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HomeMy WebLinkAboutFolio 2024-2026 Permit - CR 6383 CR 6383 - 9/24/2024 CONTRACTOR REGISTRATION 100 West Dania Beach Boulevard * Dania Beach, FL 33004 (954)924-6805*3651,3633 or 3652 Fax(954)922-2687 r, �, SANIVEB EH SEP ZO24 . II PLEASE PRINT LEGIBLY (0lJ 5 3 Type of Contractor GENERAL CONTRACTOR Company: NameANGELS REMODELING&CONSTRUCTION LLC Office Address 5944 CORAL RIDGE DR#275 City/State/Zip CORAL SPRINGS FL 33076 Office Phone# 954-691-8102 Qualifier:Name CHRISTINE JAGAT Office Address 5944 CORAL RIDGE DR#275 City/State/Zip CORAL SPRINGS FL 33076 Home Phone# 9546918102 Owner: Name CHRISTINE JAGAT Office Address SAME AS ABOVE City/State/Zip Home Phone# PROVIDE PHOTOCOPIES OF THE FOLLOWING DOCUMENTS Qualifier's Driver's License J230100729680 State: FL City Business Tax License BT-4172 City: CORALSPRINGS County Business Tax License County: 182-271743 State License CGC1516339 Certificate of Competency Certificates of Insurance must show the City of Dania Beach as the Certificate Holder General Liability Expiration Date: 8-27-2025 Workers Compensation Expiration Date: 9-4-2025 I hereby certify that the information contained herein is true and accurate to the best of my knowledge. CHRISTINE JAGAT --1 Qualifier's Signature Date The foregoing instrument was acknowledged before me this 2ND day of SEP 20 , By CHRISTINE JAGAT Who is personally known to me or has produced as an id(or did not)take an oath ,)(1) '�' i � I ent`fic t nMy Commission Expires: :a: �, LOUISIUS JOSEPH �r,�; Notary Public-State of FLORID :; •* BrowardCountyA `: Commission ft HH379018 Contractor Registration Rev. =?- ,GmmssionExpaeSMar 31 202 09/26/2017 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#:GENERAL1 CONTRACTOR Business Name:ANGELS REMODELING CONSTRUCTION LLC Business Type: Owner Name:JAGAT CHRISTINE Business Opened:09/15/2015 Business Location: 5944 CORAL RIDGE DR #275 State/County/Cert/Reg:CGC1516339 CORAL SPRINGS Exemption Code: Business Phone: 954-691-8102 Rooms Seats Employees Machines Professionals 4 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years l 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 fcr 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: ANGELS REMODELING CONSTRUCTION LLC Receipt #WWW-23-00276904 5944 CORAL RIDGE DR #275 Paid 07/31/2024 27.00 CORAL SPRINGS, FL 33076 2024 - 2025 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-1 00, Ft. Lauderdale, FL 33301-1895 - 954-357-4829 VALID OCTOBER 1, 2024 THROUGH SEPTEMBER 30, 2025 Receipt#: 180-271743 Business Name:ANGELS REMODELING CONSTRUCTION LLC Business Type:GENERAL CONTRACTOR Owner Name: JAGAT CHRISTINE Business Opened:09/15/201.5 Business Location: 5944 CORAL RIDGE DR #275 State/County/CertfReg:CGC15163'9 CORAL SPRINGS Exemption Code: Business Phone: 954-691-8102 Rooms Seats Employees Machines Professionals L 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 0.03 27.001 Receipt #WWW-23-00276904 Paid 07/31/2024 27.00 ....,ni II. �f 'y � i mo ' 0 b 70 > co F. v m O o m Z m N g m D > m "I o T z in 7) O `^ N m O D C m a o �, m N ` n0 - co n � 0 �• •p m Onm D OT - 0 tn o — O m D 0 (� = D Z Z rl o z z � Do D si > -ni Z N —Di m = O C 70 r O D m o 7 o — D 3 Q .� z O o ° 0 v m m G) m G� n m Z m v = o o C n -n < z N -�n "0 O 5 v v W � � -1 r0 n n O 70 w N w C X Z 70 m m -n °. o = !� w m n rTI > - Z (J) N -s rn N ( a` N . D m - N rD a so D o Z 0 o I-- ET rD —_ Z 03 Z n � o O I-' y) ,rp --Im th _D -, N C) m v n D :_F O Z A`cRLf CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 9/3/2024 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: South Florida Casualty, Inc. IA/c No.Extl: 561-533-6144 FAX (A/c.No): 561-533-6170 E-MAIL 415 North 4th Street ADDRESS: certslasouthfloridacasualty.com Lantana,FL 33462 INSURER(S)AFFORDING COVERAGE NAIC N INSURER A: Western World Insurance Com 13196 INSURED INSURER B: Progressive(CA) 24260 Angels Remodeling and Construction LLC INSURER C: DBA Call Air Conditioning Service INSURER D: 5944 Coral Ridge Drive#275 INSURER E: Coral Springs,FL 33076 FL 33076 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 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INCn,WVD POLICY NUMBER IMM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A ' NPP8973980 6/27/2024 6/27/2025 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) BODILY INJURY(Per person) $ 10,000 OWNED SCHEDULED B AUTOS ONLY X AUTOS 04248267-0 11/19/2023 11/19/2024 BODILY INJURY(Per accident) $ 20,000 HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) $ 10,000 $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION$ WORKERS COMPENSATION $ PER OTH- AND EMPLOYERS'LIABILITYSTATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (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) Heating or Combined Heating and Air Conditioning Systems Equipment-Dealers, installation,service or repair Subcontracted work in interior building repair,construction or reconstruction Remodeling -exterior CERTIFICATE HOLDER CANCELLATION City of Dania Beach SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 100 W Dania Beach Blvd. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Dania Beach, FL 33004 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE /�J/� W dS i ©1988- ,,,n ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD "1' Fo olio 4 1,ziT,E . JIMMY PATRONIS w 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: 9/5/2023 EXPIRATION DATE: 9/4/2025 PERSON: CHRISTINE JAGAT EMAIL: CJAGAT@YAHOO.COM FEIN: 474141145 BUSINESS NAME AND ADDRESS: ANGELS REMODELING &CONSTRUCTION LLC CALL AIR CONDITIONING SERVICE 5944 CORAL RIDGE DR#275 POMPANO BEACH, FL 33076 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 SE EXEMPT E01747197 QUESTIONS?(850)413-1609 RULE 69L-6.012, F.A.C. REVISED 01/2023 Floridan LICENSE _ r.Li'J230-100-72-968-0 ``'£ JAGAT CHRI5TINE 57II0 NW 12Nd 2 TER CORAL SPRINGS.FL 3376 +• .:a 12/28/1972' = .,e',' 12/281024 •e.c 5•-06- -;-A NONE 12 13/2016 ,.4.. , 1i121411)6;1ft •,Acca 07062c2 f