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MC-14-1898Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-218827 Permit Number: MC -8-14-1898 Scheduled Inspection Date: September 24, 2014 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Owner: CHOWNING, ELIZABETH J Job Address: 53 NW 99 Street Miami Shores, FL Project: <NONE> Contractor: AIR ZONE MECHANICAL INC eullicai Comments REPLACEMENT OF A 3.5 TON HVAC SYSTEM FOR A NEW 3.5 TON HVAC SYSTEM Inspection Type: Final Work Classification: A/C Replacement INSPECTOR COMMENTS Phone Number (305)753-8874 Parcel Number 1131010180500 False Phone: (305)556-7667 <q4 q i ?_'-i I I t September 23, 2014 For Inspections please call: (305)762-4949 Page 8 of 25 Inspector Comments Passed Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. September 23, 2014 For Inspections please call: (305)762-4949 Page 8 of 25 I P �1 N BUILDING PERMIT APPLICATION 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 ❑BUILDING ❑ ELECTRIC 0 ROOFING AUG 2 9 2014 �//FBC 2010 Master Permit No./'G,L: / � - /00,7S f S Sub Permit No. ❑ REVISION ❑ EXTENSION [-]RENEWAL ❑PLUMBING ❑O MECHANICAL ❑PUBUCWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP' CONTRACTOR DRAWINGS JOB ADDRESS: 53 NW 99 ST City: Miami Shores County: Miami Dade Zip: Folio/Parc�el#:11-3101-018-0500 Is the Bulldit Historiaft Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): ELIZABETH J CHOWING Phone#.305-753$874 Address: 53 NW 99 ST City. MIAMI SHORES State: FL Zip: 33150 Tenant/Lessee Name: Phone#. Email: CONTRACTOR: Company Name: AIR ZONE MECHANICAL INC Phone#. 305-556-7667 Address: 16600 NW 54 AVENUE UNIT# 3 may. HIALEAH State: FL -zip: 33014 Qualifier Name: BELGRABE PLASENCIA Phones 305-556-7667 State Certification or Registration #: CACI 814226 Certificate of Competency #: DESIGNER: Architect/Engineer. Phone#. Address City: -state: Zip: value of Work for this Permit.$2375-00 Square/Linear Foobge of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New 0 Repair/Replace ❑ Demolition Description of Work: REPLACEMENT OF A 3.5 TON HVAC SYSTEM FOR A NEW 3.5 TON HVAC SYSTEM. Specft color of color thru We; Submittal Fee $ • 0 Permit Fee $ 1, % .) 1U66's 1 en CO/CC $ Scanning Fee $ ®I - Radon Fee $ �`� DBPR $ 2- Ob Notary $ 0 Technology Fee $ t2- '40 Training/Education Fee $ Double Fee 92 Structural Reviews $ 2 Bond $ TOTAL FEE NOW DUE $ (RevkedMA4/2014) 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 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 lawn 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 such posted notice, the Inspection will not be approved and a reinspection fee will be charged. The foregoing instrument was acknowledged before me this F day of . 20 by sx�-- who ispersonally known to me or who has produced ktd as identification and who did take an oath. APPROVED BY (ReVISW02/24/2014) IN The foregoing inst day of me or who has produced acknowledged before me this .20 l `-f by ;�;;ally who kno to as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal:(41171 • ' ssssssssssssssssssssss. Plans Examiner Structural Review Zoning Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fm(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. r Job Address (where the work is being done%: 5-3 N u,) -s6 reST -31 S`l City: Miami Shores Village County: Miami Dade Tip Code: 3 31 e O 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 AHRI DATA SHEET REQUIRED Change disconnecting means: YES ❑ NO JZ] ARHI Sheet Attached: YES [N NO ❑ Contract Attached: YES EZI 1. Minimum Circuit Ampacity (Wire Size): 5-057 2. Maximum Overcurrent Protection{Fuse/Breaker Size): 5® l u D 3. Voltage of Circuit (208/240/40: .2-0 g 4. Size Disconnecting Means: Contractor's Company Name: E G �KB n e- #,a,,ra u�' Phone-.�AW M—i (e,ie? State Certificate or Registration C I 1 4 2-2 0 Certificate of Competency No n Signature Date: 1. �" I s I (RevisedO2/24/2014) UNIT BEING REPLACED DATA NEW UNIT C-7 o O d YYl 0, n MANUFACTURER 1)OL4 W 1 wr , A 1= Pr- q2 LP O t (-P aA AHU or PKG. UNIT MODEL # t- X " -4 V `I 4 O O A L, I! -M t3— O 42 -?-- COND. UNIT MODEL # N R )UP t4 Z Gi K-/4 10 le -W KW HEAT 10 ktu -3-T NOM TONS 3 • S 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 U see v YES NO REPLACING DUCTS YES CNO YES NO REPLACING THERMOSTAT YES NO YES NO NEW eCONCRETE SLAB YES YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES O 1. Minimum Circuit Ampacity (Wire Size): 5-057 2. Maximum Overcurrent Protection{Fuse/Breaker Size): 5® l u D 3. Voltage of Circuit (208/240/40: .2-0 g 4. Size Disconnecting Means: Contractor's Company Name: E G �KB n e- #,a,,ra u�' Phone-.�AW M—i (e,ie? State Certificate or Registration C I 1 4 2-2 0 Certificate of Competency No n Signature Date: 1. �" I s I (RevisedO2/24/2014) This combination quare for a Federal Ener! Efficiency Tax Credit when placed in servtf htween Feb 17, 2009 and Dec 31, 201 Certificate of Product Rat -in AHRI Certified Reference Number. 6949626 Data: 8/29/2014 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Numb. NXA642GKA* Indoor Unit Model Number. FXM4X48' 'AL Manufacturer. DAY & NIGHT Trade/Brand name: DAY & NIGHT Series name: 16 SEER R410A AC Manufacturer responsible for the rating of this system combination is DAY & NIGHT Rated as follows in accordance with AHRI Standard 210/240 2008 for Unitary Air -Cond'iti'oning and Air -Source pHeat arty in Equipment and subject to verification of rating accuracy by AHRI-sponsored, Independent, third test Cooling Capacity (Btuh): 42000 EER Rating (Coaling): 13.00 SEER Rating (Cooling): 16.00 JEER Rating (Cooling): `Raffiw fiftmW by an ahs (h indlaft a votmtary rerate of previohhsly pubes data, w t m accomponlod with a WA& hvI I,1 its an invokaidwy rerate. DISCLAIMER AM does not endorse the product(s) listed on this Ceafilicate and nmkes no or gmantees as to, and assumes no responsibilft fon; the product(s) Luted on Orffi Certificate AM expressly dim aA fir for damages of any kind ariingout of the we or pedennance of the prodhwt(sk or the ramvti11-1of data lid! on U& Certificate. Cartilled ratings are v alld only for models and con1hparallons listed In the direr atww ahridirecto►y.org. TERMS AND CONDITIONS This Certificate and Us contents are pmpriatary products of ANRI. This Certificate shall only be used for I dividvat, pamonal and M- I �derdlal reference purposes. Tim collards of this Certificate rimy rmt,ln whole or to part, be rModuced; cople ordered into a conviderda or all a uti6zcd, In any form or man ner or by any nugm*,1 for Ora usWe individual, and conlitientlal reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The Irdomration for the model cited on this certificate can be vim at eroww.shridirectory.org, click on "Jerify Certificate' tbdr we make life beth,.. and enter the ARM Certified Reference Kund r and the date an which the certificate was wed, which Is Wed above, and the Certificate No, which is laded at bottom rigid. 930537849i430Si� ©2814 Air -Conditioning Heating, and Refrigeration Institute CERTIFICATE NO.: Page 1 Air Zone Mechanical, Inc. 16600 NW 54 AVE Unit # 3 Hialeah, Florida 33014 Phone: (305) 556-7667 Fax: (305) 623-1966 Licensed & Insured State License # CAC1814226 August 11, 2014 Via Emai& Ichowning@hellsouth.net To: Elizabeth J. Chowning From: Air Zone Mechanical, Inc. Proposal for: 53 N.W 990 St. Miami Gardens, FL 33150 Please note below a list which indicates the scope of work and amount to be paid. SCOPE OF WORK INCLUDED: (same for both outions): • Removal and Disposal of existing 3.5 ton Aar Conditioning System (R-22) • Installation of new 3.5 ton 16 seer Air Handler and Condenser (8410 Freon) • New digital Thermostat non programmable • All material and Labor Included OPTION #1 RHEEM 3.5 TON 16 SEER TOTAL AMOUNT DUE: $2,931.95 If Permit is required, it is additional cost as per City charge OPTION #2 DAY AND NIGHT (by Carrier) 3.5 TON 16 SEER TOTAL AMOUNT DUE: $2,375.00 If Permit is required, it is additional cost as per City charge **Manufacturer Warranty: 10 years on compressor/ 10 years on parts/ 1 year labor thra AZM **If paid with credit card a 3% fee will be incurred** new U. Plight system TOTAL AWUNT DU9 495.00 'Note: We recommend maintenance to your unit at least twice a year, which is a one time fee that will be charged in the first visit. Please let us know if yon are interested"* pueA,sr,r e"v 1 c>4& i o r -o ori resat fv-r&,fAo, p"C. -r4AT AD work will be performed according to the above proposal any alterations or deviations from such involving extra cost will be executed only upon written orders and will be subject charge over and above this proposal. Any and all patching and carpentry work will be the sole responsibility of the customer. Air Zone Mechanical shall not be responsible for any existing building or electrical code violations. If it becomes necessary to bring any action to collect amount due on this invoice, purchaser shall be responsible for reasonable attorney's fees and court cost incurred by vendor inInterest shall accrue at 10% per month on outstanding balance. PthASO sEND T6aWf a&N Wo POr-- ATA C CA10s T rO 1oVe OaSr pvA -' its Cn UA -tam. Uiritl../�yU)0 D,F Accentance ofProuosal "rd eYZ. 604L -Clef Air Zone Mechanical is authorized to do the work ed Accepted 0 A/ F&I Print Name eixzAm t J . C-40-WriF N& 40STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 . 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 PLASENCIA, BELGRABE AIR ZONE MECHANICAL INC 16600 NW 54 AVENUE #3 MIAMI FL 33014 --C:ongr-aTQ a amt-tlifiihrthis ii lou -become -one eflmJ ,-neady--,-, - one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to 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 inibrmation about our services, please log onto www.myflorMalicerne.com. There you can find more information about our divisions and the r�ulations that impact you, subscribe to department newsletters and team more about the Departrnent's Initiatives. Our mission at the Department is: License Effrdentiy, 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 Iicensel DETACH HERE .......... ........._.._._._......._........_.............__ .. RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CAC1814226 The CLASS AAIB CONDITIONING CONTRACTOR `' - Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2116 Wz, ISSUED: 07/17/2014 DISPLAY AS REQUIRED BY LAW SEQ # L140717000N14 2014-08-29 11:26 Eguino & Associates 7863133738 >> 1 800 685 7530 P 1/1 AcoRr�? DA IE (EQ + CERTIFICATE OF LIABILITY' INSURANCE 1 ' THIS CERTIFICOTF IC ICeie"n" w� w .•,•ti.': ; p 08/29/14 GF=KTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, "TEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESrS BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOL.DIrR. i IMPOATANT: If thatha cortiflcato holdor is an ADDIT70NAL INSURED, the k ioa must bo ondomad. I! SIIBROt3ATION IS W RIE. BuAJect tho terns and conditions of tho policy, certain Policies may require an ondommont. A stato►nont on this cordfkato does not confer rights to the e!TfICeto holdor In Ilan of such ondorsomont(s). PRODUCER ON fAC°r. MARI'IZA INCLAN -• - .- , ....- «,... w ..T- r Eguino & AssociatesAmir, (PANNO E% (308} 266.1700F 05 267-1181 7229 Coral Watt EMAIL ` t%4 ww �.v.•n _�_ + .w•r tA/61 Nati—.ell.. ADDRL'SS; _ Mlnelan�epulno.Com Miami, FL 33156 � •--•—��-,------�••••••--• - ................. .,.�,�,.� rIN8UERB;AlrZone Mechanical, Inc. S16600 NW 54th Ave, Unit #3 Hialeah, FL 33014 (305) 556-7667UMBIwR: URER p T'HI'S i5 7p CERTIFY TMA7 7hiE POLICIE' SOF INSURArICE LISTED BELOW WAVE BEEN iSSUED % TI -!-IW— URED Aaw6 AI80VE SION N—FOR�THE POLICY PERI INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH T1 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 MAUM nCem Dcn„ncn o.. w...... _._... _ GENERAL LABILITY I COMMERCIAL GENERAL LWpILITY Q CLAIM&MADE [] OCCUR A Y OEN•I, AGGRCOATE LIMIT APP41ES PER; PR C7 PQ1rIGY,• JE LOC AUTOMOBILE LIABILITY f®�� ANYppAUTO I..] AAt1TOS NED ❑ SCHEDULED NUDT"O NEO i ❑ FIIREOAUTOS ©AUTOS Q UMBRCLLA LIAR .uR. ..,. „....._ ❑ occ ❑ EXCESS LIAR n w, __ , ... _ ,L. �o - - •. JTYXC-V ... . 08/1.x+/2014 - "-' `" - . #IWauo . _ LIMITS EACIi acTURR w "oA�nAaE To RL'NTpp E E S•( ° ° a�� 08/15/2015 MWw_D W ( onerm"On PERSONALBADV INJURY YGENERALACCREC,Ar r PRODUCYS . CaMPJOP ACiG ._AGO COMOIN90 81 IiIdEl Li— BODILY INJURY (po person) BODILY INJURY (Par sedaerd EACH O�CURRCNCE 0 s S 3 S T.avw -t S S 9 YIN IA DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attalla ACORD 101, Additions! Remarks sehadula, H Moro apace is AIR CONDITIONING INSTALLA"ON, REPAIRS AND SERVICES. rm►'""°dl CITY OF MIAMI SHORE 10060 NE 2ND AVE MIAMI SHORE, FL 33138 1 SHOULD ANY OFYTH OVEDESCRIBEDPOIJCIESBECANCELLED BEFORE THE EXPIRATIONTHEREOF. NOTICE waL BE DELIVERED IN ACCORDANCE);E POLICY PROVISIONS, I............. _,..,.........::....MARITZA` .., .,.......__... _ .._....,._...� P ....R ACORD 28 (2010105) QF 4 )1988,2010 ACORD CORPORATION. All rights resptyod, The ACORD name and 1090 are roplatorod marks of ACORD CERTIFICATE OF LIABILITY INSURANCE 08/2 /2014 'r''' 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 pollcypes) 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 endorseme s . PRODUCER Paychex Insurance Agency Inc PAYCHEX INSURANCE AGENCY, INC. 150 SAWGRASS DRIVE ( 6.0M; 877-266-6850 (AIC, Nor 585-389-7426 ROCHESTER, NY 14620 L Certs@paychax.com INSURER(S) AFFORDING COVERAGE NAIL # INSURED INSURER A. ILLINOIS NATIONAL INSURANCE COMPANY 23817 Paychex Business Solutions, Inc. Air Zone Mechanical Inc INSURER B: INSURER C: 811 PANORAMA TRAIL SOUTH ROCHESTER, NY 14625-0387 INSURER D: 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. 1111811 TR TYPE OF INSURANCE SIL R POLICY NUMBER POLICY EFF POLICY(WID�' LINpTS GENERAL LIABILITY EACH OCCURRENCE $ SCOMMERCIAL GENERAL LIABILITY L_--1"�S-MADE(.., DCWR DAMAGE TO RENTED $ MED EXP (Arty are perm) $ PERSONAL & ADV INJURY GENERALAGGREGATE $ AGGREGATE LIMIT APPLIES PEI: POLICY PROS== LOC PRODUCTS - COMP/OP AGO $ $ AUTONIOBILE LIABILITY ANY AUTO ALL OVOIED SCHEDULED AUTOS INGLE LIMIT $ $ BODILY INJURYAUTOS (P -P—) NUN p REDHI AUTOS 0 ANW& BODILY INJURY $ (Per ecddert) PROPERTY DAMAGE $ (Par accident) U119101A UAB OCCUR EACH OCCURRENCE $ IDWESSLRAB Q CLAWS -MADE AGGREGATE $ DED I IRE-rENT10N 5 $ WORIGMSCOMPENSATMAND Y� uY 011732318 06/01/2014 06/01/2015 X WCSTATU- OTE- E.L. EACH ACCIDENT $ 1 000,000.00 ANY PROPRIETCRIP� OFFlO ER EXCLUDED? YAW ph ddwy in NN) LTJ Aeon. deafte Ian N/A X EJ— DISEASE - EA EMPLOYEE $ 1,000,000.00 E.L. DISEASE - POLICY LIMIT $ 1,000,000.00 T-1 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Renfeft Schedule, it more apace Is requlmd) Workers Compensation coverage is provided to only those employees leased to, but not subcontractors of the named Insured. Waiver of Subrogation granted In favor of the certiticate holder. CERTIFICATE HOLDER CANCELLATION C of Miami Shores SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED SWORE THE ExPIRATLON 1050 NE 2nd AVE DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WRH THE POLICir Miami Shores, FL 33136 PROVISIONS, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, iTS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE S ACORD 25 (2010105) C lOW2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD