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MC-15-774Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-231678 Permit Number: MC -4-15-774 Scheduled Inspection Date: April 20, 2015 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Inspection Type: Final Owner: WILLIAMS, MAGDALENE Job Address: 191 NW 98 Street Miami Shores, FL Project: <NONE> Work Classification: A/C Replacement Phone Number Parcel Number 1131010240020 Contractor: AFFORDABLE AIR & HEAT INC Phone: (305)940-0777 luilding Department Comments REPLACE 4 TON WITH DUCTWORK Infractio Passed Comments INSPECTOR COMMENTS False Z'6 April 17, 2015 For Inspections please call: (305)762-4949 Page 20 of 39 Inspector Comments Passed Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid April 17, 2015 For Inspections please call: (305)762-4949 Page 20 of 39 BUILDING PERMIT APPLICATION Miami Shores Village Building Department -1_ C TAIIV E r 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 APR 0 6 015 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 Master Permit No.� Sub Permit No. BUILDING ❑ ELECTRIC F-1 ROOFING F-1 REVISION M EXTENSION ❑RENEWAL r-1 PLUMBING n MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [-]CANCELLATION ❑SHOP CONTRACTOR DRAWINGS JOB ADDRESS: l_ 9 � NUJ 9�; a ) City: Miami Shores„// County: Miami Dade Zip: �I4ou Folio/Parcel#:1 t -*A® I ” 0�4 " 0020 Is the Building Historically Designated: Yes NO Occupancy Type: 0[® Load: Construction Type: a Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): .X� �. � � Phone#• Address: 191 WL0 % �5- city: MbWt �l� —State �Fl �Q Zip; Tenant/Lessee Name: Phone#: Email: 1�4 1 A - CONTRACTOR: Company Name:At" AINZ A I e— `I' *j I Phone#: q--40 ®—M Address: r'51 �� i� IQ (6I City: NNA l -State: - Zip:';;�Obiqq Qualifier Name: ��� Phone#: State Certification or Registration M DESIGNER: Architect/Enginee Add of Competency #: Value of Work for this Permit: $ Square/Linear Footage of Work: State: Zip: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: f__ Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Permit Fee $ Q—1 (3 , a) CCF $, Radon Fee $ Training/Education Fee $ DBPR $ CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ t ] q-. 9 0 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 inspection which occurs seven (7) days after the building permit is Issued the ab ence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. 10 Signature OWNER or AGENT The foregoing instrument was acknowledged before me this � day of �l��\ > .20 1 , by lQ�e who is personally known to VA me or who has produce6FL0L*W45-2-5L) 0 1 as identification and who did take an oath. & CONTRACTOR The foregoing instrument was acknowledged before me this �P day of \ 20 1 by l ►� Iry o is ersonall �o me or who has produced identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign•2a]\� '� o > Sign Print: ISL;- Print- Seal: uu'r'.�`Bi''� DASSILLE N. DURAN Seal: N^1' mida ,3162 S�' 'o• NoWV-Publla - State of Florida an 28, 2018 •= CommISS� N IFF 193782 ��'� NotaryMa�l. My Comm. Expires Jan 28, 2019 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 1 _ I r 9 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(a�re not acceptable. Job Address (where the work is being done): NW�I 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 AHRI DATA SHEET REQUIRED Change disconnecting means: YES ❑ NO M ARHI Sheet Attached: YES ® NO ❑ Contract Attached: YES, 1. Minimum Circuit Ampacity (Wire Size): 60 A A 14 �v 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 15Dn 3. Voltage of Circuit (208/240/480):b V 4. Size Disconnecti eans: tD MAP Contractor's Com ny N me: ��,,ssff � k a-45 A4 1 Phone: ' 124%)x" A' i State Certificate o Re>±i ration No. 006 t l I Certificate of Competency No. Signature (Revised02/24/2014) Date: (QuaRflees si , ature) UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER bq aQ ® AHU or PKG. UNIT MODEL # c� ® COND. UNIT MODEL # M Ai IA qqlAcl KW HEAT 9 NOM TONS AHU Co CU -K) PKG 1) M.C.A AHU CUW PKG AHU fQ CU 5-0 PKG 2) M.O.P AHU CU ffp PKG AHUA`I® CU 9A PKG 3) VOLTS AHU 94CCUAO PKG PKG UNIT / / PKG UNIT EER/SEER JWL ES NO REPLACING DUCTS YES NO NO REPLACING THERMOSTAT NO NO NEW 4"CONCRETE SLAB ES NO YES ' O NEW ROOF STAND YES YES d9ff:) NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): 60 A A 14 �v 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 15Dn 3. Voltage of Circuit (208/240/480):b V 4. Size Disconnecti eans: tD MAP Contractor's Com ny N me: ��,,ssff � k a-45 A4 1 Phone: ' 124%)x" A' i State Certificate o Re>±i ration No. 006 t l I Certificate of Competency No. Signature (Revised02/24/2014) Date: (QuaRflees si , ature) hL N-4 — Pvnaft: WIL/dnry Otarvfce IS ATTUroaofe — 515 N.E. 190th Street - Miami, FL - 33179 CAC04811 Dade (305) 940-0777 • Sroward (954) 987-9943 PRIMARY fl QO .! SECONDARY / s' % EIAA NAME: + J08NAAAE2'�/y yf STREET: etdiecn I CITY ALti%ZCsr.,. .f P 'J�.T�';�i{ MANUFACTURERK tDq/p ��� ..{...rye 1 (Y► Ap BL .;�� r n`.A.{f ( iahl• { . TONS Yr 7 '1 1 h.,; r J' 4 ,I a JOB DESCRIPTION:�ti t�,� DESCRIPTION OF SERVICES PERFORMED Title to the above merchandise remains with Affordable Air and Heat. Inc. AIR DISTRIBUTION: r Y ...5. s— :o.r • 1•I .:_.. r .,ux x. ;� .. ±. .., w. ,:. � .. .-,��..: .., :. ,., .. yi�r.:� s "L�•/Ll: .y�•i ( ;,`ala, 9 W -S :'�:,., _ '.t .1. !'._ a,f �pp 5, ttir W I;�V 4. "lt - `•1 F:�vFt �1'n k j ! 7F' � �} t � 1 i. II 4 t�,� DESCRIPTION OF SERVICES PERFORMED Title to the above merchandise remains with Affordable Air and Heat. Inc. AIR DISTRIBUTION: (seller) untg paid for in full.. in case of default in any terms of this contract. the Ductwork will be designed, fabricated and installed In atocordance with salter shah have the right to take Immediate possession of said merchandise accepted engineering practices and U compliance with all buNng codes in dand ue and amount of the purchase price then unpaid shall become Immediately payable at the seller's option without notice or demand. All monies paid force On above date. shag remain with the seller as liquidated damages, In the event the services of an DUCT WORK: �t t/ �`^'/" attorney are required to enforce the interest of the seller, the purchaser shall be required to pay all reasonable aftomey's!fees together with Interest and all costs System M flexlRbet and/or duCiwork•Mdth NOwarranty outstanding outlets and �_ returns. Subject to modMeation according to structural thereto. service shallperformed on accounts an balance. Labor wertanty excludes,, existing ductwork,k,ale existing electrical systems, or other requlrements and maintenance related repairs. LABOR WARRANTY: In the event the purchaser refuses to allow seller to commence work after Service will be provided free by us for a period of A _113 thwpontract has been executed, purchaser shall be responsible to the seller for 26% of the total price as liquidated and agreed damages. Seller shall not be year(s) from date of installation during regular working days & hours. responsible for any existing building or electrical code violations. MANUFACTUREER WARRANTY i All material Is guaranteed to be as specified. All work to be completed in a Parts Werra (Yrs) A I (7 BL- workmanlike manner according' to standard practices. Any alteration or Compressor Warranty (Yrs.) A B deviation from the contract specifications Involving extra Costs will be executed upon written orders and will be subject to charges'over and above this estimate. EXTENDED WARRANTY through a_ Initial Here Provided __ for year(s). AFFORDABLE AIR & HEAT, INC. WILL PROVIDE: YFS NO EXISTING 9 YES NO EXISTING INSTALLATION OF EQUIPMENT ❑ ❑ CONCRETE S � ❑ ❑ REFRIGERATION LINES ( ) OR FLUSH ( ► ❑ El 91, THERMOSTAT{ t11`rMU�Q(:l �l�Jy ❑ t9 ❑ GRILLES ( ) RETURNS ( ) ❑ ❑ BALANCEAM FLOW,, ❑ ❑ PERMIT FEE(S) & PLANS. IF REQUIRED :9 ❑ ❑ REMOVAL OF JOB SITE DEBRIS ❑ ❑ DRAIN PIPING ( ) OR FLUSH ( ) ❑ ❑ ( ELECTRICAL WIRING (POWER CONTROL) ❑ ❑ K AIR HANDLER SUPPORTS �g ❑ ❑ CONNECT TO EXISTING SERVICE/PANELS JK ❑ ❑ CONDENSATION PUMP ❑. K_ ❑ OTHER ❑ X ❑ EMERGENCY FLOAT SWITCH ❑ ❑ - OTHER ❑ ❑ HURRICANE TIE -DOWNS r1 I-1. __ OTHER _ F-1 n n COST 'i nrG ' REEiATEi/tEDITS " ", a,f �pp 5, ttir W I;�V 4. "lt - xIIyy�� CINA 4 F 4 4f1' t - - 1 , }9i a4 r Payment to tie mae�e as tollOW41 `{ d`bposi barilance upon I up. • + ',gip ,H+ 1. k 1 A 1k ;_'2 ^µ1.,. ,C r�nr Authorized Company Slgnature4i114 777. 777` This proposal subject acceptance r� ,days" ills vokl lherb:alert the opt(ort ofe seller. sPEclRcaTRins aRB corromo�SARE Rea THE ABOVE PRICES, _ s_ PAYiMrrwRa. BE geABE#"lNEn Asove Option Chosen Signature' ' " °h a.r `r Date"° x" This combination qualifies for a Federal Enerl EfFlclency Tax Credit when placed In servil between Feb 17, 2009 and Dec 31, 201 Ceilificate of Product Ratinas AHRI Certified Reference Number: 3799429 Date: 3/10/2015 Product: Split System: Air -Cooled Condensing Unit, Coll with Blower Outdoor Unit Model Number: 14AJM49 Indoor Unit Model Number: RHLL-HM4821+RCSL-H*4821 Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD; WEATHERKING Series name: Manufacturer responsible for the rating of this system combination Is RHEEM SALES COMPANY, INC. Rated as follows In accordance with AHRI Standard 210/240-2008 for Unitary Air -Conditioning and Air -Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, Independent, third party testing: Cooling Capacity (Btuh): 46000 EER Rating (Cooling). 13.00 SEER Rating (Cooling): 16.00. IEER Rating (Cooling): Ratings followed by an asterisk (') Indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which Indicates an Involuntary rerate. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranty 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 CertHicate. Certified ratings are valid only for models and configurations listed In the directory at tvww.ahridirectory.org. TERMS AND CONDITIONS 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; ARR entered Into a computer database; or otherwise utilized, In any form or manner or by any means, except for the usees Individual, personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The Information for the model cfted on this certificate can be verified at www.ahridirectory.org, ellck 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 —_- ©2014 Alr-Condltloning, Heating, and Refrigeration Institute CERTIFICATE NO.: 13o7o4s2136206 59� . y Miami Shores Village 10050 CCF N.E. 2nd Avenue NW DBPR Fee Miami Shores, FL 33138-0000 DCA Fee Phone: (305)795-2204 Project Address Parcel Number Applicant 191 NW 98 Street 1131010240020 Miami Shores, FL Block: Lot: MAGDALENE WILLIAMS Owner Information Address Phone Cell MAGDALENE WILLIAMS 191 NW 98 ST MIAMI SHORES FL 33150-1755 Contractor(s) Phone Cell Phone AFFORDABLE AIR & HEAT INC (305)940-0777 Tons: 4 Additional Info: REPLACE 4 TON WITH DUCTWORK Classification: Residential Approved: In Review Comments: Date Approved:: In Review Date Denied: Type of Work: Scanning: 3 Fees Due Amount CCF $3.60 DBPR Fee $3.15 DCA Fee $3.15 Education Surcharge $1.20 Permit Fee $210.00 Scanning Fee $9.00 Technology Fee $4.60 Total: $234.90 Valuation: $ 6,000.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # MC -4-15-55077 04/06/2015 Check* 2540 $ 50.00 $ 184.90 04/15/2015 Credit Card $ 184.90 $ 0.00 Available Inspections: Inspection Type: Final Review Mechanical Review Mechanical In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructio,�Vzonin Futhermore, I authorize the above-named contractor to do the work stated. �.� April 15, 2015 AyEfiorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy April 15, 2015 RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUS114ESS AND PROFESSIONAL REGULATION CONSTRUd'0QN INDUSTRY LICENSING BOARD CAC048111 ., The CLASS B AIR CONDITIONING CONTR) Narrred below IS CERTIFIED Under the pfovisions.of-Chapter 489 FS. Expiration date: AUG 31,•2016 FREEMAN;. NNIE S .. „�` AFPORDaBLE-Iac�R wHr44 515 NE 10TR,ST MIAMI ._. - ISSUED: 08/28/2014 DISPLAY AS REQUIRED BY LAW 001541 Local Business Tax Receipt Miami—Dade County, State - of Florida -THIS IS NOTA BILL - 00 NOT PAY 2102424 BUIMOSS NAMEJLOCAMON RECEIPT NO. AFFORDABLE AIRS& HEAT INC RENEWAL 515 NE 190 ST 2211126 MIAMI R. 33179 SECT# L1408280001794 IEPTEMBER 30,.2019' Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC.'TYPE OF BUSINESS AFFORDABLE AIR & HEAT INC 198 SPEC MECHANICAL CONTRACTOR BY TAX COLt.LECTOR PAYMENT "Ci/EO Workers) 1 CAC048111 $75.00 07/22/2014 CREDITCARD-14-029169 This Local Business Tax Receipt only confirm payment of the Local Business Tax. The Receipt is not a license. permit era certilicNion of the hotder'apualHicatious, to do basMess. Holde�complywkh any governmental ornottgovernmental regulatorytaws and requirements which apply to the b The RECEIPT N0. above must be displayed on all commercial vehicles- Warm -Dada Code See Be -M For mitre Information, visit mn w.miamidede.lov/taxootteatm OP ID: AP CERTIFICATE OF LIABILITY INSURANCE COVERAGES CERTIFICATE NUMRFR! RFVISIAN NUMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD DA -ii 04101/20/ Y17 04/01 /2015 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 Riemer Insurance Group Hallandale Branch PO Box 250 Hallandale, FL 33008-0250 Vita Kagan Gopman CONTACT PNHONE FAX A/c No Ezt : AIC,No): E-MAIL: ADDRESSPRODUCER CUSTOMER to #: AFFOAI1 INSURER(S) AFFORDING COVERAGE NAIC # POLICY EXP (MMIDDIYYYY1 INSURED Affordable Air & Heat, Inc. 515 NE 190 Street Miami, FL 33179 INSURER A: Wesco Insurance Co. INSURER 8: INSURER C : INSURER D: INSURER E: A INSURER F: X COVERAGES CERTIFICATE NUMRFR! RFVISIAN NUMRFR- 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 AUTHORIZED REPRESENTATIVE POLICY NUMBER POLICY EFF MM/DD/YYYY) POLICY EXP (MMIDDIYYYY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx_] OCCUR X P1055018-03 03/17/2015 03/17/2016 PAMAGE TO RENTEIT_ REM SES Ea occurrence) $ 100,00 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 X POLICY JECT M F71 PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE $ (PER ACCIDENT) $ NON -OWNED AUTOS $ UMBRELLA LI/AB OCCUR EACH OCCURRENCE $ EXCESS! CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATIONWC STATUS OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N / A TORY LI ITS E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) fl es, describe under DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space Is required) Air Conditioning Contractor; Service, Installation & Repair// City of Miami Shores is named as additional insured. CERTIFICATE HOLDER cANCFI I ATInN City of Miami Shores CITYMIA 10050 NE 2nd Ave SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores, FL 33138 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD '4E�?!Wr CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYY) 1/15/2015 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. It ITANT: 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 TACT Renee Bowman Corporate Insurance Advisors PHONE (954) 315-5000 FAX (956)315-5030 1401 E Broward Blvd'D Suite 103 Ft. Lauderdale FL 33301 showman@ciafl.net INSURERS) AFFORDING COVERAGE NAIC A INSURER AAssociated Industries Ins Co 23140 INSURED Affordable Air & Heat, Inc. 515 NE 190th Street INSURER B: INSURER C: INSURER D: INSURER E: Miami FL 33179 1 INSURER F: COVERAGES CERTIFICATE NUMBERRevd WC14-15 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 RBY PAID CLAIMS. LTR TYPE OF INSURANCE SUOR POLICY NUMBER EE�pDLLU��CED MMIDD C IFF EXP LID YY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F—I OCCUR EACH OCCUoRRENCE $ LN I LV PREMISE a $ MED EXP (Arty one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMPIOP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED CEM BLED SINGE LIMIT BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ cciiden DAMAGE $ Per accident) $ UMBRELLA LIABOCCUR EXCESS UAB CLAIMS-0MDE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITYLIM ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory M NH) It yes, describe under DESCRIPTION OF OPERATIONS below N I A RNC1035459 /8/2014 /8/2015 WC STATU- OTH- E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEj $ 500,000 E.L. DISEASE - POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additlarol Remarks Schedule, H more apace Is routrea► Except 10 Day Notice of Cancellation for Non Payment of Premium -Air conditioning contractor; Service; Installation; and Repair. M Village of Miami Shores Building Department 10050 NE 2 Ave Miami Shores, FL 33138 ACORD 25 (201 INS025 oninn.si m SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Schwartz/BOWMAN ©1888-2010 ACORD CORPORATION. All rights reserved. Tlta Annnn name and Innn aro reniefaraei mar*a of ar:nlirl Snap -Rite Mfg. Inc. PO.sox 577 Coats,INC.27521 PH.910-897-4080 w ti � �> /� • � ie FX.910-897-6662 www.snaprite.com - 01 _1021A 041 3€ 1 91 ALV The new Patent Pending "FATBOY" Condensing Unit Tie Down is truly unique. Its univers4al trsign is u�. equaled. The "Fatboy" can be installed as a standard screw installation or as a 3/115" cable installation or a,1" .4 • . hanging strap installation. Making the "Fatboy" the only truly universal Tie Down n:*e incMSOry0000. . Eng�nee0.: Ex-clusively for Florida. Engineering reports are included in all cable and strap kits... • • • • . • • 0..;..� FBTD Pegboard 4 Pak ••6• 0 0.000 000000 000000. •��• ; 6664 FBTDB Bulk 100 pcs. "Fatboy" Screw Installation Guide Conde�f lh Unit • FBTDC Cable Kit ,� ••••4' • FBTDS Strap Kit 14 GAUGE THICKNER, J, • 0000.; • 0000 • -*Fatboy" 0grArt'sing Unit Tie Down Fatboy" Cable Installation Guide 'atboy" Strap Installation Guide DUAL TAPCON HOLES (2) -ea. #10 x 112" Self Tapping Tek Screw (1)-3/16" x 1314" Tapcon -optional (2) Tapcons A ng Unit 3/16" Steel Cable 3116" Cable Clamp or Sleeve "Fatboy" Condensing Unit Tie Down (1)-3116" x 1314" Tapcon Optional (2) Tapcons 4" Slab ing Unit -1" 22ga., 24ga., 26ga. strap #10 x 112" Self Tapping - Tek Screw "Fatboy" Condensing Unit "Tie Down 1)-3116" x 1314" Tapcon )ptional (2) Tapcon .-- 4" Slab "FAiDOY" WSfAU.At10N iM NOTE: IHS MrAL 15 A aMt& REF %NfA110N Of IPE QP FORM SEE MES FOR PROPER M MDER OF AffAQftNr5 FEN, SDE ACl,OR71N6 f0 ® WICW OF WNIMM PND 114E OF ArfAG"W • "FAIT3CF" • • • •iUVi^ElO.•�� �' V. i �-•- �.nr 1 �*Lo:u x �•. vie 5LOf5 2" LONG X x' 4tADE " Fc z �Arcy�� • .. • P.gF.L At'thTiNM' � 0{WG FLAT • r6• tea" •Ak v 1N fAZLi,?to •'L WK. PLATE 1" MX I I' LPaE QA W CR :EVE W/ J�" 0A L00P. "FAIVCN" CONOQ,tSpJG Lur rE DOWN "FAIPOrl CA u WSrAI moN a= NOTE: Oi5 DE fAA ISA CRA WA1. 9M5eWAWN OF Ot CLP FORM. 8 SEE MOLES FOR PROPER MIMDER OF AffA0$ftT5 PW 5DE ALCf MWI f0 FEM OF W AALLAIM AW M OF AfrAafiftj NOTE: CATAYi MAY ON.Y OE USED FOR YtFF17 SPEED5170 hYHAN7 ® wMr�Ex of cLPs of 1 PEt; � ar FElctlroF tE55 rrvuv Is' ALI.OniR FEtOt15 f0 6o F f. AND 170 MPH U� 2 UA.ES PER �7E. NOTE: SEE TAUS FOR MW VN.00UY AW ff-3a f OF IN5TALLAIICIN APM OZOW. a150 55E WLE5 FOR CMECrOR Illi *ft AMO" f0 ALS OR STEEL. AV. 51EEL 5W - ZZ (A w •ua\slncrev TAY2 oram.wr.e Ae G.Tr• +DrB or arnur CTFn a.eASLn nn '" ak moat W/ 0<02.. Loa wf & WA%W . ..• w it vom CLP (1)-1-6'X241"OKON 1 2 2S' 2 2 2 30' 2 2 2 • . . ••. 3 . OEM NO GD' NO • NO • ... • • "FAiDOY" WSfAU.At10N iM NOTE: IHS MrAL 15 A aMt& REF %NfA110N Of IPE QP FORM SEE MES FOR PROPER M MDER OF AffAQftNr5 FEN, SDE ACl,OR71N6 f0 ® WICW OF WNIMM PND 114E OF ArfAG"W • "FAIT3CF" • • • •iUVi^ElO.•�� �' V. i �-•- �.nr 1 �*Lo:u x �•. vie 5LOf5 2" LONG X x' 4tADE " Fc z �Arcy�� • .. • P.gF.L At'thTiNM' � 0{WG FLAT • r6• tea" •Ak v 1N fAZLi,?to •'L WK. PLATE 1" MX I I' LPaE QA W CR :EVE W/ J�" 0A L00P. "FAIVCN" CONOQ,tSpJG Lur rE DOWN "FAIPOrl CA u WSrAI moN a= NOTE: Oi5 DE fAA ISA CRA WA1. 9M5eWAWN OF Ot CLP FORM. 8 SEE MOLES FOR PROPER MIMDER OF AffA0$ftT5 PW 5DE ALCf MWI f0 FEM OF W AALLAIM AW M OF AfrAafiftj NOTE: CATAYi MAY ON.Y OE USED FOR YtFF17 SPEED5170 hYHAN7 ® wMr�Ex of cLPs of 1 PEt; � ar FElctlroF tE55 rrvuv Is' ALI.OniR FEtOt15 f0 6o F f. AND 170 MPH U� 2 UA.ES PER �7E. NOTE: SEE TAUS FOR MW VN.00UY AW ff-3a f OF IN5TALLAIICIN APM OZOW. a150 55E WLE5 FOR CMECrOR Illi *ft AMO" f0 ALS OR STEEL. AV. 51EEL 5W - ZZ (A w •ua\slncrev TAY2 oram.wr.e Ae G.Tr• +DrB or arnur CTFn a.eASLn nn '" ak moat W/ 0<02.. Loa wf & WA%W "FA WI COM tr-" w it vom CLP (1)-1-6'X241"OKON 1 4" CON011 ' IFAiBON' 5WP W5rA1.6MM an ® WOTE: M5 7ErAL 15 A Cib'PFYiY. iJ WENTAHON OF RE CX FOZA1, SEE rAOLE5 FOR FROFER N1bMW a AMAQ'WN5 FEV 5a ACWOM46 W Kalf OF WSfALLAi M 40 tPE a Ar1ACFY W Wit; 5tRlV'AffAL7WENf MAY OM.YPE UfL9Af W. Ct (Y-15' FI. AW POR 170 AY i MY M FM TABLE OFDtRECT ATTAOINIETIT TO UNITSHELL aGI10MNOCFPI0 I '--NYSO •IB BE. ABONT GROUND SCVXWS SELF SCREV DRILLINO SCMS NP. P-DRLLLPYi SCRE, V. NOTES: f U ALL SCWVS SKILL RE NUMBER C\ CLIP. ®II FOR 17058R.LND IRB SWH THERE SRUA BE A BON. OF TWO CLIPS PER SIDE or CMT. J) ALL SCRE%S SHALL BE STALKLESS STEEL VNU BE A)LLYLLTCBI OF f-LLTCTL. �, rtw/•rrErRAnonr.IRxsL�c.ILL� I. �D,� nan w •ua\slncrev TAY2 oram.wr.e Ae G.Tr• +DrB or arnur CTFn a.eASLn nn e 0<02.. alio. 20' 1 2 2S' 2 2 2 30' 2 2 2 40 3 mBpp 3 NO OEM NO GD' NO NO NO TABLE OFDtRECT ATTAOINIETIT TO UNITSHELL aGI10MNOCFPI0 I '--NYSO •IB BE. ABONT GROUND SCVXWS SELF SCREV DRILLINO SCMS NP. P-DRLLLPYi SCRE, V. NOTES: f U ALL SCWVS SKILL RE NUMBER C\ CLIP. ®II FOR 17058R.LND IRB SWH THERE SRUA BE A BON. OF TWO CLIPS PER SIDE or CMT. J) ALL SCRE%S SHALL BE STALKLESS STEEL VNU BE A)LLYLLTCBI OF f-LLTCTL. �, rtw/•rrErRAnonr.IRxsL�c.ILL� I. �D,� nan w •ua\slncrev TAY2 oram.wr.e Ae G.Tr• +DrB or arnur CTFn a.eASLn nn e 0<02.. alio. 20' 1 2 2S' 2 2 2 30' 2 2 2 40 3 3 3 NO NO NO GD' NO NO NO GENERAL NOTES: 1.ATTALTmiF�.r TocmeDeresxALL DE srewnawmevel a-a.L TAROKu MANWACTDNV STITP j An M COLLOA sLIM►14 D.11Rt COXRZ.IlO"Wff p Sm10lLWMPTICDM,MWC: NCRmOTII ®C0.KRCTCArD WROA BDNDlLL PGdTYT10.r DITOCONCERTRtl' It AND SP�SENSE DOT. ALTRRNATE ArrACMSENT. POWERB PASTRAERS, INC. TAPPER. SCREW WO MRS PM CDRYRZUM A 0111 CE"CRQC IA Ar DI t- TOTALEMSETIVC n.EDBtNT ANW I J- N. LDGE ONTIAWS. APA IoOSMOL RXMNET T,&NSj YCOICRLTC TOWLDCSATTACHMENT or CLIP O MADE ULU RAAT AOOWRSa jTREmOTi1GP'SFOFM l-STEp.STRAPe OVESK L'N[C1 WALL RE U— G,LLVArOEDSTCEL RED"CONFORf@q TOASTY A SM STANDARD WET HQALVAPWM W COmP�MANt[ AITX O/OAmD "AVt A TIELo Sla"WENO►M L•B SIM" ELSr SHALAB%t'%'DRANORLC MCTEDWrMA Y Du STEEL SOLT WITH WAMOR AND RE TI SBMED. s ANOLECLO (14111% ATTACT&W THE STRAP TO T M ELT4WOL`R. STRLCTmICM1AU. ReAS W11L6`AM10m aT, BRAP-UTC Met ►LfEDSOm RD. LAR PARC OA M W ANDAS DCTARED O THIS DYWn16 4ATTACIO/C•q OT t1.IP TOA L,, MIALLBE RT(SCCA RO IT_ FE.r_.= T AR SVARATOR BtTwEflF CW AND47POQTOIC AIA$tONMSTSCiTVRSAND LREOTA a•DLASOTERSEL►TApr,,Dm DWLLED BOLT NTES LOC► VAAOSAND NVI. SVPPORTEn STRLCnTZSNALt.KATLEAST YTRttEALV►DRLD/SMCTMR Ifth" RC M% MO TT ALLOY. 7. ATTACI01LrT OP CLIP TO SL9 QTL+G STEEL ST,,,Mi MLLLL SE DTAYMOFPN TANOSCRCWA.• WMr RR TIALATiLl4f j- riDCC E[Rcw MAT RE IS RAL OIIT Soon. r ADnRIRrALP1Aie OSEDAS RRuvrmulo MILL RE NODAL SPCCIFWATInr AS CLIP Amo BE DRILLED Wqx OmLT ONE ROLE MAM In11` DWLLTERIN TIO SNORT LEO AND BE THE TIRC►TES, SP[CIFOD AmD I•.W[ f -LSE OP CASLE OLSTCAD Or STEEL STRAP SHALL CONI'MM TO PTDER.LLSPECIMATION R&WFIOD SO[TING DL\I6rIIOlAL STRLrO[x DEOIMrditrTBp' LOLWATA)OD AS SLOPUTD DT II1TE SALL411K. Wln/ A BREAEpOSTPLYOTII Ot 910 LBS AHD 1WK A MP61U 1 OIA10TEN OF k Tx T BTRAmffi IA ATTACKING CLAMPSNALL BL I}•' oWOiTII STE0. CONFUR\IL O TOASTMAMSTAmDARDSbMN.yl DOr3a LSISEECLIPDrTACFOR ATTACUMM LOCATION, Q11-'W""STHATC0.'ObRM TOTHE SPECITIED ATTACIOWNT Fx.LLL BE No IARGeR nL\.risr aTOE E lur WCN Aro WiTex NO Len LM.L+IMUS AS TSED Lr TIN, Egm E, ❑. wIND LO.aO\liED im TIIR DTSIG] o11AL1 SL AS PES.ASCE tqO . - TIM (rAm SLP[RCEPDS AL1 IRE%IOLI =ITS, SEL BE\TMasA L A5LLFORLAST6 T:MTL A'�ILvvrDr miTABaaUo A.A IA:! d� A.A Rz owu m I A.A • .OV J WVQ �Q}SOW zam U.°O it _3 LU OUB 00 U}OV jJ W— LL LL 1F1\\ L it U �IL O DTUMN A.0.A aleexeD, A.A. DATE: 6-04-07 SCALE` AS NOTED . Ho.. SHEET: \ OF 1