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RC-15-1694 (4) YY � Miami Shares Village Cpy pn Building DepartmentUG 2 2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 2014 BUILDING Pe"'t N . P—C--4— t >- 1(694 PERAM APPLICATION Master Permit No. 2 4 89' Permit Type:Electrical JOB ADDRESS: 310 N r � City: Miami Shores County: Miami Dade Zip: S& 13 Folio/ParceW Is the Building HkitorlcsDy Designated:Yes NO Flood Zone: p,' 5t� OWNER:Name(Fee Simple Titleholder): �� Phone#: It�n) ` Address: S1 O K3�. of: `z> city: MOM cskk_c� state: zip: Ten:nt/L,essee Name: Phone#: Email: CONTRACTOR:Company Name: Phona#: -3,0 S Address: /S y® .F,!zT 7 e-� • City: e4fAez Qualifier Name: laA !oAl Phone#: State Certification or Registration#: &e /$-:2 Q d 31 06 —Certificate of Competency#: Contact Phone#:;705-2/9—75/9 f Email Address: DESIGNER:ArchitectlEngineer: Phone#: Value of Work for this Panit:$_„ O SquareAUnear Footage of Work: Type of Work: UAddress DAlteration ONew ORepair/Replace l?Demolition Description of Work: I1 Sd&-J 94-9 d o, Aas J VIA,( U Subndttal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ • • Bonftg 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 meat 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 the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Signature /l �7iytwc-vel Owner or A ent Contractor The€orego' g instrument was acknowledged before me this The foregoing instrument was cknowledged before me tbis 3 day of. 5 20 15by day of .20 by 4U0AXe fA&er- sTorE who is personally known to me or who has produced who' o or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Ste; Sign: Q v� Print Print: cNotary Public-State of Florida My Commission EM My Co a ize COMM.Expires Oct 4,2017 JEFFREY OLKINITSKY Cornmitsion S FF 052809 ?' +S MY COMMISSION EE 149835 &"'led N%*N Nar e sesesao4eeea�se * ,A;; *e � � ear*v��es.aosos►as+aas+sweerrw� a a APPROVED BY Plans Zoning Structural Review Clerk (Revised 3/1=012)(Revised 07/10107)(Revised 06/10I10MXRevised 3/15/09) CERTIFICATE OF LIABILITY INSURANCE ,0MA4` Y' �».-- O1d14 THIS CERTIFICATE IS 188M AS A MATTER OF 11111MMATI011 6.Y-AND CONFERS NO RIMM UPON THE ClUtM tom.TIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NECIATIVELY AMEW,EXTEND OR ALTER THE CW9tAGE AFFORIM BY THE MJCM BELOW TISS CERTIFICATE OF ANC DOES NOT CONSTRUTE A CONTRACT BETWEEN THE MUM 901RERM AUTHORIZE REPRESENTATIVE OR PRODMR,AND THE CI?RTOWATE NOIJWt. HYtPDR'TAIIIT: S the boil r par tho P ipn)neap be aaatWU& IrSINNOSATIONISNAWKSUblootto We t arras OW corodithms o,dre poky,certain poAdea may regWm an e+ndoraa . A on Oft awkilkaft doaa rant tomer to the cerafts"taper In Neu or omb ondarsea ma oI. PPANX OER All hmnw=8erYtcesM-4472 Mb)="354 1548 W.37 St. xoom Hialeah,FL 33012 a Phow W-4472 Fax 555 4 GRANAMINS "NAINED AMERICAN POWER ELECTRIC CORP 1540E 7 Ct FL 33010- (305)218-7481 manamp^ COVERAGES CERTSCATE NUMBIBt: !REVISION NUI88m THIS 64 To cERTiFT THAT THE Poxes OF INSURANCE Ltsm BEt.CW HAVE uEN NC m TO THE wamm NAMED Aww FOR Tld:PC=, i tNO1CATED. NCMAffHSTANDM ANY RZOLWOAM.TEMA OR CONDMON OF ANY CONTRACT OR OTHOt DOCUMENT WITH RESPECT TO WHICH THIS t CERMCATE WAY BE ISSM OR tA4Y PERTAK THE INSURANCE AFFORDED BY THE POLICIES DESCU90 HEREIN 6 SUBJECT TO ALL THE TERM, { EUSIONS AND CONDITIONS OF SUCH POLICIES.LWITS SHOWN MAY HAVE SEEN REDUCED&Y PAID O A94. A9ft SUM tY UK" 4011MAL UA&I M , 000.oc ,E..... rBRAL LIAss.rty 1{X1,01!0 0.00 . + ❑ O' W ® CCS 0185FL000 O t D tr7tP t, one n &y000.00 A Y 09d27M4 09127=5 PBR:gAt.aAcwwjuAY a 100DG00.00 GENOW OPPRgqATf s ,00Da1o.00 t 19 AtJtiRWA1Ei 1 PMfflog TB• AW a 1,000,000.00 71 0 PoucY 0 2a Q uz s ALiliNtORU LNtSI M i T _ Fl ANY AUTO � BOON NAM tib+pain) a -i ALL CaAlt D SCMfiD1l S0 t...J AUrm Q AIJTs� Y aVJI1RY pax n ❑ t €D AUTOS 1 AUT D $ _ a 0 WARR A UAS ocajoEA04OCCURRENCE a tie URB 0 WaSSMACe AGORMATS a 13 0.0- 0RUENTMI i Tia R A emftjoym LUMNL TY YIN S.L EACH ACC 01 W1' in ElNiA EL.MESE•!IA EMPt.M t 0P9RATa below I oweAse•POLICY Lur a OE8CRIPT�tOOPOPMtATIt�S t LOOATa r1�►pCLS$[Atm ACARD 1@r, t �Regie tN�� } STATE UCENSE#EC13003100 I CERTIFICATE"OLDER CANCELLATION a ILD ANY OF THE ASM 0=1111111110 POLE 09 CANC MIAMI SHORES VILLAGE THE EXPIRATION*ATE TIS,NOTA WILL N VOLIVOR50 N 10050 NE 2ND AVE ACS WITH THE PAY PROVISICNB. MIAMI SORE$,FL 33138 AWWWaW rOntMWAMYS INEZ FERNANDEZ Q 1888." TRMi. AN doft reserved. ACORD 26(MOM)QF Thar ACORD taNm ame regfolowl n wM o1 ACORD Feb 19 2016 01:09PM American Power Electric C 3056037413 page 2 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 I LORENTE, RAMON AMERICAN POWER ELECTRIC CORP 1540 E 7TH CT HIALEAH FL 33010 CongratulationsI With this Oconee you become one of the nearly one 0luo Floridians licensed by the Department of Business and Professional Regulation, Our professionals and businesses rang* STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. PROFESSIONAL'REGULATION Every day we work to Improve the way we do business in order to EC13003100 ' gi1EL1: 07!3112014 serve you better. For Information about our services,please log onto ' www.myflaridallconse.com. There you can find more Information CERTIFIED ELE 1 CO T%kCTOR about our divisions and the regulations that impact you,subscribe r �r ,�a:�:.:,:•.: to department newsletters and learn more about the Department's LORENTE, RAM.:.,;::.:. ,•.: :. Initiatives. AMERICAN PORP nrtU�M J d!••+y Our mission at the Department Is:License Efffclently,Regulate Fairly. •a ' .We constantly strive to serve you baiter so that you can serve your customers. Thank you for doing business In Florida, iS CERTIFIED under the provisions or Chase FS. and congratulations on your new Ocertsel Exift ianelfe:AUG 91,2015 u4W310002257 DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD EC13003100 ADDITIONAL BUSINESS QUALIFICATION The ELECTRICAL CONTRACTOR , Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2018 LORENTE, RAMON 5¢d N 6°• ,� . AMERICAN POWER ELEeTC.CORP 1540 EAST HIALEAH .. .......CSL'�` .. �.IAi! .. ... ... ._ ,�� .... mni mn• n7r4innta MRPI AY AC RFf]I IIRFn RY I AW SEQ# L1407310002257 Feb 19 2016 01:09PM American Power Electric C 3056037413 page 4 Local Business Tax Receipt Miami-Dade County, State of Florida -THIS 1S NOTA BILL-00 NOT PAY �. LBTJ 60715129 BUSINRSS NAME/LGICATION RECEIPT NO, EXPIRES AMERICAN POWER ELECTRIC RENEWAL SEPTEMBER 30, 2016 CORP 5942548 1 S40 E T C T Moat be displayed at ptaae of bualneaa HIALEAH,FL 33010 Pursuant to County Code Chaplai tiA-An.8&10 owMBR SEC.TYPE OF BUSMESS RECEIVED AMERICAN POWER ELECTRIC CORP 196 ELECTRICAL BY TAX TOLLWTOR CIO LORWE RAMON CONTRACTOR 45.00 06127/2016 Worker(b) 2 EC13003100 FPPUOS-16-018421 TW Local Botiaoas Tax Receipt only coafoam p poont oNke Local Basin Tax.Tb Receipt is nota Ilcom panolt ora carHacadva solo botdoes qa MaSo w to do Iveh .Holler mat cempty with any gavera invoW or nongovarnatsatal regalataq Iawa and regalromata wddah apply to gn badness. Thi BEMPT N0.aiwve aria ie dteplayad ce all commercial ve6ieba-Mlaiai-Vada Cods 8ce ft-M. per more falor�loa rfal Feb 19 2016 01:14PM American Power Electric C 3056037413 page 7 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 certifles that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 8/10/2014 EXPIRATION DATE: 6/8/2016 PERSON: LORENTE RAMON FEIN: 752984422 BUSINESS NAME AND ADDRESS: AMERICAN POWER ELECTRIC CORP 1540 EAST 7TH COURT HIALEAH FL 33010 SCOPES OF BUSINESS OR TRADE: ELECTRICAL WIRING WITHIN BUIL Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by ging a certffioate of election under this section may not recover beneft or compensation under this chapter.Pursuant to Chapter 440.06(12),F.S.,Certlltir:ates 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 shag 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 owtltifloate no longer meets the requirements of this section for issuance of a certificate.The department shag revoke a certificate at any time for failure of the person named on the cartNkate to most the requirements of this section. 0FS:tM-DWC-2132 CERTIFICATE OF ELECTION TO_AE FxEMPT REVISED 07-12 QUESTIONS?(65011413-1180111— PLEASE CUT OUT CARD BELOW AND RETAIN FOR FUTURE REFERENCE -----------------------� T j STATE OF FLORIDA I Pursuant to chapter 44o.05(1pORs ANT IMP officer of a corporation I DEPARTMENT OF FINANCIAL SERVICES I who elects exemption from lhls chapter by fling a certificate of DIVISION OF WORKERS'COMPENSATION I F O1ect►on under this section may not recover benartte or I ( CONSTRUCTION INDUSTRY EXEMPTION 10 compensation unser this chapter. 1 CeRTIFICATE OF ELECTION TO BE EMPT FROM FLORfDA IL Pursuant to Chapter 440.06(12),F.S.,Certificates Of election t0 WORnW CONDENSATION LAW D Iw be exempt...apply only within the scope of the sirtees or trade I EFFECTIVE DATES 8110=4 GIONRATtON DATE: 8r MIS I Ileted on the notice of election to be exempt. 1 1 PEFOON: LORENTE RADION IH 1 1 FEIN: 752884M � Pursuant to Chapter 440,05(13),F.S.,Notices of election to be E exempt and certificates of election to be exempt shall be BUSINESS NAME AND ADDRESS: I R subject to revocation if,at any time after the filing of the notice I AMERICAN POWER ELECTRIC CORP I E or the Issuance of the certificate,the person named on the notice or certificate no longer meets the requirements of this l 1540 EAST 7TH COURT I section for issuance of a Certificate.The department snail revoke I a certificate at any tine for failure of the person named on the I HIALF.AN FL 33010 i certificate to most the requirements of this section. SCOPES OF BUSINESS OR TRA JELECTRICAL WRING L/I/ITHIN—LUILBUIL ._ + -------_ ---------.._ ---------------------------� ren ,+n ht447I.wan ^C Cr Cr%"^XI r^C3,C GVLIAO`r 0C\/I0Qr%^7 46 P17 1CQT1/ZMM t93f9MA44 440AA Feb 19 2016 01:15PM American Power Electric C 3056037413 page 8 07-08-2014 JEFF ATWATER STATE OF FLORIDA CHIIIFIFINANCIALOFfTICIER 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: 07/20/2014 EXPIRATION DATE: 0711912018 PERSON: PEREZ OSCAR FEIN: 752984422 BUSINESS NAME AND ADDRESS: AMERICAN POWER ELECTRIC CORP 1840 B 7TH Cr HIALEAH PL $3010 SCOPES OF BUSINESS OR TRADE: 1- ELECTRICAL WIRING WITHIN BUIL IMPORTANT: Pursuant to Chapter 440 . 013(14), F.S., an officer of s corporation who elects exemption from tilts chapter by filing a eonitigte of election ender this aeadon may not recover benefits or corspenaetion adder this chapter. Pursuant to Chapter 440,35itz), P,8„ Certificates of election to be exempt... apply only within the scope of the basins,, or trade listed as the notice of election to be exOmPI, Punaatt to Chapter 440,0511131, F.8., Notices at election to be exempt and cennicetes of election to be exempt shall be subject to revocation If, at any (free alter the flllog of the notice Or the tosuexco Of ate cWtlficete: :he person named at the notice tN certificate no longer meats the requfrsmeato of ibis section for issuance of a conflicste. The department shall revoke a cenifieate at any time tot failure of the person named ao the certificate to most tke requirements of this section. 13WC-262 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 QUESTIONS? (850) 413-1811 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE DEPART FNTOFFLORIDA IMPORTANT DEPARTMENT OF FINANCIAL SERVICES DIVISION OFrWoltitt3ta'COMPBIVSATiONPursuant to Chapter 440.05(141. F.3- an officer of a corporation who CONSTRUCTION INDUSTRY elects exemption from this chapter by filing a cortif(ome of election WORK@R4'�QOMP�I It9�igTION LAW a MPT FROM FLORIDA L under this section may not recover benefits or comparsstion under this 0 D chapter. EFFECTIVE: 07/20/2014 EXPIRATION DATE: 07/10/2016 pursuant to Chapter 440,06(12), F.S., Cerdfitetes of election to be PERSON OSCAR PEREZ H exempt,.. apply only within die scope of ate business or trade listed on FEIN 752884422 R the notice of election to be exempt, BUSIAMERNESS P NAME AND ADDRESS: E Pursuant to Chapter 441105(13), F.S., Notices of election to be exempt 1540 CAN POWER ELECTRIC CORP and certificates Of election to be exorytpt shall be subject to revocation 1540E 7TH 3 If. at arty time after the filing of the notice or the Issuance of the HIAL6AN, RL 93010 certificate, the person named on the notice or certificate no longer meets the requirements of this section for Issuance of a certificate. The I department shall revoke a certificate at any time for failure of the i SCOPE OF BUSINESS OR TRADE: Person named on the certificate to meet the requirements of this 1. ELECTRICAL WIRING WITHIn OWL section. QUESTIONS? (850) 413-1808 CUT HERE * Carry bottom portion on the Job, keep upper portion for your records. DWC-262 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 Feb 19 2016 01:16PM American Power Electric C 3056037413 page 9 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: 8/1/2014 EXPIRATION DATE: 7/31/2016 PERSON: ROMERO YUNEXIS FEIN: 752984422 BUSINESS NAME AND ADDRESS: AMERICAN POWER ELECTRIC CORP 1840 E 7TH CT HIALEAH FL 33010 SCOPES OF BUSINESS OR TRADE: ELECTRICAL WIRING WITHIN BUIL 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 Utts 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 paled on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notion of election to be exempt and certificates of election to be exempt shalt 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 fallure of the parson named on me certificate to most the requirements of this section. DFS-.E2 DWC 252 CERTELGA=F ELECTION TO BE EXEMPT REVISED 07-12.. QUESTIONS?(850)413.1509 PLEASE CUT OUT CARD BELOW AND RETAIN FOR FUTURE REFERENCE :---------------------_ — . T!� —_ — --_ —IMPORTANT------------- � STATE OF FLORIDA Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation jDEPARTMENT OF FINANCIAL SERVICES ( who elects exemption from this chapter by filing a certificate ofunder this section { DIVISION OF WORKERS'COMPENSATION . on F compensationelectrunder this chapterot recover benefits or. CONSTRUCTION INDUSTRY EXEMPTION O CERTIFICATE OF ELECTION TO 89 EXEMPT FROM FLORIDA L Pursuant to Chapter 440.05(12),F.S.,Certificates of election to { WORKERS•COMPENSATION LAW D be exempt...apply only within the scope of the business or trade l l aPFL'CTIVE DAT! 81112014 EXPIRATIONDATE: 7/3112016 l Hated on the notice of election to be exempt. { l PERSON' ROMERO 7UNEWS I H Pursuant to Chapter 440.05(13),F.S.,Notices of election to be { I FEIN: T5208U= E exempt and oertificates of election to be exempt shall be BUSINESS NAME AND ADDRESS: IRsubject to revocation ff,at any time after the filing of the notice { l AMERICAN POWER ELECTRIC CORP E or the issuance of the certificate,the person named on the I I { notice or certificate no longer meets the requirements of this I l 1840 E 7TH CT I section for issuance of a certificate.The department shag revoke l s certificate at any time for failure of the person named on the l HIALEAH FL 35010 I certificate to meet the requirements of this section. SCOPES OF BUSINESS OR TRA l (ELECTRICAL WIRING WITHIN BUIL-- ------ -------__—� ._— _------- -- - -- — { M ro+Tt/111I TA Or CVCIIAO r mcwicCI1117_19 OUESTIONS?!8501413.1609 Feb 19 2016 01:09PM American Power Electric C 3056037413 page 6 CERTIFICATE OF LIABILITY INSURANCE TMS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT$UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTIIIND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF 111BURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUM INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUWA AND THE CERTIFICATE HOLDER. li the csrMcdt holler b on ADDITIONAL IN U must be endorsed II S MR0@ATION IS W ,uddsst to 1110tens and condwans of ft Polley,oerMie policies may"RtArs an snawaemeM A atetement on lhls catfncate don riot sotlfsr ripMs toms sm Vft ma holder in TMD of such attden wl(s} 'Alarm Slt MWOT kI Insumnas S'elvlwo OW 822-4472 300 $04354 1548 W.37 St. Fammozea wMfIl ilaleah.FL 33012 MMWAMRq=C0v9"= "W4 306 622-4472 Fax J300)_556-4354 A: VYESCO INSURANCE COItPANY NWS won,B t FLO1410A OITRUB 8 DMI4688INDUSTRIES FUND AMERICAN POWER ELECTRIC CORP N C: /540 E 7 Ct G: Pleleah,FL 33010- (305)218.7481 :OVERAtiE;S CERTIFICATE NUMBER: REVISION NUMBER: THIS 18 TO CERTIFY THAT THE F750119 OF INSURAN LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEIi100 INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTM9R DOCIAUErT WITH RESPECT TO WNUCH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES.LIPATS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS, TYPBOF WSURANOE ADDI SUM W NIUMM LIMITS tieNEr4uL.IAeIun ® COMMERCIAL OENERALUABILITY EACHOCCWtRENC 1 ODICODO.00 P 10 gas f>a a 100,0110.00 a ❑ CL/UM&MADE ® ^ OCCUR y WPPI407070-00 08127/2015 0927/2018 IP • 011 a 5,000.00 a 1,000,000.00 ❑ O TE I 2 000 000.00 GA44M 779 LAST APP Pl* P -COYP1oP s 2,000,W0.00 El po 1:1 M El Laca AtrrOMoalLELJABILITY aro R ❑ ANY AUTO SOOILY INMY(Psr pe=n) a ❑ 00 ❑ nuT D BOOLY INuty pW ooddaa a ❑ ABED AUTOS ❑ WNW a a C] LUMU LLA LL40 ❑OCCUR EACH OCWRRENCE a 1 006LIAS El CLAon.swoa AGGMGATB INOINUM COMPS lsa'TM AND RIPLOYRM NAO&M YIN WC STA 1. 1,ODO,000.OD ANY PR RMARTN6R/EItgCUTNE 9 a� SERExCLU�7 NIA 10057004 E.L.6ACNA0=l 1000000.00 sem, N� 081242015 06@4f201s 111.DISEASF..EAtl&L s 1,000.000.00 IPTtaNOFOPERAT10N8 E.L.DISSASS-POLICYLIWT a )BBCR PTIDN OF OPERATHMI LOCATN)Iii/VE ES VWWh AGORD 1101,AdiSft"IW0v" 0Wd; ,Rime oPSa to-ngV I "EC13003100 ost2t"Contmc 0T rERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES U CM=LLBD SWORE MIAMI SHORES VILLAGE THE EXPRATION DATE T11lREor,NOTICE WILL SE DELIVERED IN 10050 NE 2ND AVE ACCORDANCE WRN THE POLICY PROVISIONS. MIAMI SHORES.FL 33138 AUTI/OnaoplunwA rrAva 94EZ FERNANOCZ ACORD 28(201 W88)OF0 INS-2010 ACMWW;COiRFAkR&ft All rWite reserved. The ACORD nsr1M and bgo aro sterol maTlte of ACORD �� s �� \ �'