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EL-14-1093Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-233063 Permit Number: EL -5-14-1093 Scheduled Inspection Date: April 24, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Owner: MAINADE, FRANK & KELARA Job Address: 925 NE 92 Street Miami Shores, FL 33138 - Project: <NONE> Inspection Type: Final Work Classification: Addition/Alteration Phone Number Parcel Number 1132060060070 Contractor: HIGH PERFORMANCE ELECTRIC CORPORATION Phone: (786)586-0133 Building Department Comments ELECTRICAL WORK AS PER PLANS INSPECTOR COMMENTS False Inspector Comments PassedI CREATED AS REINSPECTION FOR INSP-213177. Need low voltage F �T permit and inspection. Failed. Correction 7 ly," %� S Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid April 23, 2016 For Inspections please call: (305)762-4949 Page 25 of 33 S Miami Shores Village g Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Tyw: Electrical JOB ADDRESS: FBC 2010 Permit No. Z-7/ /e�� Master Permit No. �. % % City: Miami Shores County: Miami Dade Zip: Folio/Parcelt Is the Building Historically Designated: Yes OWNER: N (Fee Simple Title Address: " City: ®�'I NO Flood Zone: f �a/1V.-- U'IGti State: TenantUssee Name: Phone#: Email: CONTRACTOR: Company Name: Address: S0.40 S W City: A Qualifier Name: State Certification or Registration #: Contact Phone#:a (k dell 3 �& "I / '5313 State: -76 Zip: 3 9 S DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 1 ro SquareMinear Footage of Work: Type of Work: OAddress OAlteration New,, � / ORepair/Replace ODemolition Description of Work: t .� � L 115 112e i 12/x-2 9 P Submittal Fee $ Permit Fee $ 9,00 ~CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ _ Technology Fee $ TnTAi. FFF. Nnw fliTF. $ .3� 1 � Bonding Com pany'kName (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Zip State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged 2 Signature Signature Owner or Agent L� Contractor The for�egooin-g' instrument was acknowledged before me this ` The foregoing instrument was ack owled befor this day of , 20 , by � �day of , 20 L by it who is personally known to me or who has produced who is personally known to me or who has produced As NOTARY PUBLIC: Print: Pv ., AIYLENE RUIZ I MY CNIVIISSION t FF 100079 EXPIRES: March 10, 2018 v'1f pF.al' ao^G•lc i in Naiary Public Underwbm as identification and who did take an oath. NOTARY PUBLIC: off,;P;4,, AUYLEn Rutz ?.:+f MY COMMISSIOCd 9 FF 100079 EXPIRES: March 10, 2018 Sig SRP„ 9nidc : Yh:n;vc! r Put ,c UndenxrdeB Print: My Commission Expires: My Commission Expires: APPROVED BY S` �/`` Plans Examiner Zoning Structural Review Clerk (Revised 3/1212012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Miami shores V Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore, you may be personally liable for the worker compensation injuries of any_person allowed to work under this permit. Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Owner Print Name: fflml,ngl,�4 Signature: State of Florida ) County of Miami -Dade) j Sworn to an 11 s c 'bed before me day of , 20 (SEAL) Type of Identification ADYLENE RUIZ MY COMMISSION 9 FF 100079 _XPlp�e• 81dedrnmripe o 10: a,ti;g Contractor Print Name:Ter aN. �K 1 wres t Signature: State of Florida ) County of Miami -Dade ) 14 Sworn to aqd1subscribed before me thisf I day of t4 a44 20 of ADYLENE RUIZ 08SION It FF 100079 CANIZARES, FERNANDO J HIGH PERFORMANCE ELECTRIC CORPORATION 15629 SW 85TH TER MIAMI FL 33193 ------------- -- (850) 487-1395 Congratulations! With this license you become one of the nearly one million STA7EflF FLOMA, `� Floridians licensed by the Department of Business and Professional Regulation. Our DBARTMEIITT gip, POg$H� professionals and businesses range from architects to yacht brokers, from,};. boxers to barbeque restaurants, and they keep Florida's economy strong. ER.1301456, 81, Every day we work to improve the way we do business in order to serve you Bette x For information about our services, please log onto www.myfloddalicense.com There you can find more information about our divisions and the regulations that R$G CA1tTIL' Impact you, subscribe to department newsletters and loam more about the HCH Pl?RFOtCI Department's initiatives. (INDISDUAI�_: BHT 127003051 TOR'; LICENSING s Our mission at the Department is: License Efficiently, Regulate Fairly. We TO CONTRACTNG=;: ANX.... A constantly strive to serve you better so that you can serve your customers. RE(3ISTiRED txe m� Thank you for doing business in Florida, and congratulations on your new license! Stp;;rAtion flatei:A17 3Y�,'2ii�4 , k.7 L DETACH HERE .3 i H � c yr r��rniuF[ A) R SEQ# L12080702810 003524 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6766860 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES HIGH PERFORMANCE ELECTRIC CORP RENEWAL SEPTEMBER 30, 2014 15629 SIN 85 TERR 212 7040272 Must be displayed at place of business MIAMI FL 33193 Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED HIGH PERFORMANCE ELECTRIC CORP 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR Worker(s) llE000080 $75.00 08/18/2013 CREDITCARD-13-005750 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit or a certification of the holders qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 9a-276. For more information, visit www.miamidade.gov/taxcollector GTQB Construction Trades Qualifying Board LISINESS CERTIFICATE OF COMPETENCY 11E000080 PERFORMANCE ELECTRIC CORPORATION CANIZRRES FERNANDO Is certified under the provisions of Chapter 10 of Miami -Dade County VALID FOR CONTRACTING UNTIL 09130/2015< A4+°�""�. 0 05/285/28 O CERTIFICATE OF LIABILITY INSURANCE DAT D,YYYY) - /14 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 poltcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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 endomement(s). PRODUCER Lopez Insurance Agency dba State Wide Insurance 5755 W. Flagler Street #204._ CONTACT NAME: Egglis Cepero PHONE (305)2643636 FAX Nc : (305)264-3357 eggiiac®statewideins.net INSURER(S) AFFORDING COVERAGE �c>f Miami, FL 33144 _ _ _ INSURER A: Ascendant Insurance Company Phone (305) 2643636 Fax (305) 264-3357 INSURED INSURER B: INSURERC: HIGH PERFORMANCE ELECTRIC CORPORATION INSURER 0: 15629 SW 85 Terr Miami, FL 33193- INSURER E: _ INSURER F 01/07/2014 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 SR TYPE OF INSURANCE R WVD IBR' POLICY NUMBERR M/DDIYWFYI_ MMIMIDO �P — GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 - DAMAGE TO RENTED 100,000.00 _PREMISfSSEa ocamencel $ I MED EXP (Any one person) $ 5,000.00 { A ❑ COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE © OCCUR ❑ I I n GL -36459-2 01/07/2014 01/07/2015 PERSONAL & ADV INJURY $ 1,000,000.00 ❑ _ GENERAL AGGREGATE $ 1,000,000.00 PRODUCTS - COMPIOP AGG $ 1,000,000.00 $$ f _ GEWL AGGREGATE LIMIT APPLIES PER: 1:1 POLICY ❑ T ❑ LOC_ AUTOMOBILE LIABILITY j OD E MT BODILY INJURY (Per person) $ ANY AUTOI ❑ ALL OSWNED ❑ SAUTOSULED NON -OWNED ❑ HIRED AUTOS ❑ ❑ ! E I I I I BODILY INJURY (Per accident $ P�20Pant AMACiE $ — $ __❑ ❑ UMBRELLA LIAB ❑OCCUR ❑ EXCESS LWB ❑ CLAIMS -MADE i i i j I EACH OCCURRENCE $ AGGREGATE $ ❑ DED ❑ RETENTION$ _ _ $ j I WORKERS COMPENSATION❑ AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORIPARTNERIEXECUTIVE EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA ! I WC STATU- DTH I T CCS ❑ , L. EACH ACCIDENT j $OFFICERIMEMBER .L. DISEASE - EA EMPLOYEE _ $ �E.`- — _-- E.L. DISEASE -POLICY LIMIT $ I DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, K more space Is required) jElectrical Contractor #11 E00080 I I i CERTIFICATE HOLDER CANCELLATION Village of Miami Shores 10005 NE 2nd Avenue Miami Shores, FI 33163 ACORD 25 (2010105) OF 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 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 02-21-2013 JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 02/13/2013 PERSON: CANIZARES FEIN: 273900194 BUSINESS NAME AND ADDRESS: HIGH PERFORMANCE ELECTRIC CORPORATION 15629 SW 85 TERRACE MIAMI FL 33193 SCOPES OF BUSINESS OR TRADE: 1- ELECTRICAL WIRING WITHIN BUIL EXPIRATION DATE: 02/13/2015 FERNANDO J IMPORTANT: Pursuant to Chapter 440 . 05114), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election ander this section may not recover benefits or compensation under this chapter. Parsnant to Chapter 440.05112), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(18), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named an the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. O.UESTIONS? (850) 413-1609 OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 ------------------ PLEASE CUT OUT THE CARD �BELOWAt -AND:-RfTAIN_-FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW 10 EFFECTIVE: 02/13/2013 EXPIRATION DATE: 02/13/2015 PERSON: FERNANDO J CANIZARES FEIN: 273900194 _ BUSINESS NAME AND ADDRESS: HIGH PERFORMANCE ELECTRIC CORPORATION 15629 SW 85 TERRACE MIAMI, FL 33193 SCOPE OF BUSINESS OR TRADE 1- ELECTRICAL WIRING WITHIN BUIL `T" IMPORTANT OF Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemptiorr from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be H exempt.. apply only within the scope of the business or trade listed on Rthe notice of election to be exempt E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413-1609 CUT HERE * Carry bottom portion on the job, keep upper portion for your records. DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 G ecAz, 02-21-2013 JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION % This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: PERSON: 02/13/2013 EXPIRATION DATE: 02/13/2015 CANIZARES FERNANDO J FEIN: 273900194 BUSINESS NAME AND ADDRESS: HIGH PERFORMANCE ELECTRIC CORPORATION 15629 SW 85 TERRACE MIAMI FL 33193 SCOPES OF BUSINESS OR TRADE: 1- ELECTRICAL WIRING WITHIN BUIL IMPORTANT: Pursuant to Chapter 440 . 05041, F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section mey not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation It, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section tar issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named an the certificate to meet the requirements of this section. QUESTIONS? (850) 413-1609 OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 PLEASE CUT OUT THE CARD BELOW AND. RETAIN .FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW 9 EFFECTIVE: 02/13/2013 EXPIRATION DATE: 02/13/2015 PERSON- FERNANDO J CANIZARES FEIN: 273900194 BUSINESS NAME AND ADDRESS - HIGH PERFORMANCE ELECTRIC CORPORATION 15629 SW 85 TERRACE MIAMI, FL 33193 SCOPE OF BUSINESS OR TRADE: 1- ELECTRICAL WIRING WITHIN 8111L IMPORTANT F Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who O elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be H exempt_. apply only within the scope of the business or trade listed on E the notice of election to be exempt R E Pursuant to Chapter 440.0503), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. CUT HERE QUESTIONS? (850) 413-1609 * Carry bottom portion on the job, keep upper portion for your records. OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 .n. um� �ORN�' Miami shores V11age Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers m the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore. you may be personally liable for the worker compensation iniuries of any person allowed to work under this permit Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. State of Florida ) County of Miami -Dade) Sworn to and subscrribO before me this Q- L4 day of , 20_Ll By --- " A NNEV ANSI DELGADO (SEAL) Tvpe of Identificititin nrodiwed Contractor Print Name: s Y v� �,� �,y� Zq ✓ PS Signature: Z State of Florida ) County of Miami -Dade ) Swornto d bs 'bed before me s day of , 201. B ANNEYAN31 DELGADO Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6766860 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES HIGH PERFORMANCE RENEWAL SEPTEMBER 30, 2015 ELECTRIC CORP 7040272 15629 SW 85 TERR 212 Must be displayed at place of business Pursuant to County Code MIAMI, FL 33193 Chapter 8A- Art. 9&10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED HIGH PERFORMANCE ELECTRIC 196 ELECTRICAL BY TAX COLLECTOR CORP CONTRACTOR 75.00 09/30/2014 Worker(s) 1 llE000080 0228-14-009445 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0. above must be displayed on all commercial vehicles — Miami—Dade Code Sec 8a-276. MIAMKWWE For more information, visit www.miamidadeAov/taxcallecto Municipal Contractor's Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY CC NO: 1 1 E000080 BUSINESS NAME&OCATION HIGH PERFORMANCE ELECTRIC CORP 15629 SW 85 TERR 212 MIAMI, FL 33193 MC RECEIPT NO. EXPIRES NEW BUSINESS SEPTEMBER 303 2015 7455632 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER TYPE OF BUSINESS HIGH PERFORMANCE ELECTRIC CORP ELECTRICAL CONTRACTOR MIAMI— - For more information, visit www.miamidade.gov/texcollector PAYMENT RECEIVED BY TAX COLLECTOR 200.00 09/30/2014 0228-14-009445 • - s CTQB Construction Trades Qualifying Board ` BUSINESS CERTIFICATE OF COMPETENCY 1 EO00080 -- — HIGH PERFORMANCE ELECTRIC CORPORATION D.B.R.: CANIZAR2ES FERNANDO is certified under the provisions of Chapter 10 of Miami -Dade County VALID FOR CONTRAC T iNG UNTIL 09130/2015 Fp, whether you have a Permitting need or issue, we are your solution! Ady Ruiz 786.768.6253 floridapermitexpeditor live.com www floridapermitexpeditor Com Residential & commercial Permits Open & Expired Legalizations New construction or Renovations Zoning Approvals -Notice of Commencement Code violations • Bealth Permits 40 Yr. Re -Certification .' v���■ an ■vrw■ a— v■ O—N/1V/a0—/ • ■ •0wVwv'SoInv■— I 1023!14 ' 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 potky(ias) must be endorsed. ff SUBROGATION IS WAIVED, subject to the terms and condi Ions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Neu of such endorsement(s). PRODUCER Lopez Insurance Agency dba State Wide Insurance 5755 W. Flagler Stmt 1f204 Miami, FL 33144 Phone (305) 264-3636 Fax (305) 2643357 � CONTACT Eggffs Cepero PHONE(305)264-36;16 FAX (305)264-3357 ADDRESS.egg6scr tatewideins.net AFFORDING COVERAGE NAIC B INSURER A , Ascendant IIIS altce Company INSURED HIGH PERFORMANCE ELECTRIC CORPORATION 15629 SW 85 Teff Miami, FL 33193- INSURER B INSURER C: 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 RECUIREMENT, TERRA OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAVAS. MMIILTR TYPE INSURANCE ADD POLICY NUMBER POLICY EFF MhwDrfYYYl POLICY EXP LwIITS A GENERAL. LIABILITY ❑ COMMERCIAL GENERAL LIAsury ❑ ❑ CLAIM&MADE ® OCCUR ❑ n GL -36459-2 01/07/2014 01/072015 EACH OCCURRENCE $ 1,000,000.00 DAIAGESTO $ 100,000.00 IVIED EXP (Any am ) $ 5,000.00 PERSONAL &ADV INJURY $ 1,000,000.00 ❑ GENERALAGCREGATE $ 1,000,000.00 GEN'L AGGREGATE LWr APPLIES PER: El POLICY ❑ PRO- ❑ LOC PRODUCTS - COMP/OP AGG $ 1,000,000.00 $ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OOWNED El AUT SCHEDULED WNED F1HIRED AUTOS ❑ OS OMHtt SINGLE L1MIT BODILY WJURY (Per person) $ BODILY INJURY (Per acci�t $ PROPERTY $ ❑ UMBRELLA LUAB ❑ OCCUR ❑ EXCESS LIAB ❑ cLA=.MADE I EACH OCCURRENCE $ AGGREGATE $ ❑ DED ❑ RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNEWEXECUTIVE OFFfCERIMEMSER EXCLUDED?NIA (MandalwyiIn NH) DESCRIPTION OF OPERATIONS bW*w ❑ � STATU- , ElOTH EL EACH ACCIDENT $ L DISEASE - EA EMPL $ EL DISEASE - POLICY LIWI $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addidanal Renaft Schedule, if ram space M required) Electrical Contractor #1l EO0080 CERTIFICATE HOLDER CANCELLATION Village of Miami Shores 10005 NE 2nd Avenue Miami Shores, F133163 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 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) OF The ACORD name and logo are registered marks of ACORD