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MC-14-1311Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-214534 Permit Number: MC -6-14-1311 Scheduled Inspection Date: July 14, 2014 Inspector: Perez, JanPierre Owner: MOSHEIM, PAUL AND SUZY Job Address: 1098 NE 96 Street Miami Shores, FL 33138 - Project: <NONE> Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number (305)757-8233 Parcel Number 1132060143460 Contractor: WEATHERMAKERS AC CONTRACTORS INC Phone: (305)233-5820 Building Department Comments EXACT REPLACEMENT AC 3 TON Infractio Passed Comments INSPECTOR COMMENTS False Failed p V Needed ❑ July 11, 2014 For Inspections please call: (305)762-4949 Page 12 of 26 Inspector Comments Passed 10 Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. July 11, 2014 For Inspections please call: (305)762-4949 Page 12 of 26 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 BUILDING Master Permit No. nki® PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION ❑RENEWAL PLUMBING MECHANICAL [::]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP S+- CONTRACTOR DRAWINGS JOB ADDRESS: �f 'y� �l (D Sl : %&aai qrre-s 3n OL' 25 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: i 1-320( z 0I4— 34(P0 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee �((F�/ee Simple Titleholder): '16w 1' 0yj I 1 ► Phone#: M-rro) �y'- L01AY Address1CM KE 9CP d" Sig �n City: f ItC rr' i ShD State: Zip: Tenant/Lessee Name: Phone#- Email: �hu'j""e,M oye, 0 C -1D CA"YY'j - - CONTRACTOR: Company Name: WA?j0tWA`��' &MN E+e- IL"6 Phone#: 015233""53.2 Address:_ ���5 _5W, 119'6- /� A City:. M (an -1 State: FLI Zip: Qualifier Name: Mi"°Ei SOLO -to Phone#: 2,33^ � State Certification or Registration #: C0552 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: �� �� U e0L� - ��� l(%I� QQ PDW Specify color of color thru-tile: �-� Submittal Fee Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Rev1sed02/24/2014) CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ M�" 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspectigr which occurs seven (7) days after the building permit is issued. in the absence of such posted notice, the inspection will not bdhpproved and a)nspecti n fee will be charged. Signaturey - — Signature OWNER or AGENT ",CONTRACTOR The foregoing instrument was acknowledged before r e this I I `� day of pt� ,r,) 120 by �'��t t y , who is personally known to me or who has produced��)�'I . I ,�_ 11r as Sign:_ Print: Seal: ho did take an oath. I4f x'7'697 -"- e 'WKWUIC LCVVV Notary Public - State of Florida My Comm. Expires Jan 12, 2010 Commission # EE 158384 The foregoing instrunt was acknowledged before me this f �? day of 20 Pby .� Asa.. who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: ; Y Sign: - -� Print: PU'ea2+'�� MAGGIE LECCO Seal: _ Notary Public - State of Florida My Comm. Expires Jan 12, 2018 °•.;�oF o4q;:r Commission # EE 159384 APPROVED BY Plans Examiner Structural Review (Revised02/24/2014) Zoning Clerk 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): 1099 IUE 9(e) S� City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS ARI (AHRI) DATA SHEET REQUIRED Change Disconnecting means: YES ❑ NO ❑ ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES ❑ 1. Minimum Circuit Ampacity (Wire Size): -# O 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 55^�-t> 3. Voltage of Circuit (208/240/480): �-U 4. Size Disconnecting Means: 4II' �,4 k� GLA`' ,/ '� ,�, pa�^ Contractor's Company Name: �Q UIQ W f&VQXS A GW, V l e. Phone: 30 -2-33-592-0 State Certificate or Registration N. CPCgO055Certificate of Competency N KSignature signature only) Date: UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL # \C ' COND. UNIT MODEL KW HEAT `.®1 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 AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER l YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT t, YES NO YES NO NEW 4"CONCRETE SLAB I-etcN YES NO YES NO NEW ROOF STAND AM YES NO YES NO NEW RETURN PLENUM BOX p YES NO 1. Minimum Circuit Ampacity (Wire Size): -# O 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 55^�-t> 3. Voltage of Circuit (208/240/480): �-U 4. Size Disconnecting Means: 4II' �,4 k� GLA`' ,/ '� ,�, pa�^ Contractor's Company Name: �Q UIQ W f&VQXS A GW, V l e. Phone: 30 -2-33-592-0 State Certificate or Registration N. CPCgO055Certificate of Competency N KSignature signature only) Date: WEATHERMAKERS WILL SUPPLY ALL LABOR & MATERIALS TO: DATE 5/22/14 PROPOSALFOR PAUL MOSHEIM INSTALLADDRESS 1098 NE 96th ST CAC 057053 CAC 1813423 CITY MIAMI SHORES STATE FL zip 33138 EMAIL PAULMETALMOVE@AOL.COM FURNISH AND INSTALL A NEW TRANE XR-16 SERIES 3 TON RATED 16 SEER SINGLE -ST COMPRESSOR OPERATION R -410A COMFORT SYSTEM WITH NEW DIGITAL THERMOSTAT. 12EMOUTION & REMOVAL 127 0 Reconnect Existing Plenum 100 Demo. Existing Package Unit 128 Fab & Install Supply Plenum tot Q✓ Demo. Existing Condensing Unit 128 Fab & install New System Mixing Box 102 Demo. Existing Air Handling Unit 130 QI Fab & Install R/Air Plenum 103 Q Demo. Other 131 IJ Install Fitter Return Air Grill X X F{��IrIP-�MENT INa rAl e A aSART llP 132 0 Re -Connect Existing Electrical 104 L 1 Pkg. Unit t Model # 133 Q Install New Return Air Grill X X SEER Tons 134 0 Complete Duct System as per Pians or Draining Attached 105 Condenser Model# 4TTR6036B1000A 134A+D Other SEER 16 Tons 3 106 [D Air Handier model # 4FWHF036A1000B Hesterl(W 10KW-BAYHTRDS141OSLO 107 0✓ Thermostat HONEYWELL 5000 108 ✓ Condenser Slab 36 x 48 x 4 109 Electronic A/Cleaners 110 Condenser Stand 111 ✓ Air Handier Stand 18" 112 ❑ Hanging System A.H. 113 Auxiliary Drain Pan X 114 New Heat Recovery Unit 115 Pipe Existing Heat Recovery Unit 116 ❑ New Install Heat Recovery Unit 117 u Condensate Pump 118 ❑ Pipe Condensate Pump 119 El Misc, MATERIAL DUCT. PIPE a FITTINGS 120 Q—1 Reconned To Existing Piping 3/8" X 3/4" I—_L 121 L . Now Una Set 122 Line Cover 123 [✓ Condensate Piping FLUSH 124 �✓ Flush R-22 ones R-11 FLUSH 125✓M Drain Una Most Switch ANY ELECTRICAL OUTSIDE OF RECONNECT NOT INCLUDED. umtted warrardy;.A# tatbw mqutred to support am aramman#maad warranties rs car (1) area yeah 11 as Oth- kadkrated 0 wft. The ma pActurw far die Air OXWNx+ing and HeafirgT Equipment k0baw in mis propo" warrants dte compressor parte forioyaars mad Bae etjuipraerd cotapanerd.tar zoyears tiara ft date of ftwa#atima. tmmAAws: 10y_r compressor 10vr parts 1vr labor AUTHORIZED SIGNATURE Daniel Campos c «. OTF 135 M in UnillSize X X 136 Q in Ceifrng/Size X X t a CELL: _ (305) 794-6218 13965 HOME: (305) 757-8233 >4arlamct>Ft`33O WORK:_ t3t)� 2 233.582$P (305 635-3360 ) flax. (305) 2334336 FAk www weatherm;.akeza.met WEATHERMAKERS WILL SUPPLY ALL LABOR & MATERIALS TO: DATE 5/22/14 PROPOSALFOR PAUL MOSHEIM INSTALLADDRESS 1098 NE 96th ST CAC 057053 CAC 1813423 CITY MIAMI SHORES STATE FL zip 33138 EMAIL PAULMETALMOVE@AOL.COM FURNISH AND INSTALL A NEW TRANE XR-16 SERIES 3 TON RATED 16 SEER SINGLE -ST COMPRESSOR OPERATION R -410A COMFORT SYSTEM WITH NEW DIGITAL THERMOSTAT. 12EMOUTION & REMOVAL 127 0 Reconnect Existing Plenum 100 Demo. Existing Package Unit 128 Fab & Install Supply Plenum tot Q✓ Demo. Existing Condensing Unit 128 Fab & install New System Mixing Box 102 Demo. Existing Air Handling Unit 130 QI Fab & Install R/Air Plenum 103 Q Demo. Other 131 IJ Install Fitter Return Air Grill X X F{��IrIP-�MENT INa rAl e A aSART llP 132 0 Re -Connect Existing Electrical 104 L 1 Pkg. Unit t Model # 133 Q Install New Return Air Grill X X SEER Tons 134 0 Complete Duct System as per Pians or Draining Attached 105 Condenser Model# 4TTR6036B1000A 134A+D Other SEER 16 Tons 3 106 [D Air Handier model # 4FWHF036A1000B Hesterl(W 10KW-BAYHTRDS141OSLO 107 0✓ Thermostat HONEYWELL 5000 108 ✓ Condenser Slab 36 x 48 x 4 109 Electronic A/Cleaners 110 Condenser Stand 111 ✓ Air Handier Stand 18" 112 ❑ Hanging System A.H. 113 Auxiliary Drain Pan X 114 New Heat Recovery Unit 115 Pipe Existing Heat Recovery Unit 116 ❑ New Install Heat Recovery Unit 117 u Condensate Pump 118 ❑ Pipe Condensate Pump 119 El Misc, MATERIAL DUCT. PIPE a FITTINGS 120 Q—1 Reconned To Existing Piping 3/8" X 3/4" I—_L 121 L . Now Una Set 122 Line Cover 123 [✓ Condensate Piping FLUSH 124 �✓ Flush R-22 ones R-11 FLUSH 125✓M Drain Una Most Switch ANY ELECTRICAL OUTSIDE OF RECONNECT NOT INCLUDED. umtted warrardy;.A# tatbw mqutred to support am aramman#maad warranties rs car (1) area yeah 11 as Oth- kadkrated 0 wft. The ma pActurw far die Air OXWNx+ing and HeafirgT Equipment k0baw in mis propo" warrants dte compressor parte forioyaars mad Bae etjuipraerd cotapanerd.tar zoyears tiara ft date of ftwa#atima. tmmAAws: 10y_r compressor 10vr parts 1vr labor AUTHORIZED SIGNATURE Daniel Campos c «. OTF 135 M in UnillSize X X 136 Q in Ceifrng/Size X X 137 ❑ in Wak/Siza X X 138 ❑ Planned Maintenance Agreement SUB -CONTRACTORS 139 ❑ Crane Service 140 Q High Lift 141 ❑ Electrician 142 ❑ Wisc. PER14AtT3 & OTtdHR 143 M Permits MIAMI SHORES 144 Notice of Commencement 145 ✓ Heat Load&Ptans HEAT LOAD ONLY 146 ❑ Other TOTAL ESTIMATE: $4,279.76 EXTENDED WARRANTY FPL REBATE ($585.00) ELECTRICAL OTHER SERVICE CALL ($194.76) TOTAL $3,500.00 PAYMENT DUE REBATE GRAND TOTAL $3,500,00 FINAL INSPECTION NOT PART OF INSTALLATION, SCHEDULED SEPARATELY. PAYMENT VISA MC❑ AMXE:1 ## EX DATE: PAYMENT TERMS WILL SE $ $1,750.00 DEPOSITAND $ $1,750.00 UPON COMPLETION OF THE INSTALLATION. OTHER *LABOR WARRANTY DURING NORMAL OPERATING BUSINESS HOURS ONLY* AHRI#6179478 accepted. �atlons and conditions are satisfactory and are hereby Payment will be made as:oullined above. Signature__. w.v......: f — Date of Acceptance: (1(Wa) have read the contftions on reverse side). This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2013. AHRI Certified Reference Number: 6179478 Date: 6/18/2014 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 4TTR6036131 Manufacturer: TRANE Indoor Unit Model Number: 4FWH(A,F)036A* Manufacturer: TRANE U.S. INC. Trade/Brand name: TRANE Series name: Manufacturer responsible for the rating of this system combination is TRANE U.S. INC. Rate. Heat party * Ratings followed by an asterisk (*) indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an Involuntary rerate. )urce hard DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS 17, This Certificate and Its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered Into a computer database; or otherwise utilized, In any form or manner or by any means, except for the user's individual, personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The Information for the model cited on this certificate can be verified at www.ahridirectory.org, click on 'Verify Certificate" link we make life better - and enter the AHRI Certified Reference Number and the date on which the certificate was Issued, which is listed above, and the Certificate No., which is listed at bottom right F '`""" " 13047592373323041©2014 Air -Conditioning, Heating, and Refrigeration Institute + ERTIFICATE NO. Property Search Application - Miami -Dade County Page 1 of 1 op u"I'Flu"E OF THE PROPERTY APPRAISER I , j Summary Report Property Information Folio: 11-3206-014-3460 Property Address: 1098 NE 96 ST < Owner PAUL MOSHELM &W SUZY Mailing Address 1098 NE 96 ST MIAMI SHORES, FL 33138-2552 Primary Zone 1400 SGL FAMILY - 3001-3250 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY :1 UNIT Beds I Bathe I Half 4/3/0 Floors 2 Living Units 1 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 3,607 Sq.Ft Lot Size 18,961.8 Sq.Ft Year Built 1925 Assessment lnformatlon Year 2014 2013 2012 Land Value $360,483 $240,322 $227,685 Building Value $257,724 $259,607 $293,111 XF Value $29,6321 $29,8711 $33,492 Market Value $647,839 $529,800 $554,288 Assessed Value $399,104 $393,206 $386,634 Benefits Information Benefit Type 2014 2013 2012 Save Our Homes Assessment Taxable Value 1 $U9,1041 $343,2061 $336,634 Cap Reduction $2`18,735 $136,594 $167,654 Homestead lExemptlon 1 $25,0001 $25,0001 $25,000 Second Exemption $25,000 $25,000 $25,000 Homestead $50,000 $50,0001 $50,000 Taxable Value $349,1041 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description MIAMI SHORES SEC 3 PB 10-37 LOT 1 BLK 81 LOT SIZE IRREGULAR OR 17248-1353 06961 Generated On: 6/16/2014 Taxable Value Information Previous 20141 20131 2012 County Exemption Value $50,0001 $50,000 $50,000 Taxable Value 1 $U9,1041 $343,2061 $336,634 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value 1 $374,1041 $368,2061 $361,634 City Exemption Value I $W'0001 $50,0001 $50,000 Taxable Value $349,1041 S343,2061 $3,634 Regional Exemption Value $50,000 $50,0001 $50,000 Taxable Value $349,1041 $343,2061 $336,634 Sales Information Previous Price OR Book- Qualification Description Sale Page 06/01/1996 $300,000 17248-1353 2008 and prior year sales; Quai by exam of deed 12135-1327 2008 and prior year sales; Qual by 05/01/1984 $240,000 exam of deed 04/01/1978 $125,000 09998-1667 2008 and prior year sales; Qual by exam of deed The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http:llwww.miamidade.gov/i Wcflsdaimer asp (http://www.miamidade.govinfo/disclaimer asp) Version: http://www.miamidade.gov/propertysearch/ 6/16/2014 f t �� r� �, �/ Y � 1 � � � 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. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDERTO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXEMPTION) 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 10030 NE 2ND AVE MIAMI SHORES, FL 33138 ■■eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeseeeeeeeeeeeeeeeeeeeeeeeeee� COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: W a f RI,% 6 BUSINESS ADDRESS: IN55 sW I �q Att, CITY STATE r ( ZIP CODE 1- - BUSINESS PHONE:( DrJ)^ '50 FAX NUMBER ( �J��) CELL PHONE { } QUALIFIER'S NAME: QUALIFIER'S LIC NUMBER: ��� E-MAIL ADDRESS (IF APPLICABLE): 1 �/` IeJL���'� ►� Created on 3119109 BY MLDV I RV 3!26109 MLDV a r� OwNi , SEC. WEATHEftIUTAKERS A C CONTRACTORS 196 INS CACC 1►�orker(s) 3 This Local Busine6tiot Receipt obfil confirms p�rm►f ora cart�fication of the holder s quatifi rrongOVeinmentat reguletorylaws ngd raquirei R - irhe RECEIWN" iJ. above mW',display [or motOd iformati f lVlt GtiHtX1LHL V V Iv BYTAXCQ4%LECTSifi 0/30%fY13 a 3-03 I UHSI 0 3 orrt of the lAcal Business Tax. The Receipt is not a ��icense, :tdaio baseness Hold@r must orot `With governmental or :ny which gppCyto the beside 7 all commercialvehic—A9mritr IJede CoSec Sa-27f> y twww miamidade novhacollector =� =-' _. � _� - WEATH-1 OP ID: LORE '4 ID1►11 CERTIFICATE OF LIABILITY INSURANCE DA0410312014I� 04/03/2014 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). PRODUCER Phone: 305-666-6636 Wilson, Washburn and Forster 16505 N.W.13th Avenue Fax: 305-662-7778 Miami, FL 33169-5719 Sarah J. Washburn CON Lorena Jofre ac°NNo E,1.305-666-6636 IC No): 305-662-7778 E-MAIL ADDRESS: cerUflcates@wwfins.com INSURER(S) AFFORDING COVERAGE NAIC @ INSURERA:Bridgefield Employers Ins. Co. INSURED Weathermakers Air Conditioning Contractors, Inc. 13955 SW 119th Avenue Miami, FL 33186 INSURER B: Hanover American Insurance Co. 36064 INSURER C INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATF NIIMRFR- RFVICInN NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village 10050 NE 2nd Avenue POLICY NUMBER POLIC EFF MWDD POLI Y EXP MMIDD LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx_1 OCCUR LZJ8817485 08/07/2013 08/07/2014 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER 1-1 POLICY jR� LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS Ewa aBBIINdED SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILYINJURY (Per accident) $ PROPERTY DAMAGE $ Per accident $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE UHJ8815073 08/07/2013 08/07/2014 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED I I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTNEY/N OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If describe under DES RIPTION OF OPERATIONS below NIA 830-14313 04/01/2014 04/01/2015 X WC STATU-OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS t VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) HVAC contractors CERTIFICATE HOLDER CANCELLATION MIASH01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village 10050 NE 2nd Avenue THE ACCORDANCE WITH THE POLICY PROVISIONN DATE THEREOF, S. WILL BE DELIVERED IN Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD