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EL-11-583Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL r Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 157892 Scheduled Inspection Date: November26, 2012 Inspector: Devaney, Michael Owner: MEDIA, GILBERTO Job Address: 165 NE 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: CREST ELECTRIC INC NEWWORK TO UPGRADE SERVICE AND REPAIR FIRE DAMAGE UP TO CODE. A/C SYSTEM HOOK UP AND SMOKE DETECTORS Permit Number: EL -4 -11 -583 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060132330 Inspector Co Passed Failed Correction ❑ Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Phone: (954)520 -2748 November 26, 2012 For Inspections please call: (305)762.4949 Page 1 of 11 Permit N Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Owner's Name (Fee Simple The Holder): c/�i� q Phone #: -71r6' SV;z S /Z3 Owner's Address: / C fY 5 ¢ City: State : Zip Code: Job Address (Of where work is being done): 65 " 9e_3; City: Miami Shores State:—Florida Zip Code: Contractor's Company Name: C,zes 1.Z /Ac Phone #: 9S41 5-??o Address: Sz City: /- f Z&,,-e State: F/ Zip Code: :10W Qualifier's Name: - d g�Lo Lic. Number:c i3�oy�19 Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: Describe Work: I hereby certify that the work has been abandoned and/or the contractor /architect is unable or unwil ' " g to complete the contract. I hold the Building Official and the is hores harmless for all legal involvement. Signatu Signature o erorAgent Contractor or Architect The oregoing ' ent was And be me The foregoin instrume'nt -'w�aJs aknowledged before me this 14 day ,b ` l C-o this day of 201` b Wh is r Wally kn/o� n to one or who has produced who is personally known to me or who has produced 4) Id as indentification. as indentification. Notary Notary Publ r�� Sign: Sign: Seal: S'rA'►° n '� r ;� .k Seal: ° y 5. %' •..d va e-��e� },,�'kt,5 B0I1U11��}GfloitlC. //////!/r1111111111 \�\�` Qa„ Unu 6/27/11 BuildNet 210533 Biscayne Blvd Aventura, FL 331M Dear Jonathan, This letter Is to Inform you that unfortunately, we will not proceed with your company at this time at the job located at 165 NE 98 St. Miami, FL 33138 because we have chosen the services of another company. We apologize for any Inconvenience that we have caused but would still like to do business with your company In the near future. � 3 NOTARY PUBUC'STATE OF FLORWA - •.�' °4 >. �.r,la James I COMWdssioa DD8391199 NOV 19, 2012 $ONDW =W ATIdIN1gCBONDINGCO,= A ti e /a l/J ■ Completh Items 1.2• and 3. Also complete Item 4If Re*kted Qeomy,Is d m print your name and address on the feverse so that we can retum the card to you. ■ Attach this card to the back of the mauplece, or on the front if spares permits. 1. Afte Addmswd to: • F y &lkm 53i� °o pagmmw D Rt;dtnn R9Oelpt irnr n , [3 amrad Beau o coo. 4. RoOkMad o~ Pft Fee) 0 Yes 2. ArMS Ntnntter fmmam. 701[J Cimnesdo Patton Rwelpt ,x2393-02 M -,640 Ps Form 3611. Fe ruery 2004 _ - Ln cc i e ru ♦ e . • I(T . ° cc r` Postage $ ►]b rI CertlNed Fee •u X3 32 r � C3 (Endorse ant Required) y )} �F eO r3 Restricted Delivery Fee `ti (Endorsement Required) W Q;-il CO r%- Total Postage & Fees s `' ru C3 nt o Z97 -- -. -. -f rI-- -------------------------------------------------------------- or PO Box No. �° a - ~ I ---- - --- - Clly, §late. �lP+4 � a�✓)�/ i l�� i a Miami Shores Village�CEIVED Building Department AUG 2 2 2011 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 cr. INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No. PERMIT APPLICATION Master Permit No. /// 2S FBC 20 Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): �/ f��J� ��l� Phone #: j7& s4e7 S12-? Address: VC 4?3'5 City: s " State: _ Zip: `33 /3r Tenant/lessee Name: Phone#: Email: JOB ADDRESS: A.5- �� 4,f iT City: Miami Shores County: Miami Dade Zip: 3 3/3 Folio/Parcel #: Is the Building Historically Designated: Yes CONTRACTOR: Comnanv Name. q City: r NO Flood Zone: Qualifier Name: Phone#: State Certification or Registration #: C ` DO 'V/p 9 Certificate of Competency #: fit ! Contact Phone #: 60Q 0 v/)"T /6) Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ c5ibn. oO Square/Linear Footage of Work: Type of Work: UAddress UAlteration UNew *epair/Replace UDemolition Description of Work: Submittal Fee $ 'T Permit Fee $ CCF $ CO /CC $ Scanning Fee $ Notary $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ r Bondiug„Comp4ny'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 w ich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be apptoved an� reinspection fee will be charged. Owner or The fo go' ms men was day of, 2C 20 � I , b who Is persona Vlkn wn to me or who has produced 41L —u '0 ilAs i dentification and who did NO AIynn BLIC_ Sign: Print: My Commission Expires: Signature ac � Co tor I this Y The foregoing instrument was acknowledged before me this 1 �� day of �V+�L„ , 20 t 1, by N fir` ��+ who is personally known to me or who has produced e an oath. as identification and who did take an oath. W APPROVED BY 490 %eilf Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) NOTARY PUBLIC: My Commission Expires: Zoning �1 tE?RD . CERTIFICATE OF LIABILITY INSURANCE LTR 7YPRCFINSURANCB /31/2011 TKi�s cERTIRCATL IS ISSUED As A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CNITttFICATE HOLDER THIS CERTIFICATE DOES NOT AFRRMA'TIVPI.Y OR NEGATIVELY AMEND, EXTEND OR ALTER THE GDVE'RA ©E AFFORpED By THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(s), AUTHOR, M REPRESENTATIVE OR PRODUCES AND THE CERTIFICATE HOLDER. tMPORTANT: If 90 CWt ffodty holder lit an A1093 MAL INSLIREb, the pelley(les) muck be andemutL If sfiBR06ATION IS WAIVED, suisjalx to the terms and conditions of the Policy, ce bIn polWas may require an andommattt A statement on this caMcate does not aonfer rlghts to the cartil icetc holder in ROU of such 4t,dorsement(s). mumcBR "Reph Delays Rick ciibbs, P.A. Insurance Agr=ay 1000 S. State Road 7 I'" (954)881 -7740 ^x Iesetsa._FS�s N°8 .jnesrialegi8bgpn.cre� PRowcam �u,�Taratatsl 0014632_ lW&U=4$lAVPMWMsCOVEltAGE NatCs Plantation BL 33317 'NSUREP ws Fffir A'D ZN8178ANCE CO /27/2012 pigg s- 5 1, 000, 00 Crest $leatric mwmat s s,000 5234 NI0 Aeva Cir INmom D' INSURERS 6 Ta /,. Port 9e.flnt= ie ]TL 34956 INSURFRF: Rr-V1050- rrVlrlrstiC: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE i1STFD BEi.OW HAVE 132;EN ISSUED TO THE FNSUMD NAMED ABOVE FOR THE POLICY PEREaD INDICATED. NOTWITHSTANDING ANY RE OUIREMEiNT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH Tma CE3RTIMCA►TE MAY 86 ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DEsc MBED HEREIN IS SU111ECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN RRRUCE3D BY PAID CLAIMS. _ - LTR 7YPRCFINSURANCB ! aoucrNFalseR m+aa _ Ltbttts A eE1t4AAI.ueeFUrY S COMMERMAL GMMAI UARIUrc CLAt1+0.4d/ADE OCCUR ; �x8s8b000267x3. I /27/2031 /27/2012 encn oc mvmce 5 1, 000, 00 SAT I 9w ma+oq UEa ta+ m+apff=+t s 100, 000 s s,000 PERSONAL&ADVFMFURY 4 1,000,000 GETIEItld AGGREGATt' 9 2,060,060 G A(Q6R0($aKrBit app MtrLtEgPFR MIL Pao Le. PROmI,lnn- cQtfmp 1 0oo,66a AuroFiloalLS cwawrY ANrAUro I COMMO Sable Unar CO •n i BODRYINA WONry rwe) i AuOWNFWAUTOg ffotALrwjuKrrwamaa+D S SCFEOULEDAUTOS PROPERTY bAMMA 1FeraoBdenO $ FO REOAVTOS � � & KOH-OWNF.DAUTOS F g WNBRH3wuAa OCCUR EXCESS w" woldom "WERM COIIMU AAWA YfN + 1 t" PRCff%M0FffPAftnQ-W=UrM OF L=" E7(> a 1H (p 0C 'iT0be10W i ( /A E F 1 EM N OWUR $ AGQIiEGATE S A 5 C+rao lr+' S -- - EJ..D{SE+AS - EwE1UPL0 S 6.L D=480 POLICY UWt $ i + D=WPT=OFOF%Xa wstLOCA'RONgIYENa 9 tANa�ACORD101,AdditionaFRemml� dtlk,irdwracpaseiaraquirmfj rFO'rrtrrw� urn. nee MIAMI SHORES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED MORE MIAMI SHORES VIItACiE THE MWIRATION DATE THEREOF, NOTICE UR L. Be nM jmm in BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS 20M NX;tnd AVENUE I&RAMI SHORES, FLORIDA 331M AUTHOWW RERMEWATNB - FAY4305 7SO 8972 'n- = �� ►— - Joseph Delauro /ooSSpB AC012D w (2009109) ®1988 2609 ACORD CORPORATION. All fight$ mow tAtS�145ronneneA 'n...wrnbn- _____ea_ -- .-'-.-----' -- _ ....... •........y., o.� .aay.c.a:sa>.a.uaane ua Ka.vlcv J email - Images in "" CCF05172011 00002. jog C-) INVOICE ESTIMATE () RECEIPT POa 0517 +1 -1 Date W!7.11 CREST ELECTRIC INC EC13004199 10 EMERGENCY SERVICES 24 INC 5234 NW REBA CIR Attn ANDREW BiWOODSTON PORT ST LUCIE FL 34986 ADDRFSS 1120 IiOLLAND DR OFFICE 954 -520 -2748 772 -336 -8948 BOCA RATON FL 33487 PAX 772 -338 -8948 PHONE: 561 - 451 -62'0 Fax S61241 1228 Jab Location Residen a at G. iberta Melia R Gvstavu Prada 165 NE 98th STRF.FT MIAMI SHORES FL 33138 ITEMSrDA d L DESCRIPTION PRICE 1 Total rewre of Hajse all new matenal new Se +vice Eq prnent and new Lighting fixtures 2 Nate AI! vrnr.g to he Ncmneetxhc�Sheathed cable 3 Budget to, Electvicat Permit Fee g , 3110 X 4 Budget lar 1.rghlmg Fixture$ Pa0k 51200 with P�ardl;nq charge S . 200 :1C S firs Paco is tram on Estimate takeoff P 0 05171' 0 from EXdrreal Plan dated 2 -20 -2011 Shee17 6 Payment Schedule 2T', Deposit = $2655 00 S59,1., at Rough inspection = S 7028 25 25 0r. at F:na; Inspection = S 319,375 TP�is Prrce IS based on Estimate takeoff P,O Q51711 -C from Fleoftcal Plan dated 2 -20 -2011 SheW 7 FIRE DAMAGE REPAIR PLANS fr- '65 NF 98St , MIAMI SHORES FLORIDA. OWNERS GIBERTO MEXA $ GUS TAVO PRADO $ 10.57500 Ca1� Jack Flanagan 954 -523 -2748 I ACCEPT THE A80VF- PRICE AND SPECIrICATrONS NOTES CC F05172011 _00003. j pg I OTAL 5 12 775 00 DATE ' .23 Page 1 of 2 httnc-/ /mail annalP 4q/,)n/)AI 1 `hmail - Images in "" ESTIMATE Sit V2011 PO 051711 -0 CREST ELECTRIC INC TO E- efgency Serv:xes 24 =nc 5734 NW REBA CtR 1120 Hodanrf Dr Su40 01. Bona Raton F: 3348 PORT St LUCIE. FL 34986 Phone 954 -913 -3314 Fat 551-241 1228 OFFICE 954- 520.2748. ','72.336 -89+48 Residence Gilbelo Merjea & Gustavo Prad6 I -AX 772 -.326 -8948 165 NE 98th St , Miam iShares FI OUAN DESCRIPTION �w PRICE SUBTOTAL 42 RECEPTACLE- OUTLET 3 WEATHER PROOt REC OUTLET 4 GROUND FAULT REC 15 SWITCH "SINGI F POLE" 10 SWITCH ",'d1fdAY' L SWITCH "4)WAY` ^^ '4 6- RECESSED LIGHT "HIHAT G 4' RECESSED LIGHT 'HIHAT' ` 3 FAN BOXES 0 Fl.001) LIGHTS 5 SMOKE DETECTOR 3 SURFACE MOUNTED LIGHT FIXTURF'5 2 WEATHER PROOF LIGHT'S � - -' DISPOSAL 1 DISH WASHER 1 REFRIGERATOR 1 WASHER a FREEZER ` 1 MATER HEATER i DRYFR 0 COOK TOP 0 OVEN 1 RANGE 1 A1C COM i AOR HANDLER 6---- SUB PANEL 1 POOL PANEL 'PANFI. ONLY Ez1 EXTRA 1 HOUSE PANEL "20 AMP- 'OVER 200AM ?S EXTRA' 1 SERVICE DISCONNECT '200 AMP" OVER 2'00AMPS EXTRA" 0 DIMMER SWITCH'S "SINGLE POLE ONLY 3,1W AND 4-1.111 ARE EXTRA - 0 THERMOSTAT 2 TELEPHONE 2 CABLE "R -G-6" 0 UNDER CABINET LIGHT 0 CIRCUsT FOR EOUIPMENT 0 WHIRL POOL TUB RUN FOR SFRVICE TO PANEL 35' ^' ©_ 0 ALL PRICES ARE 1310 ONI v TOTAL 5"0 S75 I ACCEPT THE ABOVE PRICE. ANC) SWECIFICATIONS. DATE 201 t NOTES Page 2 of 2 ttt4»c.• /lvr.ai) iennnles nnra.l e.it /�?..S —h D.Sl.- 2...11 L.1llAlD...:..... —sa0 aL_1'fAA00AAt�10,.'7A -CO -�: eHA /�1n1 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 1*11§1 P�ECTION'S PHONE NUMBER: (305) 762.4949 APR 0 Q 2011 r' Permit No. -F-1 C �� XION Master Permit No. r JOB ADDRESS: 16, t 5 �(-:� I� City: Miami Shores County: Miami Dade Zip: 3 �ll Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Phone #: � --7> -&6 :;il ev, -=, Address: City: nL�tj'�V State:�Z�d`' Qualifier Name: o „ State Certification or Rye J istratio n #: Certificate of Contact Phone #: - 7Z40 — t Email Address: DESIGNER: Architec ngin Value of Work for this Type of Work: ❑Add Description of Wo - -- Square/Linear Footage of Work: -0 too alteration , JNew ,Mepair/Replace ODemolition —r�D 2-'H�r Submittal Fee $ Permit Fee $ ®QP�� Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Technology Fee $ ago— "5 TOTAL FEE NOW DUE $ Oil- Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State zip zip. Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for 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 of su posted notice, the inspection will not be roved and a reinspection fee will be charged. Signature Signature Owner ent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this z day of , 20 11 ' by G;i 16,%4 &eti day of ' , 20 LL, by , who is personally known tome or who has produced who i ovally o me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: 14vu—� Sign: Print: Print: My Commissi My C E Wo ►g�ublic State of Florida WO,, 'Gala Silver LtOS6 33 ualssiww03 •ti"�'"'��fd,� o� MY Commission DD717157 010z'til saa 9 aiidx3 ,wwo.1 Aye �� ®� Facpires 10120/2011 �.o,.- mR119 VQ 3NbisOr .,.a,��.ud�o APPROVED Plans Examiner Zoning Structural Review Clerk (Revised 07/10/07 )(Revised 06 /10/2009 )(Revised 3/15/09) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 F= (305) 756.8972 Permit No. -,Re- / / Job Name.r�' CRITIQUE SHEET ze %d�rr� G °mod• ." 11/2/2010 8:52 AM PAGE 2/003 Fax Server BUILCOR -01 ALKA ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE MMMI1D PRODUCER Automatic Data Processing Insurance Agency, Inc 1 ADP Boulevard Roseland, NJ 07068 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 Buildnet Corporation 20533 Biscayne Blvd #482 Miami, FL 33180 INSURER A: Twin City Fire Insurance Comparry 29459 INSURER B: INSURER C: INSURER D: INSURER E: EACH OCCURRENCE 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 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. I 1M -i OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ L)AMM71m TO RENTED PREMISES Ee occurence $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE 1-1 OCCUR MED EXP (Any one person) $ PERSONAL BADVINJURY $ GENERAL AGGREGATE $ GENL AGGREGATELIM7 APPLIES PER: PRODUCTS - COMPIOPAGG $ POLICY PRO• LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Es accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per ecddent) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per ecoldent) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FI CLAIMSMADE AGGREGATE $ $ $ DEDUCTIBLE $ RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS` UABR.ITY FROPRCUcuTrvE OFICEREME LD 76WAIEGLU1730 12128!2009 1212812010 X WC STIMIT O R E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE 100 00 $ + If yes describe under SPEGnIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 5w+0 OTHER DESCRIPTION OF OPERATIONS t LOCATIONS I VEHICLES t EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION Maims Shores Building and Zoning 10050 NE 2nd Ave Miami, FL 33138. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOP 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 OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED 0 ACORD CORPORATION 1988 r 14 TWP : 55 RNG : 39 [ O n 3059141010150 MIAMI -DADE COUNTY R v . MIAMI —DADE COUNTY DEPARTMENT" OF PLANNING AND ZONING PERMANENT CERTIFICATE OF USE _ING ADDRESS/CONTACT P BU I LDNET CORPORAT I c0533 DISC AYNE BL AVIENTURA, FL 3318 [NESS USE: OFFI �u SPECIFICS: OFFI ) I T I ONS : 2ND USER aL DESCRIPTION: PINS UNIT OF CU ISSUANCE:10 /2 3 CERTIFICATE M U S rr, 3 CERTIFICATE OF USE IS )W PROVIDED THERE ARE _RSH I P. ALSO, THERE MAY B APPROVED USE. ALL CHANGES L CERTIFICATE OF USE. F EIt4E OR AS INDICATED , BUSINESS NAME OR RATIONS OR ADDITIONS TO REQUIRE ISSUANCE OF A CERTIFICATE OF USE DOES NOT RELIEVE THE APPLICANT FROM COMPLIANCE i ANY FEDERAL, STATE, OR LOCAL REGULATIONS. YOU ARE ALSO REQUIRED TO rid ZONING INSPECTIONS AT ANY REASONABLE TIME BY REPRESENTATIVES OF r, DEPARTMENT, FAIR MORE INFORMATION, PLEASE CONTACT THE ZONING PERMIT -ION AT (786) �1 r°-2G6Ge IN ADDITION TO THE ZONING PERMIT SECTION, . I CANT MUST ALSO CONTACT THE BUILDING DEPARTMENT AT ( TGG) 315-2100 ' OCCUPANCY REQUIREMENTS AND LOCAL. BUSINESS TAX RECEIPT AT p 01470 88 0 I g ��r f- I " u $ vi i pp to ac lxr- (Ono ,� • 9 4t Fes- f K K > O m LL tiO . L '..1 -1 M \O I X '1 gX 1k �OD O iN S N . aa MH ChO(0 1 ct3 �m 1 .rte O 1 ON �•.. NNN to w_ t HJS O� 0% �h"4 M hl 4+ 03 ..JJ p 46 O (JJ U(3 1 gs. -If �N aw tFi r r v -ti �W O J n N > n � tLLWO4 t- u LLS1 LL�1 Ng�h LmmU II p n T � UH�qd jtUi.F- �HH PC 3t" O�O n Y II N � Aec)"Rbir CERTIFICATE OF LIABILITY INSURANCE I DATE /DD/YY) 11 1/02 /02/10 PRODUCER First Commercial Insurance Agency THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION P.O. Box 295 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Cassadaga, FL 32706 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone (386)775 -1781 Fax (386)775 -3666 INSURERS AFFORDING COVERAGE NAIC # INSURED BUILDNET CORP. iNSURERA Western Heritage 20533 Biscayne Blvd #482 Adventura, FL 33180- INSURER E: COVERAGES 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 OF 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. INSR ADO'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M/DD/YYYY POLICY EXPIRATION DATE WDD LIMITS GENERAL LIABILITY EACH OCCURRENCE 1,000,000 © COMMERCIAL GENERAL LIABILITY 08/14/2010 08/14/2011 PREMISES occurrence) RMSS Ea �eSCP0818855 50,000 MED EXP (Any one person) 5,000 ❑❑ CLAIMS MADE © OCCUR A ❑ ❑ PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE 2,000,000 ❑ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG 11000,000 © POLICY ❑ PROJECT ❑ LOC AUTOMOBILE LIABILITY ❑ ANY AUTO COMBINED SINGLE LIMIT (Ea accident) ❑ ❑ ALL OWNED AUTOS ❑ SCHEDULED AUTOS ❑ HIRED AUTOS F] NON OWNED AUTOS BODILY INJURY (Per pe rson) BODILY INJURY (Per accident) ❑ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ❑ ❑ ANY AUTO ❑ OTHER THAN EA ACC AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE ❑ ❑ OCCUR ❑ CLAIMS MADE AGGREGATE ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? OR LIMITS W C STATU- ❑ OTH- ❑ T E E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE (Mandatory In NH) E.L. DISEASE - POLICY LIMIT If yyes describe under SPEG�IAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ELECTRICAL APPARATUS INSTALLATION SERVICE AND REPAIR CERTIFICATE HOLDER CANCELLATION ACORD 25 (2009/01) OF ©19BB -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Miami Shores Building & Zoning 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 10050 Northeast 2nd Avenue THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY Miami Shores, FL 33138 -2304 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) OF ©19BB -2009 ACORD CORPORATION. All rights reserved. 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 •�``� +a'�• TALLAHASSEE FL T STRFLT32399 -0783 MOORE, JOHNATBAN EMANUEL BUILDNET CORP 2I3CAYNE BLVD #FL2 A ENTUR 33180 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers #o barbeque restaurants, and they keep Florida's economy strong. 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.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and loam more about the 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. Thank you for doing business in Florida, and congratulations on your new licensel DETACH HERE QUALIFYING TRADE(S) 0001 ELECTRICAL �! 0002 BURGLAR ALARM 0004 FIRE ALARM SPECLT Hemdwo cmnm9k2 P.E y yp pMims www.odamwade. Building MIAMFDADE 11805 SW 26th Street Miami, Florida 33175 -2474 786 -315 -2100 miamidade.gov AFFIDAVIT FOR 30 DAY TEMPORARY ELECTRIC SERVICE ELECTRICAL CATEGORY 26 ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY TERMINATION UNLESS APPLICATION IS RENEWED OR CERTIFICATE OF OCCUPANCY OBTAINED. It is understood that the temporary electrical approval by the Miami -Dade Building Department is given in connection with the building bein constructed under the Building Permit # and Electrical Permit# ltd -- �i 3 ataddress lbS �i� �/ S`Tiz -��T rt��►►r Slw�ej.t =c 331-18 for owner: a TAEAi A and is being given only for construction purposes or for testing the following equipment in said structure: The owner does hereby agree to assume the responsibility of maintaining the installation in such manner that there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said structure for the purposes of use and occupancy, and no occupancy shall be granted or permitted until final inspections have been called for and approved by the inspection divisions concerned, and/or a Certificate of Occupancy or Completion is obtained. The undersigned also understands that the temporary electric approval is subject to rescis!�on and cancellation and electric power can be cut off at the discretion of the Building Official and will be disconnected if the building concerned is occupied before final inspections are approved and /or a Certificate of Occupancy or Completion is obtained. I, cl , f� being first duly sworn, depose and say that I am the owner of the above described property, and that I Agree that the structure covered in this agreement shall not be occupied building controctor has obtained approval of final inspections and/or obtained a Certificate of Occ ncy .or...!4P /q' %�� Completi ot`te: Failure to comply with the provisions of this affidavit will result in your being unabl oc4�`n futur em y permits. ermits. v,, s,•d'i CD Sig t %El� f O ner Signature of Notary `•° ; ��; My Commission Expires: I, � � ' o `� being duly sworn, depose and say that I am the J, + r the b e- descr• pr erty and tha t electrical installations as now existing will not c , rcj tem ary rvice is c � �` NU i RID1 yl .� . s S an Signature & Electrical Contractor Signature of Ni ary—' D TRW&v z[E>so umCo.,we My CommissioUi Expires: I, being first duly sworn, depose and say that I am the Building Contractor of the above'described property and that I will not permit occupancy of this building until final inspections have been called for by the contractors and sub - contractors concerned and final approval by the inspection division obtained and that I have the authority insofar as the owner of said property is concerned to prohibit occupancy until such final inspections are obtained and/or a Certificate of Occupancy or Completion is issued. Signature of Building Contractor Signature of Electrical Inspector 12301-124 6106 Signature of Notary My Commission Expires: Date: Date released to FPL: M CTQB Construction Trades Qualifying Board BUSINESS CER IFICATE OF COMP ACCAR al CERTIFICATE OF LIABILITY INSURANCE III 5/31/2033 71418 CERTIFICATE 0 DIED AS A MATH OF INFORMAMON MY AND CONPERIt NO MOMM UPON THE CERTIFICATE HOLOtR THIS Ct7t'tiFICATE Dm Nor APFiRMATNELY OR Nt:OAtwELY AMEND, MUM Sift AJLTER. 7HE COVERAGIS AFFOWIM FIV THE POLIO B&OW. THIS CMnRCATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEGN THE I$'SMS IMMIERn ArM0IIZED REPREMMATIVE OR PRODUCER. AND THE CERTIFICATE HOL M IMPORT the aerHm;pks 115tt!@T Is an ADMW IUD, the IuffeW ea) mud be endarawL It SUBROGATION IS WAN®, ed t0 the terms and wndMm of Ow parlay, aertaln PoRdes MY MgU1m an endammoat. A stMuent on this astfiede dose not eons ►19hte to the aerNisatc holder In Rest of with sndgrt 9 P FAMUGM Detamv Rick Gib, P.S. Xuamranata Agency (954)581 -7740 tP.O.Zsass 1000 S. t3tate Road ti nti4 0014632 Crest xla.CtrLa 5239 NK Rava dir Porter geed to Lucia 3% $4986 COVERAGES CERMCATE MUIY1Uft=153100572 REVISION NUMBER: THIS 15 TO CERTIFY THAT THE POUCIE9 OF INSURANCE LISTED 8MGW HAVE BEEN HUM TO TIU INGUREb NAMED ABOVE FOR THE MW PERIOD naDlCd M. NOTWITHSTANOM ANY REWROdENT, TERM OR COMMON OF ANY C!}1VMACT OR OTMM Do4'Y, ENr VM`H AMeff TO WHICH THIS CERi1 ICA E MAY BE ISSt1E0 OR MAY P MUN, THE INSURANCE AMOR000 BY THE POLMIES DESCR{9ED HERM 18 $ Ci TO ALL Tfm To1S, MCCLLFaMNS AND CONDMONS OF MCH POUCIRS, LMITS SHOWN MAY HAVE BEEN R=I> aD BY PAID CLAtl I TYPEarela MMUE BUM t t�IIXTi oO ALUASU r I I eAaEi ammutb= Is 1.000, 600 g ��ie aGkl 6Ak tJpBsJtY j'• I �I%"; IYaW6SMAOE O ►R I j �n.AQMMM7EUWrAPFUES:� % 1 UZ •03.83PTi00026713. j ! M WMATIt?I+N DATE TMEW, XMICE VALL BE DELIVERED IN /27004 1 I 197/a0u 4 �rs�.wa�me� 8 100.00 meat 5.000 PUMMA SADVINA Y 8 1.000.00 � s 2.000 OOG AA�RICSa.�APAM l.aoa.00 •5 AW0MQM9LVML Y AWPAO ALL OWMWAWM t 1A.10]AIdTC9 � NNW AUM j tmwamwAum ` j 1 G®taQm��ac L11WT $ %vaul<tRYWpm$" $ 9CbRYlltAtaY(Po * aaArtenp 9 . O'�a'mi0�4 � uMMMA+Jletik E9fCM UM p� yt tl OPf1mou 1 I (j1 IMMEam S _ S TIN nmwnmtwomm=?n;tu=*nw9iva=w e=5W=15MW" r,4Mm f.AUPIM I A7TAL �IIkAa815HD� SHOWW ANY QF THE ARM 086GRIM POLUi1l4q ffi GANGOWM 01WtM MIAMI SHORES VIIlAM M WMATIt?I+N DATE TMEW, XMICE VALL BE DELIVERED IN BLIM 1t6 M310 TM UT ACCURDAMRE WITH "M POLJCY PRISryisP KIL 10050 N.E. 2nd AVENUS AUUWRMa mrE MIAMI 31MM, FLORIDA 83138 FAX009M8972 3eaelsh fleZauroJJOS33P8 t': -,A• -- ACOM ZS 8009109? Nnos-rsetr A�.vnv ti werWnAt tun. An ngnaa n NUMBE6 INS08S (ao1►M The AC RD n� and hip arm [BgYBkMd marks of ACOFW A&!F ' CERTIFICATE OF L UMLITY 1NSURMCE amovocumm 5I31120ii 71418 CERT09CA -M a 18RUED AS A MATTER OP MORMFION ONLY AND CONFIM NO RIOU UPCIN TM CEMMICATE HOLGM Tait$ CERMCATE Dan NOT Appg MA71VELY OR NEOA'ftVEI.Y AMEf1C, EXTEND OR ALTER 7H6 COVERAGE, A7?POMM BY THE POLLMM BELOW. THM CERTIFICATE OP INSURANCE, DOES NOT COMMUTE, A CONTRACT BETWEEN THE HONG INSURE7i{8). AUTWRQED RPRRESENTATM OR PRODUCER, AND THE CERTIFICATE ttOL,1 M MpMAF7 it the mMficate Aidd" is an lNISURED, the patiGlt *4 must he andorsed. it ,BUMMA769N 18 WAMM, mu6jeGt im the temm and arntdl6one or the pallar, MWn p aRolas may ra4iAro ttn ondomente>>t A ant on Oft cer6fiaata don not confer 119MM to Um smacdo holder in Eau of such oado s pRabum Joseph sel.awo Rich 43bbe. P.A. XUvvwaudb A96ncY (994)581-7740 tRS*1 -as19 1000 S. State Road 7 •otde _...._. , ... -. 41014632 9MURRIi CreSt ul actmLe c: .- 5234 NW Sava dLr a- Part gaitst: LueliO mr, 34986 p. THIS IS TO �Ri1Fy''F64AT Tt1E PfJ1.IGiC3 Ut flVu`WtiAlv4z uri,. -., acavrr rwvc a�cn cwv&tir -v rua m =u,sc A o nouvm run mr- ruut.-T rcn uu MMCATIM. NOTWMWA%nM ANY IiMUIiIlEI1 SW, TU RM OR CONDITION OP ANY CONTRACT OR OTHM DOGI,IMEN'r WRrH AEMFM TO WHICH THIS CERTIFICATE MAY Be 1$$ M OR MAY F MAIN, THE INSURANCE AFFVFMg 7 BY THE POLtCIE3 QESCRMM HEREIN IB $UBMT TO ALL THE TMWG, =LuSIONB AND CONI)MONS or SUCH POUCH& LMITS SHOM MAY HAVE BEEN RODI.FM BY PAIO CUMMI L rIMO RiRRAANUE FOtd l LMftr$ oHIlWAt LutSanY ; Ma 5 1.806, 000 � S� S 100,000 A 4YAI 40E ' 3.11S8LDe02B7x3. 127l20JU i IX912ou ��, wmaaswd ! 3,400 i I AMM $ x,000,00 3 41.004, 00 FM km' 1 of nUKUPoi ATIOUILWATI9NVIVO - Ruutm hAC=M. MwW8daede % .ammsapaMbregm" 0001 .g taNraagtmRr Mm addwiQ S MMYeuuRrt[ic►PNQ" $ .YMuAYvw q a FROPEWCAVAGE ACCORI?ANCE WRH TIC POLSOY PROVOC IL 70830 UL 2nd AVENUE, s to 0001 NUMI SHOt11B S"MILV ANY OF THE ARM MMM i'DLLOM !B cANCId.t..aa MLVWM M W SHORES Vl ME THE t3.XFgRATM DATE WIMCF, NOTICE WILL M D>31VMM 0r auu R m QENARTMENT ACCORI?ANCE WRH TIC POLSOY PROVOC IL 70830 UL 2nd AVENUE, h M=M, FL0M0A s1 U AUTIMEMIMMEMWAME FAXa3459868978 magoph Delaarolacslma ACORD 2R (20@9JQ9) 0 9889 -M9 ACORD CORPORATIOM. All dghta r nAwL INSMOOM The ACORD name and logo are ragbbm d matt of ACOM ACDR � CERTIFICATE OF LIABILITY INSURANCE 011-29 00064- /DATE AC31- 2900064- 999289 06/02/21011 03:12 PM PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 5510 Iffighpoint Risk Y, Services SUITE 120 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 5510 r , Y, suxa� iaoo HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Dallas, ms 75aao (800) 632 -5096 (972) 715 -0959 INSURERS AFFORDING COVERAGE INSURED: PPS 1 /C /f: INSURER A. COLDSPOT A/C INC INSURER B: 1646 SW 7 AVE POMPANO BEACH, FL 33060 INSURER C: (954) 560 -9097 Fax: (954) 933 -7103 INSURERD: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERRA 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, EXCLMSIONS AND COMM70NS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATI LIMITS AUTHORUED REPRESENTATIVE LIABILITY EACH OCCURRENCE $ FIRE DAMAGE (Any One Fite) $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE M OCCUR MED DIP (Any One pemm) $ PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE UMIT APPLIES PER: PRODUCTS - COMP/0P AGG $ POLICY M P LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ee acddeM $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per P—) $ HIRED AUTOS NON47WNEDAUTOS BODILY INURY (Per ) $ PROPERTY DAMAGE (Per eo�ent) $ GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $ OTHER THAN EAACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS LIABILITY EACH OCCURRENCE $ OCCUR MCLAIMSMADE AGGREGATE $ DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS'LUUMI.ITY CPMU12044 01/01/2011 01/01/2012 X WC ATU X E.L EACH ACCIDENT $ 1000000 A E.L. DISEASE -EA EMPLOYEE $ 1000000 E.L. DISEASE - POLICY UMrr $ 1000000 OTHER LIMrrs $ LIMITS $ DESCRIPTION OF OPERAnONBJLOCAn ONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS 1. This certificate remains in effect, provided the client's account is in good standing with PPS. Coverage is not provided for any emplo ee for which the client is not reporting wagges to PPS. Applies to 100% of the employees of PPS leased to COLDSPOT A/C INC effective 91/0I/2011 2. Insured is afforded Workers Compensation & Employers liability as a co- employer under the policy for employees leased from PPS. rt=n"nc r_ATe unt neo I 1 ADDTTIONALINSURM WSURERLETTER: r1AUn=1 I ATV1u ACORD 25-S (7197) ® ACORD CORPORATION 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE VISUNG INSURER WILL ENDEAVOR TO HAIL 30 DAYS WRTTIEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 80 SHALL MIAMI SHORES BUILDING DEPARTMENT 10050 NE 2ND AVENUE IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR MIAMI SHORES, FL 33138 REPRESENTAT1YE8. AUTHORUED REPRESENTATIVE ACORD 25-S (7197) ® ACORD CORPORATION 1988