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HomeMy WebLinkAboutFolio 2024-2025 Permit - CR 7870 CR 7870 - 9/24/2024 • CONTRACTOR REGISTRATION 3� 0 ., , B100 West Dania Beach Boulevard*Dania Beach, FL 33004 (954)924-6805*3651,3633 or 3652 Fax(954)922-2687 DANIAi 'Ir BELO. liACH SEA�' i PLEASE PRINT LEGIBLY Type of Contractor /2 po-"/Ails Company: Name ?/ ct,le24) R00Fi/v (p/2r . Office Address a&'j , ai 7 7 PL• City/State/Zip /-4,9-Cg4-df•/ry 330/6 • Office Phone# 6' os) $22-9 qCoq Qualifier: Name A-L&-A(iS //A2T//vez Office Address �-Gq(47 /4) 77'e42G . City/State/Zip ,4t4;¢-6 6',gie/ 3 3©/( • Home Phone# Owner: Name �UL/O Ai O1.4- tie5z Office Address ,y(o Cc) 7 '— • City/State/Zip ,1ir,4 A. 33(7/(, Home Phone# C3-0,5) 3 Y,f---SV r PROVIDE PHOTOCOPIES OF THE FOLLOWING DOCUMENTS Qualifier's Driver's License /46 a S-000-SS-33 d1-o State: -Zo2/,9r'? City Business Tax License -/.19S-/056. City: County Business Tax License County: State License /26 D 56501. Certificate of Competency (Ye- 5008- 12-X Certificates of Insurance must show the City of Dania Beach as the Certificate Holder General Liability Expiration Date: O 5747 i/a-00-S" Workers Compensation Expiration Date: ev S/oi/9-oa s' I hereby certify that the information contained herein is true and accurate to the best of my knowledge. • Qualifier's Signature Date The foreg ing inst ent was acknowledged before me this k3 dayof 02 BY who is personally known to me or has produced as identification and did(or did not)take an oath e 4.`" ' '•`«• CARLOSA.URRINA My Commission Expires: 7/3//�7 • MY COMMISSION#Hti=i 1U88S "".'Foc.F.oi;• EXPIRES:July 31,20.27 Contractor Registration Rev. 09/26/2017 _A�Rom® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/01/2024 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Regina Bunker Acrisure Southeast-Frank H Furman PHONE (954)943-5050 FAX (A/C,No,Ext): (A/C,No): (954)942-6310 1314 East Atlantic Blvd. E-MAILss: rbunker@acrisure.corn ADDRP.O.Box 1927 INSURER(S)AFFORDING COVERAGE NAIC# Pompano Beach FL 33061 Houston Specialty Insurance Company 12936. INSURER A: p Y INSURED INSURER B: Travelers Casualty Ins Co of America 19046 Precision Roofing Corp INSURER C: Bridgefield Employers Ins Co 10701 2646 W 77th PI INSURER D: Evanston Insurance Company 35378 INSURER E: Hialeah FL 33016 INSURER F: COVERAGES CERTIFICATE NUMBER: 2024 All Policies 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 SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE CLAIMS-MADE X OCCUR PREMISESO(Ea occurrence)nce) $ 100,000 X Contractual Liability MED EXP(Any one person) $ 5,000 A CONHSGL000058900 05/01/2024 05/01/2025 1,000,000 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PRO- JECT LOC PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER: Designated Constr $ 5,000,000 AUTOMOBILE LIABILITY COMSWED-8INGEEaIMIT $ 1,000,000 X ANY AUTO (Ea accident) BODILY INJURY(Per person) $ B OW SCHEDULED NEDBA1N56068A AUTOS ONLY AUTOS 06/28/2024 06/28/2025 BODILY INJURY(Per accident) $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ PIP-Basic $ 10,000 UMBRELLA LIAB X OCCUR $ 5,000,000 A X EXCESS LIAB EACH OCCURRENCE CLAIMS-MADE CONHSCX000045200 05/01/2024 05/01/2025 $ 5,000,000 AGGREGATE DED RETENTION $ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY X PER OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N STATUTE ER C OFFICER/MEMBER EXCLUDED? N N/A 830-38032 06/20/2024 06/20/2025 E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 ID Professional Pollution and Incidental Each Occurrence $3,000,000 Professional Liability Services Liability ECPENV05631 05/01/2024 05/01/2025 Aggregate $3,000,000 Deductible $2,500 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ,NOTICE City of Dania Beach Building Department ACCORDANCEON WITHTE THE POLICCY PROVISIONSL BE DELIVERED IN 100 West Dania Beach Blvd AUTHORIZED REPRESENTATIVE Dania Beach FL 33004 �' y I ,/ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD �� 4 .: --.4.,,e"..?„-- t"} ` f, ` eu NI P" gt 41 4. I ,. 8 ,fit #s,:9 ° 4 x a 4 CERTIFICATE OF COMPETENCY BR WARD ALEXIS MARTINEZ Roofing PRECISION ROOFING CORP CC# 88-5008-R-X EXPIRES 2023-0P L..... ._ 0 —0_ca.) O_ _,. c cu . 22 —Iw m c V CY wLE W 0 Z w o ui Q m 0 I- Z Q o ez TJ Z V < Z Z 'no v O c_~n Q U Z O a� N -� - u o Q Z 3 0 -_1 Z � w `O `� a, 0 IL W w E Q Z X o u 8 Lp I- V J C L 1 O ' P. _ - _ a N � - c — O J . 0_a J v D oco 0 O >' = o: -J I- Q Z = w _ LL. cc Z 00 < Z " w0 N w Q u W 0 E— W 7f- H O N O N w '-' g c) Q w w W ~ CO W ° o 0 _ ~ 2 O _Z Zw Q o F- tuni tn Z en 0 Q �- O Q z ° N - m Q W — t-- 2 O `� `O W Z �' ; to Z Z Q a- w •o Q Z O ° ° O J Q N = W H •u O - = 0 < 2 r � 0 m H z cn D Z =' a s o c� V O Z 0_ w X > LL D U O > 2 '�' 0 ct 0 cn p 3 , I - F- z j z — Q Z N `� O - C Z O O c V w W = 0 cii Q E— o a Jrw `d0 rigr„„fp Q xL ' .;itsz,+�� a3'�!•M4 Clt.e„�kCl Local Business Tax Receipt LBTJ Miami-Dade County, State of Florida -THIS IS NOT A BILL-DO NOT PAY 3203635 RECEIPT NO. BUSINESS NAME/LOCATION RENEWAL PRECISION ROOFING CORP 3337482 EXPIRES 2646 W 77TH PL SEPTEMBER 30, 2025 HIALEAH, FL 33016-5637 Must be displayed at place of business ID Pursuant to County Code ' { Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS PRECISION ROOFING CORP 196 SPECIALTY BUILDING PAYMENT RECEIVED BY TAX COLLECTOR CONTRACTOR Worker(s) 2 94BS00298 45.00 07/25/2024 INT-24-447949 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 holder's 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 he displayed on all commercial vehicles-Miami-Dade Code Sec 8a-276. MDADE For more information,visit www.miamidade.gov/taxcollector • • BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-357-4829 VALID OCTOBER 1,2024 THROUGH SEPTEMBER 30,2025 Business Name: PRECISION ROOFING CORP Receipt#:R56 OOF NOG/SHEET METAL CONTRACT( BUSIneSS Type: (ROOFING CONTRACTOR) Owner Name:ALEXIS MARTINEZ Business Opened:06/14/1994 Business Location: 2646 W 77 PLACE State/County/Cert/Reg:RC0056501 MIAMI DADE COUNTY Exemption Code: Business Phone: 305-822-9969 Rooms Seats Employees Machines Professionals 2 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 29.70 Receipt Fee 27.00 Packing/Processing/Canning Employees 0.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: ALEXIS MARTINEZ 2646 W 77 PLACE Receipt #30A-23-00001587 HIALEAH, FL 33016 Paid 08/13/2024 29.70 2024 - 2025 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-357-4829 VALID OCTOBER 1, 2024 THROUGH SEPTEMBER 30, 2025 Business Name: PRECISION ROOFING CORP Receipt#: 185-1056 Business Type:ROOFING/SHEET METAL CONTRACTOR (ROOFING CONTRACTOR) Owner Name:ALEXIS MARTINEZ Business Opened:06/14/1994 Business Location: 2646 W 77 PLACE State/Count /Cert/Re MIAMI DADE COUNTY y e:RC0056501 Exemption Code: Business Phone: 305-822-9969 Rooms Seats Employees Machines Professionals 2 Signature For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 29.70 Receipt #30A-23-00001587 Paid 08/13/2024 29.70