RC-14-2634Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-231725 Permit Number: RC -12-14-2634
Scheduled Inspection Date: April 13, 2015 Permit Type: Residential Construction
Inspector: Rodriguez, Jorge Inspection Type: Final Building
Owner: MCHALE, EDWARD
Job Address: 9500 NE 12 Avenue
Miami Shores, FL 33138 -
Project: <NONE>
Work Classification: Alteration
Phone Number
Parcel Number 1132060143640
Contractor: GLOBAL LINK SYSTEMS INC Phone: (954)753-2665
uepanment comments
BATHROOM REMODEL, REPLACE PLYWOOD FLOOR, ' ' • False
__......_.._
TILE SHOWER AND FLOOR. INSPECTOR COMMENTS False
Passed
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP-231638. Missing safety glass
stamp on shower enclosure
April 10, 2015 For Inspections please call: (305)762-4949 Page 14 of 25
its ��� ��1�: � ■L�
Administrative Office
100 West Main Street, P.O. Box 730
Sackets Harbor, NY 13685
Phone: (315)848-2234
safety glazing certification council Fax (315)648-2297
E-mail: staff@amscert.com
ACKNOWLEDGEMENT OF CERTIFICATION
THIS IS TO ACKNOWLEDGE THAT AS OF THIS DATE
The Original Frameless Shower Door
Coral Springs, FL
IS A CURRENT LICENSEE AND HAS MET ALL GUIDELINES AND REQUIREMENTS FOR THE
SGCC® CERTIFICATION PROGRAM AND AS SUCH IS ELIGIBLE TO LABEL THE BELOW
INDICATED PRODUCT(S) AS SGCC® CERTIFIED. THE FOLLOWING ARE IN COMPLIANCE
WITH ANSI 297.1-2009, CPSC 16 CFR 1201 STANDARDS, OR BOTH STANDARDS, KNOWN AS
COMPOSITE CERTIFICATION.
SGCC#
IN
MM
JjR@Code
MamSize AMI Class Test SW
4661
1/4
6
TTG
U A COMPOSITE
4662
3/8
10
TTG
U A COMPOSITE
4663
1/2
12
TTG
U A COMPOSITE
THIS SGCC® PROGRAM CERTIFICATION IS CURRENT AND IN FULL EFFECT AS OF THIS
ISSUE DATE. CERTIFICATION IN THE SGCC® PROGRAM IS SUBJECT TO SEMI-ANNUAL
RENEWAL. PLEASE CHECK THE CURRENT CERTIFIED PRODUCTS DIRECTORY OR
THIS OFFICE FOR MOST CURRENT INFORMATION.
Wednesday, Febnmry 26,
2014 F14
DATE OF ISSUE CERTIFICATION PERIOD ADNUN3M VE. A-=
06%,01f
safety glazing certification council
P.O. BOX 730
SACKETS HARBOR, N. Y. 13685
PHONE 315-646-2234
FAX 315-646-2297
Record of SGCC Compliance Testing
The information contained herein is viewed to be accurate by SGCC, a third party certification
agency, as of the indicated date of issue.
1)
Identification of the Product:
4661; 1/4" (6mm) TTG U
2)
Citation or Standard to Which the Product
CPSC 16 CFR 1201 II & ANSI Z97.1-2009
is Being Certified:
CLASS A
3)
Identification of the Importer or Domestic
The Original Frameless Shower Door
Manufacturer:
3591 NW 120th Ave.
Coral Springs, FL 33065
Phone:9547572114
4)
Contact Information for Individual
See 5) below
Maintaining Records of Testing:
5)
Date and Place of Manufacture:
Date Available from Manufacturer
The Original Frameless Shower Door
Michael High
3591 NW 120th Ave.
Coral Springs, FL 33065
Phone:9547572114
6)
Date and Place Product was Tested for
7/13/2014
Compliance:
Fenestration Testing Laboratory Inc.
8148 NW 74 Avenue
Medley, FL 33166
Phone: (305) 819-7877
7)
Identification of Third Party Laboratory:
See 6) above
For additional information, contact the manufacturer or US
7/16/2014
DATE OF ISSUE
Importer directly
John G. Kent
SGCC ADMINISTRATIVE MANAGER
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
OBUILDING ❑ ELECTRIC ❑ ROOFING
A1C �IL114
717',��
FBC 20(0
Master Permit No. - H- S�
Sub Permit No.
❑ REVISION ❑ EXTENSION F1 RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION [:]SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9500 NE 12 Avenue
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-3206-014-3640 Is the Building Historically Designated: Yes NO X
Occupancy Type: Res Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Edward McHale Phone#: 305-758-9823
Address: 9500 NE 12 Avenue
city. Miami Shores State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Global Link Systems Inc. Phone#: 954-753-2665
Address: 11065 NW 21 Place
City: Coral Springs State: FL Zip. 33071
Qualifier Name: Keith T. Sorensen Phone#: 954-448-8847
State Certification or Registration #. CBC1251040 Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address: City: State:
Value of Work for this Permit: $ 7500.00 Square/Linear Footage of Work: MrJ
Type of Work: ❑ Addition ❑ Alteration ❑ New N Repair/Replace
Description of Work: Bathroom remodel, replace plywood floor, tile shower and floor
Specify color of color thru tile:
Submittal Fee $ E Permit Fee $ r
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $ _
Structural Reviews $
(Revised02/24/2014)
CCF $_
DBPR $
Zip:
❑ Demolition
CO/CC $ 0//?
Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $
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 Z=C
ING, CO T WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTI E CEME
Notice to Ap' t: As a condition o the issuance of °p building permit with an estimated value exceeding $2500, the applicant must
promise . g ad fa► at a the notice of commencement and construction lien law brochure will be delivered to the person
whose rope is sub. att �h Also, a certl ft1 °copy of the recorded notice of commencement must be posted at the job site
for the rst inspection rs seven days afteX the building permit is issued. In the absence of such posted notice, the
inspectio ill
no, be appy ve an a reinspect► ee will b� charged.
Signature ASignature
OWNER or A
CONTRACTOR
The foregoing instrument was acknowledged before me this
The foregoing instrument was acknowledged before me this
c7` q day of �OQVm' e r , 20)9by
"i .\ day of V�'I�?Q ech\-,z-ek 20 1` _ by
Lam' fa Mct %k 4E-- , who is personally known to
Ce� ®\ tiro who is personally known to
me or who has produced as
me or who has produced as
identification and who did take an oath.
identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIC:
Sign•0.�J9riaJ
Sign:
�61L
Print:
DDRB Mwe
Seal:
fth" Sim �of rFlorrda
'
� = K" ROMANO
2' YD17
a ; e WCOMMISM8EE184416
WIRES. mom 8i 2018
l� 6
APPROVED BY Plans Examiner
Zoning
Structural Review Clerk
(Rev1sed02/24/2014)
isbftgt pb S' $04
20ts ot kpuQq
001 j)g Z
Miami shores Village
Building Department
CONTRACTORS' REGISTRATION
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A. X COPY OF QUALIFIER'S STATE LICENCES
B. X COPY OF LOCAL BUSINESS TAX RECEIPT
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
C. X COPY OF LIABILITY INSURANCE*
D. X COPY OF WORKERS COMPENSATION INSURANCE*
(Workers Compensation EXEMPTION must have NOTICE TO OWNER Affidavit)
IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY:
A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER
B. COPY OF LOCAL BUSINESS TAX RECEIPT
C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL
CONTRACTOR'S TAX RECEIPT.
D. COPY OF LIABILITY INSURACE*
E. COPY OF WORKERS COMPENSATION INSURANCE*
(Workers Compensation EXEMPTION must have NOTICE TO OWNER Affidavit)
*YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW:
Certificate Holder:
MIAMI SHORES VILLAGE BLDG DEPT
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
Certificate must specify the description of operations or contractor license number.
.........................................................................................
BUSINESS NAME: Global Link Systems Inc.
BUSINESS ADDRESS: 11065 NW 21 Place
BUSINESS PHONE: ( 954 ) 753-2665
Coral Springs STATE FL Zip 33071
FAX NUMBER9( 54 ) 753-2645
CELL PHONE9( 54 ) 448-8847 QUALIFIER'S NAME: Keith T. Sorensen
QUALIFIER'S LIC NUMBER: C13C1251040
RICK SCOTT, GOVERNOR.
KEN LAWSON, SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
CBC1251040
The BUILDING CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2016
SORENSEN, KEITH T
GLOBAL LINK SYSTEMS INC
11065 NW 21ST PLACE
CORAL SPRINGS FL 33071
ISSUED: 05/28/2014 DISPLAY AS REQUIRED BY LAW SEG # L1405280000933
-BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT
115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000
VALID OCTOBER 1, 2014 THROUGH SEPTEMBER 30, 2015
DBA:
Business Name: GLOBAL LINK SYSTEMS INC
Owner Name: KEITH SORENSEN
Business Location: 11065 NW 21 PL
CORAL SPRINGS
Business Phone: 954-753-2665
Rooms Seats Employees
1
Ry 3
Business Tpa*GENERALCONTRACTOR (BUILDING:CONTRACTOR)
Business Opened: 0 8 / 2 1 / 2 0 0 0
State/Cou nty/Cert/Reg: CB C 12 5104 0 / QB2 5 817
Exemption Code:
Machines Professionals
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is
non -regulatory in nature. You must meet all County and/or Municipality planning
WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when
the business is sold, business name has changed or you have moved the
business location. This receipt does not indicate that the business is legal or that
it is in compliance with State or local laws and regulations.
Mailing Address:
KEITH SORENSEN Receipt #OlA-13-00005210
11065 NW 21 PL Paid 07/10/2014 27.00
CORAL SPRINGS, FL 33071
2014 -2015
rvr vunwing ousule88 only
Number of Machines: Vending Type:
Tax Amount
Transfer Fee
NSF Fee
Penalty
Prior Years
Collection Cost
Total Paid
27.00
0.00
0.00
0.00
0.00
0.00
27.00
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is
non -regulatory in nature. You must meet all County and/or Municipality planning
WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when
the business is sold, business name has changed or you have moved the
business location. This receipt does not indicate that the business is legal or that
it is in compliance with State or local laws and regulations.
Mailing Address:
KEITH SORENSEN Receipt #OlA-13-00005210
11065 NW 21 PL Paid 07/10/2014 27.00
CORAL SPRINGS, FL 33071
2014 -2015
GLOBI -C OP ID: DE
CERTIFICATE OF LIABILITY INSURANCE
°A1�11142014
11!1412014
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(Sh AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(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
Bobby Mascarella, Agent
Sena & Whitney, I.I.C.
NAME: Bobby A. Mascarella
PHONE
c No E,0:561-391-4661 No : 561-338-6551
n SSS: bmascarella thesena rou .com
190 Glades Road, Suite C
Boca Raton, FL 33432
Bobby A. Mascarella
INSURER($) AFFORDING COVERAGE NAIC
INSURERA: Mid -Continent Casualty Com pany 23418
EACH OCCURRENCE $ tow'ooq
INSURED Global Link Systems, Inc.
11065 NW 21st Place
Coral Springs, FL 33071
INSURER B:
INSURER C:
GENERAL AGGREGATE $ 2,000,
INSURER D:
INSURER E :
$
INSURER F :
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNEDSCHEDULED
AUTOS AUTOS
HIRED AUTOS NON -OWNED
AUTOS
COVERAGES r'FRTIFIr_ATF NIIMRFR• RFVICInN h111MRF0•
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.
IN
TYPE OF INSURANCE
AUDL
12MM
OUB
WVD
POLICY NUMBER
POLICY EFF
MMIDDNYYY)
POLICY EXP
(MMIDDfYYYYI
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X❑ OCCUR
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
04GL000891590
12/17/2013
12/17/2014
EACH OCCURRENCE $ tow'ooq
PREMISES Ea occurrence $ 100+0
MED EXP (Any one person) $ Excluded
PERSONAL & ADV INJURY $ 1,000,
GENERAL AGGREGATE $ 2,000,
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO- LOC
X POLICY JECT
PRODUCTS- COMP/OP AGG $ 2,0W,
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNEDSCHEDULED
AUTOS AUTOS
HIRED AUTOS NON -OWNED
AUTOS
COMBINED SINGLE LIMIT
Ea accident $
BODILY INJURY (Per person) $
BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
PER ACCIDEN
UMBRELLA LIAR
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE $
_
AGGREGATE $
DPS I I RETENTION $
$
WORKERS COMPENSATIONWCSTATU-
AND EMPLOYERS' LIABILITY Y f NLIMI
ANY PROPRIETORIPARTNERfE>ECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N I A
OTH-
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ARach ACORD 101, Additional Remarks Schedule, If more space Is required)
GENERAL CONTRACTOR
CERTIFICATE HOLDER CANCELLATION
MIAMIS4
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
MIAMI SHORES VILLAGE
ACCORDANCE WITH THE POLICY PROVISIONS.
BLDG DEPT.
AUTHORIZED REPRESENTATIVE
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
O 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
ACORO®CERTIFICATE OF LIABILITY INSURANCE
DA'�13/°014
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS,
11/13/2tl14
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 ALTERTHE COVERAGE AFFORDED BYTHE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(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($).
PRODUCER
Risk Transfer Programs, LLCTFAX
219 East Livingston Street
Orlando, FL 32801
CONTACT
NAME:
PNC N Ext): 866-481-9363 1 A/ NO).
E-MAIL
ADDRESS:
INSURERS AFFORDING COVERAGE NAIC #
INSURER A.Technology Insurance Company, Inc. 42376
INSURED
Stafflink Outsourcing, 11, III, IV, V & VI Inc.
INSURER B
INSURER C:
1776 N. Pine Island Road
Suite 108
Plantation, FL 33322
INSURER 0:
INSURER E:
INSURER F
PERSONAL & ADV INJURY $
COVERAGES CERTIFICATE NUMBER:S2GYNQDN 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 MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSSR
LTR
TYPE OF INSURANCE
ADL
INSR
BR
POLICY NUMBER
POLICY EFF
M1DD
POLICY EXP
MID
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE $
DAMAGE TO RENTED
PREMISES Ea occurrence $
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE E-1 OCCUR
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG $
POLICY PRO- LOC
$
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Fa accident
BODILY INJURY (Per person) $
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident) $
NON -OWNED
HIREDAUTOS AUTOS
PROPERTY DAMAGE
Peraccldent $
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE $
AGGREGATE $
EXCESS UAB
CLAIMS -MADE
DED RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNEWEXECUTIVE Y/N
OFFICER/MEMBER EXCLUDED?
(Mandatory in NMI
N/A
TWC3404060
03/01/2014
03/01/2015
XWC 3TATU- OTH-
E.L. EACH ACCIDENT $ 1,000,000
E.L. DISEASE - EA EMPLOYEE $ 1,000,000
Ifyesdescribe under
DESGARIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space Is required)
Coverage is extended to the leased employees of alternate employer in all states except in monopolistic states (ND, OH, WA, WY) and other states (AK, HI, ID, OK): Global
Link Systems, Inc #1187 (Effective 6/2/03)
This certificate only applies to License #CBC1251040.
leidel"aaa_uLai c_
SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
MIAMI SHORES VILLAGE BLDG DEPT I AUTHORRED REPRESENTATIVE
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
Page 1 of 1 m 1988-2010 ACORO CORPORATION. All
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
GLOBI -C OP ID: KM
AC6JRL7" CERTIFICATE OF LIABILITY INSURANCE
D 1YYI'Y)
1 ?J17121712014
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
Bobby Mascarella, Agent
Sena& Whitney, LLC.
190 Glades Road, Suite C
Boca Raton, FL 33432
NAME: Bobby A. Mascarella
PHONE No •561-391-4661 ,vc No: 561-338-6551
nMm uRkss; bmascarella@thesenagroup.com
04GL000918961
Bobby A. Mascarella
INSURERS) AFFORDING COVERAGE NAIL 9
INSURER A: Mid -Continent Casualty Company 23418
PREMISES Eeoccurrence $ 100,00
INSURED Global Link Systems, Inc.
11065 NW 21 st Place
Coral Springs, FL 33071
INSURER B:
INSURER C:
GEN'L AGGREGATE LIMIT APPLIES PER:
X POIJCY PRO-
JECT LOC
OTHER:
GENERAL AGGREGATE $ 2,000,00
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.
IL R
TYPE OF INSURANCE
AVOL
INSO
BUD
POLICY NUMBER
POLICY EFF
MMIDD
MMIDDIYY YY
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FKI OCCUR
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
04GL000918961
12/17/2014
12117/2015
EACH OCCURRENCE $ 1,000,00
PREMISES Eeoccurrence $ 100,00
MED EXP (Any one person) $ Excluded
PERSONAL & ADV INJURY $ 1,000,00
GEN'L AGGREGATE LIMIT APPLIES PER:
X POIJCY PRO-
JECT LOC
OTHER:
GENERAL AGGREGATE $ 2,000,00
PRODUCTS -COMPIOPAGO $ 2,000,00
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
H RTED AUTOS OS AUTOS
AUTOS
COMBINED SINGLE LIMIT $
Me accident
BODILY INJURY (Per person) $
BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
Per accident
UMBRELLA LIAB
EXCESS LIAR
HCLAIMS-MADE
OCCUR
EACH OCCURRENCE $
AGGREGATE $
DED I I RETENTION
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERM EMBER EXCLUDED? �
(Mandatory In NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
N I A
STATUTE EORTH
E.L. EACH ACCIDENT $
E.L. DISEASE- EA EMPLOYEE $
E.L. DISEASE- POLICY LIMIT $
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more apace Is required)
GENERAL CONTRACTOR
CFRTIFIC9TF NnI nr:R ramrm 1 ATInN
MIAMIS4
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
MIAMI SHORES VILLAGE
ACCORDANCE WITH THE POLICY PROVISIONS.
BLDG DEPT.
AUTHORIZED REPRESENTATIVE
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
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