EL-16-1928 e
Inspection Worksheet
Miami Shores Village �
10050 N.E. 2nd Avenue Miami Shores, FL 'J
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-263010 Permit Number: EL-7-16-1928
Inspection Date: October 11, 2016 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: KLEIN, NELSON Work Classification: Pool - Private
Job Address:9310 BISCAYNE Boulevard
Miami Shores, FL 33138- Phone Number (786)344-2378
Parcel Number 1132060141610
Project: <NONE>
Contractor: GLOBAL ELECTRIC SERVICES LLC Phone: (305)218-0752
Building Department Comments
POOL LIGHT AND GROUNDING OF POOL LADDER Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed Ef
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
For Inspections please call: (305)762-4949
October 11,2016 Page 1 of 1
I� Miami Shores Village OCT 0 � 2�;6
to
i
n^C� C n 1 Building Department $Y:
0 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 2014
BUILDING Master Permit No:j>�:P f,' I Ct 2—
PERMIT
PERMIT APPLICATION Sub Permit No. E I (o — 1 92 -
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION F-1 RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP
f CONTRACTOR DRAWINGS
JOB ADDRESS: 3I c (i
City: Miami Shores County: Miami Dade Zip: l
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): K L'E I N S Q-t-QA4 ddy V655— "6 N U Phone#: ? ,S6-3 zfL/.< 3 r 3
Address: 5,50 OF A) i7 Tt 2
City: State: t- Zip: J 12
Tenant/Lessee Name: Phone#:
Email: / /
CONTRACTOR:Company Name: k7 LO. a t 470' e- S.VLI((1(5 GLCPhone#:
Address:
City: State: LFL Zip: P j
Qualifier Name: Phone#:
State Certification or Registration#: /ao I!q S,�9 Certificate of Competency#: 000 Z �
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration EJ New E:1Repair/Replace F-1Demolition
Description of Work: C Dr C
Specify color of c for hru tile:
Submittal Fee$ Permit Fee$ p®'099 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—aznd co s r coon lien law-hroharp
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 ap ed and a reinspection fea-will be charged.
Signature Signature L°
OWNER or AGENT NTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of (_3'_ _ .20 by P3 day of fx_e o3 c 2 .20 l im by
who is personally known to who is personally known to
me or who has produced �v+22 as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: `10og IIIINi/ NOTARY PUBLIC:
Sign: aC: °• ,� .99 e
_ _ Sign:
Print: `�Jf ''�2 k! Print: My cOMMISSION#GG29585
Seal: o V°���'A-: EXPIRES:September 13,2020
��'•;a '�; r e Seal: M'n 4~
O�r�Illl11111N���'gp\' \a
APPROVED BY � ���G�/� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
a
♦51Nu�S G� Miami
shores Village
Knell� �o
m��� Building Department
fiR'Ipp► 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
�® I o� CHANGE OF CONTRACTOR / ARCHITECT
Permit N. `U l P 4�J2191
Owner's Name (Fee Simple Title Holder):KVI[N) 4AUft (I f)-1fgI` S LCA- Phone#: 365,9q Z 313
Owner's Address: /)
E: lW ei-o IE rz
City: f�/ � State : ( Zip Code--'3 3
Job Address (Of where work is being done): ,j l 4u 19G A Z �?
City: Miami Shores State: Florida Zip Code: 3 31 3
Contractor's Company Name: f'� '1/7 Phone#:
Address: q&1231
City: e ® State: Zip Code: 33 — /Z 3 °
Qualifier's Name: Lic. Number: C — /? Od3 2—
Architect/ Engineer of Record Name: Phone#:
Address:
City: State: Zip Code:
Describe Work:
1 hereby certify that the work has been abandoned and/or the contractor/architect
is unable or unwilling to complete the contract. I hold the Building Official and the
a
,_---,---Miami Shores harmless of all legal involvement.
Signature Signature
Owner r Agent ontractor or Architect
The for oing instrument was raknowledged before me The foregoing instrument was aknowledged before me
thisday of _,20��1,by this (� day of�,29(by
Who is persy kno n to me or who has produced who is p rso nown to me or who has produced
MA as indentification. 'Z" tification.
ti e° E GUEVARA
Not ubl lc: eyke_ E GUEVARA Nota l iG Yp�;= MY COMMISSION#FF 075127
MY COMMISSION#FD
?*d =*= EXPIRES:April 6,2o18
Sign: ,,� EXPIRES:April 6Sign: a• `;�,
Rf,...`
Bonded No P
Seal: Seal:
DRIVER LICENSE CLASS E
0;524-640-70-106-0
OSMANI
GONZALEZ VINA
15905 Sw 105TH CT
MIAMI. FL 33157-1571
1)05: 03-2F-1970 SEX: M
,ISSUED: 03-05-2012 HGT: 5-09
EXPIRES: 03-26-2020
t REST
ENDORSE:
REPLACED: 12-18-2ft_
SAFE DRIVER
ve!71cle constitutes consent In an%- sobriery tett inquired bN IaM /
TQB
Construction Trades Qualifying Board
BUSINESS CERTIFICATE OF COMPETENCY
12EO00422
GLOBAL ELECTRIC SERVICES LLC
D.B.A.:
GON LEZ OSMANI
Is certified under the provisions of Chapter 10 of Miami-Dade County
w
r
01"eu L)Y-Iua
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATIONe
I ELECTRICAL CO"RACTORS LICENSING BOARD j
EY12000297 -
The ALARM SYSTEM CONTRACTOR 1
Named below HAS REGISTERED - p+ "°' •` �o,isse ,:
E. Under the provisions of Chapter.489 FS.
Expiration date: AUG 31,2018 f�
">
(INDIVIDUAL MUST MEET ALL LOCAL;LICENSING
E _ REQUIREMENTS PRIOR TOG IN ANY AREA) 1
Y
C' - GONZALEZ,OSMANI ❑ ❑ ";;
' GLOBAL ELECTRICS LLC
t 15905 SW 105 CT .� �
MIAMI - Yr3i td
MIAMI
-.1_ e�rw�.�,•` .
ISSUED: 07r2=16 DISPLAY AS REQUIRED BYLAW SEQ A L160720000164
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
(l� STATE OF FLORIDA
( DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD 1
=a? 1
The ELECTRICAL CONTRACTORPo
Named below HAS REGISTERED - -- ."
`.. s
Under the provisions of Chapter 489 FS. = ,
r Expiration date: AUG 31,2018
s (INDIVIDUAL MUST MEETALL I: pSLICENSING i
REQUIREMENTS PRIOR.T EA)
G IN AN L•
.._ _�• Yom'• . .`�
` GONZALEZ;OSMAN!
GLOBAL ELECTRIC S, ILC
v
.:,,:
-15905 SW 105TH C
s `r���,° e �• 4`i
V. ,`.�°:''�
Al
It R
ISSUED: 0720/2016 DISPLAY AS REQUIRED BY LAW SEQ 0 L1607200001620
Scanned by CamScanner
Y
Local Business Tax Receipt
Miami-Dade County, State of Florida
THIS IS NOT A BILL-DO NOT PAY
7052889 1 . �LBT ---�
BUSINESS NAMEILOCATION RECEIPT NO.
EXPIRES
GLOBAL ELECTRIC SER CES LLC RENEWAL SEPTEMBER 30, 2017
15905 SW 105 Cr 7330376 Must be displayed at place of business
MIAMI FL 33157 Pursuant to County Code
Chapter 8A-Art.9&10
OWNER SEC.TYPE OF BUSINESS
GLOBAL ELECTRIC SERVICES LLC 196 ELECTRICAL CONTRACTOR PAYMENT RECEIVED
i 12E000422 SY TAX COLLECTOR
warker(s) 1 875.00 07/26/2016
CREDITCARD-16-043958
This Local Busiaoss Tax Receipt only confirms puym qt of the Local Business Tax.The Receipt Is not a license,
Permit or a cernm6ficatioa of the holder's qualifications,to do business.Holder trust comply with any gorarmmettW
or nongoverental regulatory laws aad requirements which apply to the business. i
The RECEIPT NO.above mast be displayed 010;;vnearercial vehicles-Miaml-pada Code Sac Ra-ZIB.
for more infnimatior.,
WO',
y(p
'41l� , 1� �
Miami Shores Village i "3e �(6 � � Itlill�Il °y:
10050 N.E.2nd Avenu !P7
e
ftrk>ulalss� ti� + rIV�
Miami Shores,FL 33138-0000
ee, k Pen»t5tatu AfiP13 � .
Phone: (305)795-2204
,+ , 1 Expiration: 01/21/2017
Project Address Parcel Number Applicant
9310 BISCAYNE Boulevard 1132060141610
KLEIN 8 SALOME INVESTMENT
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
KLEIN&SALOME INVESTMENTS LLC 9310 BISCAYNE Boulevard (786)344-2378
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 250.00
AE TECH CORPORATION (786)245-0733
__..._.. „r,._. Total Sq Feet: 50
Type of Work:POOL LIGHT AND GROUNDING OF POOL LA Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Final
Scanning:1
Light Niche
a •:� 9 �:.�� �;�� Bonding
�jj
Review Electrical
it
J00 Alarms
Al TIMES 3 r
rP %W f
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
Invoice# EL-7-16-60556
DBPR Fee $3.36
DCA Fee $3.36 07/25/2016 Credit Card $241.36 $0.00
Education Surcharge $0.20
Notary Fee $5.00
Permit Fee-Additions/Alterations $225.00
Scanning Fee $3.00
Technology Fee $0.60
Total: $241.36
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 J zoning. Futheunore,I authorize the above-named contractor to do the work stated.
July 25,2016
Auth ized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
July 25,2016 1
I t
Miami Shores Village JUL 201x '
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
FBC 20/
BUILDING Master Permit No.- " �7
PERMIT APPLICATION Sub Permit N®.0 t 16 `" / 0X-
❑BUILDING ® ELECTRIC ❑ ROOFING REVISION EXTENSION []RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: S I u 3 I S GA -fAJ <�) 1:)
City Miami Shores County' Miami Dade Zip: 3 3 1 3
folio/Parcel#: 11 - 3<O(- O 1" - I(x' 10 Is the Building Historically Designated:Yes NO -�
Occupancy Type: Ow1<161- Load: Construction Type:
c f,C
FlloodZone: BF�E:
FFE:
OWNER:Name(Fee Simple Titleholder): 3,lq
37��""►J �� Phone#:
Address: j
City: A, / ti rig 6(ff, State: Zip: 53167 �
—
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company A� 71e
Name: Corg0y'ay
llo✓, Phone#: �7XG) aS- 07.33
Address: t,�,J� `� X 5330,51
City: /(�a.-n* State: F' /= zip: 3315
Qualifier Name: Cir 10.S Gan C.&-do Phone#:
State Certification or Registration#: Cr 13003 112- Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ G(J Square/Linear Footage of Work: SO
Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition
Description of Work: f(/4,C 4AA0 4641t4f% &E PPy�-l/-t 0lXXg/L
Specify color of color thru tile:
z o y c �
Submittal Fee$ ," Permit Fee$ � dF$ Q-. (00 Co/CC$S
Scanning Fee$ c;3 Radon Fee$ 2�3-'G DBPR$ :39 Notary S
Technology Fee$ Training/Education Fee$ 6 , 2-0 Double Fee$
Structural Reviews$ Bond$ /,,
TOTAL FEE NOW DUE$ ` J`w
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address -
City _State Zia
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 the; no .pork 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 low brochure vvill 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
—4�
OWNER or AGENT VCONTRACTOR
The foregoing instrumet was acknowledged before me this The foregoing instrument was acknowledged beforemethis
_day of 2U , by day o' p 20�'" by
f 1
dexersonally known to a who is personalty kno vn to
me or who has produced as me or who has produced as
Identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
%. dy ;�
Si Sign:
n n 1 24,' -- --
nnt ,• �r �.� irP1iS21S
Seal: c�00uoo o ry uW ate of Florida
Seal: "�° h'.l1 Sla.'ltiEE2S6169
a�
Joanna i1A ioiano >�,' �OtP!RES:JULY 15,2016
c M commiss on FF 082753
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;1 —, Expires 01/1212018
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APPROVED BY '��J��Y/lo Pians Examiner Zoning
Structural Review Clerk
(F.e'es�dQ2/2x,12®l�l
AC� CERTIFICATE OF LIABILITY INSURANCE DATEIMMOO•'M)
�� 11013/2016
THIS CERTIFICATE IS ISSUED AS A (NATTER 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: H the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be ondorsed. 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 I leu of such endorsement(s).
PRODUCER co F! Ougth Grave de peralta
Fortun Insurance, Inc. PHONE (305)445-3535 01 Nal;_
>r,Ball: —__-
36S Palermo Ave. ADDRM:Judieh.gravedeperalta@fortuninsurance.com
INSURER(S)AFFORDING COVERAGE __ MAIC R
Coral Gables FL 33134-6607_— MURERARAPFRE Insurance Co.
INSURED INSURER BRetailFirst I_n_s_urca_n_c_e_company__ _
Global Electric Services LLC INSURERC:
15905 SW 105 CT INSURER O:
INSURER E:-
Mi ami
:Miami FL 33157 INSURER F
COVERAGES CERTIFICATE NUMBER:CL16 82 910084 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 NMICH 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.
T TYPE OF INSURANCE AWL SUOR7 POLICY NUMBER T VOLICY eiF -P C1'f p -- - LIMITS
$ COMMERCIAL GENERAL LIAWLIITY
EACH OCCURRENCE S 1.000,000
A CLAIMS-MADE X OCCUR
PREMISES(Ea accurrrnca'
[7AMAGE Tf�L'NTED
s 100,000
,- 42SO160024165 Bj94/2086 S/30/d017 IAED E XP(Any ore person) 5 51000
PERSONAL B ADV INJURY _5 11000,000
GFN"L AGGREGATE LIMIT A•PPUES PER GENERAL AGGREGATE S 2,000,000
X POLICY JPERa LCL PRODUCTS-C OVROP AGC S 2,000,000
OTFER Frr�BenrAm 5
AUTOMOBILE LIABILITY COM61NEO SINGLE LUM11(ED omaw�ll
3
ANY AUTO _ _ BODILY INJURY(Per person) $
ALLOWNED SCHEDULED BODILY INJURY(Per aiG4enll 3
---AUTOS AUTOS ---..--
HIREDAUTaSAUTOS RPROOPE�RTY�DAMAGE f s
PPeraccalcm) ----
`— UMBRELLA LIAB i OCCUR �AIGGREOAI`E
CH OCCURRENCE S
EXCESS LIAR
CLAIMS-MADE. -_---- ---- 5
DED � TR NT I g
WORKERS COMPENSATIONPEROTH-
ANDEMPLOVERS'LIABILITY YIN; UT
.__STATE__,__ ER
iANY PROPWETORIPARTNERIEXECUTrVE E L EACH ACCIDENT e
B TOFFtCERA4FUSER EXCLUOED7 _- .'�Nf A 1,000,000
(Mandatary in NN) 520-48297 7/1S/2016 7/15/2017 €.L DISEASE-EA EMPLOYEE 5 1,000,000
R ge�s.aftcnde --
LA! RIPTION O!!OPERATIONSbi-_m E.L.DISEASE-POLICY LIMN S 2,000,000
I
i
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLE$(ACORD 101,Addit o Rmnarks Schedutc mey be sMufted N moo space Is required)
LIC#12EO00422
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 AUTHORIZED REPRESENTATIVE
Hector FOrtan/IZ
®1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
INS025 r7nmml