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PL-16-2271 (2)
Inspection Worksheet Miami Shores Village �j:_16 _21910050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-265291 Permit Number: PL-8-16-2271 Scheduled Inspection Date: August 18, 2016 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: FIX-HUFF,STUART AND COLLEEN Work Classification: Repair Job Address:1290 NE 103 Street Miami Shores, FL Phone Number (305)754-6476 Parcel Number 1132050250110 Project: <NONE> Contractor: BIONIC PLUMBING CORP. Phone: 305-498-9100 Building Department Comments GAS VENT FROM HEATER TO THE ROOF 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. August 17,2016 For Inspections please call: (305)762-4949 Page 17 of 33 Miami Shores Village �. 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 s ! r Phone: (305)795-2204 x ' � xi ¢. Rki Expiration: 013/2017 Project Address Parcel Number Applicant 1290 NE 103 Street 1132050250110 STUART AND COLLEEN FIX-HU '! Miami Shores, FL Block: Lot: Owner Information Address Phone Cell STUART AND COLLEEN FIX-HUFF 1290 NE 103 ST (305)754-6476 MIAMI SHORES FL 33138-2654 Contractor(s) Phone Cell Phone Valuation: $ 350.00 BIONIC PLUMBING CORP. 305-498-9100 Total Sq Feet: 0 Type of Work:GAS VENT FROM HEATER TO THE ROOF Available Inspections: Type of Piping: Inspection Type: Additional Info: Final Bond Return Review Plumbing Classification:Residential Scanning:1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.80 Invoice# PL-8-16-60962 DBPR Fee $2.00 08/17/2016 Credit Card $ 108.60 $0.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $108.60 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT certify t all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and z g uth re,I authorize the above-named contractor to do the work stated. August 17, 2016 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy August 17,2016 1 Miami Shores Village ' ' BuildingDe '; AUG Department ) �r , 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 _ Tel: (305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20N BUILDING Permit No. PERMIT APPLICATION Master Permit No. 4 14 a d/ Permit Type: PLUMBING JOB ADDRESS: " o A/, d�13 1'� City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: , Is the Building Historically Designated:Yes NO ood Zone:_ 7� OWNER:Name(Fee Simple Titleholder): Ile t-77 ' "� j SKr 1 Phone#: Address: /a�D D City: State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:CompanyName: 0 A f J17 �� Phone#: 90� yq Address: j city: 'en State: Zip: Qualifier Name: (, LCi Phone#:_ /1)C State Certification or Regis tion#: J`//��i 7f` � Certific a of Com ency#: Contact Phone#: Email Address: 6)2'-4'V 1AP171G LC DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ —9ff D Square/Linear Footage of Work: Type of Work: ❑Address DAlteration /� ONew ®Repair/Replace ❑Demolition Description of Work: Q(�S &17 % -Pre &7 h e l® -�h e r;cam x���xx�x�������a�����•xxxmxaxm�mm�mxx����Feesx�x�x���au����x����x�m���xxsxxmxxxx��x�����* Submittal Fee$ Permit Fee$ b®lo CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City tat 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 IlVIPROVEMENTS 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 ��( �-(a V Signature Owner or Agent Contractor The foregoing instrument was acknow dged before me this The foregoing instrument was acknowledged before me this t day of_ _� 20-,&,by day of ,2X ,by,� '12N3'-4- who is personally known to me or produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC• �rv�� p�ii//i Sign: 6ULOCK Sign. ublic-State of Florida Print: •r Print: a3.c aS+�•�3 My Comm.Expires Nov 8.2019 My Commission Expires: My Co o'ty �s: NotaryAssn, `` •••.. � through Natlanl APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) A�ROF CERTIFICATE OF LIABILITY INSURANCE °A s;, 1°'s"'I' 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 NCONTACT Scott Carde Maxim Insurance Group PHS 813-689-5105 aNoy 813-354-2336 - - 11252 Winthrop Main Street EMAL ADDRESS: mail@maximinsurancegroup.com Riverview,FL 33578 INSURE AFFORDING COVERAGE NAIC 0 INSURERA; Associated Industries Insurance Company 25372 INSURED Wst3RER s: _ Bionic Plumbing Corporation INSURER c: 8011 SW 99 Court INSURER 0: Miami,FL 33173 BNURER E; ENSURER 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. INSRFF POLICY EPOLICY EXP LTR TYPE OFWSURANCE POUCYNUMBER R WD LIMITS COMMERCIAL GENERAL LU%BILrrY EACH OCCURRENCE $ _ CLAIMS-MADE FIOCCUR AMAGE O _ � PREMISES Me ocaurence $ MED EXP(Any one person) $ I PERSONAL&ADV WJURY $ _ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JET F LOC PRODUCTS-COMPIOPAGG 1$ _ OTHER is AUTOMOBILELIABILITY COMBINED SINGLE LIMIT $ F aa;�demm __ ANY AUTO med I� SCHBODILY INJURY(Per per ) $ AULOOS I AUTOSU� 130DILY INJURY(Per aoddent) $ HIRED AUTOS t NON NNED PROPERTY DAMAGE $ AUTOS aa�ent UMBRELLA LEAK [d OCCUR EACH OCCURRENCE $ EXCESS L1AB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION PER OTH- AND EMPLOYERT LIABILITY STATUTE X ER JANYPROPPJE TOR/PARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $ 500,000 A OFFICEIWE.r EREXaUDEm �N N!A X AWC1046628 10/30/2015 10/30/2016 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500.000 Hdescribe ander _. DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attm*W if more space Is required) Plumbing contractor-both commercial and residential plumbing services. CERTIFICATE HOLDER CANCELLATION Miami Shores Village TFH�IIRRAATIIONHD DATE THE THEREOF, NOPOLICIES CE IE ILL B CELLED REDO IN 1150 NE 2nd Avenue ACCORDANCE WITH THE POLICY DROVISIONS. Miami Shores,FL 33138 AUTHOR&MD REPRES ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD CTQB Construction Trades Qualifying Board t BUSINESS CERTIFICATE OF COMPETENCY 000012646 BIONIC PLUMBING CORP ^- D.B.A.: R' 0BUL CK GARY W Is certified under the provisions of Chapter 10 of Miami-Dade County RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD RF11067135 N#I ; The PLUMBING CONTRACTOR Named below HAS REGISTERED 7, Under the provisions of Chapter 489 FS. _ �` Expiration date: AUG 31,2017 (INDIVIDUAL MUST MEETALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) ROBULOCK, GARY W 0 ❑■ BIONIC PLUMBING CORP 8011 SW 99TH CT _ MIAMI FL 33173 � 0 � . _ ISSUED: 0�lD1L2D1�i_ ___ - — ASPLAYAS REQUIRED BYLAW SEa# L1509010002119 005001 Local Business Tax Receipt Miami-Dade County, State of Florida -THIS IS NOTA BILL - DO NOT PAY LBT 1 6212286 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES BIONIC PLUMBING CORP RENEWAL SEPTEMBER 30, 2016 8011 5W 99 CT 6476899 Must be displayedat place of business MIAMI FL 33173 Pursuant to County Code Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS BIONIC PLUMBING CORP 196 PLUMBING CONTRACTOR PAYMENT RECEIVED CFC1427452 BY TAX COLLECTOR Worker(s) 2 $75.00 07/09/2015 CHECK21-15-085183 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 NO.above must be displayed on all commercial vehicles-Miami-Dade Code Sec Be-276. For more information,visit www.miamidads.naMoxaallactor 002392 Local Business Tax Receipt Miami-Dade County, State of Florida -THIS IS NOTA BILL - DO NOT PAY LBT 4107025 BUSINESS NAMEMOCATION RECEIPT NO. EXPIRES j _BIONIC PLUMBING CORP RENEWAL SEPTEMBER 30, 2016 8011 SW 99 CT 4289005 Must be displayed at place of business MIAMI FL 33173 Pursuant to County Code Chapter BA-Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED BIONIC PLUMBING CORP 196 PLUMBING CONTRACTOR BY TAX COLLECTOR Worker(s) 1 000012646 $75.00 07/09/2015 CHECK21-15-085103 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 qualilications,to do business.Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO.above must be displayed on all commercial vehicles-Miami-Dade Code Sec 8e-276. For more information,visit www.miamidade.gov/lexcollector DATE(MTamomrrY) A`C)R E® CERTIFICATE OF LIABILITY INSURANCE 08/10!2016 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 N 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 ScottCarde NAME: Maxim Insurance Group PHS 813-M-5105 No), 813-354-2336 11252 Winthrop Main Street ADDRESS: mallCmaximinsurancegroup.cam Riverview,FL 33578 INSU AFFORDING COVERAGE NAIL INSUPERA; Associated Industries Insurance Company 25372 INSURED INSURER B: Bionic Plumbing Corporation INSURERC: 8011 SW 99 Court INSURER D: Miami,FL 33173 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. INSR ADDL TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LTR LIMITS LT COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEUAWRG-970 RENTED $ CLAIMS-MADE 1-1 OCCUR I P MISES Me o=rrmnce $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PEP GENERAL AGGREGATE $ POLICY❑,ECT 1-1 LOC PRODUCTS-COMP/OPAGG $ _ OTHER $ AUTOMOBILE LIABILITY MMAST-- ELIMR $ ANY AUTO ^ BODILY INJURY(Per person) $ ALLOSWNED F ,SCHEDULED BODILY INJURY(Per acident) $ AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS eraccident) _.__. UMBRELLA UAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE X ER YIN A �'ANYPROPRIErORMARTNER/EXECUTIVE EL EACH ACCIDENT $ 500,000 OFRCEEMBEREXCLUDED?RrM ®N/A X AWC1046628 10/30/2015 10/3042016 500,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ _. B describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY IJW $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,AddOional Remarks Schedule,may be, H more space Is required) Plumbing contractor-both commercial and residential plumbing services. CERTIFICATE HOLDER CANCELLATION Miami Shores Village THHEEULD EXPI�RATIION D�ABOVE NOTICE POLICIES WILL CBE CDELIVERED IN 1150 NE 2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores,FL 33138 AUTHORIZED R EPRE.3 f O 1088-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ACO V SU NCE DATE(MMtDDIYYYY) CERTIFICATE OF LIABILITY IN SU THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS U N 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 polley(les)mum be endorsed, n SUBROGATION IS WANED,subject to ---i the terms and conn lieu o of the policy,certain policies may require an erMorsemerrL A statement on this certificat0 does not confer rights to the certificate holder in lieu of such endorsement(s). ' PRODUCER --- -- JOSE MERILLE iCONTACT -- ---- — NgME: _ - US-1 Insurance PHONE —----^- --- c No (305)670-1422 FAx 9808 S.Dude Hwy. �L --- -------- (AIC.Nor (30670-0013 ADDRESS uslirlsurance9BDa(�att.net _ Miami,FL 33156 -- Phone (305)670-1422 Fax 305 670-0013 _ INSURER(S)AFPORDINO COVERAGE _ NAIC 0 ( ) I GRANADA INSURANCE COMPANY INSURED INSURER A: - INSURER B Bionic Plumbing Corp INSURER C: X11 $W 90 Ct INSURER D: MIAMI,FL 33173- (305)299-9741 _INSURER E: -- - -- ---- —' INSURER COVERAGES CERTIFICATE NUMBER: _ _ __ REVISION NUMBER: 1 - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NA EED 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 IADDLISUBRi -- - --- - LTR TYPE OF INSURANCE yNSR_WVg___ NUMBER POLICY EFF POLICY -Q-------- (MMIDDMYYY) (MM/D GENERAL LIABILITY i i----�—�1YYYY�' LIMITS _ S 1,000,000.00—~ ® COMMERCIAL GENERAL LIABILITY -EACH OCCURRENCE DAMAGE PREMISES TO RENTED a occurrence S 100,0 .00 A ❑ CLAIMS-MADE a OCCUR 0185fl00063068 MED EXP An_ Y Y 09/23/2015 09/23/2016 (Any one person) s 5,000.00 I I ® Contractor Liability - I PERSONAL 8 ADV INJURY S 1,000,000.00� - GENERAL AGGREGATE $ 2,000 000.00 i GEN')AGGREGATE LIMB APPLIES PER POLICY PRODUCTS-COMP/OP AGG i 5 2,000,0W.00 { ❑ © JEROCT ❑ LOC -- AUTOMOBILE LIABILITY -- ---- ----- S COMBINED SINGLE LIMIT ------1 ❑ ANY AUTO Ea accident)__--- ALL OWNED SCHEDULED BODILY INJURY(Per person) S ❑ AUTOS ❑ AUTOS - -- ❑ HIRED AUTOS - NON BODILY INJURY(Per accident S ❑ AUTOS Op 4gMAGE ), S --- ❑ UMBRELLA LIAR ❑OCCUR - -- ------------- ---i ------- S EACH OCCURRENCE EXCESS)IAB S i ❑ _❑CLAIMSMADE 4__ I QED ® RETENTIONS IAGGREGATE S----}-----_----, WORKERS COMPENSATIONAND EMPLOYERS'LIABILITY YIN n WC STATU- OTH- - ANY PROPRIETORIPARTNER/EXECLMVE "TORY LIMITS ❑ IR OFFICERWEMBER EXCLUDED7 ---.;NIA i E.L.EACH ACCIDENT S (Mandatory InNMI be under tlescribE L DISEASE-EA EMPLOYE S IT � Iyes ---1 � DESCRIPTION OF OPERATIONS below - -f--� + - --------- __- EL DISEASE-POLICYLIMITj $ - , DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,d more space is rewired) GL--COMMERCIAURESIDENTIAL PLUMBING CONTRAC C --- - ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE�DE BECANCELL MIAMI SHORES VILLAGE BUILDING DEPT THE EXPIRATION DATE THEREOF,NOB CE WILL ED POLICIES BE DELIVERED I Eo BEFORE 10050 NE 2ND AVENUE ACCORDANCE WITH THE POLICY ovlSI S. MIAMI SHORES,FL 33138AUTHORIZED REPRESENTATEIV �I - - ACORD 25(2010/05)QF ©1888-2010 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD