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Home My WebLink About07-6783 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 6783 Permit Number: Permit Type: Class of Work: Proposed Use: Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: 6783 COMMERCIAL ADD/AL T COMMERCIAL COMMERCIAL Address: 38544 5TH AVE ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 11-26-21-0010-16900-0080 31,000.00 7/23/2007 263.90 263.90 7/23/2007 Phone: REMOVE/REPLACE GAS CANOPY 30x20 JAPAG P.O. BOX 711 DALLAS,TX 75221 IL FIRE PLAN REVIEW FEES 26.40 6LD& ~ 00112 & Z S:-b r-l nu..lu~ "6JrT 107 <a-{2B;{o7 ItCsL.- E FOOTER BOND ROUGH ELECTRIC PRE-SLAB LINTEL PRE-METER SHEATHING REINSPECTlON FEES: Reinspection fees will comply with Florida statute 553.80 (2)(c) when extra inspection trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d) work not ready for inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible. MISC. MISC. FIRE DEPT. FINAL ELECTRICAL FINAL BUILDING FINAL 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 permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "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." CONTRACTOR SIGNATURE PERMIT OFFI PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER .Il 4K~~' El · J ~~1~. ectrlc ~n.~ 2517 COUNTRY CLUB ROAD SANFORD, FLORIDA 32771 407/323-6300 407/323-6206 FAX service@kkelectric.com POWER OF ATTORNEY I hereby appoint Tasha R. arian to be my lawful attorney in fact to act for me and apply to the 011 h r h;/IS Building Departmentfor pennitsfor work to be peifonned at the location described below or for the purpose of attaining a license for the following: 38"544 5~ ~-e. tQrGl.' :1:1: 1l-<9l.t> -cl 1- ~OlO - lCPQOQ- 00%0 Certified Electrical Contractor: CHRISTOPHER N ERRARA LICENSE #EC0001650 Signature of Certified Contractor: Christopher N Ferrara, who is personally known to me and who did not take an oath acknowledged this foregoing instrument before me this / V^- day of ~(jS+ ,2007. County of Seminole State of Florida Notary Public: ~. ~(~'-_.- TAMMy A. LVVV IHCK COMMISSION' 00289978 ~"~~~ EXPIRES f~I~8 r" ,.., ,.".' llONDfD THROUGH ~ .. ":". ..~' "~NCECOMPANY ..~ t.. '\_..___",-nx:'-.'L :_-~.-": -f~' Signature: Printed Name of Nota ~~ CJ} ~~ ~~ mo ~o ~o ~o ro~ ~~ ""~~~~~~O~'ltm~~" ~ i~~ I;~ I~ :'111 i:~' i.~ I@; ,~ 'i I~ "" I'i ~ ..., is; i~ i:S I.. IS: ~ jg ;; !~ t: I~ > '\ li~ I~ II~. b ~L- ilf i~ ;::; I v, ~U I~P'\ I~; I~ 1ffi!5 Iiii!O Iu I' 1iW ~ ] I~~ :E Iw Cw, ..... ~ N . 51 t") ..-I oN ~S QOl OlOl <nS (I)~ Ole: 1-:J ....0 0.0 XO WCZ: ~;; 6 ::' I \ ;-~.~ (5 ;- :~ B me :/) i..L; .~,.. us :::l ,..Q Z .J.l D ::/' .j "7 '.i 0:: cz: 0:: 0:: W IL ISZ It) \DO:: ..-IW I~ I- u<n WH 0:: I:J: U '* o I 001- W....Ol 1-...1.... cz: ..... ...1Ol.... ::>.&.J..-f <!J <<HU w~ :J 0::<n0' 'I; ...,. I..:J ) ;~ '-' ~ :> '- ~ o 0:: U ..-I zoo..... H::>..... ...1N UUt") H 0::> 1-0::...1 Ul-IL WZ ...1 ::> . woo uo:: ~ 0 .....IL t4..-1Z It)cz: ~N<n ,-.. 0:: W,-.. UO:: HW ILU ILH OIL -IL o - cz: 0:: CZ:W 0::0:: 0::0:: wo ILl- cz: Z...1 ...1 o::w wo :J: 0.....1 o I-<n <ncz: HE 0::0 :J::J: ul- ..!~ii i;sl :.~ i.:::;' i~~i iEi ~il !i:; i!~ jgj "" ~:? Ii:.: ~ ,~ ,,,,, i~~ I~ !~: L:, i.;" ii~; ii_~ I;;;; I~ I!~ ~ I~ 19 i;,s; I~ 0:5 ,i !;I ii2: Ii! ig i~ '~ l:Ei ..-I i~ 'C""f '= loa ~ 172' ~ I ~ IS \D ~ N \D ..-I IS ..-I o 0:: U ..-I zm..... H::>..... ...1N uut") H 0::> 1-0::...1 Ul-IL WZ ...1::> . woo uo:: ~ 0 .....IL t4..-1Z 1t)CZ: ~N<n ~ It) <:r * '0 .... IU 0.. .&.J e: :J o E cz: BJT Ai TiE :OF f'UJg~[[))A DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 (850) 487-1395 ;fb 1- 3Z3-63tkJ FERRARA, CHRISTOPHER N K & K ELECTRIC, INC, 3965 ATRIUM DR ORLANDO FL 32822 ,'~. STATE OF FLORIDA AC# :::::: 23:" =: j ~.~ ,DEPARTMENT OF BUSINESS AND "',;"",-) PROFESSIONAL REGULATION EC0001650 06/20/06 058094916 CERTIFIED ELECTRICAL CONTRACTOR FERRARA, CHRISTOPHER N K & K ELECTRIC, INC. IS CERTIFIED under the provisions of ch,489 FS. l Expiration date, AOG 31, 2008 L06062001079 DETACH HERE AC# ? r:: ? ~ -~) n ::- ..J ~ --""," ..- __. -y STATE OF FlORIIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD SEQ#L06062001079 : - LICENSE NBR 106 20 2006 058094916 EC0001650 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS, Expiration date: AUG 31, 2008 , DATE FERRARA, CHRISTOPHER N K & K ELECTRIC, INC. 2732 TOLWORTH AVE ORLANDO FL 32837 JEB BUSH GOVERNOR DISPLAY AS REQUIRED BY LAW SIMONE MARS TILLER SECRETARY ACORD~ CERTIFICATE OF LIABILITY INSURANCE OP 10 Lf DATE (~DDIYYYV) K&KEL 1 11/27/06 PROllUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE qrown & Brown of Florida, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR . O. Box 15519 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ~ampa FL 33684-5519 'INSURERS AFFORDING COVERAGE I Phone: 813-226-1300 Fax: 813-226-1313 I NAIC# INSURED INSURER A: SOUTHERN-OWNERS 10190 INSURER B: AUTO OWNERS INSURANCE 18988 K&K Electric Inc INSURER c: Bridqefield Emplovers Ins. 10701 2517 countX'J Club Rd !INSURER D: Travelers Prop Cas of AIDer 25674 Sanford FL 2771 INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTRiNSRD TYPE OF INSURANCE POUCYNUMBER ; DATE (.....DD/YY\- DATE'I;.wDrfiii" LIMTS T T GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 i------, A R3MMERCIAL GENE~IABILITY 20659855 12/01/06 12/01/07 ~~~~s (Ea occurence) $ 300,000 CLAIMS MADE ~ OCCUR MED EX? (Anyone person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 i ~ ' GENERAL AGGREGATE $ 2, 000, 000 I GEN'L AGG~nE LIMIT APPLIES PER: i PRODUCTS. COM PlOP AGG $2,000,000 ! Xl . PRO- n . , i X POLICY ! JECT LOC I ~TOMOBlLE UABlLlTY , I I COMBINED SINGLE LIMIT ! $ 1,000,000 B ~ ANY AUTO 4613860301 12/01/06 12/01/07 i (Eaaccldent) i ALL OWNED AUTOS I BODILY INJURY ~ SCHEDULED AUTOS i (Per person) $ I~ HIRED AUTOS I BODILY INJURY $ ~ NON.OWNED AUTOS I (Per accident) " I PROPERTY DAMAGE H I (Per accident) $ , ! ~RAGE LIABILITY i I AUTO ONL Y - EA ACCIDENT $ I I OTHER THAN I , H ANY AUTO EA ACC $ i ! AUTO ONL Y: AGG $ i : : i EXCESS/UMBRELLALIABlUTY I EACH OCCURRENCE $ 1,000,000 B Ii] OCCUR [J CLAIMS MADE 4613860300 12/01/06 12/01/07 AGGREGATE $ 1,000,000 I $ ~ DEDUCTIBLE $ X RETENTION $10,000 I $ WORKERS COMPENSATION AND I I X I Tg~lLI~if's I IUE~- C EMPLOYERS' LIABILITY 83029562 12/01/06 I 12/01/07 $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE EL. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? I E.L. DISEASE - EA EMPLOYEE $ 1,000,000 ~rc;'~Ls~~~~~~NS below . , E.L. DISEASE - POLICY LIMIT $ 1,000,000 J OTHER i i D I Lsd/Rntd Equip QT6604956C571 12/01/06 12/01/07 Lsd/Rntd $100,000 , . , Ded $1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS E1ectrical Contractor CERTIFICATE HOLDER :-- City of Zephyrhills 5335 8th St Zephyrhills FL 33540 CANCELLATION CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 010 DAYS WRITTEN NOTICE TO THE CERTlRCATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHAlL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPR SENTATlVES. AU 0 ESENTATIVE .". 1 ACORD 25 (2001/08) @ACORD CORPORATION 1988 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813) 780-0020 BUILDING PERMIT 6783 Permit Number: 6783 Permit Type: COMMERCIAL Class of Work: ADD/AL T COMMERCIAL Proposed Use: COMMERCIAL Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: 31,000.00 7/23/2007 263.90 263.90 7/23/2007 Phone: REMOVE/REPLACE GAS CANOPY 30x20 Address: 38544 5TH AVE ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 11-26-21-0010-16900-0080 B FIRE PLAN REVIEW FEES 26.40 E FOOTER BOND ROUGH ELECTRIC PRE-SLAB LINTEL PRE-METER SHEATHING REINSPECTlON FEES: Reinspection fees will comply with Florida statute 553.80 (2)( c) when extra inspection trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d) work not ready for inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible. MISC. MISC. FIRE DEPT. FINAL ELECTRICAL FINAL BUILDING FINAL 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 permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your prope . If you intend to obtain financing, consult with your lender or an attorney before reco ing your noti of commencement." TURE PERMIT OFFI PERMIT IRES IN 6 MONTHS WITHOUT APPROVED INSPECTION A L FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 7/11 Gas Canopy - 5th Ave - 38544 - Jimco Sales SQ. FEET PRICE MAIN OR LIVING: - $ - OTHER AREA UNDER ROOF: - $ - OTHER: - $ - VALUATION $ - FEE SHEET $ - ADDRESS $ - DRIVEWAY $ - BUILDING: $ 202.50 ELECTRICAL: $ 35.00 PLUMBING: $ - MECHANICAL: $ - SUB-TOTAL $ 237.50 RADON: $ - TOTAL $ 237.50 SEWER: $ - WATER: $ - IRRIGATION: $ - TOTAL: $ - WATER METER: I $ IRRIGATION METER $ - I FIRE DEPARTMENT FEES PLANS TOTAL: $ 26.40 INSPECTION TOTAL: $ - PERMIT TOTAL $ - TOTAL: $ 26.40 PUBLIC SAFETY IMPACT FEES POLICE $ - FIRE $ - 5% $ - TOTAL: $ - Not Applicable SUB-TOTAL $ 263.90 I PARK IMPACT FEESI$ . I Not Applicable SIF'S: $ - 100.0% $ - 1.0% $ - TOTAL: $ - Not Applicable T I F 'S :1 $ 99% $ 1% $ : I Not Applicable TOTAL: $ 263.90 I City of Zephyrhills - Building Department 5335 8th Street PH: 813-780-0020 Zephyrhills, Florida 33542 FAX: 813-780-0021 Date: 6-28-2007 TO: Thomas Rychlock FROM: 1(aren Email: kmiller@ci.zeohvrhills.fl.us # PAGES: 2 FAX#: 407-298-3894 Message: In response to our conversation, please sign the attached under the Electrical and refax back to me. Thank you. JUN-29-20~7 ;0:41A FROM:RYCH~O~K ELECT~IC 40~2983894 TO: 18137800021 JUN12B1200 l/THU U8: ~~ AM It;t'HYlffilL~ WlLUlM.i ~AA No, 111 j-1~U-UULl P.l 1". UUL 11~ Cily of %eptlymII8 Permit AJJpllcdan ~0IpIIanI ,..,~.,.., ... AMIfM o-w.,... ...... 0............. r ........... .....1 0lMa"t ... I 1 =~~~ ~~~~:~~~~l .............-w__ ~~. . B NlWCONSTIt B ~"..iS2 .. 0 IoCJI/I! CI IJirDJSfl . IN8TALL IlEPAlII PAOPOIID" c:l 8M CJ CCMI Cl OMiR I 'fYIIICJI~ 0 .ILDCIC D l'IWIE CJ ma. -CJ cmtI!RL =.., ~'..~~~~5b~ ~ So 8tIUlNI r . ~\.eQO J VALUA1lCItIMTOTALCON8I'IlUC'I'lO CJ E\.&elIlICAL r f NlPI8MCZ c::J PMGRaaIBl!RG'l ~ D PL~ ~ I ~e;t CJ IIl!.CHIlNIOAI. r I \IALUo\1IClN Of IECiwIcAL 1NIITALLA11flN - ~~. CJ GM CJ ROClI''' 0 PRW-W CJ OPB - . =- __ . -- . -, - '~1'IDOR1!l1lVA1'lON& I J FL.DClDZOte.w!A c:::Jva CJNo aD.CR:> _ =",_1 'Y'1 ~~ ~~ = I~ ~ U!U " . Jet. -= ....... ~. JT.~ ~ f ~, ~r'~ I ~==N Q, ~ == I ~(6::=-~\~~"1.~ to I~ ~ MdtwI 'a 'J.. t'\ 41" ~ 0 lc fI 0.. J ~? olJ-. I ~ e OOCS \ ~ CD" I . = L LWLJ . 1M""" ~ ' I UaMII. r I I =: I U!.!!..J .._ u.au I J ~. , I I = I LWLJ ........ L.WU I I ~. I I "' F/rr' -f.,ltL~ ~ Cl WRJ!.C. PLu.BI lIGNA'''''. ,..,....1 ==1 ...... I =-1 ~r ~ ClOIIIIRI:W. "ill PIlI ~ lfJ _ .....PIItlI; (t)... .,........ ......11II(10)......,...,.......... ~..... CCIIINlfMPIInI,...., ,..... '.... ,..m-.,....."'-('I)...._~. " ..... ttat__............. ,......... ~......lIIIiIIfy,.....a ,........ "........ ........................ MItlIl CIJ-.............i~1URYIi'I......_.1III!W II .A.~_ lIICJN ....,. DlM"- .., 1Ul............. 0Inr.~...._1lII............. tt_--.......c--...'nrv- 'If....... wc,......--. .. A.- (IIr"'~.""'.-",""''''''--'''-''''--'''''''''-''''''- ova.... ccunIil__....o (PIIrIafJlllllllallDn ~ ..... ..... llItla \lpIIIdIe IIIC '-~I-"" D.1I. ~....NIII_OcndIrI..",*~M1N 813-180-0020 Date Received Owner's Name JOB ADDRESS SUBDIVISION WORK PROPOSED PROPOSED USE TYPE OF CONSTRUCTION DESCRIPTION OF WORK BUILDtNG SIZE g BUILDING D ELECTRICAL D PLUMBING D MECHANICAL D GAS 1$ 1$ 1$ 1$ D FINISHED FLOOR ELEVATIONS I 111I1111III1111II. BUILDER SIGNATURE Address I ELECTRICIAN- SIGNATURE Address PLUMBER SIGNATURE City of Zephyrhills Permit Application Building Department Fax-813-18D-0021 Owner Phone Number Owner Phone Number I Owner Phone Number I 3 5+9 I E3 NEW CONSTR B ADD/AL T ~ SIGN D MOVE D DEMOLISH INSTALL REPAIR D SFR D COMM D OTHER D BLOCK D FRAME D STEEL D OTHER I I QeM~/ ;b l<e~Io~ (;:t\;'~ c''l6fil I sa FOOTAGE:?:> 0 )(. ~ H~IGHT _11I;1 - Flrn - l.v/l '- ~\~7 c~~;:- 4._i/~.' ~0C- ... F~"Z ~'~\\\ .. _ ~- ~\tOOO I I I I D I Olb, C5l? _ I~~- VALUATION OF TOTAL CONSTRUCTION D AMP SERVICE PROGRESS ENERGY VALUATION OF MECHANICAL INSTALLATION ROOFING SPECIALTY D OTHER FLOOD ZONE AREA DYES DNO It& 10'MCO~ I Y IN I FEE CURRENT ~ License II COMPANY REGISTERED Y/N FEE CURRENT W!!...J License II COMPANY REGISTERED Y/N FEE CURRENT W!!...J License II COMPANY REGISTERED Y IN FEE CURRENT W!!...J License II Address MECHANICAL I SIGNATURE Address I OTHER I SIGNATURE Address I RESIDENTIAL COMMERCIAL SIGN PERMIT Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) wor1<ing days after submittal dale. Required onslle, Construction Plans. Sanitary Facilities & 1 dumpster Attach (3) sets of Building Plans; (1) set of Energy Fonns. Minimum ten (10) working days after submittal date. Required onsile, ConstlllCtion Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance. Attach (2) sets of Engineered Plans. -PROPERTY SURVEY required for all NEW construction. _J 1>.. Directions: Fill out application completely. Owner & Contrador sign back of application, notarized If over $2500, a Notice of Commencement Is required. (AIC upgrades over $5000) Agent (for the contrador) or Power of Attorney (for the owner) would be someone with notalized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades AlC Fences (PlotlSurveylFootage) Driveways-Not over Counter if on pUblic roadways"needs ROW P.Ol/Ol TRANSACTION REPORT JUN/28/2007/THU 09:58 AM RECEIVER 814072983894 TYPE/NOTE OK FILE ECM 4825 ..................."....... .........,.............. ..................... ......... ....... City of.Zephyrhills - Building Department 5335 8th Street PH: 813-780-0020 Zephyrhills, Florida 33542 FAX: 813-780-0021 Date: 6-28':2007 TO: Thomas Rychlock FROM: Email: # PAGES: . 1.(pren kmi lIer(Q)ci .zeDhvrhi IIs.fLus 2 FAX:IF: 407-298-3894 Message: In response to our conversation, please sign the attached under the Electrical and refax back to me. Thank you. Fire Chief Robert Hartwig ZEPHYRHILLS FIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 Bus (813) 780-0041 Fax (813) 780-0044 FIRE SERVICE USER FEES Occupancy No.: Plan No.: O?-~ ~~~:~:~~~~X:~s: I $ $~ Business Phone No.: Billing Phone No.: t#'J'- ~Y7- ~3c) Business Fax No.: Billing Fax No.: Contact: Contact: A. PLAN REVIEW FEES Cllfivl'lf'~ite Plan N/C 1~ j Building Plans .04 sf ~/p11 Revision .06 sf STANDPIPE SYSTEM [J Per Riser $25 SPRINKLER SYSTEMS n 0 - 25 Heads $30 o 26 plus Heads $60 FIRE PUMP o Per Pump $100 FIRE ALARM SYSTEM o 0 - 25 Devices $30 026 plus Devices $60 SUPPRESSION SYSTEMS ~ Wet $35 Dry $35 C02 $35 Other $35 GREASENENTILATION o Hood/Ducts $35 PLANS TOTAL ~ Comments: INSPECTION FEES Annual N/C 1 st Re-inspection $25 2nd Re-inspection $50 3rd Re-inspection $125 4th Re-inspection $250 5th Re-Inspection $500 Construction $15 Commercial $25 SPRINKLER SYSTEMS Hydro Undergrounds $45 Hydrostatic System $45 Wet Acceptance $30 Dry Acceptance $45 Hydrant Flow $25 Hood / Booth $30 Grease Duct $15 FIRE ALARM SYSTEM B System Acceptance $50 Recall Acceptance $50 OTHER Fire Wall/Smoke Wall $15 LP Gas $25 Natural Gas $25 Fuel Tanks $25 Tent $15 INSPECTION TOTALc:::=J GRAND TOTAL PERMIT FEE FALSE ALARM FEE 1 st Alarm N/C 2nd Alarm N/C 3rd Alarm N/C 4th Alarm $25 5th Alarm $50 6th Alarm $75 7th Alarm $100 8th Alarm $150 9th Alarm $200 10th Alarm $250 Non Compliance $150 "Affidavit of Service/Repair" SPRINKLER SYSTEMS o Automatic $15 FIRE PUMP 0 Fire Pump $15 FIRE ALARM SYSTEM 0 Detection $15 OTHER ~ LP Gas $45 Natural Gas $45 Fire Works $25 Fuel Tanks $45 GREASENENTILATION o Hood/Ducts $15 o Kitchen Suppression $15 FALSE ALARM I PERMIT TOTAL! TOTAL Date: 6/~(61 Jir/Lj ~/l/i!ff - rPl Inspector: ZephyrhiUs Fire Rescue 6907 Dairy Road, Zephyrhills, FL 33542 Fire Marshal Kerry Barnett Bus (813) 780-0041 Fax (813) 780-0044 June 26, 2007 , Plan Review Comments I have reviewed and approved the plans for a fuel canopy located at the 38544 5th Ave. for the 7-Eleven Station. My comments have been placed below. Please contact me if you have any questions with regards to my comments. 1. Certified fire extinguisher in accordance with NFPA 10, shall be located in a fire extinguisher cabinet on/next to one of the pump islands. Inspections Required: 1. Canopy Final -ROVED l\P P { 'le\1h'jrhi\\s \)'-1 Ere Marshal o. .led' with -p\an(s) ] ts nro\'lU . th comrnen l:' { -:.N\ I ft(1J!J &1 City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: ...'3,m(lc:::. ~ 7/ " S-\o~ Site: Co -\ 2 - D-, 3<65 Y Y 5tt1 ~.e- Date Received: Permit Type: GFVS r~jrlt"~~ Approved wino comments: ~pproved withe below comments: 0 Denied withe below comments: 0 This comment sheet shall be kept with the permit and/or plans. Bil =>/ Date Contractor and/or Homeowner (Required when comments are present) NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the Pasco County Building Inspection Division-Licensing Section at 727-847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County . TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and 90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. CONTRACTOR's/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other govemment agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, WaterlWastewater Treatment. Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment. Septic Tanks. US Environmental Protection Agency-Asbestos abatement. Federal Aviation Authority-Runways. I understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone 'Y' unless expressly permitted. If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER. I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job Is considered abandoned. 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. FLORIDA JURAT (F.S. 117.03) ~ (_ OWNER OR AGENT CONTRACTOR _ _ G fr Cle;O 76 ~ Subscribed and sworn to (or affirmed) before me this Subscribed and sworn to or alii ) fore e this by 5.dS'". 07 b (? Who is/are personally known to me or has/have produced Who is/a personany known me or h s/have produced as identification. as identification. Notary Public PAMELA M. CONNOLLY * &~ * MY COMMISSION' DD 444182 ...~ EXPIRES: October 23, 2009 ':.,~t;OF Fctf''''''' Bonded Thru Budget Notary Services Commission No. Name of Notary typed. ponted or stamped AC# , .... .. " ~"o' .. . : " ::..' . . t.., '. ....L~... , ,'STATE'DF;:FL~A " '. ,: ~;:,'~" 'H .:-,:., ,; . - .. ~: :-:.-.;:. '.~ ~. j;'';!.' :' ," . ': '~'" .. ,~~' '.~ .:. ':', DBPARTMENT 01'.. atmIris..:;,..ih PSlO)iSSIODL RBGULATIOH ...: '< :::":,":'-':;.;'>;': ,;: CONSTRtr~~ltON~,:~hy ,~L:ICJ:NS:ING BOARD ' SEQtLb'io8(J,'oo~i:s: . .' ....' ',' ',." ~:c~::O~" ~R" ....4 'belOW IS CBRTIFDm 'Under tbeprovi.ion8 of Chapter 489 FS. Expiration date! AUG, 31,' 2Q9,,8 ::::. I 2700874 I .~. BRYAN, KIEBL DONN JR ' ,:,,':~'.:, JIHCO SAL S tt MANtJ1I'ACTURINQ' 'tHe 105 PYTCH BY CT ' LONGWOOD PL 32779 " " '. " 0..' ~:~f;~' : .,' .0. . . ..:'.:~t JD BUSH OOVDHOR '~'';:,i ,":, ',::, ~~;(~ ~i!; :.: ~r.I'; ;~,.; -;"~~'"~; ~~r~l'l~ ," . ,t,~ ......'1 '" .. . :~'. I -:' t'. : . , - :sIllOlltl. JIAJtS'1':ILLER . SECRETARY DISPLAY AS 'REOUIRED BY LAW uc~ ~d U0 JU:~~a ~U~HI' TUUNl:i 10/11/2005 09:35 FAX &]79248643 ..J 1.\,rU ..,,'"u....._ 407-46S-2SS4 p.2 2005-2006 OCCUPATIONAL LICENSE TAX MIKE .HOGAN OFfICE OF THE TAX COLLECTOR CITY OF JACKSONVILLE and/or COUNTt' OF DUVAL. FLORIDA ,c,'. ~AST I'ORSVTH STR1:ET RoaM 130, JACI<SOI'lVILU, Fl. 32202 PH~ 19Q4lUo~ FAX: CS041lJ30-143Z , NQle ~ ,,.,,,,,l'y 15 impOSe<! for f"ilur. Ul lte.p t"ls IIcCll$. e,.l\lbhec:lconlPleuou11V lit your estal>llshment or placo cd bu.'n..s~. , This license is furnished in jOUTsuanC6 of elI.aptor 171-712 City 0I6In.,..,. ....d.5. 8RY AN, MICHAEL OONN "R 10 ~lMCC SALES & MFG INC 3'1',3 ST LOUIS AV FOR,\-{ WORTH. TX 75110 ACCOUNT NU~BER: 212991-0000-] LOCATiON ~OORESS: DESCRIPTION: QUALIFYING AGENT. CONTRACTORS County License Code: hu01C. ?a! License Code: 770.000-005 772.325 County Tax~ IWnicipal Tax: Total Tax Paid: N/A $100.00 $100.00 VALID FROM OCTOBER I, 2005 TO SEPTE~BER 30. 2006 RCPT #: 00lTOO039~ DATE: 9/10/2005 AMr: $100.00 ATTENTION *""'-fhe FOllowing COIISttlJction Contrectora Require Additional Licensure"'** POOL ALUMINUMNINYL BUILDING ROOFING SHEET METAL SOLAR PLUMBING. . IRRIGATION CARPENTRY WATER TREATMENT HEATING AIR CONDITIONING \ ALAfn~1 RESuDENTiAL l ELECYRICAL 11 ~ViiECHANICAL GENlEKAL I UNDERGROUND UTILITY I REFR>G'ERA TtON I I Tfli. .. .c, cccupa:lonal Jjc~n&e ta)( only. 11 does ncot pel'1l'llt _ Il-.... to viol..to lIIIY o>clstins regulatory or zoning I~ of t1\e Counw Of CiW. 1'<0' or",., " exompt th~ liceft5ee from any other lic~. Of perm't Tcqulrect by 1_. This is not a unification ot tile tie"""..'" qul1I11icat;cn. ~ou!l~ THIS BECOMES A RECEIPT AF~. VAlIDATION . 'l:" ... i I .. .. '1. ~i:;.;:,i(i/Y~: .(; . ',' . *,;~f;;~::;:if~::,');; , , L.atIGIWiOaO 11II: ~'.:"" . .l.~.( '"... "',.:ll. . ",:.~{. '. .",'1,.' ....... "~:_. "..... . ~ - ,."'J.... h ..f1 \ '..~ ~, .-..... jij ~ .-. '" ....,-~,:,''',:.. .. . "~"I"""1.=.'IIllI.('i"~' ,. ~ " . . " I.... .'" '1Pl7'I' k)' . ~ " ,~~'..I . ..... .' ;,j,f~I.. ,,-. ~~..,' :':..,}1"''''''; ,... ~ t._....:, .;.:~?:; . " .. , , , . .,'" . ' ...... ~Jl'-... : . , ",,,," ". ""''?'iiilaII-- t,,' . J'r: l ,.....~'\<" . . CU"lallll"_IIa,,,.;Iin_~~.~...'~'i;;W; ---.-.---.--:------ . J (pt.f- 3 7- 3~~O . ~. .. " :.. . .''':t , '. r .' ., . - ., ~ ; " PETROLEUM EQUIPMENT CONSTRUCTION INC. . PO BOX 910 APOPKA, FL 32704 5246 Wachovia Wachovia Bank, N.A. wachovia.com 63-751/631 yJ--o 7 $ 4;,c5c~ DOLlARS l II. 0 0 5 2... b II. I: 0 b 3 ~ 0 ? 5 ~ 31: 20000 2 b 0 2 f b q u. MEMO PeeOJ!.e 7~3A.P~ PETROLEUM EQUIPMENT CONSTRUCTION INC. 5246 ., ELEVEn .@ July 20, 2007 City of Zephyrhills Building Dept 5335 8th Street Zephyrhills, FL 33542 RE: Canopy Contract To Whom It May Concern: 7-Eleven, Inc., does not issue a contract to canopy contractors. Please see attached quote for the following project: 7-Eleven Store #16533-38544 5th Ave, Zephyrhills, FL Should you require additional information, please contact me at 407-532-2063. nthony M. Edwards Division Construction Manager Florida Division / 1300 Lee Rd / Orlando, Florida 32810 7- Eleven, Inc. Construction Agreement Gasoline Projects MARKET #1551 STORES # 16533-025 STREET ADDRESS 38544 5th Ave CITY / STATE: Zephvrhills. FL THIS CONSTRUCTION AGREEMENT (the "Agreement") is dated as of July 20. 2007 between 7-Eleven, Inc., a Texas corporation, with an address at One Arts Plaza, 1722 Routh St., Dallas, TX 75201 ("Owner") and Petroleum Equipment Construction. Inc., with an address at 7232 Overland RD. Orlando. FL 32810 "Contractor" In consideration of the mutual covenants contained herein, Owner and Contractor agree as follows: ARTICLE I THE WORK / COPIES OF PERMITS, INSURANCE CERTIFICATES AND BONDS 1 .1 Contractor shall perform all work, furnish all equipment and purchase all materials, other than the equipment and materials to be provided by Owner as specifically shown and described on the Drawings or Specifications (as defined in Section 2.2 below), necessary for the construction and completion of Tank Replacement (the "Project") as further described in the Contract Documents. 1.2 Prior to commencing the work, Contractor shall provide Owner with (i) copies of all required permits or licenses, (ii) certificates of insurance (from both Contractor and any Subcontractor) in the form required by Article XI of the General. ARTICLE II CONTRACT DOCUMENTS 2.1 The General Conditions attached hereto are hereby made part of this Agreement. In addition, this Agreement is intended to be read in conjunction with the Contract Documents described in Section 2.2 below. To the extent that definitions, terms, or conditions of the Contract Documents conflict with the Agreement, this Agreement will control. 128770 Form 4400158 5/04 GC 2.2 In addition to this Agreement and the General Conditions, the Contract Documents consist of: 2.2.1 Drawings numbered and dated 3/23/07 2.2.2 Specifications dated 2/8/07 2.2.3 Cost Breakdown form 7/20/07 2.2.4 Project Construction Timeline dated 7/20/07 ARTICLE III PROJECT SUM/REQUEST FOR PAYMENT 3.1 Owner shall pay Contractor the total sum of Two Hundred Thirty-one Thousand, One Hundred Seventy-four Dollars and Thirty Cents ($231.174.30) for the completion of the Project in accordance with this Agreement (the "Project Sum"). The Project Sum may not be increased except with Owner's prior written agreement given as required by Article XIII of the General Conditions. 3.2 Payment terms for this Agreement will be one ofthe following options as noted below (check one): _ Option 1: 30/30/30/1 0, which shall mean three Interim Draw Requests (submitted pursuant to Section 3.4A below) and one Final Draw Request (submitted pursuant to Section 3.4B. below) as follows: (i) the first 30% Interim Draw Request will be submitted when 30% of the Project is complete, (ii) the next 30% Interim Draw Request will be submitted when 60% of the Project is complete, and (iii) the final 30% Interim Draw Request will be submitted when 100% of the Project IS complete. The Final Draw Request covering the final 10% of the Project Sum will be submitted pursuant to Section 3.4B below. _ Option 2: 50/40/10 _2L Option 3: 90/10 (Payment under Options 2 and 3 will be calculated according to the methodology described with respect to Option 1, but using the percentages comprising those options.) 128770 Form 4400158 5/04 GC 3.3 Payment terms for the Project Sum are net 30 days, provided that Owner shall be entitled to the following discounts for earlier payment: 1 % discount for net 15 day payment, 2% discount for net 10 day payment, 3% discount for net 5 day payment. 3.4 The procedure for the payment of the Project Sum to Contractor shall be as follows: A. Interim Draw Requests. Contractor shall invoice Owner periodically during performance of the Work using Owner's "Request for Payment" form attached hereto as Exhibit B. Each Request for Payment shall contain (i) a detailed description of the Work covered by the interim draw request, (ii) a breakdown in accordance with the format on Exhibit C of the specific amounts contained in the interim draw request, (iii) a partial waiver of lien (properly endorsed and sealed) from Contractor in the amount of the interim draw request (or evidence that such claim has been bonded against as permitted in Article IX of the General Conditions), and (iv) copies of all permits required from any applicable governmental authorities required to perform the Work (the "Permits"), and (v) all backup documentation reasonably required by Owner. Owner shall have five (5) business days from receipt of the interim Request for Payment to inspect the covered Work. Contractor will promptly, at its expense, correct any items requested by Owner as a result of Owner's inspection, prior to payment. Owner's inspection pursuant to this Section shall not affect or limit Owner's final inspection rights as described below. 128770 B. Final Draw Request. Upon final completion of the Project, Contractor shall submit to Owner for approval, a Certificate of Substantial Completion, in the form attached as Exhibit D. Owner and Contractor shall, at Owner's option, jointly inspect the Project and Owner shall compile a list of defective work or "red tagged" items, which shall promptly be repaired or remedied by Contractor, after which the Work shall be re-inspected by Owner. Upon written acceptance of the Work by Owner, Contractor shall submit its final Request for Payment which shall include (i) a lien waivers (properly endorsed and sealed) executed by Contractor and each Subcontractor and major material supplier retained by Contractor in connection with the Work, each of which shall indicate full and final payment for all work performed or supplies provided (or evidence that such claim has been bonded against as permitted in Article IX of the Form 4400158 5/04 GC General Conditions), (ii) all operator's manuals and product information data pertaining to any equipment and machinery installed on the site, (iii) copies of all Permits, and (iv) a certificate of occupancy or, as applicable, other evidence that the Work has been inspected and approved by all required governmental authorities. The final Request for Payment will include all retainage previously withheld. C. Owner's inspections or payments shall not affect or limit Contractor's warranty or indemnity obligations. All payments and payment obligations shall be subject to the terms and conditions of this Construction Agreement and the General Conditions. D. Notwithstanding anything herein to the contrary, no Request for Payment, either interim or final, will be made unless adequate written documentation is submitted to Owner in conjunction with the Request for Payment, sufficient to show, prior to commencement of any Work (whether by Contractor or any Subcontractor) on that part of the Project covered by the Request for Payment, that (i) all required Permits for the Work were obtained; or (ii) a permit for the Work was not required. ARTICLE IV BOND 4.1 Contractor f8Hall) (Shall Not) obtain a performance or surety bond in form acceptable to Owner. Such form shall include coverage for any administrative or regulatory fines or penalties incurred by Contractor or by Owner as a result of Contractor's non-compliance with law or the provisions of this Contract. The bond shall be renewed annually and remain in place until a period of one year after Contractor's receipt of final payment hereunder. 4.2 Owner (will) ('Nillnot) provide builder's risk insurance coverage as provided in Article XII of the General Conditions. ARTICLE V ASSIGNMENT 5.1 Owner has selected Contractor as general contractor for the Project because of Contractor's particular abilities to perform the Work. Therefore, Contractor shall not be permitted to assign or broker its duties and obligations under this Agreement, provided this Contractor may subcontract all or part of the Work in accordance with the provisions of this Agreement. 128770 Form GC 4400158 5/04 ARTICLE VI TIME OF COMMENCEMENT AND COMPLETION 6.1 The Work shall be performed in accordance with the timetable referenced in Section 2.2.4 above. The timetable may not be altered except with Owner's prior written consent given in accordance with Article XIII of the General Conditions. IN WITNESS WHEREOF, Owner and Contractor have executed this agreement as of the day and year first above written. OWNER: 7-ELEVEN, INC. By: CONTRACTOR: Petroleum Equipment Construction, Inc By: Name: Name: Title: Attest: Title: 128770 Form 4400158 5/04 GC ATTACHMENT Bid/Contract Documents (Plans, timelines, cost breakdowns and specifications included in bid packages to become part ofthe Agreement) GENERAL CONDITIONS ARTICLE I CONTRACT DOCUMENTS 1.1 The Contract Documents are intended to include all labor, materials, equipment and other items necessary for the proper execution and completion of the Project and the terms and conditions of payment therefor, and also to include all Work which may be reasonably inferable from the Contract Documents as being necessary to produce the intended results. 1.2 The Contract Documents shall be signed in not less than duplicate by Owner and Contractor. By executing the Agreement, Contractor represents that he has visited the site and familiarized himself with the local conditions under which the Work is to be performed, including all permitting requirements. 1.3 The term "Work", as used in the Contract Documents, includes all labor necessary to complete the Project required by the Contract Documents, and all materials and equipment incorporated or to be incorporated in such Project. ARTICLE II OWNER'S OBLIGATIONS 2.1 Owner shall at all times have access to the Project to review the progress of the Work. 2.2 Owner shall have authority to reject Work which does not conform to the Contract Documents and require that it be re-performed by Contractor. 2.3 If needed to complete the Project, Owner shall secure and furnish any current, existing land surveys. ARTICLE III CONTRACTOR'S OBLIGATIONS 3.1 Contractor shall supervise and direct the Work to assure completion of the Project in strict accordance with the Contract Documents and all required Permits. Contractor shall be solely responsible for all construction means, methods, techniques, sequences and procedures and for coordinating all portions of the Work under the Agreement, including any work performed by Subcontractors (as defined in Section 4.1 below). 3.2 Except to the extent specifically noted in the Agreement, Contractor shall provide and pay for all labor, materials, equipment, tools, construction equipment and machinery, utilities (water, electricity and gas) transportation, and other facilities and services necessary for the proper execution 128770 Form 4400158 5/04 GC ATTACHMENT Bid/Contract Documents . (Plans, timelines, cost breakdowns and specifications included in bid packages to become part of the Agreement) and completion of the Work. Contractor will not substitute any materials, equipment or fixtures for those referenced in the Specifications, without the prior written consent of Owner. 3.3 Contractor shall at all times enforce strict discipline and good order among his employees and Subcontractors. Contractor and all Contractor employees or Subcontractors performing the Work, are, and will at all times during the Project be, fully certified, where available, by all manufacturers of equipment being installed by Contractor as part of the Project (including with respect to any updates or bulletins available from such manufacturers). 3.4 Contractor shall (i) pay all sales, consumer, use and other similar taxes required by law and (ii) secure all Permits, fees and licenses necessary for the execution of the Work and provide copies thereof to Owner prior to commencement of the Work. 3.5 The Work will be performed in accordance with best industry standards. Contractor shall give all notices to, and comply with all laws, ordinances, rules, regulations and orders of, any public authority bearing on the performance of the Work, and shall promptly notify Owner if the Drawings or Specifications are at variance therewith. 3.6 Contractor shall be responsible for the acts and omissions of its employees and all Subcontractors, their agents and employees, and all other persons performing any of the Work under contract with Contractor. 3.7 Contractor shall review, stamp with his approval and submit all samples and shop drawings, as directed for the approval of Owner, for conformance with the design concept and the information given in the Contract Documents. The Work shall strictly conform to the approved samples and shop drawings. 3.8 Contractor shall at all times keep the Project free from accumulation of waste materials or rubbish caused by its performance of the Work. Upon completion of the Project, it shall remove all of its waste materials and rubbish from and about the Project as well as all tools, construction equipment, machinery and surplus materials and shall clean all glass surfaces and leave the Project "broom clean" or its equivalent. 3.9 Contractor shall indemnify, defend and hold Owner and its agents and employees harmless from and against all claims, damages, liabilities, losses and expenses including attorneys' fees and costs, arising out of or resulting from (i) Contractor's (or any Subcontractor's) failure to comply with the obligations of Contractor as contained in the Agreement or the Contract Documents (including breach of any warranty), (ii) the performance of the Work by Contractor and its Subcontractors, or (iii) the negligence or intentional conduct or omissions of Contractor. or Subcontractors. The indemnity obligations contained herein shall include any claim, damage, losses or expenses attributable to bodily injury, sickness, disease or death, or to injury to or destruction of tangible property, including the loss of use resulting therefrom, and which is caused in whole or in part by any act or omission of Contractor, any Subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, REGARDLESS OF WHETHER OR NOT CAUSED IN PART BY THE NEGLIGENCE OF A PARTY INDEMNIFIED HEREUNDER. In any and all claims against Owner or any of its agents or employees by an employee of Contractor, any Subcontractor, anyone directly or 128770 Form 4400158 5/04 GC ATTACHMENT Bid/Contract Documents (Plans, time lines, cost breakdowns and specifications included in bid packages to become part of the Agreement) indirectly employed by any of them or anyone for whose acts any of them may be liable, the indemnification obligation under this Section shall not be limited in any way by any limitation on the amount or type of damages, compensation or benefits payable by or for Contractor or any Subcontractor under worker's compensation acts, disability benefit acts or other employee benefit acts. The obligations of Contractor under this Section shall not extend to the liability of Owner, its agents or employees arising solely out of errors in maps, drawings, reports, surveys, designs or specifications provided by Owner, except to the extent the claim arises out of modifications thereto made by Contractor or its Subcontractors. The indemnity obligations contained herein shall survive termination or expiration of the Agreement. 3.10 In the performance of the Work, Contractor will act solely as an independent contractor, and nothing herein will at any time be construed to create the relationship of employer and employee, partnership, principal and agent, or joint venturers as between Owner and Contractor or Contractor's employees or Subcontractors. 3.11 Contractor warrants that no gift or gratuity or any promise of gift or gratuity, has been given, offered, or made to, or for the benefit of any employee or agent of Owner for the purpose of influencing the selection of Contractor. Furthermore, Contractor certifies that no gift or gratuity or any promise of a gift or gratuity will be offered or made to, or for the benefit of any employee or agent of Owner as a result of Contractors receiving the Agreement. 3.12 In order to assist Owner in its efforts to maximize the value of the goods and services that Owner procures from its vendors, Contractor shall exceed the minimum standards of Owner's Code of Business Conduct by refraining from providing any entertainment or gifts to Owner's employees and will use any sums previously reserved for expenditures on gifts and entertainment to lower Owner's cost of goods and services. ARTICLE IV SUBCONTRACTORS 4.1 The term "Subcontractor" shall mean a person or entity under contract with or retained by Contractor to perform any of the Work on the Project. 4.2 Unless otherwise specified in the Contract Documents or in the instruction to bidders, Contractor, as soon as practicable after execution of the Agreement, shall furnish to Owner in writing a list of the names of Subcontractors proposed for the principal portions of the Work. Contractor shall not employ any Subcontractor to whom Owner may have a reasonable objection. Contractor shall not be required to employ any Subcontractor to whom he has a reasonable objection. Contracts between Contractor and the Subcontractor shall be in accordance with the terms of the Agreement and General Conditions (including all insurance requirements) and shall include as an attachment thereto, these General Conditions insofar as applicable. 128770 Form 4400158 5/04 GC ATTACHMENT Bid/Contract Documents (Plans, time lines, cost breakdowns and specifications included in bid packages to become part of the Agreement) ARTICLE V SEP ARA TE CONTRACTS 5.1 Owner reserves the right to award separate contracts in connection with other portions of the Project or other work on the site. 5.2 Contractor shall afford subcontractors and Owner's other contractors, if any, reasonable opportunity for the introduction and storage of their materials and equipment and the execution of their Work, and shall properly connect and coordinate his work with theirs. 5.3 Any costs caused by defective Work shall be borne by the party responsible therefor; provided that Contractor shall be directly responsible for all work performed by its Subcontractors. ARTICLE VI ROYALTIES AND PATENTS 6.1 Contractor shall pay all royalties and permit and license fees. Contractor shall defend all suits or claims for infringement of any patent rights and shall indemnify and save Owner, its agents and employees, harmless from loss on account thereof. ARTICLE VII TIME 7.1 All time limits shown in the Project Construction Timeline, or otherwise stated in the Agreement and the Contract Documents, are of the essence to the Agreement. 7.2 If Contractor is delayed at any time in the progress of the Work by changes ordered by Owner in the Work, by labor disputes, fire, unusual delay in transportation, unavoidable casualties, causes beyond Contractor's control, Contractor shall so notify Owner in writing of the delay promptly after it arises. Contractor shall use all reasonable efforts to overcome the delay. After receipt of such notice, Contractor and Owner shall consult as to the duration of the delay and efforts to overcome the delay. In the event the delay event extends beyond 45 days from its inception, Owner may terminate the Agreement (paying Contractor for all Work properly performed through the effective date of the termination) and retain another contractor to complete the Project. Applicable time limits may be extended by change order for such reasonable time as Owner and Contractor shall mutually determine. ARTICLE VIII PAYMENTS 8.1 Payment shall be made as provided in the Agreement. Payments may be withheld on account of (1) defective Work not remedied, (2) claims filed or noticed, including lien claims, (3) failure of Contractor to make payments properly to Subcontractors or for labor, materials, or equipment (and to provide required lien waivers from Subcontractors), (4) damage to another contractor, (5) unsatisfactory 128770 Form 4400158 5/04 GC ATTACHMENT Bid/Contract Documents (Plans, timelines, cost breakdowns and specifications included in bid packages to become part of the Agreement) prosecution of the Work by Contractor, or (6) other breach by Contractor of its obligations hereunder or failure by Contractor to comply with its obligations under the Agreement or hereunder (including failure to comply with the provisions of Section 1.2 and Articles III and IV of the Agreement, or failure to properly or timely submit a Request for Payment). 8.2 The acceptance of final payment by Contractor shall constitute a waiver of all claims by Contractor except those previously made in writing and still unsettled. Final payment shall not operate as a waiver of any claim by Owner under the Agreement or the other Contract Documents or affect Contractor's warranty or indemnity obligations. 8.3 Contractor acknowledges that timely closeout of the Project is of substantial importance to the Owner. Accordingly, Contractor agrees to submit its final Request for Payment (and all required backup documentation) within ninety (90) days of the issuance of the permanent use and occupancy certificate. Contractor acknowledges that delays in submission of the final Request for Payment will result in damages to the Owner that are difficult to measure. ACCORDINGL Y, CONTRACTOR AGREES THAT IN THE EVENT CONTRACTOR FAILS TO SUBMIT THE FINAL REQUEST FOR PAYMENT AND WITHIN THE 90 DAY TIME PERIOD SET FORTH IN THIS SECTION, THEN THE AMOUNT OWED BY OWNER TO CONTRACTOR SHALL BE REDUCED BY AN AMOUNT EQUAL TO TEN PERCENT (10%) OF THE THEN OUTSTANDING TOTAL BALANCE, AS LlQUIDA TED DAMAGES AND NOT AS A PENALTY. CONTRACTOR FURTHER AGREES THAT SHOULD IT FAIL TO SUBMIT THE FINAL REQUEST FOR PAYMENT (AND REQUIRED BACKUP DOCUMENTATION) WITHIN THE 90 DAY TIME PERIOD SET FORTH IN THIS SECTION, THEN CONTRACTOR SHALL BE DEEMED TO HA VE WAIVED AND RELEASED (TO THE EXTENT PERMITTED BY LA W) ANY AND ALL RIGHTS IT MA Y HA VE TO FILE A MECHANICS OR MA TERIALMENS LIEN, AND IF SUCH LIEN IS WRONGFULLY FILED, CONTRACTOR SHALL INDEMNIFY, DEFEND AND HOLD OWNER HARMLESS FROM AND AGAINST ALL COSTS (INCLUDING ATTORNEYS FEES AND COURT COSTS) INCURRED BY OWNER IN CONNECTION WITH THE REMOVAL OF SAID LIEN. CONTRACTOR FURTHER AGREES THAT IF CONTRACTOR FAILS TO SUBMIT THE FINAL REQUEST FOR PAYMENT (AND REQUIRED BACKUP DOCUMENTATION) TO OWNER WITHIN THE 90 DAY PERIOD SET FORTH IN THIS SECTION, THEN WITHIN TEN DA YS AFTER RECEIPT BY CONTRACTOR OF WRITTEN NOTICE FROM OWNER SPECIFYING THE SUM OWNER IN GOOD FAITH BELIEVES TO BE DUE WITHOUT RECEIPT OF THE FINAL INVOICE (WHICH AMOUNT SHALL BE NET OF THE TEN PERCENT DEDUCTION DESCRIBED ABOVE), OWNER MAY, IN FULL SATISFACTION OF ALL SUMS DUE TO CONTRACTOR UNDER THE AGREEMENT, PAY TO CONTRACTOR AS AN AGREED UPON SETTLEMENT, THE SUM SPECIFICED IN OWNER'S WRITTEN NOTICE TO CONTRACTOR. CONTRACTOR ACKNOWLEDGES THAT THE PROVISIONS OF THIS ARTICLE VIII ARE A MATERIAL INDUCEMENT TO OWNER'S ENTERING INTO THE AGREEMENT, THAT CONTRACTOR HAS RECEIVED FULL AND ADEQUATE CONSIDERATION FOR SUCH PROVISIONS, AND THAT 128770 Form 4400158 5/04 GC ATTACHMENT Bid/Contract Documents (Plans, timelines, cost breakdowns and specifications included in bid packages to become part of the Agreement) CONTRACTOR HAS HAD AN OPPORTUNITY TO REVIEW SUCH PROVISIONS WITH CONTRACTOR'S ATTORNEY. ARTICLE IX MECHANICS AND MATERIALMENS LIENSIBOND OF INDEMNIFICATION 9.1 Contractor shall make timely payment to all Subcontractors and suppliers. If Contractor desires to withhold payment due to a claim by Contractor against a particular Subcontractor or supplier, Contractor shall obtain a payment bond in form, and from a corporate surety, mutually acceptable to Owner and Contractor, whenever any lien is affixed, attempted to be affixed, secured or claimed against the Project. Such bond shall be payable to the lien claimant, describe the Project referred to in the lien with sufficient clarity to identify the lien and be of a dollar value at least equal to the amount claimed under the lien. 9.2 Contractor shall not allow any proceeding to be brought against the Project to establish, enforce, or foreclose any lien, or claim of lien. Contractor will indemnify, defend and hold Owner harmless from and against any claim by any Subcontractor or supplier of Contractor. 9.3 Final payment shall not be due and payable until Contractor has delivered to Owner lien waivers covering all material and labor included in the Work, including lien waivers from all Subcontractors and material suppliers for all material and labor, (or evidence that any such claim has been bonded against as permitted above). If any lien remains unsatisfied after any payments have been made (and has not been bonded over as permitted by Section 9.1 above), Contractor shall refund to Owner (or Owner may deduct from any outstanding unpaid Project Sum), those sums necessary to discharge such lien, including costs and reasonable attorneys fees. ARTICLE X PROTECTION OF PERSONS AND PROPERTY 10.1 Contractor shall be responsible for initiating, maintaining and supervlSlng all safety precautions and programs in connection with the Work. Contractor shall take all reasonable precautions for the safety of, and shall provide all reasonable protection to prevent damage, injury or loss to employees or Subcontractors on the Project and other persons who may be affected thereby. Contractor shall take all reasonable precautions to protect, and shall be responsible, at Contractor's sole cost and expense, for any damage, destruction or loss (including theft) of all materials and equipment to be incorporated in the Project, while within the care, custody or control of Contractor whether in storage off site, in transit, or at the Project site, and other property at the Project site. Contractor shall at all times have and maintain a list of equipment and inventory under Contractor's possession and control, whether on or off site such that any lost, damaged or missing equipment and materials can be identified as such. Contractor shall comply with all applicable laws, ordinances, rules, regulations and orders of any public authority having jurisdiction for the safety of persons or property or to protect them from 128770 Form 4400158 5/04 GC ATTACHMENT Bid/Contract Documents (Plans, timelines, cost breakdowns and specifications included in bid packages to become part of the Agreement) damage, injury or loss. All damage or loss to any materials, equipment or personal property caused in whole or in part by Contractor, any Subcontractor or anyone directly or indirectly employed by any of them, or by anyone for whose acts any of them may be liable, shall be remedied by Contractor, except to the extent damage or loss is attributable to faulty drawings or specifications provided by Owner, or to the acts or omissions of Owner or anyone employed by it or for whose acts it may be liable but which are not attributable to the fault or negligence of Contractor. 10.2 Contractor shall be responsible for complying with all applicable environmental protection laws, requirements, codes and regulations. In addition, Contractor shall: (a) Not bring upon or prepare upon the Project site, nor shall any of its Subcontractors or suppliers bring upon or prepare on the Project site, any products or materials that are considered hazardous substances by the Environmental Protection Agency or any comparable state or local regulatory agency, except as expressly provided herein. Upon notice from Owner, Contractor shall remove any such material from the Project site at its sole responsibility and expense; (b) Notify Owner in writing prior to delivery of any such materials on the Project site if they are included in the Specifications for the Work or are in any specified materials or products and provide proper handling, control, removal and disposal of the same off site as required by Owner; (c) Notify Owner in writing of any such material encountered on the Project site and provide proper handling, control, removal and disposal of the same as required by Owner; and (d) Comply, and cause its employees and Subcontractors to comply, with all applicable federal, state and local environmental and natural resource laws and regulations applicable to the Contractor's Work. ARTICLE XI CONTRACTOR'S INSURANCE 11.1 Contractor, at its own expense, shall provide and maintain insurance coverage during the complete term of the Agreement that conforms in all material respects with the following requirements: (a) Workers' Compensation Insurance. Statutory Workers' Compensation coverage for all of its employees, including occupational disease coverage, as required by applicable law, and employer's liability with limits of at least $500,000 bodily injury each accident, $500,000 bodily injury by disease per employee, and $1,000,000 bodily injury by disease in the aggregate. 128770 Form 4400158 5/04 GC ATTACHMENT Bid/Contract Documents (Plans, timelines, cost breakdowns and specifications included in bid packages to become part of the Agreement) (b) Commercial General Liability Insurance. Commercial General Liability Insurance written on an "occurrence" basis with a combined single limit of at least $1,000,000 per occurrence, and a general aggregate of $2,000,000, in forms providing coverage not less than the standard commercial general liability policy including hazards of operation, broad form property damage liability coverage, products/completed operations coverage, independent contractor coverage and broad form contractual coverage for liability assumed under the Agreement, to the extent insurable under the policy. Coverage shall include liability arising out of acts of agents or Subcontractors of Contractor. (c) Automobile Liability Insurance. Coverage for all motor vehicles operated by or for Contractor, including protection for automobiles and trucks used by Contractor either on or away from the sites at which Work is being performed, with a combined single limit of at least $500,000 per occurrence for bodily injury and property damage. The policy shall include coverage for all hired, owned and non-owned vehicles. (d) "All Risk" Property Insurance. If in conjunction with the Work to be performed by Contractor under the Agreement, Contractor stores, warehouses, transports or otherwise has in its possession at the Project site, or at a location other than the Project site, any equipment, materials or any other personal property owned or leased by Owner, then Contractor shall (1) be fully responsible for said equipment, material or other personal property while in Contractor's possession, and (2) purchase and maintain "All Risk" property insurance policy on all of Contractor's buildings or facilities including, without limitation, coverage for sprinkler leakage, boiler and machinery (comprehensive form), transit, theft, flood, and earthquake (at California facilities only). The policy shall be endorsed to also cover damage to or loss of personal property owned or leased by Owner, trade fixtures, inventory fixtures or other equipment located in, on or about Contractor's premises or while in transit. Such insurance is to be written on a replacement cost basis without deduction for depreciation, in an amount equal to 100% of the full replacement value in the aggregate of all the items referred to in this Section. The policy shall include a loss payee endorsement in favor of Owner to the extent of its insurable interest in the covered property. (e) Commercial Umbrella/Follow Form Excess Policy. Excess liability policy with limits of not less than $1,000,000 per occurrence in excess of the primary underlying policy limits. The policy must provide coverage at least as broad as the underlying policies. (f) Professional (Errors and Omissions) and Pollution Legal Liability Insurance (or Contractor's Pollution Liability Insurance). Coverage with minimum limits of $1,000,000 per incident and $2,000,000 annual aggregate covering both on-site and off-site claims for bodily injury, property damage and/or clean up expenses resulting from pollution conditions or any environmental impairment occurring as a result of Services performed by the Contractor or its subcontractors under the Agreement. The policy shall include coverage for both sudden and gradual pollution conditions, and, where allowed 128770 Form 4400158 5/04 GC ATTACHMENT Bid/Contract Documents (Plans, timelines, cost breakdowns and specifications included in bid packages to become part ofthe Agreement) by law, include coverage for punitive damages, fines and penalties. For any "claims made" policy, if the Contractor does not continue to maintain this policy for one year after the termination of the Agreement, the Contractor shall purchase a "tail" for the Pollution Legal Liability policy to fully cover the period of one year following the termination of the Agreement. (g) Each of Contractor's insurance policies shall be written so as to provide primary coverage, and no policy maintained by Owner shall be required to contribute to any loss covered by Contractor's policy(s). 11.2 General Requirements. The following general requirements shall apply to all insurance policies required to be obtained by Contractor hereunder at its expense: (a) Contractor shall maintain the foregoing insurance coverage in force at all times during the performance of any Work under this Agreement. In addition, the Contractor will maintain its General Liability and Umbrella Liability Insurance (for Products and Completed Operations coverage) and the Professional Liability (Errors and Omissions) Insurance policies in force for at least two (2) years following completion of the Work and final payment hereunder. (b) Contractor shall furnish Owner with certificates of insurance (covering both Owner and any Subcontractor) with respect to the coverage required hereunder prior to the commencement of any Work and as policies are renewed, replaced, or modified. (c) All policies shall be written by insurance companies that are (a) lawfully authorized to do business in the jurisdiction(s) where work is being performed or Services are provided and (b) carry an A.M. Best rating of "A" or better and financial category of "X" or higher. Should the Professional (Errors and Omissions) and Pollution Legal Liability (or Contractor's Pollution Liability) Insurance be written on a surplus lines and non-admitted basis, Owner reserves the right to approve the insurance company. (d) Each policy shall include a provision requiring that at least 30 days prior written notice be given to Owner in the event of cancellation, non-renewal, lowering of policy limits or exhaustion of aggregates. Contractor shall provide Owner with 30 days prior written notice of any material change in any policy. Each policy, except for Workers' Compensation, to the extent permitted by applicable law, shall name Owner as an "additional insured," and shall include a waiver of subrogation in favor of Owner. (e) The insurance requirements set forth in this Article XI shall in no way limit the liability of Contractor or its Subcontractors arising under the Agreement or any other agreement or as a result of any related activities. 128770 Form 4400158 5/04 GC ATTACHMENT Bid/Contract Documents (Plans, timelines, cost breakdowns and specifications included in bid packages to become part ofthe Agreement) (f) Contractor's deductible shall not exceed $5,000 on any gIven policy, unless approved in writing by Owner. 11.3 Insurance Requirements Applicable to Subcontractors. Contractor shall require each of its Subcontractors to maintain policies of insurance of the types described above with insurance limits as are customary for the industry in which each such Subcontractor operates and coverage limits as are commercially reasonable given the nature of the Work to be provided by such Subcontractor. ARTICLE XII BUILDER'S RISK COVERAGE 12.1. Owner shall, if required by Article IV of the Agreement, purchase and maintain builder's risk coverage or elect to self-insure the Project as follows: 12.1.1 Coverage: All risk of direct physical loss or damage from any external causes except as excluded. 12.1.2 Perils not insured: Wear, tear, deterioration, rust, rot, mold, vermin or insects; loss of market, loss of use; mechanical failure, delay, faulty workmanship, latent defect; settling, shrinkage or expansion; infidelity or dishonesty, mysterious disappearance, inventory shortage; earthquake; surface waters, and flood waters, freezing, electrical failure, error or omission in design, plan or specification; war risks; radioactive contamination or nuclear damage, all as defined in the master policy and such other exclusions specified in the master policy. 12.1.3 Property Excluded: Contractors' and/or Subcontractors' equipment of every description, automobiles or other vehicles designed for highway use, watercraft, and aircraft, machinery, tools, equipment and property of similar nature not destined to become a permanent part of the installation of structure, money, notes, securities, plans, blueprints, specifications, and other similar papers, and trees, grass, shrubbery or plants. 12.1.4 Deductibles: Fire, extended coverage, vandalism and malicious mischief and all other perils. Any and all deductible losses shall be borne by the contractors in the same portion that the amount of each contractor's loss bears to the total loss to all contractors on the Project. Uninsured losses shall be borne by each contractor individually. 12.1.5 This insurance shall include the interests of the Owner, Contractor, Subcontractors, and any other sub-subcontractors. 12.2 Any loss insured under Section 12.1 is to be adjusted with Owner and made payable to the Owner as trustee for the parties, as their interests may appear. 128770 Form 4400158 5/04 GC ATTACHMENT Bid/Contract Documents (Plans, timelines, cost breakdowns and specifications included in bid packages to become part of the Agreement) ARTICLE XIII CHANGES IN THE WORK 13.1 Owner, without invalidating the Agreement, may order changes in the Work consisting of additions, deletions, or modifications, the Project Sum and the Project Construction Timeline being adjusted accordingly. All such changes in the Work shall be authorized by written change order signed by Owner and Contractor. 13.2 The Project Sum and the timeline (as referenced in Section 2.2.4 of the Agreement) may be changed only by change order mutually acceptable to Owner and Contractor. 13.3 The cost or credit to Owner from a change in the Work shall be mutually acceptable to Owner and Contractor and shall be specified in the change order. ARTICLE XIV WARRANTY / CORRECTION OF WORK 14.1 Contractor warrants to Owner that all materials and equipment incorporated in the Project will be new unless otherwise directed by Owner, and that all Work will be of good quality performed in a good and workmanlike manner, free from faults and defects and in strict conformance with the Contract Documents. Contractor shall promptly, and at its expense, correct any Work that fails to conform to the foregoing warranty where such failure to conform appears during the progress of the Work. In addition, Contractor shall, at its expense, remedy any defects due to faulty materials, equipment or workmanship which appear within a period of one year from the date of final payment for the Project, or within such longer period of time as may be prescribed by law, or by the terms of any other warranty (including any manufacturer's warranty) or other applicable special guarantee required by the Contract Documents or otherwise existing. The provisions of the Article shall apply to Work done by Subcontractors, as well as to Work done by direct employees of Contractor. ARTICLE XV TERMINA TION BY CONTRACTOR 15.1 If, through no fault of Contractor, Owner fails to issue payment pursuant to the provisions of Article III of the Agreement within 30 days of receipt by Owner of a complete and correct Request For Payment form (along with all required supporting documentation), Contractor may, upon seven days written notice to Owner, if such the amount owed is not paid within such seven day period, terminate the Agreement and recover from Owner payment for all Work executed and properly invoiced or otherwise performed. 128770 Form 4400158 5/04 GC ATTACHMENT Bid/Contract Documents (Plans, timelines, cost breakdowns and specifications included in bid packages to become part of the Agreement) ARTICLE XVI TERMINA TION BY OWNER 16.1 If Contractor fails to abide by any provisions of the Agreement, or defaults in its obligation to perform the Work in accordance with the Contract Documents, Owner may, after seven days written notice to Contractor and without prejudice to any other remedy it may have, make good such deficiencies and deduct the cost thereof from the payment then or thereafter due Contractor or, at its option, may terminate the Agreement and take possession of the site and of all materials, equipment, tools, and construction equipment and machinery thereon owned by Contractor and may finish the Work by whatever method it may deem expedient, and if the unpaid balance of the Project Sum exceeds the expense of finishing the Work, such excess shall be paid to Contractor, but if such expense exceeds such unpaid balance, Contractor shall pay the difference to Owner. Contractor shall also be responsible to pay to Owner any documented costs or damages occasioned by Owner due to the default by Contractor. Termination pursuant to Articles XV and XVI will not affect Owner's rights against Contractor, or Contractor's warranty, indemnity and other obligations which by their terms survive or extend beyond termination. ARTICLE XVII MISCELLANEOUS 17.1 Notice. Any notices under the Agreement or the General Conditions will be in writing and deemed received when personally delivered or sent by registered mail or certified mail, return receipt requested, expedited mail service, or facsimile with proof of delivery to the addresses set forth below: If to Contractor: Attn: If to Owner: 7-Eleven, Inc. 1300 Lee RD Orlando, FL 32810 Attn: Anthony M. Edwards 17.2 Choice of Law. The Agreement and General Conditions will be deemed to be made under, and will be construed in accordance with the laws of the state where the Project is located. 128770 Form 4400158 5/04 GC ATTACHMENT Bid/Contract Documents (Plans, timelines, cost breakdowns and specifications included in bid packages to become part of the Agreement) 17.3 Assignment. The Agreement may not be assigned by Contractor, either voluntarily, involuntarily or by operation of law, and any such assignment, or purported assignment, will be a material breach of the Agreement. 17.4 Amendments. The Agreement and General Conditions will not be modified, altered, amended or revoked except in writing duly executed by an authorized representative of Contractor and a vice president of Owner. 17.5 Waiver Or Delay. Any waiver of any provision of the Agreement, or a delay by either party in the enforcement of any right hereunder, shall neither be construed as a continuing waiver nor create an expectation of non-enforcement of that or any other provision or right. No term or provision shall be deemed waived and no breach excused unless such waiver or consent shall be in writing and signed by the party claimed to have waived or consented. 17.6 Severability. If any provision of the Agreement or General Conditions shall be held illegal, unenforceable, or in conflict with any law of a federal, state, or local government having jurisdiction, the validity of the remaining portions or provisions hereof shall not be affected thereby. 17.7 Cumulative Remedies. All remedies available to either party for breach of the Agreement are cumulative and may be exercised concurrently or separately, and the exercise of anyone remedy shall not be deemed an election of such remedy to the exclusion of other remedies. 17.8 Entire Agreement. The Agreement, and the other Contract documents and referenced Exhibits, constitute the entire agreement of the parties hereto and supersede all prior or contemporaneous oral or written communications, proposals, warranties and representations with respect to its subject matter and prevails over any conflicting or additional terms of any quote, order, acknowledgement, or similar communication between the parties during the term of the Agreement. I HAVE READ, UNDERSTAND AND AGREE TO THE GENERAL CONDITIONS AS STATED ABOVE. CONTRACTOR: BY: NAME: TITLE: DATE: 128770 Form 4400158 5/04 GC BF29 After recording retum to: Co ns~ \;o(} ((}11fi e( S.C. , ~O 60x Id.-C0S3 C \ffV'()OYlt-, FL?JLj7 L} -DLP~ Permit No: Tax Folio No: \ \ -~- al'DOIO - i4,fICD~OTICE OF COMMENCEMENT t.:> 111111111111 1111I1111I11111111111111111111111111111111111111 2007125068 Rcpl : 1116554 Rec: 10. 00 OS: 0.00 IT: 0.00 07/23/07 Dpty Clerk To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. ~'92~J~~~:~SC01CO~'Tl CLERK OR BK 7571 PG 1630 Street Address (if available): ~fHL/ Sty) ~ \- 2. General description of improvements: ~~ el1"A N>p\O\{€ g.G.S {" Or'C'lpl{ Name:0~ ('~2-~~~ Address: Q 1\ n S7 n~1 Interest in Property: Name and Address of fee simple titleholder (if other than owner): 1. Description of property: 3. Owner's Information: R 000"""""""""'_, 5. Surety Information: 6. Lender Information: Legal Description: C ,\.~ ot- "b:pVl"";b~~IZ PB, P6hLJ ~f::::. x9d-f:) p,'r<'f.... \~C\ C')Q'L\771<J p.____ Name: ?i'~~O ~ Address: \. \-. '. Ave. F+. I.<.JnN-h I'\::X 7 (,., I b Telephone No. Fax No. (Opt) Name: Address: Amount of Bond: Telephone No. Fax No. (Opt) Name: Address: Telephone No. Fax No. (Opt) 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: . Name: Address: Telephone No. Fax No. (Opt) 8. In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as Provided in Section 713.13 (1) (b), Florida Statutes: Name: Address: Telephone No. Fax No. (Opt.) 9. Expiration date of Notice of Commencement (the expiration date is 1 year from the date of recording unless Different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I,-SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. r......._.._....~_.._.- _._..~.~.- .:~~yrll'*' ROSAC. BURGOS . ; V "" MY COMMISSION # D0472206 } -f~OFf\.fil~ EXPIRES: Sept. 15,2009 (407) 398-0153 Flc;ida Notary SefVicB.com ~~~-~ Notary Public (Signature) Revised 07/2007 A CORDm CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 5/7/2007 "-"'DUCER (407)833-8998 FAX: (407)804-1092 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ..ihl & Associates Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 605 Crescent Excecutive Court ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 112 Lake Marv FL 32746 INSURERS AFFORDING COVERAGE NAIC# INSURED (407) 290-3010 Fax: (407) 290-1173 INSURER A: Hudson Specialty Ins Co Petroleum Equipment Construction, Inc. INSURER B: P.O. Box 910 INSURER C: 7232 Overland Road INSURER 0: Apopka FL 32704-0910 INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING 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 HEREI~!,:IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. A~~RJ:~ATE LIMIT!': !':HnWN May HAVE BEEN REDUCED BY PAID CLAIM . INSR ADD'L TYPE OF INSURANCE POLICY NUMBER P6'1+~~ri~~g8~:= Pgk!fl,~J:~~N LIMITS ~NERAL LIABILITY EACH OCCI JRRENCE $ 2,000,000 COMMERCIAL GENERAL LIABILITY ~~~~~~J?E~~~J.7r~nce\ $ A X I CLAIMS MADE D OCCUR FEe 6112184 4/15/2007 4/15/2008 MED EXP (Anv one oersonl $ ~ Professional Liab PERSONAL & ADV INJURY $ ~ Pollution Liability GENERAL AGGREGATE $ 2,000,000 ~'L AGGRnE LIMIT nES PER: PRODUCTS - COMP/OP AGG $ X POLICY ~~R;: LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ - ANY AUTO - ALL OWNED AUTOS BODILY INJURY (Per person) $ - SCHEDULED AUTOS - HIRED AUTOS BODILY INJURY (Per accident) $ - NON-OWNED AUTOS - PROPERTY DAMAGE $ (Per accident) ~RAGE LIABILITY AUTO ONLY- EA ACCIDENT $ ANY AUTO OTHER THAN EA Arc., $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY ~Ar.1-l Nr.~ $ =:J OCCUR D CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION ~ $ WORKERS COMPENSATION AND I T~~~T~W~ I IOJb'- EMPLOYERS' LIABILITY ANY PROPRIETORlPARTNERlEXECUTIVE E:L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E:L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERA TlONSlLOCA TlONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER r(813) 780-0021 City Of Zephryhills 5335 8th Street Zephryhills, FL 33540 CANCELLA nON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Robert Bowles/DIANED ~~~-_. @ ACORD CORPORATION 1988 ACORD 25 (2001/08) INS025 (0108).08a Page 1 of2 . ~~\.)\.'\UM EQUIPJ/!p ~'\.\. <-/17> CONSTRUL1'ION P.O. Box 910 - Apopka, Florida 32704-0910 PC-C047016 - RQ-0066486 - CG-C02496 Date:~ To: C \~ ~ ~c.=>~ 'rr-.f rn l \ts To Whom It May Concern: Please be advised that the bearer of this letter, Lucas Young, Casey Rade, or Cole Flynn of Construction Courier Service, Inc. has my authorization to act on my behalf in submitting plans for permit purposes and securing the permits and any other necessary documentation as may be requiredfortheprojectofa'7-11 #16533 at 33544 5th AVE. Zephyrhills FL. 33542. Sincerely Yours, I Ronald E. Caraoza PC-C047016 'p'"",.~ JUDITH A CHASE ~ MY COMMISSION # DD4895 I I ~OFf\.~ EXPIRES: Novcmber25. 2009 14100-J.NOTARY Fl. Nowy Discount Asooc. Co. Phone: (407)290-3010 eMail: pecflorida@aol.com Fax: (407)290-1173 03-02-'07 12:26 FROM-Petroleum Equipment 407-290-1173 T-703 P001/002 F-201 - ~ ?, g\,; ~ i'l-~t' ' ~ ;,; ... l "~I . 4tr '\.~ L . ~*~~ DEPARTMBNT OJ' BUSINESS AN!) PROnSSIONAL RBGULATION CONS'1'Rl1CTXON IN'Dl1STRY LICDSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE, FL 32399~.0783 (8S0) 487-139'5 CA2DOZA RONALD BDWARD PBTROLEUM EQUIPMENT CONSTRUCTION INC P 0 SOX 910 APOPKA VL 32704 "::.' . ..f."..~~~.. c,:,'. :,;~{...:f'~;~;~.:"~~ '.;. _.lJh,~~-,: :Oi'.BUSInS$. Aiij) j~;'< " '::".:. "P1tO~"SSX01fAL 'RRG~~I~'<~'!.f.i:'/' PCCO",'016 08/21/oe;':o's,":l~'~::< ~O.O.' , :'i':' . :'-1....;;: . i"~':' . ..'. .~,. '. .:, : ., ~\..., ".,~.... . ;,'1.,..11; <",.'~ !.:"~'..' ,.;,jo' . '. ,.. ~."'. ". . \.~;.?f " .... ,,,'" .. .. " I' . I'.. ., ./",.,:' ~ ~ . .... . ':.:':cm"ltOLLtJTMT,' S'l'QRAi:j!if'.' . '.:~ ,..........OIlJ!... R^....'Il...... BDM'Il.Dn '.' ,".',' . \ ;mo&bM"'iQUi'Pimrrr.colii~lilii~ '.' "': ,.,<;,j,'::~"., :'i,,'~~;,;;;";i~,;' rs :cmt;..f~l"~~: ~~. '~~~iil~!\'!if.:~i ,: . jI.';' . ......... Wl'.N"~".~......w..... "'," .,....... ,", ;'!i.'>.'U.':..;/"'" l'~!lod""" .;:.......U... U'~.ir,AV....::-~:&.......:20lY8 ;.~~f~...~~. .Q~f'i."fI DETACH HERE I"ACI '::273'6:9')'3 .. -:::". .,' .;.; '.;':~:~TATE'()F...f,Ld~IDA' .: . ,": " .,......,. I ';, .:.~ ..::.' ....: "'~>. ':lDB'ltR~" tiI/J&t~sit3 ,..~', PiO'~'BSs.ibN~': UGDLATION '.>:::" I.,:,' "'.':, .:'( ;'::;':~',":~l~)' \CQNsn~:rolt,:~~RY ~~~CBN's'InG'~ BOARD"."'~':':; SEQ#L0608210i190 I. 0'8' i '~o~l ~~'.ij~:'i60~:)~$;i' 'f' <~f; . '.' ....' . .... .... '", ft>.'. '. I '. :':i::.~~~=~~s~~~~tdfiS~.f~,.90~C'1'OR .'. . ,~/;~.r;~1.k-(}.?i( . M:~ . =ria~~:n~d:;~~i= ~i., ?t~.ie7";~~~"~::?~'~'. .'.>:.':.. .,.'.':"." '~~"" ':-....:. "'k:,j .,:~1..!,. '~~',-:" ~t~, ::".::;/!.~~-;;.~, '. . "::.;,'1,;' ';~;iir;~'r..::.:\, .:d~~i:' .: W~' . '?/i~ >j;:' ..' '",,' . '" .. '~.D~^ I '. ~ZAL._RONALD,.BDWARD . ,., :., PBTROLlhm BOUJ:PMENT CONSTRUCTION INC 331 HAVBRLAtCB CR APOPltA PI. 32112'. ,'\. . .~'Cl:.. ,': ," ..~ .J, ':.0: JBB BUSH GOVBRNOR DISPLAY AS REQUIRED BY LAW SIMONE MARSTILLER SECRETARY - 03-02-'07 12:26 FROM-Petroleum Equipment 407-290-1173 T-703 P002/002 F-201 I'liSllCen_ I. in adGfaon 10 <1flCl not in I..., tYr *,y 0tNll' I~.. requiNd l)y ,- or ~ OftIINlftOe. It i. .~ to ~\I18UOn of mnin9, "-lIh anef any other la, uItlOl'lly. It i. valid from October 1 Ihrougn September JO of licente ~.r. Oellnquent ......Ity 'e added October 1. -oRIGINAt,.- 2008 EXPIRes "'lItZ001 1817.0516418 '1817 POLLUTANT STOFtAGE SVS CONTR $30.00 7232 OVERLAND RD U - ORLANDO. 32810 PAID: $61.00 99-314400 811512008 TOTAL TAX $30,00 HAZARDOUS WASl'S $31.00 PREVrOUSLYPAID $81,00 TOTAL DUE SO.CC '1"1'115 ((JrM becomes a recel9t when validated by Ihe Tax CoHector. Certificate of Insurance This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder other than those provided by this policy. This ~ertificate does not amend, extend, or alter the coverage afforded by the policies described herein. ~amed Insured(s): Gevity HR, Inc and its wholly owned subsidiaries including but not limited to Gevity HR, LP; Gevity HR II, LP; Gevity HR III, LP; Gevity HR IV, LP; Gevity HR V, LP; Gevity HR VI, LP; Gevity HR VII, LP; Gevity HR VIII, LP; Gevity HR IX, LP; Gevity HR X, LP; Gevity HR Xl, LLC; Gevity HR XII Corp. 9000 Town Center Parkway MARSH Bradenton, Florida 34202 Insurer Affordine: Coveraee American Home Assurance Co., Coverages: Member of American International Group, Inc. (AIG) This is to certify that the policy(ies) of insurance described herein have been issued to the insured named herein for the policy period indicated. Notwithstanding any requirement, term or condition of any contract or other document with respect to which the Certificate may be issued or may pertain, the insurance afforded by the policy(ies)described herein is subject to all the terms, conditions and exclusions of such policy(ies). (Aggregate) Limits shown may have been reduced by paid claims. Type of Insurance Certificate Exp. Date Policy Number Limits Emnlovers Liability Workers' 1-1-2008 RMWC9719932 Bodily Injury By Accident Compensation RMWC9719957 $ 2,000,000 Each Accident Bodily Injury By Disease $ 2,000,000 Policy Limit Bodily Injury By Disease $ 2,000,000 Each Person Other: Employees Leased To: Effective Date: 1/1/07 9933 Petroleum Equipment Construction Inc ~f"'~DI..' ~.'iWrtr~.'~ "[111m I.' 'if"" The above referenced workers' compensation policy(ies) provide(s) statutory benefits only to the employees of the Named Insured(s) on such policy(ies), not to the employees of any other employer. Notice of Cancellation: Should any of the policies described herein be cancelled before the expiration date thereof, the insurer affording coverage will endeavor to mail 30 days written notice to the certificate holder named herein, but failure to mail such notice shall impose no obligation or liability of any kind upon the insurer affording coverage, its agents or representatives. Certificate Holder: /Jr(~e. U/~ City of ZephyrhilIs Building Dept 5335 8th St Zephyrhills, FL 33542-4312 Michael C. Weiss Authorized Representative of Marsh USA Inc. (866) 443-8489 Phone 01/01/2007 Date Issued ACORD,.. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 4/16/2007 ""'1DUCER (407)833-8998 FAX: (407)B04-1092 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA nON ..ihl & Associates Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 605 Crescent Excecutive Court ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Sui te 112 Lake Mary FL 32746 INSURERS AFFORDING COVERAGE NAIC# INSURED (407)290-3010 Fax: (407) 290-1173 INSURER A: Hudson Specialty Petroleum Equipment Construction, Inc. INSURER B: Hanover Insurance Company P.O. Box 910 INSURER C: Firemans Fund Ins. 7232 Overland Road INSURER 0: Apopka FL 32704-0910 INSURER E: 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. l~~: ADD'L P~.k+~~ri~~gg~~ Pgk!fll~':'~~N I'......." TYPE OF INSURANCE POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 f-- ~~~~~~J?E~~~J.7r?ence\ ~ 5MMERCIAL GENERAL LIABILITY $ 50,000 A CLAIMS MADE ~ OCCUR FEC 6112184 4/15/2007 4/15/2008 MED EXP (Anyone oerson' $ 5,000 f0- X B1kt Add'l Insureds PERSONAL & ADV INJURY $ 2,000,000 X Blkt Waiver of Suhro GENERAL AGGREGATE $ 2,000,000 @'LAGGREGATE LIMIT flES PER PRODUCTS - COMP/OP AGG $ 2,000,000 .nPRO- X POLICY JECr LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 I- ~ (Ea accident) $ ANY AUTO B ALL OWNED AUTOS AZJ875615801 4/15/2007 4/15/2008 BODILY INJURY t--- (Per person) $ - SCHEDULED AUTOS ~ HIRED AUTOS BODILY INJURY ~ (Per accident) $ NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $ ==i ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY I FACH $ 3,000,000 ~ OCCUR 0 CLAIMS MADE AGGREGATE $ 3,000,000 $ A ~ DEDUCTIBLE FXS 6112185 4/15/2007 4/15/2008 $ X RETENTION $ 10,000 $ WORKERS COMPENSATION AND IXXf STAT~~ I OJ~- EMPLOYERS' LIABILITY T RY 1M T ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUOED? E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ C OTHER Contractors MZI97507781 4/15/2007 4/15/2008 Rented/Leased Equipment Anyone Item $150,000 Idsaster $250,000 DESCRIPTION OF OPERATIONS/LOCATlONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: Ron Cardoza License #PC-C04716 CERTIFICA TE HOLDER CANCELLA nON (P13)780-0021 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City Of Zephryhills EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Building Department 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT 5335 8th Street - Zephryhills, FL 33540 FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE _._._---::=_~:~~~., ~.............~ Robert Bowles/DIANED ~=~ ~--- ACORD 25 (2001/08) INS025 (0108).08a @ ACORD CORPORATION 1988 Page 1 of 2 May,10 2007 9:31AM STAHL No, 0804 p, 2/2 ACORD.. CERTIFICATE OF LIABiliTY INSURANCE DATE (MMIODNVYY) 5/7/2007 PRODUCER (4C7)833-8998 FAX: (407)804-1092 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION StI 0.1 & ~sociates Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6uS Crescent Excecutive Court AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 112 Lake Mary FL 32746 INSURERS AFFORDING COVERAGE NAIC# INSURED ("107)290-3010 Fax: (407) 290-1173 INSURER A Hudson Specialty Petroleum Equipment Construction, Inc. INSURER B. Hanover Insurance Company P.O. Box 910 INSURER c. Firemans Fund Ins. 7232 Over],and Road INSURER D Apopka FL 32704-0910 INSURER E 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 01HER 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, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR iADD'L TYPE OF INSURANCE POLICY NUMBER Pr?i'}~~~U66~ Pg~~(~~b~~N LIMITS ILTR IINSRD GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 - ~~~~~~~?E~~~~';;~encel X COMMERCIAL GENERAL LIABILITY $ 50,000 A I CLAIMS MADE ~ OCCUR FEe 6112184 4/15/2007 4/15/2008 MED EXP (Anv one person) $ 5,000 X Blkt Add'l Insureds PERSONAL & ADV INJURY $ 2,000,000 - ~ Blkt Waiver of Subro GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 Xl nPRO- n X POLICY :IFrT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 - (Ea aCCident) $ X ANY AUTO - B ALL OWNED AUTOS AZJ875615801 4/15/2007 4/15/2008 BODILY INJURY - {Per person I $ SCHEDULED AUTOS - X HIRED AUTOS BODILY INJURY - $ X NON-OWNED AUTOS (Per aCCident) - PROPERTY DAMAGE $ (Per aCCIdent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ H ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESSIUMBRELLA LIABILITY ~A'''H roN', 'RR~W'~ $ 3,000,000 ~ OCCUR D CLAIMS MADE AGGREGATE $ 3,000,000 $ A ~ DEDUCTIBLE FXS 6112185 4/15/2007 4/15/2008 $ X RETENTION $10,000 $ WORKERS COMPENSATION AND I T'6~{ItJH-s I OTH- EMPLOYERS' LIABILITY ER ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ Ilyes, describe under SPECIAL PROVISIONS below EL DISEASE- POLICY LIMIT $ C OTHER Contractors MZI97507781 4/15/2007 4/15/2008 Rented/Leased Equipment Any one Item $150,000 Idsaster $250,000 DESCRIPTION OF OPERATIONSfL.OCATIONSNEHICLE~XCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER , 3) 780-0021 City Of Zephryhills 5335 8 th Street Zeph~hills, FL 33540 CANCELLA T10N SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ". ..,,!>,,,,..,,,,, Robert Bowles/DIANED ACORD 25 (2001(08) @ACORDCORPORATlON 1988 ACORD", CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 4/16/2007 I PRODUCER (407)833-8998 FAX: (407)804-1092 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ahl & Associates Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 605 Crescent Excecutive Court ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 112 Lake Marv FL 32746 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Hudson Special tv Ins Co Petroleum Equipment Construction, Inc. INSURER B: P.O. Box 910 INSURER C: 7232 Overland Road INSURER D' Apopka FL 32704-0910 INSURER E: 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. AGI REGATE LIMIT!': SHOWN MAY HAVE BEFN REDUr.ED BY PAID r.LAIMS. I!'I~~ I~~r:;~ TYPE OF INSURANCE POLICY NUMBER P~.k+~~ri~f68M1E Pg~.fl,~':'g'ttWlN LIMITS ~NERAL LIABILITY "A"H OC"URREN"" $ 2,000,000 f--- ~MMERCIAL GENERAL LIABILITY ~~~lfH9E~7,~~~~nce\ $ A X CLAIMS MADE 0 OCCUR FEe 6112184 4/15/2007 4/15/2008 MED EXP tAnv one nerson' $ I--- X Professional Liab PERSONAL & ADV INJURY $ X Pollution Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREnE LIMIT APPLIES PER: PRODLJr-TS - COMP/OP AGG $ IXl POLICY jW,= n LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - (Ea accident) $ - ANY AUTO - ALL OWNED AUTOS BODILY INJURY (Per person) $ - SCHEDULED AUTOS - HIRED AUTOS BODILY INJURY (Per accident) $ - NON-OWNED AUTOS - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ =j ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY FA(~H Or.r.IIRRFNr.F $ t=J OCCUR 0 CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND I TVj,r,~If1W;, I OJ,tl- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERlEXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ II yes, describe under SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERA TlONS/LOCA TlONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICA TE HOLDER CANCELLATION (813)780-0021 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City Of Zephryhills EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Building Department 10 DAYS WRITIEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT 5335 8th Street - FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE Zephryhills, FL 33540 INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE .- .--.-.-.- -='~-=-. ---..--.--.- /~ Robert Bowles/DIANED '-----~ ~;,,;--~ . ~-~ ~--- ACORD 25 (2001/08) INS025 (010B)OBa @ACORDCORPORATION 1988 Page 1 012 Certificate of Insurance This certitlcat, is issued as a matter of information only and confers no rights upon the Certificate Holder other than those provided by this policy. This certificate does not amend, extend, or alter the coverage afforded by the policies described herein. Jamed Insured(s): Gevity HR, Inc and its wholly owned subsidiaries including but not limited to Gevity HR, LP; Gevity HR II, LP; Gevity HR III, LP; Gevity HR IV, LP; Gevity HR V, LP; Gevity HR VI, LP; Gevity HR VII, LP; Gevity HR VIII, LP; Gevity HR IX, LP; Gevity HR X, LP; Gevity HR XI, LLC; Gevity HR XII Corp. 9000 Town Center Parkway MARSH Bradenton, Florida 34202 Insurer Affordine: Coverae:e American Home Assurance Co., Coverages: Member of American International Group, Inc. (AIG) This is to certify that the policy(ies) of insurance described herein have been issued to the insured named herein for the policy period indicated. Notwithstanding any requirement, term or condition of any contract or other document with respect to which the Certificate may be issued or may pertain, the insurance afforded by the policy(ies)described herein is subject to all the terms, conditions and exclusions of such policy(ies). (Aggregate) Limits shown may have been reduced by paid claims. Type of Insurance Certificate Exp. Date Policy Number Limits Employers Liability Workers' 1-1-2008 RMWC9719932 Bodily Injury By Accident Compensation RMWC9719957 $ 2,000,000 Each Accident Bodily Injury By Disease $ 2,000,000 Policy Limit Bodily Injury By Disease $ 2,000,000 Each Person Other: Employees Leased To: Effective Date: 1/1/07 9933 Petroleum Equipment Construction Ine The above referenced workers' compensation policy(ies) provide(s) statutory benefits only to the employees of the Named Insured(s) on such policy(ies), not to the employees of any other employer. Notice of Cancellation: Should any of the policies described herein be cancelled before the expiration date thereof, the insurer affording coverage will endeavor to mail 30 days written notice to the certificate holder named herein, but failure to mail such notice shall impose no obligation or liability of any kind upon the insurer affording coverage, its agents or representatives. Certificate Holder: /Jsf~e. U/~ City of Zephyrhills 5335 8th St Zephyrhills, FL 33542-4312 Michael C. Weiss Authorized Representative of Marsh USA Inc. (866) 443-8489 Phone 01/01/2007 Date Issued ACQRD". CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 5/7 /2007 PRODUCER (407)833-8998 FAX: (407)804-1092 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Lhl & Associates Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 605 Crescent Excecutive Court ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 112 Lake Mary FL 32746 INSURERS AFFORDING COVERAGE NAIC# INSURED (407)290-3010 Fax: (407) 290-1173 INSURER A: Hudson Special ty Petroleum Equipment Construction, Inc. INSURER B: Hanover Insurance Company P.O. Box 910 INSURER C: Firemans Fund Ins. 7232 Overland Road INSURER D: Apopka FL 32704-0910 INSURER E: 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. Af.:1 RFr. TF LIMIT!': !':HOWN MAY HAVE BEEN REDUCED BY PAID r.LAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER Pgk+~1ri~~8Mr P~~WI~~~~N LIMITS GENERAL LIABILllY EACH n~~I'RR"NCE $ 2,000,000 - ~~~~U?"~~~~nce\ X COMMERCIAL GENERAL LIABILITY $ 50,000 A I CLAIMS MADE ~ OCCUR FEe 6112184 4/15/2007 4/15/2008 MED EXP IAnv one oerson\ $ 5,000 X Blkt Add'l Insureds PERSONAL & ADV INJURY $ 2,000,000 X Blkt Wai.ver of Subro GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 Xl nPRO- n X POLICY :1I=r.T LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 - (Ea accident) $ ~ ANY AUTO B ALL OWNED AUTOS AZJ875615801 4/15/2007 4/15/2008 BODILY INJURY - (Per person) $ - SCHEDULED AUTOS ~ HIRED AUTOS BODILY INJURY (Per accident) $ X NON-OWNED AUTOS - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ~ ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGG $ EXCESs/UMBRELLA LIABILITY EACH $ 3,000,000 lU OCCUR D CLAIMS MADE AGGREGATE $ 3,000,000 $ A ~ DEDUCTIBLE FXS 6112185 4/15/2007 4/15/2008 $ X RETENTION $ 10,000 $ WORKERS COMPENSATION AND IlrXg~T~,~ill OJ~- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ II yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ C OTHER Contractors MZI97507781 4/15/2007 4/15/2008 Rented/Leased Equipment Anyone Item $150,000 Idsaster $250,000 DESCRIPTION OF OPERA TIONS/LOCA TlONSNEHlCLES/EXCLUSlONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION (813)780-0021 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City Of Zephryhills EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 5335 8th Street 10 DAYS WRlTIEN NOTICE TO THE CERTlACATE HOLDER NAMED TO THE LEFT, BUT Zephryhills, FL 33540 - FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR L1ABILllY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES; AUTHORIZED REPRESENTATIVE ~~~-- Robert Bowles/DIANED ACORD 25 (2001/08) INS025 (0106).06a @ACORDCORPORATION 1988 Page 1 012