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MC-15-2061
Inspection Worksheet -� Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-241443 Permit Number: MC-8-15-2061 Scheduled Inspection Date: January 20,2016 Permit Type: Mechanical - Commercial Inspector: Perez,JanPierre Inspection Type: Final Owner: MILITANA,JOHN AND ADRIENNE Work Classification: A/C Replacement Job Address:8900 BISCAYNE Boulevard Miami Shores,FL Phone Number Parcel Number 1132060110160 Project: <NONE> Contractor: MASTER COOLING CONTRACTORS, LLC Phone: (954)770-2396 Building Department Comments REPLACE EXISTING ROOF TOP PACKAGE UNIT Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. January 19,2016 For Inspections please call: (305)762-4949 Page 10 of 56 Jan 14 16 01:40p MasterCooling Contractors 7867176164 p.1 YAC- (S--2061 Local Business Tax Receipt Miami—Dade County, State of FloridaLBT -THIS IS NOT A BILL-DO NOT PAY 7191910 BUSINESS NAMEILOCATION RECEIPT NO. EXPIRES MASTER COOLING NEW BUSINESS SEPTEMBER 30, 2016 CONTRACTOR,LLC 7473669 2520 W 78 ST SAY 3 Must be displayed at place business HIALEAH, FL 33015 Pursuant to County Code Chapter 8A-.lri.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED MASTER COOLING CONTRACTOR, 196 GENERAL MECHANICAL BY TAX COLLECTOR I-LC CONTRACTOR 45.00 10/06/2015 (:1n ANr�FI V'A RAFNA-AI nNAn Workers} 5 CAC1818156 D246-16-000064 This Local Easiness Tau Receipt only confirms payment of the Local BuainessTax.The Ilecelpt is not a ticeass, pormit,or a certification of the hellos quafiGcations,to do business.Holdormust comply with any govermneatal or nongovernmental rogalatotyImus mull requiremewswbiehapplytothebosiness. The RECEIPT N0.abova most he displayed on all Commercial vehicles-Miami-Dade Code Sac as-276. M= For more information,visit www.m is oldodg.govAaxcoll actor rPermnra Cw -15- A Miami Shores Village �3 Type ,> ec pnlcal'-Commerclot: 10050 N.E.2nd Avenue Wt�kfife ASCit, , .... a Miami Shores,FL 33138-0000 Pefftixt Stas A � ; Phone: (305)795-2204 fiTDAEx iration: 02/16/2016 �u�17ate 8120C2�1 P Project Address Parcel Number Applicant 8900 BISCAYNE Boulevard 1132060110160 JOHN AND ADRIENNE MILITANT Miami Shores, FL Block: Lot: Owner Information Address Phone Cell JOHN AND ADRIENNE MILITANA 8801 BISCAYNE Boulevard MIAMI SHORES FL 33138-3381 8801 BISCAYNE Boulevard MIAMI SHORES FL 33138-3381 Contractor(s) Phone Cell Phone Valuation: $ 3,500.00 MASTER COOLING CONTRACTORS, 1 (954)770-2396 _. Total Sq Feet: 0 Tons:5 Available Inspections: Additional Info:REPLACE EXISTING ROOF TOP PACKAGE U Inspection Type: Classification:Commercial Final Approved:In Review Review Mechanical Comments: Date Approved::In Review Date Denied: Type of Work: Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 Invoice# MC-8-15-56722 DBPR Fee $2.00 08/20/2015 Credit Card $94.40 $50.00 DCA Fee $2.00 Education Surcharge $0.80 08/14/2015 Credit Card $50.00 $0.00 Permit Fee $125.00 Scanning Fee $9.00 Technology Fee $3.20 Total: $144.40 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 construction an oning. Fut ore,I authorize bove-named contractor to do the work stated. August 20,2015 ori d Signature:Owne Applicant / Contractor / Agent Date Building Department Copy August 20,2015 1 Miami Shores Village AUG 2015 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 1 FBC 20 I ", BUILDING Master Permit No. o I '� - 2-0 6, PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING POMECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP QQ cry; CONTRACTOR DRAWINGS JOB ADDRESS: U /�� 1 �Ci i�1OI ®���801 City: Miami Shores County: Miami Dade Zip: 3' 3 13 8- Folio/Parcel#: I I -*3L®(' - '�01 b 0 Is the Building Historically Designated:Yes NO_�;gw Occupancy Type: �(GLo d: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): �� Phone#: Address: City: State: .}- Zip: Tenant/Lessee Name: I �(sXf�l����'+� �i°l 1 1 hone#: Email: /�_ / CONTRACTOR:Company Name: �0�� I u( l��C� 10/\ i7('� L-'Phone#: ��7 Address: �^�5 -7 City: � r l la o /c�k-r 6L State: � ^�! Zip: , Qualifier Name: I`-t Gl(L�( // r5c ��`IC�1 Gam- A�3,,1,ci� Phone#: 55�--7®7- 941-_ 0 State Certification or Registration#: l' 4 �- 1 " ertificate of Competency#: I V3 Z01K_3/0 DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 31500 . Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New W Repair/Replace ❑ Demolition Description of Work: C.�Qt'CJit` Specify color roof\color thru tile: ( Submittal Fee$ Do Permit Fee$ /Ol ' ®y CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 0 (Revised02/24/2014) z a' 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 suance of a building peAit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy the n tice of commence ent and construction lien law brochure will be delivered to the person whose property is subject to att hment. Iso,a certified py of the recorded notice of commencement must be posted at the job site for the first inspection whic occurs se en (7) days er the building permit is issued. In the absence of such posted notice, the inspection will not be appy ed and a r ' pection a will be charged. Signature Signature N R or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of U 20 by day of PJAA.A 20 6 by who is personally known to ��A1Wi�uTi p Y ">�Q�►Com. o is personally known to me or who has produced -P to as me or who has produced L as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC.- NOT RY PUBLIC: ((� Sign: Sign: Print: Print. Seal: osPa� �;., ANGELA L.GUERRERO ��' a Seal: ;_*�.��- Notary Public-State of Florida '" ""'�k, FERNANDO ALONSO " I ?s; : My Comm.Expires Jul 25,2016 `� MY COMMISSION#FF161930 ;;rFOF o � Commission#EE 219464 3, „ �t d��0 EXPIRES September 22,2018 ��� ** r�*�xa*�x� � *x�xxs***a**s 0 UB-0153 OtaryService.co APPROVED BY 17/A� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ,SHORs Miami Shores Village Building Department ..a. unit" 10050 N.E.2nd Avenue 41 Miami Shores, Florida 33138 A� & Tel:(305)795.2204 LOR1Dp Fax:(305)756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change-out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address(where the work is being done): 'g900 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❑ ARHI Sheet Attached:YES NO❑ Contract Attached:YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER 11) I 0®Q AHU or PKG.UNIT MODEL# f2—p'C-1-�- I COND.UNIT MODEL# KW HEAT NOM TONS AHU CU PKG 1)M.C.A AHU CU PKG AHU CU PKG 2)M.O.P AHU CU PKG AHU CU PKG _ 3)VOLTS AHU CU PKG _ PKG UNIT f PK UNIT EER/SEER YES O REPLACING DUCTS YES NO YES O REPLACING THERMOSTAT YES YES NEW 4"CONCRETE SLAB YES O YES O NEW ROOF STAND I YES YES N NEW RETURN PLENUM BOX YES 1. Minimum Circuit Ampacity(Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size)/: (lob � Q 3. Voltage of Circuit(208/240/480): z-o S V 4. Size Disconnecting Means: (420 l Contractor's Company Name: i�(7�'�7 —Phone: qS� 7 7L ����� State Certificate or Registration No. -P 1— l� 15 Certificate of Competency No. I D Z0�070 Signature Date: 0 S f 1M l (16ualiflees signature) (Revised02/24/2014) a YOUR COQUN G- TER COOLING A C CONTRACT PROPOSAL.5ITBMITED TO: WORK TO BE PERFORMED AT: .Boning Restaurants International Pizza Hut Store#012391 15600 NW 15th Ave,Suite C 8900 Biscayne Boulevard Miami,FL 33169 Miami Shores,FL 33238 DATE-.August 5,2015 We hereby submit specifications and.estimate to replace STON roof top package A/C System: 1. Pull proper permits on Miami Shores Village Building Department for.A/C replacement 2. Replace existing 5TON roof top package unit for a new STON Ruud:roof torp package unit with a new 5 KW heater and electric fresh air damper. 3. System start up and checkup,for proper working and cooling conditions, 4. Call city for final inspectionand wait for inspector to pass. TOTAL.ABOVE JOB—-...—......—.-$3,500-00+TAX Note.This proposal does not include any alterations or deviations from above specifications involving extra cost%AII be executed only upon.wnitten orders,and will become an extra charge over.and above the estimate. A 30%deposit is required after the approval of this proposal and before startingthe work.Should default occur,the undersigned further agrees to pay all cost of collectio including attorney's fees,and further agrees that venue for any action brought there under shall be in the Court of Miami-Dade County.:Payment is.due in full before the last inspection is call from the Miami Shores Village.There will be US$50.t1..6 charge for each return check or if we have to come back to collect a£ter.job is been completed.This proposal is good only for 60 days. e� �143 Accep►tante Signature/Date Masier Cob irng Contractors,LLC RR 957 SW n6`h Wad= t Laud rdale, FL 333'-5 ° u-A;=:regaster-QQQ A-9 ttactc�rsllc:coaa� C 305.'7+6j. -538 1954-7'70.239'6 • 0 954.4,,2 q400 ® _F 954.47x• 4 44m License#t ACa8t8is6 Certificate ®f Product Ratings AHRI Certified Reference Number: 7493514 Date: 8/4/2015 Product:Year-Round Single-Package Air-Conditioner,Air-Cooled Model Number: RACA14060AJT***AA Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD Region: Region Note: Central air conditioners manufactured prior to January 1,2015,are eligible to be installed in all regions until June 30,2016. Beginning July 1,2016, central air conditioners can only be installed in region(s)for which they meet the regional efficiency requirement. 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): 57000 EER Rating (Cooling): 11.60 SEER Rating(Cooling): 14.00 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,warranties 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 Certtficate.Certified ratings are valid only for models and configurations listed in the directory at www.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; entered Into a computer database;or otherwise utilized,in any form or manner or by any means,except for the user's individual, M- M personal and confidential reference. AIR-CONDITIONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org,click 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 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: 130831798214780798 193 nu. p... Miami shores Village Building Department 0 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 form and Contractor 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 form and Contractor 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 e' Certificate must specify the description of operations or contractor license number. ........................................................................................... BUSINESS NAME: Master Cooling Contractors, LLC BUSINESS ADDRESS: 957 SW 116th Way CITY Ft Lauderdale STATE FL Zip 33325 BUSINESS PHONE: 9( 54 ) 472-4400 FAX NUMBER 9( 54 ) 472-4401 CELL PHONE 9( 54 ) 707-9430 QUALIFIER'S NAME: Angelica M Baena-Alonso QUALIFIER'S LIC NUMBER: CAC1818156 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CAC1818156 The CLASS B AIR CONDITIONING CONTRACTOR = f Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2016 BAENAALONSO,ANGELICA M MASTER COOLING CONTRACTORS, LLC a a 957 SW 116TH WAY FORT LAUDERDALE 171-33325 ` e ISSUED: 04107x2015 DISPLAY AS REQUIRED BY LAW SEQ# L1504070000471 SR® AR® 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: Receipt#:HEATINGBAIRCONDITION CONTRACTR Business Name;MASTER COOLING CONTRACTORS LLC Business Type:yp (MASTER COOLING) Owner Name:BAENA ALONSO ANGELICA M Business Opened:04/08/2015 Business Location:957 SW 116 WAY State/County/Cert/Reg:CAC1818156 FT LAUDERDALE Exemption Code: Business Phone: Rooms seats Employees Machines Professionals 10 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee I Penalty Prior Years Collection Cost Total Paid 13.50 0.00 0.00 0.00 0.00 0.00 13.50 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: MASTER COOLING CONTRACTORS LLC Receipt #048-14-00008674 957 SW 116 WAY Paid 04/08/2015 13.50 FORT LAUDERDALE, FL 33325 i ! 2014 . 2015 i FROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 08/1412015 11 :31AM FAX 3055364334 ALL INSURANCE 00001/0001 A � CERTIFICATE OF LIABILITY INSURANCE DATEIMM1DDNYYY) 08/1412015 THIS - -E2--RTIFICATE IS ISSUED ASA 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($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the Polliy(les)must be endorsed If SWROGATION IS WANED,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 certifleme holder In Iieu of such endorsement(a). PRODUCER NTACT NAME All Insurance Services PHONo.ExthNE (305)822-4472 NoI, (305)556.4354 1548 W,37 St. . REss: ifemantlw�@aisrv.com _ Hialeah,FL 33012 INSURERS)AFFORDING COVERAGE NAIL o Phone (305)822-4472 Fax (305)5564354 INSURER A, NORTHFIELD INSURANCE COMPANY INSURED INSURERS= ASCENDANT COMMERCIAL INSURANCE MASTER COOLING CONTRACTORS,LLC IN6URERC: FLOFIDA CITRUS&BUSINESS INDUSTRIES F 957 SW 116 WAY INSURER b FORT LAUDERDALE FL 33325 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. ILTR TYPE OF INSUItgNCE ADD UBIq POLICY EFF MPOOLICY El( WMITS POLICY NUMBsq GENERAL LIABILITY EACH OCCURRENCE, S 2.000 000,00 ❑/ COMMERCIAL GENERAL LIABILITYAMAGE TO RENTED Ll El CLAIMS-MADE OCCUR EMISES(Eeocaxramg) S 1,000,000.00 A ❑ Y 15.13171 07/17/2015 07/17/2016 MED EXP one person) $ 6,000.00 PERSONAL&ADV INJURY $ 2,000,000.00 ❑ GENERAL AGGREGATF S 2,000.000.00 GEN'L AOGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO S 2,000.000.00 ❑ POLICY -n JERC ❑ LOC• s AUTOMOBILE LIABILITYMBINEB(SINGLE LIMIT IN $ 1,000,000.00 U ANY AUTO BODILY INJURY(Per perccn) $ ALL OWNED SCHEDULED er B ❑ AUTOS ❑�AUTOS CA38564-0 07/17/2015 07/1712016 BODILY INJURY(Pacddcn S ❑ HIRED AUTOS ❑ AUTOS�FD PROPER DAMAGE S ❑ UMBRELLA s LIAB ❑rI J OCCUR rj EXCESS LIAB I CLAIMS.MADE EACH OCCURRENCE $ AGGREGATE S ❑ DED Q RETENTIdN S S WORKERS COMPENSATION ❑PER El ET- AND EMPLOYERS'UABIL1TjY Y/N ANY PROPRIE rOMPARTNERIMCUT C OFFICER4&MBER EXCLUDED? N/A 106-56876 07/10/2015 07/10/2016 E.L.EACH ACCIDENT $ 1,000,000_00 H (Mandatory describe unQe daory in NH) E.L.DISEASE-EA EMPL �OYE $ 1 000,000.00 yes - DESCRIPTION OF OPERATIbNS below E-L,DISEASE-POLICY LIMIT I $ 1,000,000.00 DESCRIPTION OF OPERATIONS r LOCATIom$/VEHICLES(attach ACORD 101,Additional Remarks Schedule.if more Space Is required) LICENCE#CAC 1818156 CLASS-B AIR CONDITIONER CONTRACTOR CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE BLDG DEPT THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES,FL 33136 AUTHORREDREPRESENTATIVE I _ 7988-2014 ACORD COR RATION. All Ng e5erveI ACORD 25(2014/01)OF The ACORD narno and logo are registered ma 6 of ACORD