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HomeMy WebLinkAboutFolio 2024-2025 Permit - CR 6378 CR 6378 - 9/24/2024 CONTRACTOR R EGiSTRATiON 61-1 100 West Dania Beach Boulevard•Dania Beach,FL 33004 (954)924-6805`3651,3633 or 3652 Fax(954)922-2687 • B C PLEASE PRINT LEGIBLY Type of Contractor Res0entual :;n^•,mmg Company:Name MARS POOLS NNC. Office Address 520 NE 44TH STREET City/State/Zip OAKLAND PERK.FL 3333.1 Office Phone# 954-523-€46., -' Qualifier: Name MICHAEL R sTEWART Office Address 520 NF 44Th STRFr-" `m City/State/Zip OAKI_AND PARK cL 33334 Home Phone# 53-214-1720 -- Owner:Name MICHAEL R.STEWART Office Address 520 NNE 44TH STREET City/State/Zip OAK(AND PARK. I 33314 Home Phone# PROVIDE PHOTOCOPIES OF THE FOLLOWING DOCUMENTS Qualifier's Driver's License 53-5S -5C-4 20 State: City Business Tax License City: County Business Tax License County: 188-211471 State License CPC 1457E22 Certificate of Competency Certificates of Insurance must show the City of Dania Beach as the Certificate Holder General Liability Expiration Date: OB�26f202S Workers Compensation Expiration Date: 0723/2025 I hereby certify that the information contained herein is true and accurate to the best of my knowledge. MICHAEL R STEc.ART • j Qualifie s Signature Date The foregoing instrument was acknowledged before me this 3rd day of SEPTEMER 20 24 By MIC;HAEL R.S7C`.'ART RIVE >Ns€ns3s3-sse0a1,c who is personally known to me or has produced as identification and did(or did not)take an oath • n My Commission Expires: S .,2f t; < dtv.►�� GINA MARIE LEBLANC 'g Notary Public-State of Florida Commission a HH 530319 Contractor Registration Rev. ori} My Comm.Expires May 28,2028 bored through National Notary Assn. Q9/26/20i 7 MARSP-1 OP ID: DL ACoRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDrYYYY) 08/26/2024 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 954-825-0424 CONTACT Diana Lanza Schott Lanza Insurance Agency Inc. PHONE LC,No,Ext): �FAX 954-825-0424 F 9900 W Sample Road-Ste 300 FAX No): Coral Springs,FL 33065 E-MAIL Diana Lan2a�nS.COm Diana Lanza Schott ADDRESS: -. INSURE 1 AFFORDING COVERAGE NAIC INSURER A:Amtrust International 23140 a I Srs Pools,Dels,Inc. INSURERS: 520 NE 44th Street INSURERC: Oakland Park,FL 33334 INSURER D: 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 EXP pp SUBR POLICY EFF POLICY --`'-" IIN3DL WVD MM/DDNYYYI IMM/DD/YYYY1 LTR TYPE OF INSURANCE POLICY NUMBER LIMITS A X I COMMERCIAL GENERAL LIABILITY $ 1,000,000 EACH OCCURRENCE CLAIMS-MADE i X OCCUR DAMAGE TO RENTED SES1809322 02 i 08/28/2024'08/28/2025 2,000,000 PREMISES�(Ea or�urrgl>S91 S i MED EXP An ono person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEM.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 l PRO- I LOC _ l POLICY IECT PRODUCTS-COMP/OP AGG $ 100,000 OTHER $ AAUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) S — BODILY INJURY(P OWNED SCHEDULED (Per person) $ AUTOS ONLY AUTOS BODILY INJURY(Per accidents $ AU PROPERTY ONLY I NON-OWNED YY _Te $ fffl UMBRELLA LIAR (OCCUR EACH OCCURRENCE $ _ I EXCESS LIAB CLAIMS-MADE AGGREGATEI DED RETENTIONS $ WORKERS COMPENSATION PER I OTH- AND EMPLOYERS'LIABILITY Yr N STATUTE .ER.. ANY PROPRIETOR/PARTNER/EXECUTIVE I E.L.EACH ACCIDENT I$OFFICER/MEMB REXCLUDED? N/A (Mandatory In NH) E L_DISEASE-EA EMPLOYEE$ If yes,describe under DESCRIPTION OF OPERATIONS below : E.L.DISEASE•POLICY LIMIT $ I ff � I DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Romarks Schedule,may bo attached If more space Is roqulred) SWIMMING POOL CONTRACTOR MICHAEL R. STEWART LICENSE #CPC1457922 CERTIFICATE HOLDER CANCELLATION DANIABE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Dania Beach ACCORDANCE WITH THE POLICY PROVISIONS. 100 W.Dania Beach Boulevard Dania Beach, FL 33004 AUTHORIZED REPRESENTATIVE 4495121 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD t-,G i': i‘44,,,,,;, . CO 3 .-4 ° I, ..,,,„.....:. , . , .:. ..0.1.. „ ,.. arr. ti = 0 70 0 cn m 10 0 N. 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Lauderdale, FL 33301-1895—954-357-4829 VALID OCTOBER 1,2024 THROUGH SEPTEMBER 30,2025 Receipt#:POOL MAR1 INE CONTRACTOR (s RT Business Name:MARS POOLS INC Business Type:POOL/SPA cONTR) Owner Name:MICHAEL R STEWART • Business Opened:08/31/2015 Business Location:520 NE 44TH ST State/County/Cert/Reg:CPc1457922 OAKLAND PARK Exemption Code: Business Phone: 1959 52 964 61 Rooms Seats Employees Machines Professionals 1 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 27.00 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: I i MICHAEL R STEWART Receipt #035-23-00006284 9097 NW 57TH ST APT 109 Paid 08/27/2024 27.00 TAMARAC, FL 33351-4364 .: ._ ACo d CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 08/27/2024 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 pollcy(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 Automatic Data Processing Insurance Agency,Inc. Automatic Data Processing Insurance Agency,Inc, 1-800-524-7024 FAX (A10 No,Esti: IA1C Noy: E-MAIL ADDRESS:-- 1 Adp Boulevard INSURER(S)AFFORDING COVERAGE NAIC 0 Roseland NJ 07068 INSURER A: Technology insurance Company.Inc. 42376 INSURED Mars Pools Inc ---- INSURER B: _ INSURER C: - --- -- 520 NE 44th Street INSURER D: INSURER E: Oakland Park FL 33334 INSURER F: COVERAGES CERTIFICATE NUMBER: 2651429 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 SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INS° VIVO POLICY NUMBER (MMJODIYYYY) (MMIDD/YYYY) ---- UNITS •COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ —DAMAGE U CLAIMS-MADE ( OCCUR PREMISES(EaEoccurrence) $ -- -- - MED EXP(Any one person) S ' —--- PERSONAL&ADV INJURY $ GENII AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ POLICY I- PRO- JECT PRODUCTS-COMP/OP AGO $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO • (Ea acadent) BODILY INJURY(Per person) $ OWNED SCHEDULED • • AUTOS ONLY AUTOS BODILY INJURY(Per acodent) $ HIRED NON-OWNED • PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Peracuden1) $ $ UMBRELLA LIAS OCCUR EXCESS LIAR CLAIMS-MADE I EACH OCCURRENCE $ AGGREGATE $ DED i I RETENTION S WORKERS COMPENSATION P i ER OTH $ AND EMPLOYERS'LIABILITY Y t N X STATUTE ER A ANY PROPRIETORPARTNERIEXECUTIVE OFFICER9NFJdBEREXCLUDED? N NrA N TWC4452380EL EACH ACCIDENT. -$ (Mandatory In NH) I I 07/23/2024 07/23/2025 1,000,000 1,000,000 It es.desaitre under E.L.DISEASE-EA EMPLOYEE S DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be sdhched if more apace is required) MARS POOLS INC. MICHAEL R.STEWART LICENSE#CPC1457922 CERTIFICATE HOLDER CANCELLATION DANIABE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF DANIA BEACH THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 100 W. DANIA BEACH BOULEVARD ACCORDANCE WITH THE POLICY PROVISIONS, DANIA BEACH, FL 33004 PH:954-924-6805 FAX: 954-922-2687 AUTHORITED REPRESENTATIVE ®1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD