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HomeMy WebLinkAboutFolio 2024-2026 Permit - CR 5745 CR 5745 - 9/24/2024 peAdi CONTRACTOR REGISTRATION 100 West Dania Beach Boulevard*Dania Beach,FL 33004 (954)924-6805*3651,3633 or 3652 Fax(954)922-2687 DANIA BEACH 'FAIT.LIVE IL MY(IT. PLEASE PRINT LEGIBLY Type of Contractor C iff t `�l i l l .t t C_OMOicAur Company:Name c /(A-1ur[ coy-0 Office Address 1r`4_ City/State/Zip r-t��a1 :1Y1 }-�_ ?)? 1 () Office Phone# C, 'Ci Q t, 1 Qualifier:Name i-C-1-Cy enk.J1\JOV Office Address " t City/State/Zip " !' Home Phone# ! Owner:Name OfeA q Office Address 1/ City/State/Zip ' Home Phone# /✓ PROVIDE PHOTOCOPIES OF THE FOLLOWING DOCUMENTS 1 Qualifier's Driver's License V.4`l14" 1'%-- S-1-COO-U State: V Dnd G City Business Tax License City: County Business Tax License County: .✓State License (JCS. IX)4y 45 Certificate of Competency Certificates of Insurance must show the 7 of Da a. each as the Certificate Holder General Liability Expiration Date: Workers Compensation Expiration Date: (I) I hereby certify that the information contained herein is true and accurate to the best of my knowledge. /01444 rie:/j"-- Qualifier's Signature Date The foregoing instrument was acknowledged before me this I day of DQ\ 20 By k-`ei( Q.c CCf tiv\\I who is personally known to me or has produced as identification and did(or did not)take an oath 14 L 2 LP My Commission Expires: 41 / NotaryCelestM Publi oCiscGosionz Sftatealez of Florida y e .Cmmn Contractor Registration Rev. + �Vlt►. NM 250019 I 09/26/2017 Exp. .4r6/2o26 6 co ® c E co D 2 U o v = W v C.) _ ) 6 W Q w w ti L 0 J O oI- ce Z o ru Z t.7 0 Q ;, o a)V) V) 7- Q Q I 'ri ,.. tV c o u QWW O 01 J W 0 c ..0 o -® L1. VUOW OO Lr3IF- C_ O (I) J iC7 UDN . c O _ re D LL L9 ,! (9 LiN c -)Z Z O 0 U 1 W WCO I 45 l E W Q 0 0 ~ Q C o - o Z � = z ,j0 0 p -S c I- U) Z h- Q O UMw Z ` z a "' L...E— Z Z U �" •0 Q Z H u 03 0 4- W D ,. Q 1 0 JY to tin i W 'a Zv) w i o V) W Z U LY Ce u 2 O w 0. - (. V T L `i }— f-- o c Ce `) Q cn co 0 c) W F- tr, '4 " lik .,. L BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-357-4829 VALID OCTOBER 1,2023 THROUGH SEPTEMBER 30,2024 DBA: Reoelpt#:180-292465 GENERAL CONTRACTOR (GENERAL Business Name: G CONTRACTORS CORP Business Type:CONTRACTOR) Owner Name:ROSAS-GUYON, CHESTER ANDRES Business Opened:08/01/2018 Business Location:2356 W 8 COURT State/County/Cert/Reg:CGC1504445 MIAMI DADE COUNTY Exemption Code: Business Phone:786 9536002 Rooms Seats Employees Machines Professionals 38 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 108.00 0.00 0.00 0.00 0.00 0.00 108.00 Receipt Fee 108.00 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: A G CONTRACTORS CORP Receipt #WWW-22-00249197 2356 W 8 COURT Paid 07/05/2023 108.00 HIALEAH, FL 33010 2023 - 2024 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-357-4829 VALID OCTOBER 1, 2023 THROUGH SEPTEMBER 30, 2024 DBA.A G CONTRACTORS CORP Receipt#: 180 292465 Business Name: Business Type:GENERAL CONTRACTOR (GENERAL CONTRACTOR) Owner Name:ROSAS-GUYON, CHESTER ANDRES Business Opened:08/01/2018 Business Location:2356 W 8 COURT State/County/CertiReg:CGC1504445 MIAMI DADE COUNTY Exemption Code: Business Phone: 786 9536002 Rooms Seats Employees Machines Professionals 38 Signature For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 108.00 0.00 0.00 0.00 0.00 0.00 108.00 Receipt #WWW-22-00249197 Paid 07/05/2023 108.00 ACCP CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD!YYYY) 09/11/2024 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 pollcy(les)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 Heidy Grullon NAME: N51 Insurance Group LLC PHONE (305)556-1488 FAX (305)556-3680 (A/C,No,Ex0: (A/C,No): 5875 NW 163 Street EMAIL heidyg@nsigroup.org ADDRESS: Suite 207 INSURER(S)AFFORDING COVERAGE NAIC N Miami Lakes FL 33014 INSURER A: Peachtree Special Risk Brokers 5900 INSURED INSURER B: AG Contractors Corp INSURER C 2356 W 8 Court INSURER D: INSURER E: Hialeah FL 33010 INSURERF: COVERAGES CERTIFICATE NUMBER: 24/25 GL 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 AWL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSO WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 �/ DAMAGE TO RENTED CLAIMS-MADE I X OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A Y SES1814896-00 02/05/2024 02/05/2025 pER50NAL&ADV INJURY $ 1,000,000 OEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY I J JECa LOC PRODUCTS-COMP/OP AGG $ 2,000000 OTHER: Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY GOMBtNED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY _AUTOS ONLY (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE I N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 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) • 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 West Dania Beach Boulevard AUTHORIZED REPRESENTATIVE Dania Beach FL 33004 OSC�r S,,ti_ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACØRD® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 09/11/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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 Yamile Corral AAI,AAIM NAME: Brown&Brown Insurance Services,Inc. PHONE (305)714-4400 FAX (305)714-4401 IA/C,No,Ext): (ANC,No): 8825 NW 21st Terrace E-MAIL Yamile.Corral@bbrown.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Doral FL 33172 INSURER A: Bridgefield Casualty Insurance Company 10335 INSURED INSURER B: AG Contractors Corp. INSURER C: 2356 W 8 Court INSURER D INSURER E: Hialeah FL 33010 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 AUDLSUNH POLICYEFF POLICY EXP LTR TYPE OF INSURANCE INSD wV0 POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ POLICY JECT LOC PRODUCTS-COMP!OPAGG OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY _AUTOS ONLY (Per accident) $ UMBRELLA LIAR _— OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEO RETENTION$ $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y N A ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A 19643404 06/02/2024 06/02/2025 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1'000'000 Ir yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1'D00,000 DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES(ACORD 101,Additional Romarks Schedule,may be 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 City of Dania Beach ACCORDANCE WITH THE POLICY PROVISIONS. 10D West Dania Beach Boulevard AUTHORIZED REPRESENTATIVE Dania Beach FL 33004 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD , ; , ,, _ ,1 ) ,,, , ,, ..„_) ,1or:da Y , . , } ' 1:::..' iss E s 40 R424-�748 87 9OO '0 ROSAS-GUYON Jf-� : ..CHESTER ANDRES } �' ,, 7835"-SW 18 TER M#AN11; FL 33 1 55-1 346' , : o -08/151195Q 15 SEX M to e xP 08/15/2032" 16�+op;- 6'-t}1,. ,, � , ;1 � ST BF �� E4C NONE 1 • . iss 08/0912024 .' I V 5 7C� '��22di78�9t7A5i' i %.,."OW?, tt,nit. ., , 'Operation of a motor iett{tte cenit ..'ea l consent to �mi sobriety t 1 r,= ifen r +a"., 11 r . ,