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FW-16-142 Miami Shores Village
Building Department F 09 20;6
10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 W ' 1
BUILDING Master Permit
PERMIT APPLICATION Sub Permit
❑BUILDING ❑ ELECTRIC ❑ ROOFING /REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: S e;ygG 6 4SGf .
City: Miami Shores County: Miami Dade Zia
Folio/Parcel#: ����J c�®1 —���'y Is the Building Historically Designated:Yes
NO
Occupancy Type.��� Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):.PA Phone
Address:
City: _
State: �� Zip:ai
Tenant/Lessee Name:''` Phoneme\�
Email:
CONTRACTOR:Company Name: /LGY�IC2lA cC.p)Zr�7Wc�lU)') �%tG Phone#: SOY•a'3 y'
Address: (/3?Sb A4u,114V Lava, k, io 1
City: &9&I-A Ad iam l State: Zip:
Qualifier Name: a%(nj v d C . Tt�oppt r Phone#: 30S—A3 y_q/'17
State Certification or Registration#: CC 1: V So /U Z- Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ t;<x'D Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: 6Y l'[[IY1 t3 ews6m Wow Fe
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$ ��
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(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.
Signet Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
0_day of 20 \L4 , byJC day of fi,'ktV P!±�V ,20 !(e , by
nn
who rsonally known to Q0.V tmund C. �.tiT�who is personally known to
me or who has produced—��t CL l r'asss 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: t o Sign:
Print: �1 f 1�� / Print: '
Seal: Qnratm No,ary Public State of Flori&eal-
o,P" RUTH DAYS
_ }p Sindia Alvarez
My Commission FF 156750 . . _ Notary Public-State of Florida
Expires 09/0312018 "s� ; My Comm.Expires Apr 24,2017
r o,.
APPROVED BY d�9 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-252282 Permit Number: FW-1-16-142
Scheduled Inspection Date: February 10,2016 Permit Type: Fence/Wall
Inspector: Rodriguez,Jorge Inspection Type: Final
Owner: , Work Classification: Wood Fence
Job Address:9959 BISCAYNE Boulevard
Miami Shores, FL 33138-2644 Phone Number (305)979-1781
Parcel Number 1132050190470
Project: <NONE>
Contractor: TURNKEY CONSTRUCTION INC Phone: (305)234-9197
Building Department Comments
REPLACING PORTION OF EXISTING IRON FENCING Infractio Passed Comments
WITH HORIZONTAL PLANKS NOT REPLACING CHAIN INSPECTOR COMMENTS False
LINK FENCING ON EITHER SIDE OF PROPERTY
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-251178. PLANS SAY 5FT AT
JOBSITE FENCE IS AT 6 FEET NEED TO REVISE THE PLANS
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
February 09,2016 For Inspections please call: (305)762-4949 Page 17 of 44
Pei7t11t No. FW-1-16-1
Miami Shores Village PBtt fft !7e_ & cams
oE
10050 N.E.2nd Avenue
p nM ijVtltl C Ci'assirtoatici WoiFence
Miami Shores,FL 33138-0000"'. . .
,... Pen ani mat 1 PROVED
Phone: (305)795-2204 ,
Issue Date 1l21lil 3 Expiration: 07/19/2016
Project Address Parcel Number Applicant
9959 BISCAYNE Boulevard 1132050190470
Miami Shores, Fl- 33138-2644 Block: Lot: GLOBAL REAL ESTATE ACQUI£ .
Owner Information Address Phone cell
I
GLOBAL REAL ESTATE ACQUISITIONS 9959 BISCAYNE Boulevard (305)979-1781
------ -- - MIAMI SHORES FL 33138-
995920817 SW 92 Court
CUTLER BAY FL 33189-
Contractor(s) Phone Cell Phone Valuation: $ 2,000.00
TURNKEY CONSTRUCTION INC (305)234-9197
_.. _.,,.:, . _.. ..... Total Sci Feet: 84
Approved: Available Inspections:
Comments: Inspection Type:
Date Approved:: Final
Date Denied: Foundation
Type of Construction:Wood Fence Additional Info:REPLACING PORTION OF EXISTING Review Planning
Classification:Residential Scanning:3 Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
DBPR Fee $2.00 InvOiCe# FW-1-16-58378
DCA Fee $2.00 01/21/2016 Credit Card $ 121.20 $0.00
Education Surcharge $0.40
Notary Fee $5.00
Permit Fee-Wire&Wood $100.00
Scanning Fee $9.00
Technology Fee $1.60
Total: $121.20
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,PLUMBIN CHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNER AFFIDAVIT: certify at the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction d zonin th or ,I authorize the ve-named contractor to do the work stated.
January 21, 2016
uthorized Sig ture:Owner / Applicant / Contractor / Agent Date
Buil ing epartment Copy
January 21,2016 1
` Miami Shores Village ! JrV_- ID
Building Department ' JAN zo,s
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
[�' t
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 201 q J4�
BUILDING Master Permit No. '
PERMIT APPLICATION SubPermit No. F�v
M BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
F-1 PLUMBING [:] MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF Ej CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9959 Biscayne Blvd.
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-3205-019-0470 Is the Building Historically Designated:Yes NO X
Occupancy Type: RES Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder):Global Real Estate Acquisitions and Investments phone#:(305) 979-1781
Address:9959 Biscayne Blvd.
City: Miami Shores state: Fl. Zip: 33138
Tenant/Lessee Name: C/o Samantha Gardner Phone#:(305) 979-1781
Email: Samantha8873@hotmail.com
CONTRACTOR:Company Name: rLrP_Mb4 0116 fi& n(i4, i/!It%. Phone#: ' 231, 7
Address: 03b 6 ag L4" i__ a
City: SVL61 ��K6 4YI4 i State: I� Zip: 3 11
3
Qualifier Name: 42(,-W *nd -f4t Phone#: 2-3 Lf -T Lit,
State Certification or Registration#:_C 61 C I®051 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$2,000 Square/Linear Footage of Work: 84 LF
Type of Work: ❑ Addition ❑ Alteration ❑ New M Repair/Replace ❑ Demolition
Description of Work: Replacing portion of existing iron fencing with wooden horizontal planks. Not replacing
chain link fencing on either side of property.
Specify color of color thru tile:
o
Submittal Fee$ Permit Fee$1 M co CCF$ ° CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ a Training/Education Fee$ q o Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ I
(Revised02/24/2014)
1
r
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 CONTRA OR
The foregoing instrument was acknowledged before me this The(foregoing instrument was acknowledged before me this
13th day of January ,20 16 ,by s��h I day of January ,20 16 , by
Samantha Gardner ,who is personally known to zurmlvle_TPDx✓ r o is personally known to
me or who has produced as qEe:or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign Sign: ,F--
Print rint: D S
par Notary Public Sta of Florf a
Seal: ; Jotanne M Feliciano Seal
y My rommiasion FF 082753 ',.=a1+NY P°`� RUTH DAYS
EL
01/1212018 _ Notary Public-State of Florida
� :aQ My Comm.Expires Apr 24.2017
Commission #FF 011909
APPROVED BY " N" Plans Examiner f ( � Zoning
Structural Review Clerk
(Revisedo2/24/2014)
C[�RWICATE ®F LIABILITY INSURA •��� DATE,MM/DD12/22/ 2015015
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 hoider 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 NAME:
David M. Lopez
Eastern Insurance Group, Inc, PHONE (305)595-3323
9570 SW 107 A�vanue E-MAIL° AIC No;(305)595-7135 ADDRESS:amanda@easterninsurance.net
Suite 104
Miami FL 33176 INSURE-1AFFORDING COVERAGE NAIC#
INSURED
---- -- - INSURERABrid afield Em to ers Insuranc
INSURER B
Turnkey Construction, Inc.
6330 Manor Dane INSURER C:
Suite 201
INSURER D:
Miami FL 33143 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:Master 15/16 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. NOT✓�.;THSTANDING 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, —�q UBR
LTR! TYPE OF INSURANCE NSD POLICY NUMBER POLICY
MMIDIDYW MM/DD� LIMITS
COMMERCIAL GENERAL LIABILITY � �
CLAiVS-,:ADE Ji OCCUR
EACH OCCURRENCE $
PREMISES Ea occurrence $
MED EXP(Any one person) $
j PERSONAL&ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO_ GENERAL AGGREGATE $
POLICY I_J JECI _I
OTHERLOC
PRODUCTS-COMP/OPAGG $
� , :
AUTOMOBILE LIABILITY $
COMBINED
D SINGLE LIMIT
Eaaccdent $
ANY AUTO BODILY INJURY Per person)
ALL OWNED SCHEDULED
SCHEDULEDI ( p ) $
AUTOS AUTOS BODILY INJURY(Per $
i HIRED AUTOS NON-OWNED ( )
AUTOS PROPERTY DAMAGE $
Paraccdent
UMBRELLA LIAB `JI CCCUR
~ EACH OCCURRENCE $
EXCESS LIAB ! CLAIMS-MADE' I
T AGGREGATE $
' DED RETENTIONS � '
WORKERS COMPENSATION $
:AND EMPLOYERS'LIABILIT`! I PER TH-
IANYPROPRIETOR?ARTNERIEXECUTIVE Y/N STATUTE ER
A OFFICER/MEMBER EXCLUDED? II N/A E.L.EACH ACCIDENT $ 1 000,000
(Mandatory in NH) —L 1830-52156 12/23/2015 12/23/2016
If yes,cescnca unce: ! E.L.DISEASE-EA EMPLOYE $ 1 000 000
DESCRIPTION OF JPERATIONS beicw E.L.DISEASE-POLICY LIMIT $ _n 000
I� I
DESCRIPTION OF OPEPAPYIONS)LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
Contractors
CGC058142
CERTIFICATE HOLDER CANCELLATION
(305)756-8972
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 N.E. 2nd Avenue
Miami Shores, FL 33138 1 AUTHORIZED REPRESENTATIVE
David Lopez/ANA �---
©1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/0 1) The ACORD name and logo are registered marks of ACORD
INS025 onl4n I
TURNCON-01 MVOSSE
CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
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
,CLOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
.EPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pOIICAIGS)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 CONTACT
Collinsworth,Alter,Fowler&French,LLC NAME:
8000 Governors Square Blvd PHONE
Suite 301 A/C No Ext):(305)822-7800 FAX No:(305)362-2443
E-MAIL
Miami Lakes,FL 33016 ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIL as
INSURED —"-- — INSURERA:Amerlsure Mutual Ins Co 23396
TurnKey Construction,Inc. INSURER B:
633E Manor Lane INSURER C:
Suite 201 INSURER D:
Miami,FL 33143 INSURER E:
COVERAGESINSURER F
CERTIFBCATE 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
INDICWI
ATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY SE 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 NSD W1/D POLICY NUMBER �M�P;OU�C;YEFF; POLICY EXP COMMERCIAL GENERAL LIABILITY MM/DD LIMITS
CLAIMS-MADE ' OCCUR CsL20192591103 EACH OCCURRENCE $ 1,000,000
06/30/20151 06/30/2016 PREMISES Ea occurrence $ 300,000
MED EXP(Any one person) $ 10,000
GEN'L AGGREGATE LIMIT APPLIES PER PERSONAL&ADV INJURY $ 1'000,000
— POLICY X JEC LOC j GENERAL AGGREGATE $ 2,000,000
OTHER:
PRODUCTS-COMP/OP AGG $ 2,000,000
ON
AUTOMOBILE LIABILITY POLLUTILIA $ 100,00
A COMBINED SINGLE LIMIT
—ANY AUTO ___ CA2093151 003 Ea axident $ 1,000,000
ALL OWNED SCHEDULED 1 06/30/2015 106130/2016 BODILY INJURY(Per person) $
_AUTOS AUTOS
X HIRED AUTOS X_AO oOWNED BODILY INJURY(Per accident) $
— PROPERTY DAMAGE $
Per accident
X UMBRELLA LIAB OCCUR $
A EXCESS LIAB _1 CLAIMS-MADE' CU202215210 EACH OCCURRENCE $ 1,000,000
06/30/2015 106/30/2016 AGGREGATE
DED RETENTIONS 0' $ 1,000,000
WORKERS COMPENSATION $
AND EMPLOYERS'LIABIL1 Y PER
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N STATUTE ER
OFFICER/MEMBER EXCLUDED? N/A' E.L.EACH ACCIDENT
(Mandatory in NH) $
If yes,tlescribe under E.L.DISEASE-EA EMPLOYE $
DESCRIPTION OF OPERATIONS below
A !Equipment FloaterE.L.DISEASE-POLICY LIMIT $
IM20931530®03 06/3�11'1' 3Scheduled Equipment 21 800
A !Unscheduled EgL�ip jIM209315300®3 06/3Max$2,500 Per Item
20,000
i I
DESCRIPTION OF OPERATIONS i LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
General Contractors
CGC#058142
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Miami Shores Village Building Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
10050 N.E.2nd Ave, ACCORDANCE WITH THE POLICY PROVISIONS.
Miami Shores,FL 33138
AUTHORIZED REPRESENTATIVE
ACORD 25(2074I01) ©1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and Inan ara r®nino—i..,...e...-s.P..o....
enCes Good'Side Ouf.The Orttcat end hdri orf l
su Rort�ng memfjers a a-fence shah fr ee the
mterjor�4 the plot ori whibh*the fence I`3 Cared ;
and thig.=finished.side shail�face th® adj,i,,i' J M
lar or any abuttirfg right--Lway
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____. __. _... . _..._. _v__ ,...r....._ _ .._ ....... . _
-TRICK SCOTT,GOVERNOR KEN LAWSON, SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ,
CONSTRUCTION INDUSTRY LICENSING BOARD
CGC058142 , Q
The GENERAL CONTRACTOR
Named below IS CERTIFIEDa �� .��
Udder the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2016
TEPPER, RAYMOND CHARLES
TURNKEY CONSTRUCTIOW_INC x
6330 MANOR LANE
SUITE 201
SOUTH MIAMI FL 33143 a
I#`a°
ISSUED: 07/06/2014 DISPLAYAS REQUIRED BY LAW SEC!# L1407060000530
001017
Local Business Tax Receipt
Miami-Dade County, State of Florida
-THIS IS NOTA BILL - DO NOT PAY
3827269
BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES
TURNKEY CONSTRUCTION INC RENEWAL SEPTEMBER 30, 2016
6330 MANOR LA 201 3995785 Must be displayed at place of business
SOUTH MIAMIfL 33143 Pursuantto County Code
Chapter SA-Art.9&10
OWNER SEC.TYPE OF BUSINESS
TURNKEY CONSTRUCTION INC 196 GENERAL BUILDING CONTRACTOR PAYMENT.RECEIVED
CGC058142 By rax COLLECTOR
Worker(s) 12 $51.00 09/02/2015
CREDITCARD-15-043681
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 Coda Sec Sa4278.
For more information,visit www.miamidade gov/taxcollaotor
TURNCON-01 RGOMEZ
CERTIFICATE OF LIABILITY INSURANCE °A� I"'"'
_ 2r5/20/2o1s
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 CONTACT
NAME: ..
Collinsworth,Alter,Fowler&French,LLC PHO NI'. PASI"
8000 Governors Square Blvdc Ext);(306)822-7800 (AIC,No) (306)362-2443
Suite 301 MCA(
Miami Lakes,FL 33016 ADDRESS: _
INSURERS(AFFORDING.COVERAGE NAIC#
INSURER A:Amerisure Mutual Ins Co 23396
INSURED INSURER B:
_.....
TumKoy Construction,Inc. INSURERC:
6330 Manor Lane ... ....................._....._ ........ ...........
Suite 201 INSURER D
............................. _..._............................................................._.........._............., .. ..........
Miami,FL 33143wsURER 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,
"EEXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE A „SUM..s POLICYNUNIBER (M#MfiII YY� j G DB'J 1irY
A X COMMERCIAL GENERAL LIABILITY
EACHOCCURRCNC.E $ 1,000,000
CLAIMS4IADE X OCCUR GLM12591103 06/3012015''06130/20161 OAMAf3ETORCNTEC3
,PREMISE$(Eaoceurrern $. 300,000
MED EXP(Any ovpelscn) S 101dOO
__. PERSONAL&ADV INJURY 5. 1,000,00
,OWL AGGREGATE L0#RAPPLIES PER. GENERAL AGGREGAIE $ 2,000.00
..POLICY: X PRO- PRLOC ., -R _.._. ...... ....
pl?UCTs-GpMPIC9P AiG $ 200,0
pn1ER; POLLt1TION LlA $ 100,00...
AUTOMOBILELIAetUTY SINSLE LIMIT
A (Eaacciaeru)_. _....._..... .. 1,t100rti _...
ANY AUTO CA20�3151003 06130/201510613012016 BODILYINJURY(Per persm) $
ALL OWNED SCHEDULED
AUTOS AUTOS BODILY INJURY(Per accident) 5
.... .. ......
NON-0m,>CI IPEIiY pAMA�3E 5
X.:HIREDAUTOS X_ AUTOS I (Perscddenl)„ ..... ..........
_.
X UMBRELLA,LAS JC OCCt u_ ___._.........
EACH 1,000,000
A ExCESSLIAB CLAIMS-MADE; ICU202215210 06/30/2015106130/2016
.. AC R "fiTE 1,000,000
_._.
OED_X
RETENTIONS 0
WORKERS COMPENSATION
j AND EMPLOYERS'LIABILITYY 1 N - ST�jiJT`E. ._ R.... __..
ANY PROPRIETORIPARTNER/DIFCUTNE
OFFICERIMEMBER EXCLUDED? NAR - °E.L.:EACHACCt43ENT y.$ ..
(Mandatory In NH) -- E.L.DISEASE-EA EMPLOYEta$
_....... _ ._....___..
li es,describe under -
DESCRIPTION OFOPERA11ONSWow i E,L DISEASE-POLICY LIMIT
A Equipment Floater {IM20931530003 06/30/2015 08/3012016 jScheduled Equipment 29,90
A UnscheduWd Equip iM20931630003 06130/201510613012016 IMax$2,500 Per Iteq� 20,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Renmrks Schedule,may be attached It more space Is required)
General Contractors
CGC#056142
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Miami Shores Village Building Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
10050 N.E.2nd Ave. ACCORDANCE WITH THE POLICY-PROVISIONS.
Miami Shores,FL 33138
AUTHORED REPRESENTATIVE
. ou
©1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
A►C R® CERTIFICATE 4F LIABILITY INSURANCE °ATE(MM/D°"'�"'12/22/2015
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 certfflcate holder Is an ADDITIONAL INSURED,the Poilcy(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 ileu of such endorsements,
PRODUCER T Da�rid M. Lopez
PHONE Eastern Insurance Group, Inc. NAME —
(305)595-3323 �yal (305)gg5-7135
9570 SW 107 Avenue -r41NL'-'DML-- _ ...._ ...._.
REgsamanda@easterninsurance.net
Suite 104 ---_ __...._..__..__:.
€NSU"J.AFFQR=a et3vEa as
am*- FL 3317 6 --- __—
____--_.._. _ roaeua&RAri er'ieid . erg...Snstsrarxo
_ _......�._.. --_ _. —_ .__ ._._ d�L _ 01
INSURED .------
INSURER a
Turnkey Construction, Inc. ---...._.�_._..._........._.........
._._.—.....�.-._�_..,__..._—..� _,.�.
.,#NSURER c:. ..........._..... �....,.�...
6330 Manor Lane ----..._..._.. _..__..........___-. _.„..._—�..
Suite 201 _�.._..
INsuReR a:__
Miami FL 33143
INSURER F.
COVERAGES CERTIFICATENUMBERitastelr 15/16 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OE 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.
_
TYPE OF INSURANCE p. -EFF POLt�-..Ex LIMITS
GENERAL LIABILITY
CLAIMS-MADE ,OCCUR sC TCiE6ii "—'EACH 0001JRRFACES
�^ MEO EXP(Anp one aeraort S
GENT AGGREGATE LIMIT APPLIES PER: # PERSONAL&ADV INJURY $
I�OLICI GENERAL AGGREGATE S
I i re - �-
PRODUCTS-COMPIOPAGG $
' OTHER' $
AUTOMOBILE LIABILITY MMONEDUmfS
ANY AUTO = BODILY INJURY(Per person) :$
ALL OWNED SCHEDULED _............__.........
—_..... -......�,._ ...._..—_.-M,.-_—.
AUTOS AUTOS BODILY INJURY(Per accident)
NON-OWNED
HIRED AUTOS I_ ^"' """. $ "
AUTOS PRO tY .........__. �._. _— -,..
.ecc8tsrul
S
UMaRELLA LUAe OCCUR ° EACH Q> CURRENCI"
EXCESS LIAR CLAIMS-MADE I
AGORAPrT' ..._.._ �_....—__..
WORKERS COMPENSATION
;AND EMPLOYERS'LIABWTYY!N I x T, T
ZANY PROPRIETOR/PARTNERiEXECUTIVE ? A67C10EI8T 1"000 D00
OFFICER/MEMBER EXCLUDED? ❑MIA . F-L EACH
A ttttit(Mandatory In NN) 830-52156 12/23/201512/23/2016 E.L DISEASE-EA EMPLOY£ $ 1 qQg) 0bp
If yRRiPes;describe Undue
DESi" flON F'f E}^r4TtOR1�3:be1 t ®i5F.1 `-POLICY LIMIT S 1 1000.000
I
DESCRIPTION OF OPERATIONS/LOCATIONS/
Contractors VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
CGCO58142
CERTIFICATE HOLDER
(305)756-8972 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 N.E. 2nd Avenue
Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE
David Lopez/ANA r
©1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
I NS025(Pn14011