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RC-14-697Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 211786 Permit Number: RC -4 -14 -697 Scheduled Inspection Date: May 07, 2014 Inspector: Rodriguez, Jorge Owner: MALAMED, ADAM Job Address: 9215 N BAYSHORE Drive Miami Shores, FL 33138- Project: <NONE> Contractor: EE&G CONSTRUCTION & ELECTRICAL LLC eumung Department comments MOLD REMEDIATION OF DAMAGE DRYWALL AND REPLACEMENT IN SECOND FLOOR MASTER BEDROOM CLOSET. Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Alteration Phone Number (917)685 -2273 Parcel Number 1132050270590 INSPECTOR COMMENTS True Inspector Comments Passed CREATED AS REINSPECTION FOR INSP - 211647. e Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Phone: (305)374 -8300 May 06, 2014 For Inspections please call: (305)762 -4949 Page 26 of 34 ' a �� &_ QG] Environmental Services, LLC April 4, 2014 EE &G Project No.: 2014 -2236 Adam Malamed 9215 North Bayshore Drive Miami Shores, Florida 33138 5751 Miami Lakes Drive Miami Lakes, Florida 33014 Tel (305) 374 -8300 Fax (305) 374 -9004 www.eeandg.com Subject: Post Remediation Verification (PRV) Water- Damaged/Mold Damaged Building Material Remediation 9215 North Bayshore Drive Miami Shores, Florida 33138 Dear Mr. Malamed, EE &G Environmental Services, LLC was retained by Tumber y International Realty (Client), to conduct a post remediation verification following the completion of removal of mold and water - impacted building materials at the above location. The purpose of the inspections were to confirm that post - remediation criteria as presented in the "Water - Damaged /Mold Damaged Building Material Remediation Proposal", dated March 10, 2014, (hereafter referred to as the Scope of Work) were met. EE &G conducted the post remediation verification on March 24, 2012. Remediation activities were performed by EE &G Construction and Electrical Services, LLC. Visual verifications were performed by EE &G to verify that water - damaged or assumed mold growth (AMG) impacted building materials identified in the Scope of Work had been removed from the work area. The containment area is referred to in this report as follows: Second floor closet. Following completion of the visual inspections, EE &G collected bioaersol samples for airborne fungal spores inside the containment as well as inside the house. LIMITATIONS This report has been prepared by EE &G in a manner consistent with that level of care and skill ordinarily exercised by members of the profession currently practicing under similar conditions. No other warranty, expressed or implied, is made. EE &G's interpretations and recommendations are based upon the results of sample analyses, as well as investigative work. Other conditions elsewhere in the subject building may differ from those in the inspected /surveyed locations and such conditions are unknown, may change over time and have not been considered. Since the dynamics of water intrusion and mold - growth on building materials often involves damage to hidden areas (such as wall cavities and chases), it is possible that this assessment did not result in the identification of damage to areas not readily accessible. The Client is urged to proceed with recommendations presented herein with due caution. Changes or modifications to the site made after the site inspection are not covered. The parameters tested are limited by the sampling methodologies employed for this investigation. These limitations include, but are Miami Melbourne Orlando Tampa Houston, TX Mr. Adam Malamed April 4, 2014 Page 2 not restricted to, the sample locations chosen, number of samples collected, and the statistical validity of sampling and analytical methods. EE &G will not be responsible for the interpretation or use by others of data developed pursuant to the compilation of this report. This report reflects conditions, operations, and practices as observed on the date and time of the site inspection only. The interpretations and recommendations, stated in this report, are based on previous environmental studies and research conclusions. EE &G does not warrant the use of any segregated portions of this report. A qualified occupational physician should interpret the information in this report before any clinical conclusions are drawn. A screening of suspected areas of mold was performed to support the findings and conclusions of the visual inspection. Due to the limitations of science involved with biological samples, the data obtained cannot be used to establish a health-based risk assessment or otherwise be used to establish if an area is "safe for occupancy". Other conditions elsewhere in the subject property may differ from those in the remediated and inspected locations and such conditions are unknown, may change over time and have not been considered. EE &G will not be responsible for the interpretation or use by others of data developed pursuant to the compilation of this report. EE &G does not warrant the use of any segregated portions of this report. The primary method of establishing compliance with current industry standards is to document that engineering controls are used, that visibly damaged materials are removed and that the work area is left in a "dust free" and clean condition. METHODS Visual Assessment The purpose of the visual assessments was to verify primary and secondary methods used to determine that remediation work was complete were achieved accordingly: • The work was effective in removing damaged materials from the work area and that the contractor left the area visually dust free. • The work was performed under containment and used engineering controls to reduce the generation or migration of dust beyond the work area. Moisture content of the remaining building materials was measured using a Protimeter SurveyMaster. This instrument reports results in percent ( %) Wood - Moisture - Equivalent (WME). Percent WME is the moisture level of a building material other than wood expressed as moisture content of wood. A reading above 20% WME in a building material was considered a high reading for the purpose of this report. High readings indicate an excessive amount of moisture in the tested building material and should be investigated further. Mr. Adam Malamed April 4, 2014 Page 3 The percent WME was categorized into the following classifications: Less than 18% WME - The material was in a safe, dry condition. Moisture - related problems of decay and deterioration were not likely to occur. From 18% to 20% WME - The material was in a borderline condition. Moisture — related problems of decay and deterioration were possible under certain conditions. Greater than 20% WME - The material was in a wet condition. Moisture - related problems of decay and deterioration were likely to occur in time unless the moisture level of the material was reduced. Bloaerosol Sampling- Samples were collected as a means to verify the primary and secondary standards described above. Samples were collected when no visual evidence of water - damaged or AMG- impacted building materials was observed in the work areas and after the visual inspection verified that the contractor cleaned to a visually dust free state. Samples were collected from inside the containment and inside the house as well as the outdoor ambient environment, for comparison purposes. On March 24, 2014 a total of 8 samples were collected from the following areas: • Second floor closet — two samples. • First floor house interior — two samples. • Second floor house interior — two samples. • Outdoor ambient — two samples, for control purposes. Air samples were collected using Air- O- CellTM sampling cassettes, manufactured by Zefon International. Air was drawn through the cassettes at a rate of approximately 15 liters per minute (Umin) for 10 minutes. The air sampling pump was field calibrated prior and post sampling using a calibrated rotometer. The rotometer was verified for accuracy quarterly against a verified against a NIST (National Institute of Standards and Technology) DryCal® primary standard manufactured by the Bios Corporation. Airborne particulates, including mold spores, were captured on the cassette and then hand delivered to EMSL Analytical, Inc. in Orlando, Florida for analysis by light microscopy. Results were reported as counts of fungal structures per cubic meter of air (counts /m). The main criteria for evaluating fungal spore data are to compare indoor /outdoor relationships. In non - problem environments, the concentration of fungi in the indoor air is typically similar or lower than the concentration seen outdoors (i.e. < 100% of outdoor concentrations). If indoor fungal concentrations are consistently higher than those outdoors, then indoor sources may be present. In addition, the types (genus and species) of fungi found inside the building should be qualitatively similar compared with the outdoor air, if the outdoor air is the only source of fungi. . Mr. Adam Malamed April 4, 2014 Page 4 FINDINGS Visual Assessments The visual assessment conducted on March 24, 2014 found no visual evidence of water - damaged or AMG impacted building materials within the containment area and house. Furthermore, the containment area and house appeared generally free of dust and debris. The moisture content of remaining representative building materials located within the containment area ranged from 6.2% to 11.8% WME. Bioaerosol Sampling TABLE 1: Sampling Results. The following tables summarize the laboratory report for samples taken on 3/24/2014. Results are given in counts /m3: Fungal Spore Type Ambient 1 Ambient 2 1s' FL East 161 FL West 2nd FL East Ascospores 2000 2260 320 40 80 Altemada - - - - - Aspergillus/Penicillium 20 80 - 80 60 Basidiospores 870 610 20 20 - Bipolads - - - - - Chaetomium - - - - - Cladosporium 100 100 - 40 - Curvulada - - - - - Epicoc cum 20 - - - - Ganoderma 60 20 20 - - Myxomycetes 20 - 20 - - Nigrospora 20 - - - - Pithomyces - - - - - Rust 7 - - - - Stachybotrys - - - - - Cercospora 20 - - - - Pestalotiopsis - - - - - Pydculada 40 - 20 - - Cercospora - - - - - Totals 3177 3070 400 180 140 A copy of the laboratory report is attached. . Mr. Adam Malamed April 4, 2014 Page 5 Fungal Spore Type 2 "d Fl- West Containment North Containment South Ascospores 80 - 20 Aitemana - - - Aspergillus/Penicillium - 40 100 Basidiospores - - - Bipolaris - - - Chaetomium - - - Cladospodum - - - Curvularia - - - Epicoc cum - - - Ganoderma - - - Myxomycetes - - - Nigrospora - - - Pithomyces - - 20 Rust - - - Stachybotrys - - - Cercospora - - - Pestalotiopsis - - - Pyncularia - - - Cercospora - - - Totals 80 40 140 A copy of the laboratory report is attached. CONCLUSIONS AND RECOMMENDATIONS The post - remediation visual inspection of the containment conducted on March 24, 2014 did not identify water - damaged or AMG impacted building materials within the containment area and house at the time of the inspections. Furthermore, the containment area and house appeared to be generally dust free, suggesting that the work was done in accordance with current industry standards, and included the use of engineering controls and specialized work practices to reduce the generation and migration of dust beyond the subject area. Moisture meter testing did not detect elevated moisture in the remaining building materials within the subject area. This suggests that the contractor was successful in removing water - damaged or AMG impacted building materials within the subject area. The results of the bioaerosol samples collected inside the subject area on March 24, 2014 showed total concentrations of fungal spores in the containment samples were lower than total outdoor concentrations, with rank order of mold types being statistically similar to the outside samples. The test data supported the other findings and suggested that the work was completed appropriately. it is the opinion of EE&G that these results did not suggest atypical fungal ecology within the containment area and house. The results of the bioaerosol testing supported the findings of the Mr. Adam Malamed April 4, 2014 Page 6 visual inspections, suggesting that the work was completed successfully and in accordance with current industry standards. We appreciate the opportunity to assist you with this matter, please feel free to contact us with questions. Respectfully Submitted, /441� Kevin Koester Staff Professional EE &G Jay Sall, CIH IH Practice Director EE &G Attachments: - EMSL Laboratory Report 3/23/2014 EMSL Analytical, Inc. 19501 NE 10th Ave. Bay A N. Miami Beach, FL 33179 Phone/Fax: (305) 650 -0577 / (305) 650 -0578 htto: //www.EMSL.com / miamilabDemsl.com Attn: Mark Skweres Phone: EE & G Fax: 5751 Miami Lakes Drive East Collected: Miami Lakes, FL 33014 Received: Analyzed: Pro): 2014 - 2264 Order ID: 171401521 Customer ID: EEG50 Customer PO: 20142264 Project ID: (305) 374 -8300 (NO) FAX -AXES 03/24/2014 03/24/2014 03/24/2014 Test Report: Air- O- Cell(TM) Analysis of Fungal Spores & Particulates by Optical Microscopy (Methods EMSL 05413.003, ASTM D7391) Lab Sample Number. 171401521 -0001 171401521 -0002 171401521 -0003 171401521 -0004 171401521 -0005 Client Sample 10: 20175407 20175487 20175508 20175538 20175378 Volume (L): 150 150 150 150 150 Sample Location: Ambient 1 Ambient 2 1st Floor East 1st Floor West 2nd Floor East Spore Types Count/m3 Count/m3 Count/m3 Count /m3 Count/m3 Altemaria - - - - - Ascospores 2000 2260 320 40 80 Aspergillus /Penidliium 20 80 - 80 60 Basidlospores 870 610 20. 20 Bipolaris ++ - - - - - Chaetomium - - - - - Cladosporium 100 100 - 40 - Curvularia - - Eplcoccum 20 - - - - Fusarium - - Ganoderma 60 20 20 - - Myxomycetes + +_ 20 - 20 - Pithomyces - - - - Rust. 7 *. - - - Scopulariopsis - - - - - Stachybotrys - - - - Torula - - - - ulocladium Unidentifiable Spores - - - - - Cercospora 20 - - Nigrospora 20 - - - - Pyricularia 40 20 Total Fungi 3177 3070 400 180 140 Hyphal Fragment .20 80 - - - Insect Fragment 60 40 - - Pollen 20 2 2 Analyt. Sensitivity 600x 21 21 21 21 21 Analyt. Sensitivity 300x 7 *- .7* 7* 7* 7* Skin Fragments (1-4) - - 1 1 1 Fibrous Particulate (1-4) 1 i 1 Background (1 -5) 1 1 1 1 1 Myxomycetes++ = Myxomycetes/Periconia/Smut Bipolaris++ = Bipo laris/Drechslera/Exserohilum No disccrnable field blank was submitted with Oft group of samples. Ariel Escoto, Laboratory Manager or Other Approved Signatory High levels of background partladets can obscure spores and other particulates leadhng to underestimatlon. Background levels of 5 indicate an ovedoadIM of background particulates, prohbbng accurate detection and quanti8cabon. Present - Spores detected on overloaded samples. Results are not blank corrected unless othervdse noted. The detection lhrdt Is equal to one fungal spore, sbuctwe, peen, fiber per fide or Insect *aWr=L --- Denotes particles fazed at 300X Denotes not defected. Due to method stopping odes. raw courts In excess of 100 are exbepdated based on the percentage analyzed. EMSL maintains Oabft WW to con of analysis. This report relates only to the samples reported above and may not be reproduced, except in fu0, wr8 rout writer approve! by EMSL EMSL bears no responeibtOty for sample collection adivilles or analytical method limffebons. Interpretadon and use of test results are the responsibility of the diem. Samples received In good condition unless otherwise noted Samples analyzed by EMSL Anelytw Inc. N. Miami Beach, FL ANA -LAP, LLC —EMLAP Lab 102813 report from: 03/24/201414:20:20 For Information on the fungi listed in this report please visit the Resources section at www.emsi.com Test Report SPVER2- 7.30.4 Printed: 3/24/2014 02:20:20PM Page 1 of 2 EMSL Analytical, Inc. 19501 NE 10th Ave. Bay A N. Miami Beach, FL 33179 Phone /Fax: (305) 650 -0577 / (305) 650 -0578 http: /twww.EMSL.com / miamilabDemsl.com Attn: Mark Skweres Phone: EE & G Fax: 5751 Miami Lakes Drive East Collected: Miami Lakes, FL 33014 Received: Analyzed: Proj: 2014 - 2264 Order ID: 171401521 Customer ID: EEG50 Customer PO: 20142264 Project ID: (305) 374 -8300 (NO) FAX -AXES 03/24/2014 03/24/2014 03/24/2014 Test Report: Alr-O- Cell(T") Analysis of Fungal Spores $ Particulates by Optical Microscopy (Methods EMSL 05- TP -003, ASTM 07391) Lab Sample Number. 171401521 -0006 171401521 -0007 171401521 -0008 Client Sample ID: 20175354 20175374 20175369 Volume (L): 150 150 150 Sample Location: 2nd Floor West Containment North Containment South Spore Types Count/m3 Count/m3 Count/m3 Alternaria - - Ascospores 80 20 Aspergillus /Penicillium - 40 100 Basidiospores - Bipolaris ++ - - Chaetomium - - Cladosporium - - Curvularia - Epicoccum - - Fusarium - - - j Ganoderma - - - Myxomycetes ++ - - Ptthomyces - - 20 Rust Scopulariopsis - - Stachybotrys Torula - - Ulocladium Unidentifiable Spores - - Cercospora - Nigrospora - - - Pyricularia. - - Total Fungi 80 40 140 HYphal Fragment - - Insect Fragment - - - Pollen - 20 Analyt. Sensitivity 600x 21 21 21 Analyt. Sensitivity 300.x 7* 7* 7* Skin Fragments (1-4) 1 1 1 Fibrous Particulate_(1 -4) 1 1 1 Background (1 -5) 1 1 1 7. Myxomycetes++ = MyxomycetesMericonia/Smut Bipolaris++ = Bipolaris /Drechslefa/Exaerol>;lum No discernable flew blank was submitted with this group of samples. Adel Escoto, Laboratory Manager or Other Approved Signatory High levels of background particulate can obscure spores and other pailcuietes leading to underestimation. Background levels of 5 indicate an overloading of background pa Astes, prohibiting accurate detection and quantification. Present - spores detected on overloaded aamplea. Results are not blank corrected urdess otherwdse noted. The detection limn is equal to one fungal spore, structure, pollen, fiber particle or Insect frogmerd. — Denotes particles found at 300x. " Denotes not detected. Due to method stopping rules, raw counts In excess of 100 are mdrapolated based on the percentage arnlyzed. EMSL maintains ikdti0ty limned to coat of analysis. This repot relates only to the samples reported above and may not be reproduced, except In full, without written approval by EMSL EMSL beam no responalbi6ty for sample collection activities or analytical metlrod limitations. Interpretation and use of test results are the responsibility of the client. Samples received in good condition unless otherwise noted. Samples am47ad by EMSL Analytical, Inc. N. Miami Beach, FL AIHA -LAP, LLFEMLAP Lab 102813 report from: 03/24/201414:20:20 For Information on the fungi listed in this report please visit the Resources section at www.emsi.com Test Report SPVER2- 7.30.4 Printed: 3/24/2014 02:20:20PM Page 2 of 2 OrrlerIDa 171°401521 BMBL ANALYTIQAL, WC. �,Tmn.�rooumL.narma Microbiology Chain of Custody EMSL Order Number (Lab use only): 1 +1 LOA 6 a I Corn n : EE & G Street: 5751 Miami Lakes Drive East EMSL -Bill to: ❑ Same ❑ Different � If Bill to Is Different please note In Comments" Third Party Ming requires written authorization from third party Ci :.Miami Lakes _ State/Province: FL Zip/Postal Code: 33014 Country. A Report To (Nam q): Mark Skweres Fax #: Tote hone#:. 300- 3748300 E -mail Address: msh!TT2@ftartdg.com Pr t Name/ Number: _ Please Plde Results: [ ] Fax 0 E -mail rov PO# State Sam es Taken: Turnaround Time TAT Options* - Please Check 3 Hour I 2tS Hour I U lei Hour 48 Hour I Lj 72 Hour 96 Hour I Q 1 Week x Week 'Ana! Ls complatedIn a=rdance with EMSL's Terms and Cordftioris located in the Ana"Cal Price Guide. TATs are subject to methodoRW requirements Non Culturable Air Samples S ore Traps) . 1111001 Air -O -Cell • M049 ftSIS • M030. Micro 5 • M173 Allegro M2 • M003 Burkard • M174.MoldSnap M004 Allergenco M0.43 Cyclex M176 Relie Smart • M032 Allergenco -D • M002 Cydex -d • M130 Via -Cell • M172 Versa Trap Other Microbiology Test Codes a M041 Fungal Direct Examination • 1005 Viable Fungi ID and Count + M606.Viable Fungi ID and Count (Speciation) • M007 Culturable Fungi • 111100.8 Culturable Fungi (Speciabon) • M009 Gram Stain Culturable Bacteria M010 Bacterial Count and ID - 3 Most Prominent • Mill I Bacterial Count and ID - 5 Most Prominent • 04013 a Contamination in Buildin s 0 M014 Endotoxin Analysis 0 M015 Heterotrophic Plate Count • M180 Real Time Q- PCR -ERMI 36 . Panel • M018 Total Coliform (Membrane Filtration) 0 M020 Fecal Streptococcus (Membrane Filtration) 0 M210 -215 Legione0a Detection M026 Recreational Water Screen • M027 M cotoxin Analysis 0 M029 Enterococci 0 M019 Fecal Colifotm M133 MRSA Analysis M028 Cryptococcus neoformans Detection M120 Nlstoplasme capsulaturn Detection M033-39 Allergen Testing • MO" Group Allergen (Cat, Dog, Cockroach, Dustmites) • Other See Analytical Price Guide Preservation Method (Water): Name of Sara er. G��Sy ' St nature of Sam lei. Sample # Sample Location e Type Teat Code - Volume/Area Daterrime Collected 'fl _ or Pd 7 3 W C_o ra in cq - "Jzk3gE Client Sample # (a): L - Relinquished (Client) %� �/v� Reeeived (Client): Total # of Sam les: Date: Time: t Date: Time: Comments: Page 1 of pages Page 1 Of 1 P 4,0 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fag: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: BUILDING Permit No. i APR o 7 Pou BY:_32--�,, FBC 20 L 0 Master Permit No. 9-, C, I'A — " ROOFING JOB ADDRESS: 9215 N. Bayshire Drive City: Miami Shores County: Miami Dade zip; 33138 Folio/Parcel #: 11 -3205- 027 -0590 Is the Building Historically Designated: Yes NO XXX Flood Zone: OWNER: Name (Fee Simple Titleholder): Aaam MCL la mcd Phone#: a 11 ' Address: qluS N . tau v S hoir2 vQ _ City: N1 �C�l1rY1. S 1r-1r.Nv-e_S State: Tenant/Lessee Name: Phone#: 'q I 1 • tot-S' VL77 Email: ca_smulum ed ® u -�p. cnV CONTRACTOR: Company Name: EE &G Construction & Electrical. LLC Phone#: 305- 374 -8300 Address: 5751 Miami Lakes Drive City Miami Lakes State. Florida Zip: 33014 Qualifier Name: Adrian Bruce Woods phone#: 407- 876 -0729 State Certification or Registration #: CGC 1515204 Certificate of Competency #: Contact phone#: 305 -505 -8966 Email Address: wemmett @eeandg.com DESIGNER: Architect/Engineer. Phone#: Value of Work for this Permit: $5,270.00 Square/Linear Footage of Work: 50 SF Type of Work: OAddition DAlteration UNew URepair/Replace ODemolition Description of Work: Mold Remediabon of damaged drywall and replacement - Second Floor Master Bedroom Closet Color thru tile: Submittal Fee $5l �� Permit Fee $. Scanning Fee $ Radon Fee $ _ Notary $ Training/Education Fee $ Double Fee $ Structural. Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ .S Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State zip 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. 14WARNING 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 i object to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first i e from which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will t e approved and a reinspection fee will be charged. Signature Signature \I . JJJJJ1 Owner or Agent Contractor The foregoing instrument was ackqowledged before me this The foregoing instrument was acknowledged before me this da of 2i� 20 1� b oatK wA"mrio da of i��� y Y Y , 20 t.4. by A4G ^ rLra (ze.,.r.I s , who is personally known to me or who has produced who is personally known to me or who has produced. As identification and who did take an oath. NOTARY PUBLIC: M Expires: 1112--7 APPROVED BY as identification and who did take an oath. NOT Q Sign: JB81CA OELARE?A WWWWWWWW Nosy Pty _ g� of p ommission Expires: A. VEDA AAp Comm. Ezpkes ftor 27, 201 S L WSS1oN s "064126 Commission #F EE 148431 ES: ocxobQ n, 201 Plans Examiner Zoning Structural Review Clerk (Revised 3 /1212012)(Revised 07 /10 /07)(Revised 06110/2009)(Revised 3/15/09) , Walker Emmett From: Walker Emmett Sent: Thursday, March 27, 201411:27 AM To: 'NaranjoI @miamishoresvillage.com' Subject: 9215 N. Bayshore Drive Attachments: Malamed -FMI -Mold Report.pdf Attached, please find the Pre - Purchase Initial Visual Mold Inspection report you requested. I am preparing permit application for drywall repairs and removal and re- installation of existing AHU unit. The owner will be back in town Monday, therefore the permit applications should be submitted on Tuesday. Walker W. Emmett, II, Construction Project Manager EE 5751 Miami Lakes Drive East Miami Lakes, Florida 33014 Office 305 - 374 -8300 Fax 305 - 374 -9004 Cell 305 - 505 -8966 WO cl o .ra-r- � � • 'PusW0,41 z_8, 7-a 14 . 00 qaFWIT . toe ..... DATE • • • • AP46 Eb • • • • • • • Z"41W DEF►I ` • • 10 BOA 6EPf SUBJECT TO c CPLONCE NTH ML FEDE� •; • �;E A*1 fUl N TY ,IUL M AND REf3ULAT10Ns • • • •• fl• • • • •• •• ••• • • • ••• • • t r R s uz= " Mtn Y< Florida Mold Inspections, Inc. Mold & Allergen Investigations & Testing Pre- Purchase Initial Visual Mold Screening 9215 N. Rayshore Drive Miami Shores, Florida 33138 File Number: 14-9215-M Pre- purchase initial mold screening was performed at the above mentioned property location on February 28, 2014. Cabinetry: • Visible mold growth observed on interior and exterior of all kitchen cabinetry and all bathroom vanity cabinetry within residence. Air Conditioning System .Air Handier Closet (Located on Second Floor): • Water damage and subsequent mold growth observed on ceiling above air handler. • Water damage and subsequent mold Vowth observed on walls behind and to the side of air handler. • • • • • • • • • • ••• • • Water damaged wood flooring obserxiod aroind.&rl andle$ pjatVorm. • ••• -1- as • • • ••• • •• • • ••• • • • • • • • • • • • • • • • F.O. Box 970640 •:Co4ohut Ci-0, Tj&da 33tj97* -q(%0 Phone: 954 -752 -3335• Fax: 954 -575 -0381 www.mold.us.com • •• •• • • • •• •• ••• • • • ••• • • File Number: 14- 9215 -M Air Conditioning System Air Handler Servicing Second Floor (Located in Second Floor Closet): • Water damage and subsequent mold growth observed on all walls within return plenum. • Visible mold growth observed on interior of unit. • Visible mold growth observed on coil and coil frame. • Visible mold growth observed on exterior of supply plenum. • Visible mold growth observed on interior of unit. • Visible mold growth observed on coil and coil frame. Air Conditioning System Registers: • Visible mold growth observed on a/c supply registers - scattered within residence. Master Bedroom: • Peeling paint finish observed on bathroom ceiling. No visible mold observed. • Attic accessed located in closet. Access panel is not sealed which can allow hot, humid air to enter into residence. • An Infrared camera and moisture meter were utilized scattered within the residence. No anomalies or elevated levels of moisture were detected. ® A thermometer and hydrometer were utilized within the residence. Slightly elevated levels of humidity were detected. • Note: Before the start of our firm's inspection, the thermostats in the residence were set to the "on "position. This appears to be a direct correlation with the elevated levels of humidity as well as the mold growth in the cabinetry tlu'U4g1(tu4t1!b r4sidln�e. ?etting the thermostats to the "auto" position is recommended. • • • • • • • • • .. ... .. . .... ... •• ... . .. .. .... . . .... .. P.O. Box 970640 +'Coconut .. Crack l�torida 33097 -ti6. 40 Phone: 954- 752 -3335• Fax: 954-575-0381 �yyw.�nold�s,�a� � � • � � • • • • • • • • • • • •• •• • • • •• •• File Number: 14- 9215 -M • A tape slide sample was procured from the drywall on the side of the second floor air handler. The attached analysis reveals high levels of Aspergillus/Penicillium mold spores and hyphae indicating bio- growth has taken place within the substrates. • Air -O -Cell spore trap air samples were procured from the first floor air conditioning system zone, the second floor air conditioning system zone as well as the outdoor environment for comparative purposes. The attached analyses reveals amplified levels of Aspergillus/Penicilli.um mold spores in the indoor air samples. • The attached analyses revealed the presence of amplified Ievels of mold spores which may produce mycotoxins which could have an effect on one's health. Cabinetry: • Clean the interior and exterior of all cabinetry within residence; i.e.; kitchen, master bathroom, all guest bathrooms, etc. with an appropriate detergent solution. Air Conditioning System Air Handler Closet (Located on Second Floor): • Remove ceiling drywall minimum two feet beyond any water damage or visible mold growth. • Remove drywall from wall behind and wall next to air handler from floor to ceiling. Once removed, the back -sides of exposed drywall must be inspected, evaluated and remediated accordingly. • Remove drywall from. all air handler platform walls. • Remove wood flooring from closet. Once removed, the back -side of the wood flooring and the exposed concrete slab must be inspected, evaluated and remediated accordingly. Air Conditioning System Air Handler Servicing Second Floor (Located in Second .• ••• • • . • . •• Floor Closet): • • • • • • • •• • • • • ••• • • Remove drywall from all walls within l;�l�i. • ; ; 0.e .. . .......... . .. . . . . • • • P.O. Box 970640 •�ocbnut Crdbk, Fbrida 33097 -0640 Phone: 954 - 752-3335 • Fax: 954 - 575 -0381 wu.v1old.ys.CoTq ... . • . .. .. . . . . • .. ... . . . •.. . . S, File Number: 14- 9215 -M Air Conditioning Systems: ® The air conditioning systems must be cleaned in their entirety including all registers, the air handlers, evaporator coils and all associated ductwork in accordance with ACR. 2006 Assessment, Cleaning and Restoration of HVAC systems as published by the National Air Duct Cleaners Association. • Install weather - stripping around attic access panel. AMAM- • Air wash the entire residence. • Remove and discard all exposed insulation. • Clean all exposed voids and framing members with an appropriate detergent solution_ • Clean all exposed concrete slab(s) with an appropriate detergent solution. • The above procedures must be performed by certified mold remediation firms licensed by the State of Florida which are trained and qualified to do so since certain containment protocols along with the use of air scrubbers and negative air machines must be incorporated into the remediation. • • • • • • • • • • • • • • •• • • • • • • • P.O. Box 970640 4 Coconut Creek, Morida 33097 -Q640 Phone: 954 - 752 -3335 ® Fax: 954 - 575 -0387 w"+.moldAjs,covi ... . . . . . . . . . . . • .. .. . . . • • .. ... . . . ... . . File Number: 1.4- 9215 -M It is the responsibility of the remediation contractor to further review, evaluate and perform all necessary remediation to eliminate the mold conditions revealed and to determine additional areas which may need to be remediatod in addition to Florida Mold Inspections, Inc.'s recommendations and /or beyond the scope of our firm's recommendations during the remediation process as hidden damage may exist and /or be uncovered. w Neither this report nor any Florida Mold Inspections, Inc. rating is intended to provide medical. advice, nor shall. it be interpreted as an indicator of potential medical or safety problems. Mold spores may produce myeotoxins which could have an effect on one's health. If there are health concerns or questions relating to one's health, a physician should be contacted for advice. Please be advised that all visual observations, testing and recommendations made herein are set forth in accordance with the New York City Department of Health guidelines regarding mold assessment and remediation. It is important to understand that changes in occupancy, remodeling, maintenance procedures and many other factors can have a significant effect on indoor air quality. All wall coverings are conducive for bio- growth as coverings formm a moisture barrier which is not visible until exposed. Maintaining acceptable indoor air quality is an on -going effort and must be continually monitored to be effective. The results of these tests and observations represent conditions only at the time of testing or observation occurred. Thus, this report should not be relied on to represent conditions at other locations, times or dates. .. ..... . .. .. . ......... . .. ... .. . .... ••• .. ... . .. .. .. . .. .... ..... P.O. Box 970640;CoWnut Crtek, Mo rida 33 ®97 0640 Phone: 954- 752 -3335 a Fax: 9544 -575 -0381 r4,4w.mo1d us coin • • • • • ••• • • • 000 • • d i Rm ' i i i §' a File Number: 14- 9215 -M Our opinions are based on the findings and upon our professional expertise with no warranty or guarantee implied herein. This report is intended for the sole use of yourself and your assigned agents. Florida Mold Inspections, Inc. accepts no responsibility for interpretation of this report by others. The contents of this report shall not be used or relied upon by other parties without prior written authorization of Florida Mold Inspections, Inc. Peter Romano State of Florida Certified Mold Assessor # MRSA 26 Accredited Indoor Environmental Hygienist (AIEH) Certified Mold Consultant (CMC) Certified Indoor Environmental Consultant (CIEC) Enclosures PR: scr ....... . .. .. . ......... . .. ... .. . .... .. . .......... . .. .... ... P.O. Box 970640 ko;onut Crtek, Plorida 33097 -0640 Phone: 954 -752 -3335 - Fax: 954575 -0381 "gwinold.us.pop • • • • • • • • •• • • • • • • • •• • • • • •• •• ••• • • • ••• • • r EMSL Analytical, Inc. 2700 West Cypress Creek Road, Suite B -111 Fort Lauderdale, FL 333 i . Phone /Fax: (954) 786-93311 (954) 941 -4145 - htto: / /www.EMSL.com / pompanobeachlabPemsl com Attn: Peter Romano Phone: Florida Maid Inspections, Inc. Fax: P.O. Box 970640 Collected: Coconut Creek, FL 33097 Received: Analyzed: Proj: 9215 N. Bayshore Drive, Miami Shores, Florida 33138 Order ID: 561400606 Customer ID: FLOR78A Customer PO: Project ID: (954) 752 -3335 (954) 575 -0381 02128/2014 02/28/2014 03103/2014 Test Report: Microscopic Examination of Fungal Spores, Fungal Structures, Hyphae, and Other Particulates from Swab Samples (EMSL Method: M041) Lab Sample Number: 561400606.0004 Client Sample ID: 8967033 Sample Location: 4- Drywall Spore Types Category Agrocy op nus - Aitemarle - Ascospores - Aspergillus /Penicillium 'High` Basidiospores Bipolaris ++ Chaetomium - Ciadosporium - Curvularia - Epicoccum - Fusarium - Ganoderma - Myxomycetes ++ - Paetslomyces - Rust - Sc opulariopsis - Stachybotrys - Torula - Ulocladium - Unidentifiable Spores - Zygomycetes Fibrous Particulate - Hyphal Fragment Medium Insect Fragment Pollen - ategory: Countrper area analyzed • • • • • • •• are: 1 to 10 Low: 11 to 100 Medium: 101 to 1000 High: >1000 • • • • • ipolaris ++ = SipolarialDreschleralExserohilum Myxomycetss ++ = MyxomyceteslPeri o&:s" • • • = Sample contains frui ft structures andlor hyphen associated with the spores. No discernable field blank was submitted with this grouD Of Aries Escoto, Laboratory Manager EMSL n aBrtsins aahlaly thaled to cwt of analysts. This report relates only to the armples repo tedlbove and &uy not be rJbuoduceR�ox, &p„t in f'A.QMho�v� aftefpproval by EMS.. EMSL bears no respansm�ity r samde cot3adion acdvdies or anaytical method Gmitatio�. Interpeefaaon of 9ho d�a�saEre stn ttus�sp ♦ the. �`_i� l- i' -•- °(oa not detected. Samples r hmd In goad condition unless othembe nutad. • Samples analyzed by EMSL AnaiytloaL Inc. Fart Lauderdale, FL AIHA-LAP, LLC —ENLAP Awedied • • _ • • _ • • 0_0 report from: 0310312014 12:36:12 For Information on the fungi listed in this rj"least vigit tre Vnoul;ces s%don at www.emsl.com Test Report DEVER1- 7.30.1 Printed. 3/031201412:36:12PM ; ; •; Page 1 of 1 • • • • • • • • • • • •• •• • • • •• •• 000 • • • ••• 111 • EMSL Analytical, Inc. 2700 West Cypress Creek Road, Suite B -111 Fort Lauderdale, FL 333 Phone /Fax: (954) 786 -9331 / (954) 9414145 http : /ANww.EMSL.com / pompanobeachiabOemsi.com EJD: 561400606 FLOR78A Attn: Peter Romano Phone: (954) 752 -3335 Florida Mold Inspections, Inc. Fax: (954) 575 -0381 P.O. Box 970640 Collected: 02128/2014 Coconut Creek, FL 33097 Received: 02/28/2014 20210232 Analyzed: 03/03/2014 Proj: 9215 N. Bayshore Drive, Miami Shores, Florida 33138 Test Report: Air -O- Celt(T") Analysis of Fungal Spores & Particulates by Optical Microscopy (Methods EMSL 05-TP -003, ASTM 177391) Lab Sample Plumber. Test Report SPVER3- 7.30.1 Printed: 3/03/2014 12:36:12PM ; ; 561400606 -0001 ; ; 561400606-0002 561400606 -0003 Client Semple ID: ; P 20210232 20210518 20132753 Volume (L): 150 150 150 Sample location: 1- First Floor A/C Zone 2- Second Floor A/C Zone 3- Outdoor Spore Types Raw Got int 1 0 3 14.0fTmAl Rawrillunt countIm" p afTntaL Altemaria - - - - - - Ascospores 52 1100 41.1 30 630 29 657 13900 91.5 Aspergillus/Penicilhum 68 1400 52A 53 1100 50.7 14 300 2 Basiditospores 4 80 3 2 40 1.8 18 380 2.5 Bipotafis++ - - - - - - - - - Chaetomlum - - - 6 100 4.6 - - - Cladosporium 1 20 0.7 14 300 13.8 24 510 3.4 Curvulalla 1" r 0.3 - - 1' 7- 0 Epicoccwm - - - - - - Fusarium - - - - - - - Ganoderma 1 20 0.7 - 1 20 0.1 Myxomycetes++ 1 20 0.7 - - 3 60 0.4 Pithomyces 1 20 0.7 - - - - - Rust - - - - - - Scopular)opsis - - - - - Stachybotrys - - - - Torula - - - Ulociadium - - - - Unidentifiable Spores - - - - Zygomycetes - - - - - - Cercospora - - 1 20 0.1 Pyricularia 1' 7' 0.3 - - - - - - Total Fungi 130 2674 100 105 2170 100 719 15197 100 Hyphal Fragment 3 60 2.2 1 20 0.9 - - - Insect Fragment - - - - - - - - - Pqllen 1 20 0.9 16 340 2.2 Analyt. Sensitivity 600x 21 - 21 - - 21 - Analyt. Sensitivity 300x 7• - 7° - - 7` Skin Fragments (1-4) 2 - - 1 - - - - Fibrous Particulate (1-4) - 1 - 1 - Background (1 -5) 3 - - 2 - - 3 _ IBipolaris++ = Bipolaris /Dre.chslera/Exserohilum • • 000 • • • i • • • • ° Myxomycetes-i+ — Myxomycetes/Periconia/Smut • • • • • • • • `�-- -- • • • • • • • :0: • Ariel Escoto, Laboratory Manager No discernable field blanlcwas submitted with Ott group of samples. • • • • • i • • i • • • i i • • • or Other Approved Signatory t qh levels orbackground partJoulate can obscure spores and other particulates leading to tmderestirnalion. Background levels of S indicafa an cvadoading Of background partigdates, prohWag arxprete detection and nueatificaft . Present= Spores detected on ovedoaded sw. 0w. Results are rmt bank conWed unless oihavAse noted. The detecilm gmA is equal to a" fungal spare, structure, pollen, Roar pardde or bored fragment. '"- Denotes particles found of 31711X'= Denotes not delectsd. Dqp to methe*tgrpfng rulasorW cowO M Ox~ 100 are gp8polated based on the percentage analyzed. EMSLmeinbabm OaFilay akmled to cost of mudyem This repon relates only to du samples re}ftted abovMnd may ne•be repra•ucod, except• fua, m0put e itten approve[ by EMSL. EMSL bears our responsibliny for sample aoltecaoa ootl i ies or analyawi rrwOmd lirn4ations. Interpraiadon andRt�: teat lsutis Watt IEspundtbEt�of : 01161• Own Aes Aweived in good eandidon uniess o#ww ae nmod. samples analyzed by EMSL Analytical, M Fort Lauderdale, FL AJKNV P EN-AP 142794 • • • 0-* • _ • • • - • Initial report from: 03/03/2014 12:36.12 For Information on the fungi listed in thirargporl please vyg(t ;Pe jwoLFes section at www.emsi.com Test Report SPVER3- 7.30.1 Printed: 3/03/2014 12:36:12PM ; ; ; ; ; ; ; •; ; ; ; P Cabinetry i .JPG Cabinetry2.JPG Cabinetry3.JPG Cabinetry4.JPG . . . . . . . . . . . .. .. . . . .. .. Cab'tnetiyS.JPG ... . 0 0 ... . Cabinetry6.JPG Second floor air handler closet.JPG Mold growth observed on wall next to ai.r handler.JPG • • • Mold growth on ceiling above air handler.JPG Return plenum walls.JPG • • • • • • • • • • Second floor air handler coil and coil frarne.JPG so* i • • 0 • • • • 00 i •Interior of second door air handler.JPG iF f" 3 ,; • • • %. • wi`4 f P � �'k 95 • • _ i'',� ; i %k 3 r� In W • • • AW sow • • • • Mold growth on ceiling above air handler.JPG Return plenum walls.JPG • • • • • • • • • • Second floor air handler coil and coil frarne.JPG so* i • • 0 • • • • 00 i •Interior of second door air handler.JPG Interior of second Boor air handler.JPG • Coil and coil frame - first floor air handler..iPG Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: EE &G Construction & Electrical LLC BUSINESS ADDRESS: 5751 Miami Lakes Drive CITY miami Lakes STATE FL ZIP CODE 33014 BUSINESS PHONE: ( 305 ) 374 -8300 FAX NUMBER ( 305 ) 374 -9004 CELL PHONE ( ) QUALIFIER'S NAME: Adrian Bruce Woods QUALIFIER'S LIC NUMBER: CGC 1515204 E -MAIL ADDRESS (IF APPLICABLE): adrian @rcb.cc Created on 3119109 BY MLDV 1 RV 3126109 MLDV PERMIT # CONTRACTOR: �{ SUBMITTAL DATE: ` y ADDRESS: AX NAME: RESUBMITAL DATES: PROJECT TYPE: �- ZONIN STRUCTURAL ELECTRICAL PLUMBI MECHANICAL FIRE IMPACT FEES HRS /DERM r NOC 7!tt-/ I l� r c BLDG \ �'aH,�cfi1. {;r���.. �,�! ca':,��:� XP -iT kC# 6203744 STATE OF FLORIDA DEPARTMENT OF BUSINZSS AND PROFESSIONAL REGULATION CONSTRUCTION INDDSTRY LICENSING BOARD SEO# L 12 C, '72.6 0 The GENERAL CONTRACTOR below Named IS CERTIFIED Under the ov io of Chapter Expiration te® AUG 31, 2014 WOODS, ADR: �. BRUCE SOUTH ;; WINTER GARDEN FL 34787 jo E A am �I �nrnta MCTOi Jt tJ0t 3 69 trio 8 oa9 iy any nnPFccnsa " aoanptp na4 0� .44,4, d, Sec OP ID: CC CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DDNYYY) 04/07/2014 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(ies) 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 Hockman Insurance Agency 3438 Colwell Avenue Tampa, FL 33614 CONTACT NAME: PHONE FAX aC No Ext : ac No : ADDRESS: _ PRODUCER ECOSG -1 CUSTOMER ID #: INSURERS AFFORDING COVERAGE NAIC # INSURED EE &G Construction & INSURERA:Arch Speciality Insurance Co. EACH OCCURRENCE Electrical, LLC INSURERB:ArCh Insurance Company X COMMERCIAL GENERAL LIABILITY 5751 Miami Lakes Drive East Miami Lakes, FL 33014 INSURER C: Hanover Insurance Company 12EMP43870 07 INSURER D 09/19/2014 INSURER E: $ 50,000 INSURER F: rn�iccnncc f!FRTIPI('ATF NI IMRFR- REVISION NUMRFR: 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 INSURANCE Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. POLICY NUMBER POLICY MM/DD EXP LIMITS Miami Shores, FL 33138 GENERAL LIABILITY EACH OCCURRENCE $ 3,000,000 A X COMMERCIAL GENERAL LIABILITY 12EMP43870 07 09/1912013 09/19/2014 DAMAGE TO PREMISES (Ea RENTED occurrence $ 50,000 CLAIMS MADE I I OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 3,000,000 X Pollution Liab 12EMP43870 07 09/1912013 09/19/2014 Claims Made GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 3,000,00 $ POLICY rX1 PRO LOC B AUTOMOBILE LIABILITY ANY AUTO 11CABS823906 09/19/2013 09/19/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (PER ACCIDENT) $ $ X NON -OWNED AUTOS BRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A CESS LIAB CLAIMS -MADE 12EMX4376908 09/19/2013 09119/2014 tXRETENTION DUCTIBLE $ $ $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETORMARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N/A EBWCC00007 07 09/19/2013 09/19/2014 X TWO C STATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below I I A P Liab EMP43870 07 09/1912013 09/13/2014 Claim/Agg 3,000,000 C Lease /Rent Equip PJ8174753 06/30/2013 06130/2014 Limit 550,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) License # CGC 1515204. Miami Shores Village is named as Additional Insured with respect to General Liability. CFRTIFICATF HOLDER CANCELLATION MIAMISV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 NE 2nd Ave AUTHORIZED REPRESENTATIVE Miami Shores, FL 33138 � / Z,.., ©1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 26 (2009109) The ACORD name and logo are registered marks of ACORD