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HomeMy WebLinkAboutFolio 2024-2026 Permit - CR 4732 CR 4732 - 9/24/2024 -WzN L/ �73 z- 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 Receipt#: ENERAL96ONTRACTOR (GENERAL Business Name:K D CONSTRUCTION OF FLORIDA LLC Business Type:CONTR) DBA K D CONSTRUCTION OF FLORIDA Owner Name:KARL R DAVIS Business Opened:05/01/1990 Business Location: 1831 SW 7 AVE State/County/Cert/Reg:CGc016147 POMPANO BEACH Exemption Code: Business Phone: 954-344-4515 Rooms Seats Employees Machines Professionals 10 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: KARL R DAVIS Receipt #032-23-00002389 1831 SW 7 AVE Paid 08/06/2024 27.00 POMPANO BEACH, FL 33060 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 Receipt#: 180-2896 Business Name: K D CONSTRUCTION OF FLORIDA LLC Business Type:GENERAL CONTRACTOR (GENERAL DBA K D CONSTRUCTION OF FLORIDA CONTR) Owner Name: KARL R DAVIS Business Opened:05/01/1990 Business Location: 1831 SW 7 AVE State/County/Cert/Reg:CGC016147 POMPANO BEACH Exemption Code: Business Phone: 954-344-4515 Rooms Seats Employees Machines Professionals 10 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 27.00 Receipt #032-23-00002389 Paid 08/06/2024 27.00 yr c Li_ ta aU no W I Q0I— v ° v Z COm Q a) Q Z o 1 a o V) V) u' < o CO o N 6 u Q W(I) W Z w 0 `� CO M c t CO 4, 0 U.. V u O LL = _d t LL U (/y N (0 Q a �- Z ``. ce Z = V C7 o c +' LL W « o -� MJ ck a o f 0 }— WV) i cc E— O Q W u O Q Q CY D0 � W 2 Q c o Li, -o o W to 0 >, Z o D c Q W Z V = Q Zz D tWn Q 1) N o 76 4— t/f Q Z Q p ',° Q V '' ° 3 F- p tn u_ ._i —ri. L ° Ii LAJ (;), 0 --E Z W Q a, W Z u > cu 2 Q W a z; 1 V H CO 0 cn 0.1 a N w ce f: „III IC Qr 1 . .' 1 1 AC RO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ‘.....------ 9/11/2024 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 Bateman Gordon and Sands PPHON: FAX 3050 North Federal Hwy (NC No.Ext): 954-941-0900 (A/CC,No):954-941-2006 Lighthouse Point FL 33064 ADDRESS: emedlin@bgsagency.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Progressive Express Insurance Company 10193 INSURED KDCON INSURER B: Landmark American Insurance Company 33138 K. D. Construction of Florida, LLC 6451 N. Federal Hwy., Suite 1003 INSURER C:Bridgefield Casualty Ins.Co. 10335 Fort Lauderdale FL 33308 INSURER D:Vantage Risk Assurance Company 32077 INSURER E:GuideOne National Insurance Company 14167 INSURER F: COVERAGES CERTIFICATE NUMBER:1455881340 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 INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS E X COMMERCIAL GENERAL LIABILITY Y Y 56300035603 4/1/2024 4/1/2025 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $100,000 X Ded:25,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X MT LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y 03439901 4/1/2024 4/1/2025 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ B UMBRELLA LIAB X OCCUR LHA107346 4/1/2024 4/1/2025 EACH OCCURRENCE $5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$n $ c WORKERS COMPENSATION Y 19642326 4/1/2024 4/1/2025 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 D Rented&Leased Equipment IMA2400512601 4/1/2024 4/1/2025 Limit:$500,000 Ded:$5,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) General Liability: Additional Insured,Ongoing and Completed Operations,as required by written contract,per CG2010 0413 and CG2037 0413 Primary&Non-Contributory,as required by written contract,per CG2001 0413 Waiver of Subrogation as required by written contract,per CG2404 0509 Third Party Cancellation Notice,per LIGL 6479 0817. Automobile Liability:Additional Insured and Primary&Non-Contributory,per 2366 0211.Waiver of Subrogation,per 2367 0610,each as required by written contract See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Dania Beach 100 West Dania Beach Blvd. Dania Beach FL 33004 AUTHORIZED REPRESENTATIVE I 419614-Jet/CaAfr----- ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • AGENCY CUSTOMER ID: KDCON LOC#: A ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Bateman Gordon and Sands K. D.Construction of Florida,LLC 6451 N.Federal Hwy.,Suite 1003 POLICY NUMBER Fort Lauderdale FL 33308 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Workers'Compensation:Waiver of Subrogation as required by written contract,per WC000313. Excess Liability:Extends coverage to underlying General Liability,Auto Liability and Workers'Compensation/Employers Liability coverage. ALL COVERAGE IS SUBJECT TO THE POLICY TERMS,CONDITIONS AND EXCLUSIONS ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Florida • • • U 3d0.AD12O-51s-49-28 ,:LASS E s a Mai.SW 122 DST s.> FL 33156.5223 " O8b04/1949 . xo a8I 412O27 3 -5'-ilia" SAFE OR Vcp Ass QitalZil#9 SAC wrstieT3s4?14 ✓f a." MCA'-"�CJa of rilncie'3^SY11;:Sa '''�����iii ...loa 233,1 TASNmFj Teti tam..,3 :3a • e FE) CONTRACTOR REGISTRATION 100 West Dania Beach Boulevard * Dania Beach, FL 33004 (954)924-6805*3651,3633 or 3652 Fax(954)922-2687 DANIA BEACH SEA IT.LIVE IT.LOVE IT. PLEASE PRINT LEGIBLY Type of Contractor General Contractor Construction Company: Name KD Construction of Florida LLC Office Address 6451 N Federal Hwy, Suite 1003 City/State/Zip Ft Lauderdale, FL 33308 Office Phone# 954-344-4515 Qualifier: Name Karl R Davis Office Address 6451 N Federal Hwy, Suite 1003 City/State/Zip Ft Lauderdale, FL 33308 Home Phone# 954-494-3530 Owner: Name Karl R Davis Office Address 6451 N Federal Hwy, Suite 1003 City/State/Zip Ft Lauderdale, FL 33308 Home Phone# PROVIDE PHOTOCOPIES OF THE FOLLOWING DOCUMENTS Qualifier's Driver's License D120-516-49-284-0 State: Florida City Business Tax License City: County Business Tax License County: 180-2896 State License CGC016147 Certificate of Competency CGC016147 Certificates of Insurance must show the City of Dania Beach as the Certificate Holder General Liability Expiration Date: 04/01/2025 Workers Compensation Expiration Date: 04/01/2025 I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Karl R Davis - v. • — —. ChRISTINE BARRIOS 1 Qualifier's Signature I ;' Ncta�yPubiic-StateofFlorida g pr.rissix :HH 2.97439 1 My Comm.Expires Dec 2,2026 Date I ?crcec;-,:Lgb Naccra,4ctary Assn. The foregoing instruTent was acknowledged before me this 3&AA day of AU a5-71 202 Y' By() 1.44 r/ f2. lT v S who is personally known to me or has produced r'S o ha l t y ow n as identification and did (or did not)take an oath My Commission Expires: / Z/D 2126 2 Contractor Registration Rev. 09/26/2017