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PL-15-1393 I '.00 Inspection Worksheet r ' Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-236342 Permit Number: PL-6-15-1393 Scheduled Inspection Date: September 10, 2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: GAIQUI, MARITZA Work Classification: Gas Job Address: 1450 NE 101 Street Miami Shores, FL Phone Number Parcel Number 1132050240040 Project: <NONE> Contractor: FOREVER GAS CORP Phone: (305)298-0193 Building Department Comments THIS IS TO INSTALL GAS GENERATOR Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed d Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 09, 2015 For Inspections please call: (305)762-4949 Page 6 of 30 m A- 3l3t1i')3 18111 NW 68 AVE UNIT I-105 Hialeah FI, 33015 DROP TEST CERTIFICATION 305- 298 -0193 Cell 305- 331- 2572 Office Forevergas@live.com PERMIT NUMBER: 1) 6. -15-(.39 Z- NAME: !-�Qr,-I V Z k &►�U)' DATE: Z2 /6 ADDRESS I y CJD NC_ 101 5T CITY MItiKI ZIP THIS LETTER IS TO CERTIFY THAT FOREVER GAS CORP. COMPANY PERFORM A DROP TEST TO CHECK THE WHOLE GAS LINE.THIS DROP TEST HAS A THIRTY DAY WARRANTY FROM THE TESTED DATE TYPE OF INSTALLATION: NEW ❑ EXISTING THIS IS FOR A: ,WATER HEATER GAS GENERATOR. ❑ STOVE/RANGE ❑ OVEN ❑ BARBECUE ❑ POOL HEATER ❑ DRYER ❑ OTHER NATURAL GAS: i 1:1 PROPANE GAS: SYSTEM PRESSURE FROM METER: -2 Ute SYSTEM PRESSURE FROM TANK rl WATER COLUMN: 12- WATER COLUMN TEST DURATION: )0 K1lyA FLOW DATE OF TEST: h'5 PSI LOCKUP TEST DURATION DATE OF TEST: IFYANYRQUESTIONS, PLEASE CALL 305-298-0193 DATE: 7 / 3 / e��tN�1ti1{�ti9lry�,� Rb ERTO N EZ .`\�,r���g(�L11� N ✓�q iii//,/� :'�MISSIOiyF CONTRAC OR ( UALIFIER) _� :�o�a5t1?•zo+A�: z STATE#: 28379 #.FF 131111 ;o CC#LPG 28379 DATE: fJ D3 y, 6''nAsdth° `af�•oQ: SIGNATURE OF NOTARY PQ!� Permit NO. PL-6.1 rJ`-1 393 sN°R$s y_ Miami Shores Village a Permit Type.P rnbing-R" f1t 10050 N.E.2nd Avenue NEPer ..,..� ,i WorkCiastJcatiOn>Gas Miami Shores,FL 33138-0000 Permit Stets ftePhone: (305)795-2204 W9m 7'[tWM&_ Expiration: 01/06/2016 Project Address Parcel Number Applicant 1450 NE 101 Street 1132050240040 NATASHA GAIQUI &MARITZA G Miami Shores, FL Block: Lot: Owner Information Address Phone Cell NAT SHA GAIQUI& MARITZA GAIQUI& FIRST UNION PO BOX 40062/C MOORE -- - -- - JACKSONVILLE FL 32231-0062 Contractor(s) Phone Cell Phone Valuation: $ 2,100.00 FOREVER GAS CORP (305)298-0193 Total Sq Feet: 60 Type of Work:THIS IS TO INSTALL GAS GENERATOR Available Inspections: Type of Piping: Inspection Type: Additional Info: Final Bond Return: Press Test Classification:Residential Scanning: 1 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# PL-6-15-55894 DBPR Fee $2.25 DCA Fee $2.25 07/10/2015 Credit Card $ 112.30 $50.00 Education Surcharge $0.60 06/08/2015 Credit Card $50.00 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $2.40 Total: $162.30 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 FIDAVIT: Ice. fyLaa the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constru on nd zonjng. F hauthorize the above-named contractor to do the work stated. July 10, 2015 Authorized Sig ature:Owner / Applicant / Contractor / Agent Date Building Department Copy July 10, 2015 1 Miami Shores Village _ 1E C ; Building Department SIN 'I" 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax: (305)756-8972 LBY' -__= INSPECTION LINE PHONE NUMBER:(305)762-4949 �F-BC 20+0��(� BUILDING Master Permit No. PERMIT APPLICATION sub Permit No. �J�' [��3 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL � ( PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION [:] SHOP Y' ,nn CONTRACTOR DRAWINGS J f' ` JOB ADDRESS: l � 1 City: Miami Shores ��// �CCounty: Miami Dade Zip: -3-3 folio/Parcel#: '( — 021 `f 60 �fb Is the Building Historically Designated:Yes— N O Occupancy Type: S 1' Load: Construction Type: C 8S Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): MCA-`CA-Y 19V ( Phone#: _305 3 3 2— Address: Address: [ S'0 �j�—_ ) C) ( Sd- n� City: M[� Ivy \ State: fe, Zip: Tenant/Lessee Name: Phone#: Email: C CONTRACTIORQ:Company eName: 1 o cA�� �{�S �l� Phone#: 30� Address: t C7 { ` \ {v\),j (pq City: \�-�'C.�_v-euk-" State: ( � t_ Zip: l �' Qualifier Name: �'09-e'f (_QC) �`2Z 1 Phone#: 65 o 113 State Certification or Registration#: � 3� ` Certificate of Competency#: LP G 31 C1 DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: I Value of Work for this Permit:$ 1�1 10 C) Square/Linear Footage of Work: (_"00 i`¢��— Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Description of Work: v t`) As ( r`J 1 7N.' -7: Specify color of color thru tile: Submittal Fee$ �0• yL ) Permit Fee$ ISO' CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ 1 TOTAL FEE NOW DUE$ `[Z �0 (Revised02/24/2014) 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 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 the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT c404tTIRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 A by 2/ / day of oaf��r'iC 20 15 by at-Fe- ' who is rsonally known. f� C�L-Q-r i �'a.�, z-,who is personally known to me or who has produced 7 as me or who has produced_ ;2�"Z as identification and who did take an oath. identification and who did take an oath. %%%III11111111 Mj�q////���r� NOTARY PUBLIC: NOTARY PUBLIC: ••�e���SjoyF.•• t i�o�`st 2. Stg ,<,� Sign: MARIA&91A? a Print: ��'- Notary Public State of Florida Print: �9• tip, eo; lhN �;•'Or .rf;,ill!!��°'•�-�,�y� Commission #FF 035821 Seal: Seal:Print T or sta;w Arm" of N-Maq /�HIfHl1i! PersonallyKnown or Pro(iuc Type OWRQV�"Vlrocuw,,�` Plans Examiner Zoning Number on i,� Structural Review Clerk (Revised02/24/2014) ��►ORES ogle Miami Shores Village Building Department OR 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. —�COPY OF LOCAL BUSINESS TAX RECEIPT C. ✓ COPY OF LIABILITY INSURANCE* D. 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 CERTIFICATE 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: f4rpw BUSINESS ADDRESSS N M (0 6V't(0 CITY 41 CA-(f-0 ) STATE R— ZIP 32 O/S— BUSINESS PHONE: &w -7 D FAX NUMBER( CELL PHONE(3)S ) ;;2c T ` 6I c13QUALIFIER'S NAME: QUALIFIER'S LIC NUMBER: _ �9? 3 _7 C] State of Florida Department of Agriculture and Consumer Services Division of Consumer Services Certificate No: 26440 Bureau of Liquefied Petroleum Gas Inspection Exam Date: August 21,2013 =z (850) 921-1600 Issue Date: September 18,2013 Expiration Date: September 17,2016 Tallahassee, Florida Exam: 0803 MASTER QUALIFIER CERTIFICATE This Certificate is issued under authority of Section 527.02, Florida Statutes,to: ROBERTO GONZALEZ Valid For License Number: 28379 FOREVER GAS CORP 4. 18111 NW 68TH AVE APT 1105 ADAM H.PUTN M HIALEAH,FL 33015-3989 COMMISSIONER OF AGRICULTURE State of Florida Department of Agriculture and Consumer Services Division of Consumer Services License Number: 28379 Bureau of Liquefied Petroleum Gas Inspection Expiration Date: August 31,2015 850 921-1600 Date of Issue: September 1,2014 License Fee: $200.00 POST LICENSE Tallahassee, Florida Type and Class: 0803 CONSPICUOUSLY Liquefied Petroleum Gas License LP GAS INSTALLER GOOD FOR ONE LOCATION ONLY ANY CHANGE OF OWNERSHIP OR SALE OF THIS BUSINESS RENDERS THIS LICENSE INVALID This license is Issued under authority of Section 527.02,Florida Statutes,to: FOREVER GAS CORP 18111 NW 68TH AVE APT 1105 ADAM H.PUTNAM HIALEAH, FL 33015-3989 COMMISSIONER OF AGRICULTURE i I 003997 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOTA BILL - DONOT PAY BT 6978051 !!_j BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES FOREVER GAS CORP RENEWAL SEPTEMBER 30, 2015 18111 NW 68 AVE 1105 7253636 Must be displayed at place of business MIAMI FL 33015 Pursuant to County Code Chapter SA-Art.9&10 OWNER SEC.TYPE OF BUSINESS FOREVER GAS CORP 205 LPG INSTALLER PAYMENT RECEIVED LPG28379 BY TAX COLLECTOR $100.00 07/11/2014 CREDITCARD-14-026444 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 mai cations,to do business.Holder must comply with any governmental Of aoogovemmeatai regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dade Code Sec Ba-276. For more information.visit wwwmiamidade gavkaxcollectar A`,o_ CERTIFICATE OF LIABILITY INSURANCE °A o6/15 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(ws)must be endorsed. M 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 ACT CLAUDIA M DE LA ROSA Claudia's Insurance PHONE (786)293-9141 ; (786)293-9142 18901 SW 106th Ave 132E-MAIL daudia@daudiasinsurance.com Miami,FL 33157 INSURER(S)AFFORDING COVERAGE NAI:i Phone (786)293-9141 Fax (786)293-9142 INSURER A: ENDURANCE AMERICAN SPECIALTY INS.COMPANY 41718 INSURED INSURER B: FOREVER GAS CORP INSURER C: 18111 NW 68 AVE 1105 INSURER 0: HIALEAH,FL 33015 (305)298-0193 SURER 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. INSR LTR TYPE OF INSURANCE UBR POLICY NUMBER POLICY EFF C,P LIMBS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 ❑V COMMERCIAL GENERAL LIABILITY DAMAGE MAGEI RENTEDE1occurrence $ 100,000.00 ❑ F-1CLAIMS-MADE [:] 10/18/2014 10/18/2015 OCCUR CBC10001745701 MED EXP(Any one person $ 5,000.00 A ❑ -PERSONAL&ADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 1,000,000.00 E] POUCY ❑ JECT PRO- ❑ LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ❑ ANY AUTO BODILY INJURY(Per person) $ ❑ AUTOOS ❑ AUTOS BODILY INJURY(Per accident) $ ❑ HIREDAUTOS ❑ AUTOS NOWOWNED (PerraanDAMAGE $ $ ❑ UMBRELLA LIAR ❑OCCUR EACH OCCURRENCE $ I ❑ EXCESS LIAO ❑CLAIMS-MADE AGGREGATE $ ❑ DED ❑ RETENTION$ $ WORKERS COMPENSATION1:1WCST%U- OTH- AND EMPLOYERS'LIABILITY Y/NITS El ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? N/A (Mandatory In NH) � E.L DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,I more space is required) COMMERCIAL AND RESIDENTIAL GAS APPLIANCE INSTALLATION REPAIR AND SERVICES LPG 28379 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2ND AVE AUTHORIZED REPRESENTATIVE MIAMI SHORES,FL 33138 (�Va4&— (�� 88-2010 ACORD and CORPORATION. All rights reserved. ACORD 25(2010105)OF The A logo are registered marks of ACORD �"11 JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA 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: 4/24/2014 EXPIRATION DATE: 4/23/2016 PERSON: GONZALEZ ROBERT FEIN: 271764059 BUSINESS NAME AND ADDRESS: FOREVER GAS CORP 18111 NW 68 AVE#1-105 HIALEAH FL 33015 SCOPES OF BUSINESS OR TRADE: OIL OR GAS PIPELINE CONSTRUCTI Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may 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 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. DFS-F2-DVVC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS?(850)413-1609 DATE:04/06/2015 STATE OF FLORIDA COUNTY OF MIAMI SHORES BEFORE ME THIS DAY PERSONALLY APPEARED ROBERTO GONZALEZ WHO, BEING DULY SWORN, DEPOSES AND SAYS: THAT HE WILL BE THE ONLY PERSON WORKING ON THE PROJECT LOCATED AT: 1450 NE 101 ST MIAMI SHORES FL 33138 SWORN TO(OR AFFIRMED)AND SUBSCRIBED BEFORE ME THIS DAY OF /2-c- Z .2015, BY PERSONALLY KNOW OR PRODUCED IDENTIFICATION TYPE OF IDENTIFICATION PRODUCED. L DATE: 20 S SIGNATURE OF NOT P IC sEJl\9�Fhi@i9!i3l/// A /f ti AFF 1ft111 NW AR A\/F I INIT I_1nS NIAI FAN FI tam • f FI I•znS_7QR-ni wt • f1m F• ZnS_:ta1_7577 SCOC-1932 RES L!l Miami shores Village Building Department ��ORID� 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 and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances,Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: State of Florida County of Miami-Dade The foregoing was acknowledge before me this 4�- day of //�)/10120/T_20/T_ r- By j"/ -'C. cr��_ � c%e who i personally known me or has produced — as identification. Notary: 'rirt, Type or tamp N e o Notary SEAL: MARIA E DIAZ ;s�r:ally Known Notary Public-State of Florida r I-roduced Identification❑ 9e My Comm: Expires Oct 13,2017 1_ypoof rffadlon Produced Comm Number on K)