Loading...
HomeMy WebLinkAboutFolio 2024-2026 Permit - CR 7536 CR 7536 - 9/24/2024 ® 13 '4 _ AI ©R CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/18/2024 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 Lucia Estrella ACCURATE GROUP PHONE (ac.No.ExU: (305)226-8727 FAX mic,No 786-947-4408 8300 West Flagler,Suite 114 ADDRESS: accurate.certificates©gmail.com INSURER(S)AFFORDING COVERAGE NAIC N Miami FL L 33144 INSURER A: Accelerant Specialty Insurance Company 16890 INSURED INSURER B: E-Z Flush Plumbing Corp INSURER C: 9460 Fountainebleau Blvd#319 INSURER D: INSURER E: Miami FL 33172- 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 SUBR LTR TYPE OF INSURANCE POLICY EFF POLICY EXP -- INCO IA/VD POLICY NUMBER (MM/DD/YYYYI (MM/DD/YYW) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A S0031 GL000489 05/22/2024 05/22/2025 PERSONAL ii ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE $ (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION $ PER AND EMPLOYERS'LIABILITY STATUTE ERH ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may ble attached if more space is required) - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Meadowbrook Lakes View Condo Association"A" ACCORDANCE WITH THE POLICY PROVISIONS. 315 SE St Dania Beach,FL 33004 AUTHORIZED REPRESENTATIVE 7 ©1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD at,. ov:07'''':`,_.t, JIMMY PATRONIS CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW** CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 10/2/2023 EXPIRATION DATE: 10/1/2025 PERSON: KHALED HALWAJI EMAIL: KH2000@MOZEY.COM FEIN: 208687837 BUSINESS NAME AND ADDRESS: SAFEGUARD ROOFING INC 1245 S POWERLINE RD#304 POMPANO BEACH, FL 33069 This certificate of election to be exempt is NOT a license issued by the Department of Business and Professional Regulation. To determine if the certificate holder is required to have a license to perform work or to verify the license of the certificate holder, go to www.myfloridalicense.com. IMPORTANT.Pursuant to subsection 440.05(13),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to subsection 440.05(11), F.S.,Certificates of election to be exempt issued under subsection(3)apply only to the corporate officer named on the notice of election to be exempt.Pursuant to subsection 440.05(12),F.S.,notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT E01801003 QUESTIONS?(850)413-1609 RULE 69L-6.012, F.A.C.REVISED 01/2023 l ,� Ron DeSantis,Governor S Melanie S.Griffin,Secretary .fit _ dbr .,, STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTIO ENSING BOARD THE ROOFING C ,4• =ram �• �4*,. ' QED UNDER THE er-PROVISI ,�; �`.- .ry it—" ,a , ' TUTES V S f °. 1 ,0 � • '" IPA,. 4 4- LICE „ ' C 695 1 EXPIRATION DATE: AUGUST 31,2026 f Always verify licenses online at MyFloridaLicense.com 0:!Yci;, C ISSUED:07/14/2024 , ii 4#.'•#' Do not alter this document in any form. otr. This is your license. It is unlawful for anyone other than the licensee to use this document. ACORL® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/25/2023 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 Alex Hansen NAME: State Insurance Agency Inc. PHONE (772)426-9933 FAX 1010 SW Martin Downs Blvd (A/C,No,Ext): (A/C,No): (772)426-9943 ADDRESS: ALEX@STATEINSURANCEAGENT.COM INSURER(S)AFFORDING COVERAGE NAIC# Palm City FL 34990 Accredited Suretyand CasualtyCompany INSURERA: p y 26379A INSURED INSURER B: SAFEGUARD ROOFING INC, INSURER C: 1245 S POWERLINE RD#304 INSURER D: INSURER E: POMPANO FL 33069 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2392517616 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 AUUL SUBH 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 CLAIMS-MADE X OCCUR DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 A 2ACPFL17S011516200 09/20/2023 09/20/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 'L X POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ BODILY INJURY(Per person) $ OWNED SCHEDULED HIRED ONLY AUTOS BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY AUTOS ONLY (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED i I RETENTION$ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY I STATUTE I j EERH ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) ROOFING CONTRACTOR CERTIFICATE HOLDER CANCELLATION - 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 BLVD AUTHORIZED REPRESENTATIVE DANIA BEACH FL 33004 /yJ ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD IS ACORD CORPORATION. All rights reserved.