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HomeMy WebLinkAbout20-101 m H.cniIlion City, of Zephyrhills PERMIT NUMBER 5335 Eighth Street Zephyrhills, FL 33542 SPCV-000101-2020 Phone: (813) 780-0020 Issue Date: 06/02/2020 Fax: (813) 780-0021 • Permit Type: Special Event/Temporary Event/Temporary Sales Property Number Street Address 10 26 21 0020 00000 0030 5953 Gall Blvd Owner Information. Permit Information Contractor Information Name: ZEPHYR LLC Permit Type:Special Event/Temporary Sales Contractor: GALAXY FIREWORKS, INC Class of Work:Fireworks Address: 5953 Gall Blvd Building Valuation: ZEPHYRHILLS,FL 33542 Electrical Valuation: Phone: Mechanical Valuation: Plumbing Valuation: Total Valuation:$0.00 Total Fees:$531.00 f ✓ J��2� Amount Paid:$531.00 I , y►/� / Date Paid:6/2/2020 4:14:25PM Project Description TEMPORARY FIREWORK SALE JUNE 10TH-JULY 7TH 2O20 Application Fees Fireworks Permit Fee $500.00 Special Event/Temporary Sales $31.00 REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or first reinspection,whichever isl greater,for each subsequent reinspection. Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permit required from other governmental entities such as water management, state agencies or federal agencies. "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement." Complete Plans, Specifications add fee Must Accompany Application.All work shall be performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. CONTRACTOR SI TURE PE IT OFFICE PERMIT EXPI S IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER N City of Zephyrhilis PERMIT NUMBER i�...... 5335 Eighth Street "N. Zephyrhills, FL 33542 SPCV-000101-2020 Phone: (813)780-0020 Fax: (813)780-0021 L Issue Date: Permit Type: Special Event/Temporary Sales Property Number Street Address 10 26 21 0020 00000 0030 5953 Gall Blvd Owner Information Permit Information Contractor Information Name: ZEPHYR LLC Permit Type:Special Eventrremporary Sales Contractor: GALAXY FIREWORKS, INC I Class of Work:Fireworks Address: 5953 Gall Blvd Building Valuation: ZEPHYRHILLS,FL 33542 Electrical Valuation: Phone: Mechanical Valuation: Plumbing Valuation: Total Valuation:$0.00 Total Fees:$531.00 Amount Paid:$0.00 Date aid: 1ProjectDescription ITEMPORARY FIREWORK SALE JUNE 1 OTH-JULY 7TH 2020 Application Fees Fireworks Permit Fee $500.00 Special Event/Temporary Sales $31.00 REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or first reinspection,whichever is greater,for each subsequent reinspection. Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permit required from other governmental entities such as water management, state agencies or federal agencies. "Warning to owner:Your failure to record a notice of commencement may result in your paying twice for improvements to your property.If you intend to obtain financing,consult with your lender or an attorney before recording your notice of commencement." Complete Plans, Specifications add fee Must Accompany Application.All work shall be performed in accordance with City Codes and Ordinances.NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. ,YIQ96�� CONTRACTOR SIGNATURE PE 9MIT OFFICEU PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER Temporary Sales Checklist City of Zephyrhills 5335 81h Street Zephyrhills,Fl.33542 Phone:813-780-0020/Fax:813-780-0021 REQUIREMENTS _ Detailed Plot Plan showing setupi of location. Refer to Ordinance 1038-09, Sec 4 Notarized letter from property owner stating their approval. _—�A flame retardant certificate is required IF a tent is involved. Inspection required once tent is erected and prior to opening for business. Approved certified fire extinguishers per NFPA 10. No Smoking signs must be placed outside entrances. IF there is a wire fence or chain link fencing must have at least 5 Ft setback from tent and at least 2 exits. IF tent has sides,the sides shall be in the up position unless there is inclement weather, then 2 sides must be in the up position. FIREWORK REQUIREMENTS—(In addition to the above) ,/P:dof of State License. Ad JProof of Liability insurance. t of items to be sold at site. 79 � Copy of Drivers License and Social Security Number of all personnel dealing with the sale of fireworks at the tent location. FEEs _ $ 3000—City Registration(If Regulated by DBPR—Fee is Waived) _ $506.00—Fireworks fee-Fire Department fee 5.00—Temporary Sales Fee for 111 two days 1.00—Temporary Sales Fee per day for each consecutive day thereafter,not to exceed duration of 7 consecutive days and no more than two occurrences during a 12 month period on same property Ord#1038-09,See 6 $60.00—Tent Fee(45.00/1313, 15.00*/FD)—(*$15.00 waived for Fireworks) $45.00—Electrical Fee(if applicable) - . l� Z't 2/ DUB' vlwdo ou 16 Property Owner: Zephyr LLC Applicant: Galaxy Fireworks, Inc. Phone Contact: (813) 234-2264 :address Site: 5953 Gall Boulevard, Zephyrhills, Florida 33542 Date(s)of Sale: Sale of Fireworks June 10, 2020 through July 7, 2020 ..ordinance No. 1038-09(for additional requirements) Temporary Sales Checklist City of Zephyrhills 5335 81h Street Zephyrhills,Fl.33542 Phone:813-780-0020/Fax:813-780-0021 REQUIREMENTS Detailed Plot Plan showing setup of location. Refer to Ordinance 1038-09, Sec 4 Notarized letter from property owner stating their approval. A fame retardant certificate is required IF a tent is involved. Inspection required once tent is erected and prior to opening for business. Approved certified fire extinguishers per NFPA 10. Ww6 i / , No Smoking signs must be placed outside entrances. -Q/1 A �, IF there is a wire fence or chain link fencing must have at least 5 Ft setback from tent and at least 2 exits. IF tent has sides,the sides shall be in the up position unless there is inclement weather, then 21 sides must be in the up position. FIREWORK REQUIREMENTS—(In addition to the above) Proof of State License. Proof of Liability insurance. List of items to be sold at site. Copy of Drivers License and Social Security Number of all personnel dealing with the sale of fireworks at the tent location. FEE"s $30.00—City Registration(If Regulated by DBPR—Fee is Waived) $500.00—Fireworks fee-Fire Department fee $ 5.00—Temporary Sales Fee for 1st two days $ 1.00—Temporary Sales Fee per day for each consecutive day thereafter,not to exceed duration of 7 consecutive days and no more than two occurrences during a 12 month period on same property Ord#1038-09,See 6 $60.00—Tent Fee(45.00/13D, 15.00*/FD)—(*$15.00 waived for Fireworks) $45.00—Electrical Fee(if applicable) Property Owner: Zephyr LLC Applicant: Galaxy Fireworks, Inc. Phone Contact: (813) 234-2264 Address Site: 5953 Gall Boulevard, Zephyrhills, Florida 33542 Date(s)of Sale: Sale of Fireworks June 10, 2020 through July 7, 2020 Ordinance No. 1038-09(for additional requirements) x 5953 Gall Blvd. No Fireworks Discharge Fang./ExitU ht Exit4II" � _.— _. NO QFire Extinguisher a a Fire Works No Dtsstgrga Fireworks Discharge Exit A4* Exit44" of Fire Extinguisher Emg./Exit Emg./Exit Q Light Light No Fireworks Discharge _ i'0.`�,i�. mti nSa ,. _ �6—r�•.:..�C• Ib II� �• � ` ICE ^Ii III }:ti.v'�," i70.4-;'�•-'.WR.�. ..f`. IRA%I S!:'.. til_ F \ram�, ~-• '�'i� - - . may, ' • Ff- 3 'J .•;ram l � r�:, � •.. :�-d ` - ' aA. � •✓ rev.. :��.'�';<`; :�,: � 1_ Y� 1�3• .._ram\\�/'. ,� •� .` rr. bt i �j•rifr �.r t�•G � f/ / .+ _ �. MiY4^'J' 1L- � .Ce*`••Y •-rc, � r\� • i \ ��!.V.'•..+�f'.��r n.Y �-.'n.�'.�';-'L�s' v-'"r'� s :.�. f'a Je � •tY - �� • �'►i�•M[^yam 1 �i. a. �.%'" r-;' ..,� -,�c tin„•• .•- ��~~��.,,.y ,"fir = sa�,�,•�c _3` p'���r �.;k.,.�, ZS ::vim Ul r+fa`9' ! /� l/ •�•/ '� _ • VAS.-r,'��{- +! � i.. � K`l ��(�1�'.,• J �,,/� _'�- •�- ow 1 .•f. This site meets the following requirements as set forth in the Florida Fire Prevention Code: 1. Tent is not within 300' of any above ground bulk storage or bulk dispensing areas for flammable or combustible liquids, flammable gas, or flammable liquefied gas per NFPA 1, Section 65.11.3.12.6(1)through 65.11.3.12.6(3). 2. No Smoking and No Fireworks Discharge signs placed near the entrances as required by NFPA 1, Section 65.11.3.11.1, 65.11.3.11.2 and NFPA 1, Section 65.11.4.6.3 respectively.All text will be in accordance with the State Fire Code. 3. Tent is not within 50' of any motor vehicle dispensing station dispensers(NFPA 1, Section 65.11.3.12.2),above ground storage tanks for.flammable or combustible gas, or flammable liquefied gas, compressed natural gas dispensing station dispensers, or retail propane dispensing station dispensers per NFPA 1, Section 65.11.3.12.1(1)through. 65.11.3.12.1(3). 4. This tent meets all clearance criterion regarding buildings, combustibles, other tents, stands, generators(and their applicable fuel storage location), as well as any storage location for consumer fireworks.Tent parking shall be identified as located not less than 10' from the tent. See NFPA 1, Section 65.11.4.9.2.2, Section 65.11.4.9.2.3,and Table 65.11.4.7.2. 5. Interior of this tent follows the diagram provided above and meets all aisle width, exit width, aisle placement and arrangement criterion as noted at NFPA 1, Section 65.11.4.8.1, 65.11.4.8.1.2, 65.11.4.8.5, 65.11.3.14.3.1.1 through 65.11.3.14.3.1.4. There are no dead-end aisles. 6. This facility is equipped with two emergency/exit light sets per NFPA 1, Section 65.11.4.8.3 and 65.11.4.8.4.Hours of operation are suggested as from 9:00 AM through 12:00 AM. This varies as it gets closer to the holiday sales event. 7.. All battery operated equipment, electrical equipment,and electrical cords in this facility are used in accordance with their listing per NFPA 1, Section 65.11.4.9.1. 8. All temporary wiring in the tent shall comply with NFPA 70 (2005 Ed.)article 590"Temporary Wiring"and shall be secured to prevent damage caused by civilian or vehicular traffic per NFPA 1, Section 65.11.4.9.1.1. 9. Generators(if applicable)used at this location operates on a Class II or Class III combustible fuel. Specifically, any generator utilized at this location operates on diesel fuel. 2f LEASE AGREEM E NT This Lease Agreement is entered into as of the 10 day of March 2011 by and between the undersigned Lessor and Galaxy Fiieworks.Inc,a Florida Corporation,having its principal place of business at 204 East Dr.Martin Luther King,Jr.Boulevard,Tampa Florida 33603 ("Lessee's)")for the purpose of establishing the terms and conditions by which Lessor leases certain property to Lessee. In consideration ofthe following covenants and conditions,and of other consideration the receipt and sufficiency ofwhich are acknowledged,Lessor and Lessee agree as follows: 1.Premises Location:The property that is the subject of this Lease Agreement(the"Premises")is located at the following address _5943 Gall Blvd Zeohrvhills Fl 2.Occupancy:Lessor represents and warrants that it owns the Premises,and Lessor hereby grants Lessee the exclusive right to occupy and use the Premises undisturbed during each Term(as hereinafter defined),access thereto(including the rightto cross surrounding property belongingto Lessor,if any),along with all other rights provided to a tenant under the laws of the state of Florida. 3,Term:. The periods during which Lessee will be entitled to occupy the Premises("Terms")are as follows: Term 1 is from_June ISth 24I1 until 3uly7th-201I: lcrm 2 is from Dec.ISth 2011 until January 7�'20I2.("Initial Lease Period"}2011- 2016. Thereafter occupancy will be determined by Lessee's election pursuant to Section 11. This Agreement shall continue in full force and effect until the Option Periods identified in Section 11 below expire; 4. Use:Lessee may use the Premises to sell seasonal products,including but not limited to fireworks and items incidental thereto. S. Rent:Lessee will pay Lessor the sum of $2.000.00 for Term I and$1.500.00 for term 2 which will be due and payable on the first day of the applicable Term. 6. Permits:Lessee agrees to acquire any and all permits required by governing authorities for Lessee's intended use ofthe Premises. If the permits are not approved for any reason,this Agreement will be null and void,and all deposits will be refunded to Lessee.lfE after any necessary permits have been issued to Lessee,Lessee is prevented from using the Premises for the intended purpose of selling fireworks during any part ofa Term because ofan act of God,war,executive order,ordinance,change in law,or other reason beyond Lessor's or Lessee's control,Lessee will be relieved of its obligation to pay rent for that Term,and any rent paid for that Term will eitb er be refunded to Lessee or applied to the next Term,as Lessor chooses. Lessor shall make that choice and notify Lessee within ten days.of being informed by Lessee that it has been prevented-from using the Premises. 7. Indemnification:Lessee shall indemnify and hold Lessor harmless from any and all actions and claims resulting directly and soIelyfromLessee's use of the Premises,including but not limited to claims by Lessee's licensees,or invitee,and trespassers. 8. Fixtures:All structures(including tents)shall be placed,on the Premises under the approval of Lessor. Any placement shall not interfere with Lessor's use of property surrounding the Premises. Any installation shall not damage any of the Lassoes improvements on the Premises. 9. Insurance:Lessee shall provide Lessor with proof of liability insurance before the Term begins.Liability insurance shall be in an amount ofnot less than$1,000,000.for each occurrence. 10. Maintenance:Lessee shall maintain the Premises-in an orderly manner and will haul away any and all trash made by Lessee,its%istomers,and vendor prior to vacating the Premises, 11. Option:Following the Initial Lease Period,this Agreement will remain in effect for an additional five years("Option Period'.However,ifLessee notifies Lessor 30 days in advance of particular year during the Option Period that Lessee elects to not exercise its option for thatyear,Lessee will not be required to pay rent for thatyear,and Lessorw ill be free to rent the Premises to someone else for thatyea,subject to Lessee's right of first refusal set forth below. Such election will not affect subsequent years. In the event that Lessee elects to not exercise its option for a particular year,Lessee has the exclusive right ofrefusal to match any and all offers to lease the Premises during that year.Lessor shall notify Lessee in writing of any such offer andthe terms thereof,and provide Lessee thirty days to elect to exercise or waive the right of first refusal. 12. Non-compete:Lessor agrees to not sell or permit the sale of fireworks by anyone other than Lessee on any property owned or leased by Lessor - within 2 miles of the Premises. 13. Cancellation: If the Premises is sold,master leased on along tern basis other than for the sale of fireworks,or the law is changed to prohibit the sale of fireworks for all remaining Terms,this Agreement may be canceled by either party providing thirty,days written notice to the other party. IN WITNESS WHEREOF,Lessor and Lessee have each caused this Agreement to be executed and to take effect as of the date first above written as evidenced by the signatures of their respective duly authorized representatives appearing below. y Fireworks,Incorporated(Lessee) .r -. �-sr� (Lessor) �% J BY By: Signature Signature ,q Ricky Johnson.Vice-Presfdent __ Q � vY t U�Lr Na c and Title Name and Title Date Signed Date Signed t .Before me,the undersigned Notary Public,personally appeared .G U c; S`G,... known to me to be the person who . exeouted-the foregoing Lease Agreement,and she/he acknowledged to and before me that she/he executed such instrument and agrees to fully comply therewith. ,. rfir C Ce , ate of Flame Res� . Issued By : ' �� - Date Fabric R Oa B®k 128 Aunufadured 8 Number _ a -le F46,001 6 /0 ypam V.i.MM$4m8 43 ➢J Vp M+u'�0 91b Lake,, FL - 39 `1-80044 -3848 - 86 499-9 182 abdent ciker@yghoo'.CO www.abde s.co ihis is to ced- Ify that this fabric.168 flume retardant. It is inherent and cannot be removed y age. at is-registered with the Cafifamin Stale Fire Marshall. and meets gKRA. 701 and 903.2 tests and codes. _ Tho Retardantprocess Used WILL NOT Be Reve Washing& AUC TeRft BY g KCIBRO.of �adudi n-S apedniendent Tent SID Color Mark Chapter 16, verses I o into all the world and preach the gospel fo 'ev"ery creature©...... 0 1 DATE(MMIDO/YYYY) ACOORL)i CERTIFICATE OF LIABILITY INSURANCE 164� 1 1122r2O2O 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 tenns,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 ofsuch endorsement(s). TREEND - C PRODUCER c,0QN.TA;LT ERJ ACRISURE LLC PHONE JAIC No V�n_- (000.)748-0351 1375 EAST 9TH STREET,30TH FLOOR,SUITE 3000 RiMAIL)BRESS. eric:treend@btfttongellagher-com INS )AFFORDING COVERAGE NAIC# CLEVELAND OH 44114 INSURER A: FWCJUA INSURED INSURER 8,'- GALAXY FIREWORKS INC INSURER C. 204 E MARTIN LUTHER KING BLVD INSURER 0: I TAmPA FL 336030000 INSURER E. FEIN:593092878 INSURER F: COVERAGES CERTIFICATE NUMIOER., 200I220005 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 Okc6NDITION 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.LIMITSSROWN MAY HAVE 13EEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR PoLICYEFF POLICY EXP' LTR TYPE OF INSURANCE -jam-wa POLICY NUMBER fMM1DD7YYYY) (MWDDNYYY) LIMITS COMMERCIAL GENERAL LMSM EACH OCCURRENCE $ CLAIMS-MADE F7 OCCUR PREIASES(Ea o=rrenw) $ MED EXP UVw onewson) $ PERSONAL,&ADVINIURY $ GENL AGGREGATE.LIMIT APPLIESPEIt GENERAL AGGREGATE $ 7 L02C PRODUCTS-COMPIOP AGG $ Policy E SECT OTHER: $ AUTOMOBILE-LIABILITY STN LIMIT 3 ANYAUTO BODILY INJURY(Per wison) $ OWNED SCHEDULED BODILY INJURY(Per semlerd) S AUTOS HIRED ONLY MOT&NED (PPROFER AUTOS ONLY AUTOSONLY UMBRELLA LIAB OCCUR EACHOCCURRENCE, $ EXCESS LIAR HCIAIMSMADE AGGREGATE $ DED RETENTION 5 $ R ---Fs I WQRKERS COMPENSATION DA 1.ffE� I EON" AND EMPLOYERS'LIABILITY YIN ANY PRQPRIF-70R/PARTNE R`P�ECUTIVE E.L_EACHACCIDENT 500,000.00 A OFFICEWAiEMBEREXCLUDED3 FN 2E637021 1/1912020 1/1 MIA 9/2021 (Mandatory in Nri) EL DISEASE-EA EMPLOYE -$ 500,000-00 II�ygi M gtundar OF OPERATIONS below EE E.L.DISEASE-POLICY LIFAIT $ 50000-00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Rernariu;Schedulei May be attached if more SPaCe Is required) CERTIFICATE HOLDER CANCELLATION City of Zephyrhills SHOULD ANY OF THE ABOVE DESCRIBEDPOLICIES BE CANCELLED BORE 5335 M Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Zephyrhills FL 33542 AUTHORIZED REPRESENTATIVE Phone Number: (813)7$0_000d O 1988-2015 ACORD CORPORATION. Ali rights reserved. ACORD 25(2016f03) The ACORD name and logo are registered marks of ACORD 'cv:Y�% c3�^.•¢ter.>33' .tf 'Xt i; �7'i:'.,._ g.rs;r, 7p a�ot,yam .s �>•,�,;=#y.t laws "a:?�'�::> ^f ,r.,`-bj,.�':{iity�:X?;'`i!�i;`-)`rxEf%'t:,3�:,:k;7:'•7'',-a, �S*.fiftr3z4^fc •y +;t#. ,.3 js-r t,�, ..�" q;'' :U;:_fi,': :i-�•r ;:t�: rq`vi";:-�r�: .<,. �i Air.it,'ii s .f"��,-�c;�tc•;r; ,.t, ��[�,� .-,l,'- `if.`. .}.:'•,f°l:.�.iei::::i•':fy}�ei.::...,^,;.,..Y%;.t rt�'iw'i't1' R�4F4....,.rr,i�7-�r ,'f^,`•L=iF .y yt a,'.' �..t4.4%�Y;,r,:.r:er^. -r.;.r.-a.y ,,°��..,r? t+`r."!-��:! 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Jimmy Patronis Casia Sinco CHIEF FINANCIAL OFFICER BUREAU CHIEF Julius Halas DIVISION DIRECTOR Keith McCarthy SAFETY PROGRAM MANAGER FLOMA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE NLARSHAL 200 East Gaines Street -Tallahassee,Florida 32399-0342 Tel.850-413-36" Fax.850410-2467 CERTIFICATE OF REGISTRATION ' RETAIELER OFFICIAL COPY THIS CERTIFIES THAT: Galaxy Fireworks 204 E Martin-Luther King Blvd Tampa FL 33 603 Has registered pursuant to the provisions of Florida Statues to engage in the business of selling sparklers to consumers at retail at the following fixed place of business: 5953 Gall Blvd Zephyrhills Fl Hillsborough Issue Date: 02/01/2020 Type: 07 Class,:, 64 County: Pasco License/Permit 186104-0008-2010 Expiration Date: 01/31/2021- Chief Financial Officer 3' Cj Jimmy Patroais Casia sinco CHIEF FINANCIAL OFFICER BUREAU CHIEF Julius Halas Keith McCarthy DIVISION DIRECTOR .a SAFETY PROGRAM MANAGER FLOMA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE MARSHAL 200 Fist Gaines Street -Tallahassee,Florida 32399-0342 Tel.s50.-413-3.644 Fax..850-410-246.7 CERTIFICATE OF REGISTRATION DISTRIBUTOR OYSPARKLERS OFFICIAL COPY THIS CERTIFIES THAT: Galaxy Connection Inc.' 204 E Martin Luther King Blvd Tampa FL 33603 Has registered pursuant to the provisions,of Florida Statues to engage in the business of selling sparklers to a. . wholesaler. Issue Date: 02/01/2020 Type: 07 Class: 61 County: Hillsborough License/Permit#: 725841-0001-2006 Expiration Date: 01/31/2021 Chief Financial Officer Jimmy Patronis Casia Sinco CHIEF FINANCIAL OFFICER BUREATY CHIEF .7nhns Halas Keith McCarthy DIVISION DIRECTOR SAFETY PROGRAM MANAGER FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE MARSHAL 200 East Gaines Street -Tallahassee,Florida 32399-0342 Tel.850-41.3-3644 Fax.850-410-2467 CERTIFICATE OF REGISTRATION WHOLESALER OF SPARKLERS OFFICIAL COPY THIS CERTIFIES THAT: Galaxy Connection Inc. 204 E Martin Luther King Blvd Tampa FL 33603 Has registered pursuant to the provisions of Florida Statues to engage in xhe business of selling sparklers to a retailer. Issue Date: 02/01/2020 Type: 07 Class: 62 County: Hillsborough License/Permit#: 725841-0001-2006 Expiration Date: , 01/31/2021 Chief Financial Officer ',,:E.,`•r'r:,T'��'''••a^+,�".'n'., x:2'.•,11'y:.�:^t.�1 '"S'yi .L� .u•y '?C•sx r:•,:r:: i �11 J :c M +..•5",�•v„Jr'�:,'~ � �max: .S+:�;�.^:.,:':vim^.,,,'•:...:'�''• _ a it rr _ ^7 r: �S'Cr StCv;,, �.. L �.4 "U. rW: Y•r ui)". r c 'f �r '•rr. .s -fir �•, �'�•` •'. •mot,: �.� _..a_� .r r ',t x tz- - :wjr:vt� •t':' rya•. �: _ _ .,:o-W..;:�. '� '5;:..: _ __ �A .,ti"; � :C`y,: ..ram{ •c'...fir. .;.:•ttz.:•. �� "•tom .yM •a2+L•. .�'IA-7R,• .t,t,.• n+ti".+ _ )•+„'_-'_•...' a: KIN tttt „� Y,� ice'%;v'!..: L'�+.i~: .F'..rr , .:.t.�, •�Y...•�....t:` •iSt^ .. ;.,,;:-::c'' 5 . _' -'•i,-. pia': .-:.::• •'�:.. gfi ,'•> c -;; ;. •• h.eM• CERTIFICATE OF LIABILITY INSURANCEF5/21120(MM/D19 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 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: Britton Gallagher PHONEo _ aac No:21 - 1 One Cleveland Center, Floor 30 E-MAIL 1375 East 9th Street ADDRESS: Cleveland OH 44114 INSURERS AFFORDING COVERAGE NAIC# INSURER A�AXiS Surplus Ins Company INSURED INSUPiRB:Everest IndemnityInsurance Co. 0851 Galaxy Fireworks Inc. INSURER C 204 E.Martin Luther King Blvd INSURERD': Tampa FL 33603 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:1121001087 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. I� TYPE OF INSURANCE A L S POLICY EFF POLICY IXP LIMITS INSR WVD POLICY NUMBER MM/DD MM/DD B GENERAL LIABILITY SIBML00324-191 6/10/2019 6/10/2020 EACH OCCURRENCE S1,000,000 AGE TO RERTE-D x COMMERCIAL GENERAL LIABILITY PREMISES(S Ea occurrence) $500,000 CLAIMS-MADE a OCCUR MED EXP(Any oneperson) S PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2 000 000 GEN'LAGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG S2.000.000 POLICY PRO LOC S C I AUTOMOBILE LIABILITY SIBCA00081-191 6/10/2019 6/10/2020 Ea cadent L LIMIT S1,000,000 X I ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NUTOS ON-OWNED PROPERTY DAMAGE x HIRED AUTOS X AUTOS (Per accident) $ S A UMBRELLA LIAB OCCUR Excess binder 6/10/2019 8/10/2020 EACH OCCURRENCE $4,000,000 X X EXCESS LIAR CLAIMS-MADE AGGREGATE S4,000,000 DEO I I RETENTION$ S WORKERS COMPENSATION WC STATU• OTH- AND EMPLOYERS'LIABILITY YIN TT i ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandator- In NH) E.L.DISEASE-EA EMPLOYE $ Iles,describe under DCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. Location:5953 Gall Blvd,Zephyrhills Additional Insureds:City of Zephyrhills, Mark Ayer and all his agents, representatives and subsidiaries (Workmen Comp) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Zephyrhills THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 6907 Dairy Rd ACCORDANCE WITH THE POLICY PROVISIONS. Zephyrhills FL 33542 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) 'The ACORD name and logo are registered marks of ACORD DR117$RLIC't$FSsr.LA E sir.• '. Y1,A Oourasien a+aenotm vehcb ce+ntiams eon-..entmafi�saLne19 xsr roquwd ey;tr, �,� - 3i-- 140rb 5953 Gall Blvd. No Fireworks Discharge we./Exit tight U� Exk44" Q����i �■ QFire Extinguisher No Fire Works No Discharge Fireworks Discharge Exit44" Exit44' 01 FireExtiaguisher 0./Exit Emg./Exit O tight Light r---- NoRrevorksDischaree 5a �' r•i K � —_ _ _ M�i1' - ' fir, t` '.��':P„i�-�3�,' �.y�;;i',rti,;..:.:::. ."•'t.i -' '•`,e,,' _ .� •+:'iat'.,�� •:�?;� '� yr` rr �� _ <r�..�7}�. •t .� V„ _ _ .F"r it i" .g ,,;t.';s...f. "'7^.:']+-.""¢: 4Y::•;:w'-';:t::r,%'.,:i �`+1-J:' 7' .�^ ''f�•, � � T.— FfM1m _ '�iMSpL`.VA,':';1^M.�,}'ter. ..r�e�i7 'rya~..x,•;.-=rrc ..��ma. .�y,�.K.:,'S;'• - - F �: IF - May. 31. 2019 2:39PM GALAXY FIREWORKS No. 7025 P. 2 CERTIFICATE OF LIABILITY INSURANCE 21/201 THIS CERTIFICATE 8 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AFFIRiNATNELY Oit NEGATMY AMEND.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE"OF INSURANCE DOES NOT CONSTITUTE A CONMOT BETWEEN THE ISSUING INSURE4t(3),AUTHORIZED REPRESENTATIVE OR PRODUCFA AND THE CERTIFICATE HOLDER iMpORTA-0- if the,eartinescta holder is an ADDITIONAL INSURED,the policy(eas)must be endorsed. IESUBROGATION IS WANED,subjectto the tem and conditns of the polity}corlaln policies may requke an endamen+e:d. A vtatement an eft tsrtl "ts does not taller rights to the certit aW holder In Rau ofssach andeisernen 'PIi6l5tICFJZ R E: Britton Gallagher Pi# ti 97 ne Cleveland Center,Floor 30 1STS East St.Street Cleveland OH"114 WSUWMEMMMtoVMAW coma* reilm&Ayft SuMfus Ins CornR@ay WSVRW tp Fir8woft[no INWISItC. 2 Martin Luther King Blvd Ra: t Tampa FL 33M e, i COI+ERA+GE$ CERTiRGATE NUMBER:1'121001087 ut F: REVISION NUMBER: TI1t5 IS TO C FY AT THE POLICIES OF INWRANCiE LISTED BELOW HAVE BEEN 1 UED Q !N ED ED ABOVE FOR THE POLICY PERtO 7s INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONOMON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO tAHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 18 SUS=T TO AU.THE TERMS. EXCWSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWRMAY HAVE BEEN REDUCED BY PAID CLAIMS. r rmeoFlNsrtRANce VOLICYNUMSER I LIMlrs yENStALLKW v SISML00 4.191 8r701E019 6t10t20it0 EACHMRENCE $1.0W.000 C wr;;RClALovmAL"Lrry .Errs,Wuia= S9Dix= CLA)MS.MADE Q CCCUR MEDEXP(Aft em ywN 5 PER8bNA4&A4VKXRY S1.004.000 GENLOALAGGREGATE $1000 000 C-eftAGOREOATEttWACIPsPER: RRODvcTS-COMPA?AG3 000.000 I -7 POLICY M M& F1 I Is C AY'r"COL!UABII.ITY SISCACOOSI.101 0=01e W1012020 E YtN�_ �•^' _000 ANY _ "1 RY ipaP=") S Mv$NVEO A�OULfD 8t}DtLY RQURY 6WAOCit A 3 }lsii$OAA!<AfCkS X AS P 6 5 urrsREttA LIAR 7C OCCUR Eg" Nfidee 6H0i2019 CM0442D EACH 0=MR9NOD �$4.000.000 X FJCC£SSriRa CtAIMS4AAVE AMEGAM sa•_000.000 O 1 ETENTtlJN# $ I WOtkJSF M COMP�V$P.TIOM ALL OTM. AHD PAPLOVEtB'URBXM —•. I gW=11EAAKWM=V 11@("N Nto EL EACHACCIAENT S •_ t Off-4PERAT28N5 betow t-3 ' E`CfiSEASE.EA Eb1PL0Y 9 _ (IIEe,tde2o&MI" EL _ --1 , Di85• -PdLIGY LIMrt't E •,_,. I i CPSCRifYnCNOFaPERATl0HS1l,OCA'riCNS>'Vl;FttG#,LS tAll�dsAGORDi4i,ACittttaesatRcmaetcsiGet,eru,tgiteaaeevaesieteRrtatiCl Additional Insdrad extension of coverage is provided by above referenced General Liability potiay where requitesi by written agreement_ Location:5853 Gall Bw,Zephyrhills Adtlit onsl Insweds:City of Zephyrhiiis,Mark Ayer and all his agents,representatives and subsidiafts (Workman CwV) CERTIFICATE l4C1LDER CANCELLATION WOULD ANY OF THEABOV9 05MMEOPiDUCIESBECANMLEDoEFolM City i 7 f Zep rhiiis THE SWIRATION DATE THERE, NOTICE MRLL BE DELIYER'ED IN 1 6907 hiryFRLd3:i542 �►*C CE►Ntt?iTi#'IH6POuOYR %nfflONs, ZophAUTHDRWRE aTATIVM tS INO-2010 ACORO CORPORATION, All rights reserved. ACORD 25 W0105) The AGORD name and logo am ragistamd marks of ACORD i tV ems. `.�` �. .t.rr � r� ••{4 " , .� `�i�• � .• J.07 • � iL•''.:ia f .+\7•�j"'��'� �'. t+ ' . .. 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