 'ORIGINAL: * -- ... •ITEM .:COMMODT.TY; ID -.QUANTITY U M UNIT PRICE 'T'OTAL PRICE COMMODTTY_I3AME/SPECIFICATIONS':' _ -:_ . . . . . CONTRACTOR! TO :.FURNISH AND INSTALL VEHZCEL EXHAUST REMOVAL:SYSTEM AT VARIOUS MDFR. STA'TIONS .PURSUANT TU ALL REQUIREMENTS UNDER R Q-NO MDFRD VEHE% RAND ALL:ISSUED AD7END1; :EDWARD '+ILLAREAL MDFR PROJT<;CT MANAGER•` VEHICLF,EXHAUST RMOVAL,_FEDERAL GRANT :MISCELLANEOUS :CONST2UCTION CONTRACTS 7350fFED ,a02 -- 907 -99 :i10 W-+ 1(1$,4�6 0000 1{l8,466,0�} . . - .:: _ .,.. :. _ . MISCELL7-MOUS `CONSTRUCTION,FELlET2� i __CONTINGENCY. AhI;OWANCE...... ,. MISCELLANEOU�_ CONSTRUCTION CONTRACTS ::°73601.FED - -. . O03 . .:9a7 .. + ` 1.as T,t) 40,00_a 00 40,00Q:Ala 1. :;-- MISCELLANEOUS.'CONSTRUCTl+0W,FEDERAL DEDICATED ALLOWANCE PERMIT:-FEES ; - :<: MISCELLANEOUS. -CQNSTtIICTION CONTRACTS 736Qf:FED COMMODITY LINT.TOTAL_ : : -+_ : . . 1,233,13-5. 24 : GRAND :'TOTAL: $...: 1,2 ;3,13 .24 . _._ ::: . DDITTONAL..REQITI.REMRNT,S AND TERMS __ ACCOUNTING INFORMATIO$T !SEX INDEX SU$OBU USERCdb PROJCT PRJDTL GRANT GRN + . . AMO"+ / o d.2 FR,ASTFFFACI 92111 T-. FR2126 x ,233,135' 14 ._:. ...... .:�: : . . { ... ; � ` ' AUTHORSED SIGNATURE : DATE, 2� 312a13 1 . END OF DOCUMENT :... .. . _ . .: :.._ -... - ._. _. ..-. . _: ...- .... BMW 4 X t ,..,.- .-.-.... i GARRI-1 OP ID:PR CERTIFICATE OF LIABILITY INSURANCE 1 °A'031""Y'�' 03/04/13 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 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). CONACT PRODUCER 954-561-2220 NAME: Gulfstream Insurance Group Inc PHONE FAX P.O.BOX 8908 954-566-0673 A/C No Ext: A/C No l: Fort Lauderdale,FL 33310-8908 E-MAIL David Arch ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:National Trust Insurance Co INSURED Garrison Mechanical Service INSURER B:FCCI Commercial Ins.Co. Corporation dba Garrison Mechanical INSURER C: 20851 Johnson St.Ste 108 INSURER D: Pembroke Pines,FL 33029-1924 INSURER E: 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 ADOL BUHR I POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MIDD MIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE I$ 1,000,00 • X COMMERCIAL GENERAL LIABILITY IGL00120302 07/22112 07122113 DAMAGE T 100,00 REMISES Ea occurrence $ CLAIMS MADE OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER- PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY PRO- !LOG �' $ AUTOMOBILE LIABILITY Ea etBINdan')SINGLE LIMIT $ 1,000,00 • X ANY AUTO CA00189382 07/22/12 07/22113 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X $ AUTOS Peracadent X Bmd PIP X DOC $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00 B EXCESS LIAR CLAIMS-MADE JUMB00127432 07127112 07/22/13 AGGREGATE $ DED X I RETENTION$ 10,000' $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA� (Mandatory In NH) E.L.DISEASE-EA EMPLOYE S It yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION MIASHOR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave Miami Shores Village,FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD A�`� CERTIFICATE OF LIABILITY INSURANCE DATE/05/2013I� 03!0512013 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 BYTHE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Risk Transfer Programs,LLC NAME, 219 East Livingston Street PHONN g�481-9363 Ale,No): Orlando,FL 32801 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:CastlePoint National Insurance Company 40134 INSURED INSURER B:Tower Insurance Company of New York 44300 Stafflink Outsourcing,II,III,IV,V&VI Inc. 1776 N.Pine Island Road INSURER C: Suite 106 Plantation,FL 33322 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:G9CG9FEM REVISION NUMBER: THIS ISTO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTOTHE INSURED NAMED ABOVE FORTHE 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 THETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LLTRR TYPE OF INSURANCE ,ADD a POLICY EFF POLICY EXP LIMITS I INS" WV POLICY NUMBER MID M/D GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PDARMEMISES Ea occurrence $ CLAIMS-MADE D OCCUR MED EXP(Anyone person) $ ICI !PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- LOC $ i AT F7 AUTOMOBILE LIABILITY CO IN INGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE' AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WSLTHPE00020009 X WC STATU- OTH- B AND EMPLOYERS'LIABILITY Y/N WSLTHPE00014904 03!01!2013 03101(2014 TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? 1NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 tyes describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S $ $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Coverage is extended to the leased employees of alternate employer in all states except in monopolistic states(ND,OH,WA,WY):Garrison Mechanical Service Corp DBA Garrison Mechanical#1206(Effective 7/12/04) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village AUTHORIZED REPRESENTATIVE 10050 NE 2nd Avenue Miami Shores,FL 33138 Page 1 of 1 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 GARRISON, ROBERT SEAN GARRISON MECHANICAL 20851 JOHNSON ST #108 PEMBROKE PINES FL 33029 STATE of FLORIDA AC a Congratulations! With this license you become one of the nearly one million DEPARTMENT OF BUSINESS AND Floridians licensed by the-Department of Business and Professional Regulation. PROFESSIONAL REGULATION Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants,and they keep Florida`s economy strong. CAC1813264 128458477 Every day we work to improve the way we do business in order to serve you better. For information about our services,please log onto www.mynoridalleensexom. # CERTIFIED AIR COND .CONTR There you can find more information about our divisions and the regulations that GARRISON, BERT SEAN impact you,subscribe to department newsletters and learn more about the GARRISON F+ C -Department's initiatives. Our mission at the[Department is:License Efficiently.Regulate Fairly.We constantly strive to serve you better so that you can serve your customers. s31trgFxpunder era® provisions or cta.499s Thank you for doing business in Florida,and congratulations on your new license! nxpiratim dater AUG 31, 2014 L12082801233 _. _. [DETACH HERE _ ..........._. THIS DOCUMENT HAS A COLORED ACot�!= AC# 6310041 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL GULATION CONSTRUCTION INDUSTRY LICENSING BARF# SEW L12082801233 LICENSE NBR 108/28/20121128058477 ICAC1813260 The CLASS A AIR CONDITIONING CONTRACTOP Named below IS CERTIFIED Under the provisions of Chapter 4EI :FS. Expiration date: AUG 31, 2014 GARRISON, ROBERT SEAN GARRISON MECHANICAL 20851 JOHNSON STREET #108 PEMBROKE PINES FL 33029 RICK SCOTT KEN LAWSON GOVERNOR SECRETARY -DISPLAY A> REQUIRE®13Y LAW ................. .. . ........ ............................ .................... BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2012 THROUGH SEPTEMBER 0,2013 DBA: Receipt#-.183-1378 GARRISON MECHA141CAL �FATINGIAIRCONDITION CON'T'.Business Name: Business Type: 'AIR ' CO!MITTONIING CUWTPAACT Owner Name-.ROBERT SEA14 GARRISON Business Opened:04/'l/2004 Business Location-20651 jOHNSON STREET UITE .0 te/County/Ce Req:CAC'8' S rt/ 1 13260 PE114-18ROYIE. PINES Exemption Code: Business Phone:954-441-7000 Rooms seats Employees Machines Professionals 12 For Vending Sushms only Number of Machines: Vending Type., Tax Amount Transfer Fee NSF Fee Penalty prtOr Yeast coueoon Cost Total Paid 54.00 n'10 W4.CW, 0 10 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 vvithin 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: ROBER7 SEAT GARRISCZ1 Receipt #01C-11-00012259 20851 JOHNSQ'11 STRET_- SUT.TE Paid 09/17/2012 54.00 108 P�EMSROK-_- PT.NTES, Fr_ 330219 2012 - 2013 1W. .... ......... ........ .......................... ............ .................. ................ S, rt �Y PW,` OF-01 iEAN lk �� 7 y 3 .tSkE 7'.411 Y � " 1 i �T76,4j1 3r h z RESTRICTIONS: vehic9e wfth a GVWA ies-6 than 26,00 1«5 vfto la' a4 ' Y