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Home My WebLink About12-13692 CITY OF ZEPHYRHILLS 5335-8TH SIREET � ' (sis)�so-oozo 13692 FIRE WORKS PERMTT Permit Number: 13692 Address: 5943 GALL BLVD Permit Type: FIRE WORKS ZEPHYRHILLS, FL. Class of Work: FIRE WORKS Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 10-26-21-0020-0000-0030 Improv. Cost: Date Issued: Name: ZEPHYR LLC Total Fees: 557.00 Address: 5943 GALL BLVD Amount Paid: 557.00 ZEPHYRHILLS, FL. 33542 Date Paid: 12/10/2012 Phone: (813 927-2426 Work Desc: TEMPORARY SALE FIRE WORK - DECEMBER 15 2012 - JAN 7 2013 (24 DAYS) TEMPORARY SALES 5.00 CONTRACTOR CERTIFICATE 30.00 � V' � , �� l� � � Chapter 633, Florida Statutes,authorizes the City to charge and collect user fees to pay for the oosts of fire prevention and protection related activities such as inspections, plan review,administrative fees,and other wsts related to the aforementioned. Complete Plans, Specifications and Fee Must Accompany Application. Commencement of work without written approval of the Fire Department's Fire Marshal or required permits or opening up for commercial activity without an approved final inspection shall be charged double permit fee per day of operation or a minimum of$100.00, whichever is greater. All work shall be performed in accordance with City Codes and Ordinances. "FIREWORKS" per Section 791.01, Florida Statutes are considered as any combustible or explosive composition or substance or oombination of substances or,except as hereinatter provided,any article prepared for the purpose of producing visible or audible effect by combustion,explosion,deflagration,or detonation. . , � � , �Y��.,t.,�._w CONTRACTOR SIGNATU PERMIT OFFICER PERMIT EXP ES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOURS NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT- 813-780-0041 ZEPHYRHILLS FIRE QEPARTMENT , ' 6907 Dairy Road, Zephyrhills, FL 33542 �°�"��f�°��'"`�"-�s Bus (813}780-0041 Fax (813}780-0044 FIRE SERVICE USER FEES Occupancy No.: Plan No.: Contractor Business Name Billing Address Business Address Business Phone No Billing Phone No Business Fax No. Biiling Fax No Contact: Contact: PLAN REVIEW FEES INSPECTION FEES PERMIT FEE FAISE ALARM FEE BSitePlan N/C Annual N/C Sprinkler $50 1stAlarm N/C Mutti-FamiiyiCommerciai O6 sf 1 st Re-inspection N/C Standpipes $50 2nd Alarm N!C (Minimum Charge$25.00 2nd Re-inspection $100 Fire Pump $50 3rd Alarm N/C � Plan Revisions DBL 3rd Re-inspection $250 Hoods $50 4th Alarm $100 4th Re-Inspection $500 Fire Alarm $50 5th Alarm $150 SPRINKLER SYSTEMS (Business closed until LP Gas $50 6th Alarm $200 0-25 Heads $50 violations corrected) Natural Gas $50 NON COMPLIANCE $150 26 plus Heads $100 SPRINKLER SYSTEMS Fuel Tanks- per tank $50 STANDPIPE SYSTEM Hydro Undergrounds $45 Sparklers $100 � Per Riser $50 Hydrostatic Test $65 per system Fire Works $500 FIRE PUMP Acceptance Test $45 per system Camp Fire $25 � Per Pump $100 Hydrant Flow $75 Controlled Burn $100 FIRE ALARM SYSTEM Hood/Duct $50 8 0-25 Devices $50 FIRE ALARM SYSTEM Place of Assembly $50 Annual 26 plus Devices $100 System Acceptance $50 Fire Protection $25 SUPPRESSION SYSTEMS Recall Acceptance $50 Flammable Application $50 annuai Wet $50 OTHER Waste Tire Storage $50 Annual Dry $50 Fire wall�smoke wall $15 per wall Generator<KW $100 CO2 $50 LP Gas $25 per tank Generator>30 KW 150 Other $50 Natural Gas $25 persystem Bio-Hazard Waste $100 Annual KITCHEN EXHAUST Fumigation Tenting $50 � Hood/Ducts $50 Tent 10'x10'or greater $15 per tent Torch PoUApplied $50 OTHER Fire Pump $45 Haz.Materials $100 Annual 8 LP Installation per ta�k $50 Fire Suppression $30 Fuel Tank Installation $50 System Acceptance (Per Tank) $50 Exhaust Hood/Duct $30 �Natural Gas Installation $50 Re-inspection DBL (Per System) (other than annual) � Spray Booth $50 � Inspection schedufed DBL � and cancelled less than 24 hours Construction Insp N/C Emergency Vehicle Ai $50 FALSE ALARM P�ANS TOTAL� � INSPECTION TOTAL; _ PERMIT TOTALF� � TOTALI GRAND TOTAL Comments. Date � `i Inspector ��.. �� .�-��v� nin � ;��.� ` Temporary Sales Checklist City of Zephyrhills 5335 8�h Street Zephyrhilis,Fl.33542 Phone:813-780-0020/Fax:813-780-0021 REQ MENTS Detailed Plot Plan showing setup of location. Refer to Ord 1038-09, Sec 5 � r� Notarized letter from property owner stating their approval.� �.1G�5� �t�tkt'.�en�-� �A flame retardant certificate is required IF a tent is involved. Inspection required once tent is erected and prior to opening for business. f Approved certified fire extinguishers per NFPA 10. „/,Cy Zi r y� � `JlY ( : �r.�_l No Smoking signs must be placed outside entrances. �� y ' ��`� IF th c��`� _ e r e i s a w i r e f e n c e o r c h a m l m k f e n c m g m u s t h a v e a t l e a s t 5 F t s e t b a c k f r o m t e n t an d a t l e a s t �� ! � ,. 2 exits. q 1 �� f IF tent has sides,the sides shall be in the up position unless there is inclement weather, ` �' then 2 sides must be in the up position. FIREWORK REQUIREMENTS—(In addition to the above) Proof of State License. �}lL (u;e n�- cT�.'� 3c•�Z; ,/ Proof of Liability insurance. ,/ List of items to be sold at site. `� Copy of Drivers License and Social Security Number of all personnel dealing with the sale of fireworks at the tent location. FEEs � $30.00—City Registration(If Regulated by DBPR—Fee is Waived) $500.00—Fireworks fee-Fire Department fee $ 5.00—Temporary Sales Fee for 1 g`two days $ 1.00—Temporary Sales Fee per day for each consecutive day thereafter,not to exceed duration of 7 consecutive days and no more than two occurrences • during a 12 month period on same property Ord#1038-09,Sec 6 $50.00—Tent Fee(40.00BD, 15.00*/FD)—(*$15.00 waived for Fireworks) $40.00—Electrical Fee(if applicable) Property Owner: Ze�,L�r LLC J `J Applicant: F� w , ,u,. Phone Contact: �S�l3�Z3y- Ztb'/ � �`� �7�� '��('�` Address Site: 59.53 G�a11 �IVeC. Date(s)of Sale: �� t c — Ordinance No. 103 -09 (for additional requirements) . # � � � �a � a � � N � .� � � f �° ccs m o ; � � � � � � a a q ` � ,Q � c3 � � � � Q � G � y� m C � �+ � � � ¢ � C � O � � � � � � � � - �� Rf �► Rs � '� Y.. � t+1 `q� � � a w � �(�' m� _ V � � y�,, O �. �i 'Q C Q � � � � � M � � N � � � � � � � W � � � � c4 � � � a� �. � � � _ � � � °" � � � � � ' � � ~ � �. .� .� ,. � � � � �W' �� "' � � � � �` � � � ,��^ � d � �.. 0,1 �3 � ,C? — � • � �' � � � � � � � � �� :� � � � � � � � z � �` � u � � � � •-. � O � .4 O � � '� GE. � (Yl �t Ql vr 'r "'` � � � � � � � � � � � � � -� 'r 'LE ,� .i� '� � Gy � � � � � tr. .�r t0 a? p �`' `�'r � � � � c � ,�,�. .;�: L- "" C3 a,' t,� +� � C � t6 � o � ,; �°t +a '� E � � � � � � � � � � �t a: � � .� � � � E — '� z`� E:, � � '� � y �' W � � � � � � m �s; � C 1 �i �" (j � t/) p � � U,. � � Q O "� � � � �'- � � �-` t£I 'Q t!t �+ LL � � � � � � � � E F:: � Q c� � � � v W � {� � � g � v' U a �i � �•d £gs6-69Z�£68) �e�� su��enbae{� �0£�SO 64 9ti ��(' This location, has consumer fireworks , products from the following list on site for sales to the public. Inv. # SAFE/SANE ASSORTMENTS Item Number 000000000105 Big Bang 4/1 GLX-106 000000000102 Big Dipper 5/1 GLX-103 000000000103 Comet Collection 18/1 GLX-104 000000000111 Cosmic Cluster 8/1 GLX-118 000000000107 Cosmic Countdown 4/1 GLX-113 000000000116 Final Countdown 6/1 GLX-124 000000000106 Just for Kids 24/1 GLX-112 000000000101 Littte Dipper 18/1 GLX-102 000000000108 Ninja 6/1 GLX-114 000000000109 Party Time 5/1 GLX-115 805253004733 Sizzler 6/1 WC 000000000100 Star Gazor 24/1 GLX-100 805253004740 Thriller 6/1 WC 000000000113 Warp Speed 12/1 GLX-121 Inv. # FOUNTAINS Item Number 754471202011 7th Heaven 6/1 FOA Ftn. 705834221330 Ancient Myth 18/1 Y22-133 705834020223 April Showers 36/1 Y02-022 705108305018 Ass't. 8" Ftn. (Winda) 12/3 P3050 705834220630 Astro Jam 18/1 Y22-063 676551000877 Awe-Some 4/1 GPH3079 705834020360 Backyard Fountain 20/4 Y02-036 754471202110 Barrel of Fun 12/1 FOA 705108305308 Beautiful Minds 12/1 P3053 805253113633 Behemoth 9/1 WC Ftn. 705108301010 Blaze and Blade 12/12 P3010 676551000815 Blue Ice (100 gr ftn.) 24/1 GPH3073 705108310005 Blue Sunday 2/1 P3100 000000000211 Boom and Buu 40/1 Y02-021 705108304103 Brilliant Shower Ftn. 48/1 P3042 705834220722 Bulk Cones #3 Conic 18/4 Y22-082-G 761507118062 Bulk Cones #5 USA Spring Blossom 96/1 P3051 676551037590 Burn Baby Burn 16/1 GCF086 000000000202 Butterfly � Flowers 48/6 0833 000000000210 California Candle 36/6 T6018 754471200215 California Dreamin' 24/1 FOA Ftn. 754471200611 California Sunrise 36/1 FOA Ftn. 754471200017 Call of the Wild 36/1 FOA Ftn. 705834640087 Chains of M ste Fountain 4/1 Y64-008 000000001523 Climbin Panda 24/6 K1149 000000000205 Conic #3 60/12 T1515 000000015226 Crowd Thinner 6/1 GL-PS0001 676551050216 Cuckoos 24/6 GL- 0852 705834640070 Dazzling Dyno 4/1 Y64-007 705834440654 Dracula Fountain 12/4 Y22-069 705108304509 Dream Flower 48/1 P3045 693019040107 Dream Worid 24/1 WB4010 000000000226 Dreamer 36/4 P3006 754471201410 Electric Rainbow 12/1 FOA Ftn. 705834221262 Elf's Whisper 12/1 Y22-126 6932352140018 Enchanted Garden 24/1 GG-4002 680149019707 Endless Applause 4/1 LBF 12 705834640025 Fantasy Dance 4/1 Y64-002 680149008886 Fantasy Land 4/1 LBF 6 754471201113 Far Out 12/1 FOA Ftn. 705108310401 Fire Fighter Fountain 6/1 P3104 000000000231 Fire Invioable 12/3 P4002 705834221170 Firetongue Fountain 24/1 Y22-117 676551000921 Flamenco (100 gr) 18/1 GPH3084 705834640063 Floro Glo 6/1 Y64-006 80525311420 Fool's Gold 24/1 WC Fountain 80525311302 Frisky Starburst 48/1 WC Fountain 705108302703 Gadzooks 12/6 P3027 676551033851 Gardenia 32/1 GCF056 - 80525301210 Girl Power 30/1 WC Fountain 676551001027 Glitz 6/1 GPH3094 754471202219 Grand Illusion 6/1 FOA Ftn. 676551051459 Happy Festival 18/4 0925 676551071136 Happy Silvery Flowers 24/4 0847-6 754471201212 Havana Heat 18/1 FOA2012 754471202714 Hearts A-Fire 4/1 FOA Ftn. 705834220609 Heat Wave 40/1 Y22-060 705108302109 Heavy Rhinoceros 12/1 P3021 000000000302 HN-60 Asst. Fountain 36/4 HN-60 000000000303 HN-89 Asst. Fountain 18/4 HN-89 000000000304 HN-90 Asst. Fountain 18/4 HN-90 000000000224 Hollywood Park 24/1 P3013 676551001669 Hot Roll 16/1 GPH3149 676551036289 Jazz (100 gr ftn) 12/1 GCF081 754471201311 Just Another Stinkin Fountain 24/1 FOA 687985424719 Jumboshell Fountain 4/1 BP4247 000000000305 Killer Bees 24/4 GL-W499A 80525311421 Lava Lamp 6/1 WC Fountain 680149008800 London Tower Bridge 10/1 SF33 687985450817 Love On Fire 4/1 ' B500 80.525311427 M8�M 32/1 WC Fountain 676551000914 Magic Illumination 12/1 GPH3083 754471199816 Malibu Madness 36/1 FOA1998 676551001010 Mi Amor 4/1 GPH3093 705834220616 Mummy's Wrath 40/1 Y22-061 680149023001 Mushroom Cloud 8/1 SF130 754471202912 Mystic Rain 8/1 FOA 80525311370 National Treasure Ftn 6/1 WC Fountain 705834221132 Naughty Croc 18/4 Y22-113 705834640049 Nocturnal Vision 6/1 Y64-004 805253113459 One Big Fountain 4/1 WC Ftn. 705834221507 Oriental Magic 8/1 Y22-150 705108304400 Palm Party Ass't. Ftn. 4/3 P3044 805253113824 Perfect Silence 96/1 WC Ftn. 74471201915 Perfect Storm 6/1 FOA Ftn. 705834020414 Precious Stones 18/4 Y02-041 80525311423 Psychedelic 4/1 WC Ftn. 754471201519 Quiet Riot 6/1 FOA Ftn. 705834220913 Rainbow Fountain 16/6 Y22-091 000000000238 Rock Music 36/1 P3024 705108310104 Rollin Stone 4/1 P3101 676551031215 Rosy Cheeks 18/1 GCF050 676551000938 Rumba 6/1 GPH3085 687985426218 Scary Stuff 6/1 BP4262 676551037583 Screaming Monkey 12/1 GCF085 705834220678 Shell Fountain 24/1 Y22-067 676551051435 Silvery Flowers-9" 18/4 0847-9 805253130326 Six Alarm 12/1 WC Fountain 754471202813 Solar Storm 6/1 FOA 705834640018 Space Bastion 4/1 Y64-002 342529920019 S ace Lam 24/4 W427 000000000360 Stage Party 2/1 P3041 754471199717 Star Dust Ftn. 24/1 FOA Ftn. 17544712019 Stars Over America 24/1 FOA Ftn. 705108303809 Sunny Princess 36/1 P3038 687985425211 Super Fountain 6/1 BP4252 676551071167 Tigers Roaring 20/4 T1006 705834221156 Tropical Fish 36/1 Y22-115 687985426713 Up in Smoke 16/1 BP4267 805253113817 Visions 48/1 WC Ftn. 705834220753 Whistling Color Cuckoo 48/1 T1117 000000000204 Whistling Dixie (Phx Tail) 48/6 T1016A 705108304608 Wonderland 36/1 P3046 805253113794 Worlds Strongest Fountain 18/1 WC Fountain . Inv. # SPINNERS & WHEELS Item Number 676551051442 Ground Bloom Flower (Gorilla) 20/12 GL-09018 000000000513 Spinning Wheel 12/6 0544 000000000514 Tri-Rotating Wheel 24/12 T7500 Inv. # NOVELTIES Item Number 000000000500 Aladdins Lamp 48/3 W468 676551033479 Black Snake 15/48 GM801 612141811317 Black Snake (Legend) 15/48 GM801 000000000502 Booby Traps 10/144 T8501 000000000519 Crackling Balls 16/12/6 0205A 000000000503 Friendship Pagoda 144/1 W613A 680149000001 Fuse 450/1 FU30-1 0000000001522 Glow Worm 15/48 GM811 705834320231 Happy Lamp 72/1 Y32-023 000000000512 Hen Laying Egg(Cock Crowing..) 24/24 W701 612196020115 Hydra Breeding 24/12 LN6020 000000000526 Oriental Dragon 48/4 P7003 705108900121 Party Popper (6pk) 12/24 GP-T8502 000000000507 Party Poppers Champagne 12/72 T8502 000000000517 Punk 100/100 PK-3 676551033431 Snap-n-pops 6/40 GL-T8500A 676551033448 Snap-n-pops 6/50 GL-T8500 000000000510 Tanks 40/12 W705 Inv. # SMOKE ITEMS Item Number 676551033486 Mammoth Smoke 6/24/1 GL-GM807 676551033462 Smoke Balls (color, 12 pk.) 20/6/12 GL- GM800 676551033509 Smoke Balls (white, 12 pk.) 20/6/12 GL-GM823 000000000602 Smoke Grenades 12/48/1 T8571 Inv. # SPARKLERS Item Number 000000000709 #10 Color Sparkler 24/12/8 GP-07506 000000007177 #10 Gold Sparkler 24/12/8 GP-0978B 000000000701 #8 Color Sparkler 24/12/6 GP-0740B 000000000700 #8 Gold Sparkler 24/12/6 GP-0977B 000000000705 10" Morning Glories 24/12/6 GLX-28-023G 000000000704 14" Morning Glories 15/8/12 GLX-28-022G 000000000703 36" Morning Glories 96/6 Y28-025 705834480034 36" Sparkler 48/3 Y23-297 Inv. # FULL "C" ASSORTMENTS Item Number 000000000810 Alien Attack 6/1 GLX-810 000000000805 Comet Collection (WL) 18/1 GLX-805 000000000813 Cosmic Cluster 8/1 GLX-813 000000000801 Cosmic Countdown 4/1 GLX-801 000000000800 Final Countdown 6/1 GLX-800 000000008133 Galaxy Collecfiion 8/1 GLX-8133 000000008003 Galaxy's Next Generation 6/1 GLX-8003 805253044050 Little Big g�� WC 000000000802 Little Dipper (WL) 18/1 GLX-802 705108002207 Mars Attack 1/1 P0022 805253404571 More For Your Money 8/1 WC 000000000809 Night Fire 1/1 GLX-809 000000000814 Rocket Barrage 12/1 GLX-814 000000000811 Saturn's Revenge 4/1 GLX-811 000000000812 Solar Eclipse 3/1 GLX-812 805253044043 Stars & Stripes F/C Asst. 6/1 WC 805253044029 USA Assortment F/C 4�� WC Inv. # CAKES (Repeaters) Item Number 754471293811 After Midnight 12/1 BP 2491 754471292913 After Shock 12/1 BP 2491 687985249114 America Invincible 16 shot 12/1 BP 2491 705108506200 Armegeddon 12/1 P5062 705834233456 Art Attack 10/1 Y23-345 805253132658 Beach Bum 8/1 WC Cake 000000000931 Big Snow 18/2 0503 000000000924 Blue Stars W/Report 18/2 0128A 805253132887 B�@W CI'@W (Happy Hour,Bottoms Up,Pop A Top,last Ca 24/1 WC Cake 687985219414 Burglar Alarm 8/1 BP 2194 705108512508 Cherry Bomber 12/1 P5125 687985253913 China Dra on 6/1 BP2539 000000000938 Cloud Dragon 18/2 GL-0501 705108510108 Close to Heaven 18/1 P5101 000000000923 Coconut Grove 12/1 0704-19 676551050490 Color Pearl-48 shot 20/4 T2507 676551050728 Cotor Pearl-96 shot 10/4 T2521 676551000846 Colorf'ul Explosion 12/1 GPH3076 705108511600 Cool Beauty 8/1 P5116 687985211418 Cou ars 8/1 BP200 805253131774 Crazy Exciting 12/1 WC Cake 680149013767 D-Box 6/1 SSM0707 6932352120416 Dance Battle 12/1 GG-2041 000000000904 Desert at Night 40/1 L930 754471291411 Di Dancin 6/1 FOA 687985203611 Double Double 6/1 BP2036 680149013781 Double Victory 10/1 SSM0706 705108510504 Endless Quest 12/1 P5105 705108512201 Eye Candy 8/1 P5122 705108509805 Fascinating Cake 12/1 P5098 805253432048 Flirting With Greatness 18/1 WC Cake 676551000945 Four Queens 12/1 GPH3086 705108520404 Future Guy 24/1 P5204 612031615292 Galaxy Discovery 24/1 LC1615 612031614448 Galaxy Storm 24/1 LC1614 000000015257 Galaxy's Finale 8/1 GL-PS0006 612037206067 Galaxy's Warrior 72/1 GL-LC7206 000000000925 Garden in Spring 40/1 L901 676551051626 Glorious 61 Shot Ass't. 12/1 GCA087 687985245314 Golden Corn 21/1 BP 2453 687985239214 Grand Canyon 24/1 BP200 805253131675 Grapes Over Vineyard 12/1 WC Cake 705108510900 Great Expectation 24/1 P5109 000000000939 Green Bamboo 18/2 GL-0502 705834231773 Happy Firework-16 shot 48/1 K7702B 705834231780 Happy Fireworks-36 shot 24/1 K7702A 805253132055 Hard To Beat 18/1 WC Cake 6932352120393 Hocus Pocus 18/1 GG2039 805253131682 Hostile Takeover �2�� WC 676551032953 Ice Comet 8/1 GCM095 805253132863 It's A Matter of Size 48/1 WC Cake 805253130128 Jumbo Colorfulf Missile Launcher 18/1 WC Cake 000000000906 Kaleidoscope 50/1 T2512 687985215416 Killer Alligator 8/1 BP 2154 687985257515 Killer Heat 8/1 BP 2575 680149006660 King Tuts Curse 8/1 SSM0673 705108520206 Lady Universe 12/1 P5202 805253013018 Land of the Free 18/1 WC Cake 705108510405 Latest Trick 12/1 P5104 680149013750 Latin Quarter 12/1 SSM0669 680149017628 Line of Fire 8/1 SSM0685 687985242214 Magic Carpet 12/1 BP 2422 805253013506 Massive Destruction 12/1 WC Cake 687985218318 Matrix Pyro 12/1 B-500 687985283811 Mechanical Bug 8/1 BP 2838/U 705108513000 Mega City 10/1 P5130 705108511709 Mortal Knight 10/1 P5117 805253632462 Motor Mouth 12/1 WC Cake 805253131712 Natural Disaster 12/1 WC Cake 687985213216 Night Vision 12/1 BP 2132 676551001249 Onslaught (Fire in the Hole) 8/1 GPHH3107 805253132368 Power Play 12/1 WC Cake 000000000973 Purely Green 12/1 P5114 Red, White, Blue 12 Shot (Red Devil 16/1 Y23-297 705834232978 Ban j 687985290512 Red White and Blue Salute 12/1 BP 2905 805253133075 Re ae Party 24/1 WC Cake 705834233289 Rumble Ramble 9 Shot 12/1 Y23-328 705834233180 Seismic Waves 16 Shot 12/1 Y23-318 _ 687985221813 Sk Monitor 6/1 BP2539 6932352120409 Sniper 12/1 GG2040 805253012431 Snow Storm 40/1 WC Cake 705108050529 Space Adventure 6/1 P5068 676551000761 Space Express 12/1 GPH3068 705834233173 Spinning City 8/1 Y23-317 805253132009 Splitter Splatter 18/1 WC Cake 612037231663 Stand Up For USA 10/1 LC7231 705108511808 Strong Man 12/1 P5118 676551034827 Summer Bowl Commotion 8/1 GCM0148 687985200214 Super Stallion 24/1 WC Cake 705834232770 Sweeper 10/1 Y23-277 000000001519 ThunderStorm 36/1 GRL- L912 000000000963 Universal Beast 6/1 P5069 705180509205 Universal Dream 6/1 P5092 805253431959 Viagra 10/1 WC Cake 687985299515 Wake-up Call 8/1 BP200 805253130340 What Dat Do �2�� WC 687985219018 Welder 24/1 BP2190 687985257614 Wild Bear 16 12/1 BP 2576 687985200917 Wild Mushroom 12/1 BP200 687985292417 Wild West 25 12/1 BP 2924 754471291312 WOW 8/1 BP200 000000000919 Yellow Bees 18/2 0504 Inv. # 500 GRAM CAKES Item Number 754471293712 Above the Law 4/1 WC 500 612037567793 Act of God 6/1 GL-LC7567 687985207411 Aerial Dynamite 15 Shots 4/1 BP2074 676551001201 After the Storm 4/1 GPH3103 705834630101 Air Heads 29 Shot 4/1 Y63-010 687985217113 Alakazam 4/1 BP 2171 676551035343 Alchemy 4/1 GCM0165 705108531707 Amazing Ballet 1/1 P5098 805253150195 America Rhythm 1/1 WC 500 612030642251 America The Beautiful 4/1 LC0642 687985200412 Americana 4/1 BP 2004 680149019257 American Highlights 4/1 LBM-49 687985204519 American Homeland 4/1 BP 2043 687985215218 Am ed 4/1 BP2152 676551035299 Assault Troops 4/1 GCM0160 ' 67655100089�1 Atingle 4/1 GPH3081 68.7985204618 Baby Boomer 4/1 BP 2046 754471299011 Barely Legal 4/1 B-500 687985207213 BBQ Blast 10 Shots 4/1 BP2072 680149026491 Better than the Best 4/1 LBM84 705834631009 Big Bike Biker 4/1 Y63-000 676551001713 Black Magic 4/1 GPH3154 805253150010 Blonde Joke 4/1 BP2975 687985203413 Blue Prints 2/1 P5363B 805253150126 Breathless 3�� WC 805253150523 Can You Handle It 2/1 WC 500 705834630330 Call For Liberty 4/1 Y63-033 676551001270 Cannonade 4/1 GPH 3110 687985222810 Captain America 6/1 BP 2228 612037541496 Carnival Attack 6/1 GL-LC7541 612037577778 Catastrophic Storm 4/1 LC7577 687985208715 Celestial Exploring 2/1 BP2087 705834630392 Chain Reaction 4/1 Y63-039 676551001645 Coco Loco 4/1 GPH3147 754471298618 Colors of America 2/1 FOA2986 687985220618 Combat Zone 2/1 BP 2206 680149019363 Convincing Illusion 2/1 LBM60 754471297710 Cosmic Collision 8/1 FOA2977 676551037507 Cosmic Gazer 2/1 GCM0202 705108538201 Count Thunder 2/1 P5382 705834630422 Craizy Daizy 1/1 Y63-042 687985206810 Craz Creatures 4/1 BP2068 805253150393 Crazy Exciting on Steroids 4/1 WC 500 705834630774 Cyborg Duel 4/1 Y63-077 687985218714 Deadly Peril 2/1 BP2187 705108536108 Defender 2/1 P5361 705108537006 Desert Buster 2/1 P5370 680149026514 Devastation 2/1 LBM86 612037578508 Evil Spirit 4/1 LC7578 754471298519 Feel the Blast 2/1 FOA 500 7Q5108533305 Final Destination 4/1 P5333 705834630750 Final Flash 6/1 Y63-075 676551035237 Finale Freeball 4/1 GCM0155 805253150850 Flicker 6/1 WC 500 687985228812 Flood Red 4�� BP22$$ 754471299813 Full Blown Tilt 4/1 FOA2998 687985226610 Full Throttle 4/1 BP2266 680149026958 Fully Loaded 2/1 SSM185 676551001706 Galaxis 2/1 GPH3153 000000015271 Galaxy's Desire 4/1 GL-PS0004 000000015264 Galaxy's Eye Opener 4/1 GL-PS0005 000000001600 Galaxy's Golden Star 8/1 GLX-63-098 000000015240 Galaxy's Raging Gorilla 4/1 GL-PS0006 612130664321 Galaxy's Thunder 6/1 GL-LC0664 812038509253 Galaxy Assault 2/1 LC8509 705108532209 Galaxy Explosion 4/1 P5322 000000001566 Galaxy Gate 4/1 LC8591 000000015233 Galaxy Magic 4/1 GL-PS0002 687985204113 Gamma Glo 4/1 B-500 612037529156 Ghost Fighter 4/1 LC7529 687985225811 Glory, Power, Honor 2/1 BP2258 676551000563 Golden Crown 3/1 GPH3048 754471299417 Gone Wild 3/1 FOA2994 805253432116 Grave Digger 4/1 WC 500 705108532704 Great Pretender 6/1 P5327 676551001171 Grenadier 2/1 GPH3100 680149016171 Guns � Roses 4/1 LBM-43 705108531509 Happy Club 2/1 P5315 705834630477 Head Banger 4/1 Y63-047 705108539307 Hearts of Fire 3/1 P5393 680149026828 High & Mighty (Shogun) 2/1 SSM184 6932352129136 Hustle 4/1 GG-2913 705834630958 Immortal Flame 4/1 Y63-095 705834630620 Invasion Station 4/1 Y63-062 676551001195 Island Ma ic 2/1 GPH3100 705108539901 Jail Bait 4/1 P5399 705108534609 Jester's Reven e 1/1 P5346 705108535408 Jumbo Saturn Missile Battery {I 6/1 P5354 705108535903 Jumping Skier 4/1 P5359 805253132306 King of Brocade 4/1 WC 500 680149016195 King of Pirates 2/1 LBM-26 687985225712 Knockout Brocade 2/1 BP2257 687985222117 Labyrinth 4/1 BP 2221 612030124191 Landing Force 2/1 LC012-4 676551001287 Liberty Show 2/1 GPH3111 705834630576 Mad Max 4/1 Y63-000 612030609261 Magnificent America 2/1 LC0609 612030608189 Magnificent Display 2/1 LC0608 805253150775 Making Thunder 2/1 WC 3" 612037522952 Mass Destruction 3/1 LC7522 676551001683 Metropolis 4/1 GPH3151 705108536313 Multi-Color Peony 2/1 P5363A 612030658856 Need for Speed 12 Shot 4/1 LC0658 805253132238 Not in M Yard 4/1 KN835 805253029019 One Bad Mother 3" 2/1 WC 500 805253131859 One Bad Mother 4/1 WC 500 805253150379 One Bad Mother in Law 4/1 WC 500 805253150867 Oriental Dragon 500 Gram 6/1 WC 500 687985298518 Parrot Prattle 4/1 BP 2217 805253132313 Perpetual Motion 4/1 WC Cake 676551000990 Picture Perfect 2/1 GPH3089 805253150621 Power House 2/1 WC 3" 705108535309 Powerful Attack 6/1 P5353 705108533800 Prehistoric Creatures 2/1 P5338 805253150591 Pure Seduction 3/1 WC 500 705834630699 Pyro Indulgence 4/1 LBM82 680149026477 Pyro Protest 4/1 LBM82 705834630712 Pyro Swords 1/1 Y63-071 687985203918 Quake 4/1 BP2039 6932352129013 Radioactive Web 2/1 GG-2900 687985213719 Ready to Rumble 2/1 BP2137 705834630675 Red Alert (China National) 4/1 Y63-067 805253150655 Red Eye 3/1 WC 500 705108535507 Revenge of the World 2/1 P5355 705108541003 Ring Ring 2/1 P5410 705108533107 Road to America 1/1 P5331 687985207312 Roboshot 15 Shots 4/1 BP2073 687985220816 Rock On 4/1 BP2208 80525315060 Rolling Thunder 2/1 WC 500 805253150768 Rounders 2/1 WC 500 687985297917 Saturday Night Special 4/1 BP500 687985901418 Shaolin Tradition 3/1 WC 500 705834630095 Shell of Shell 4/1 Y63-009 805253151321 Shoot The Moon 2/1 WC 500 687985226016 Show Stopper 2/1 BP2260 8052531312't7 Skull & Crossbones 3/1 WC 500 805253151277 Slightly Sinful 2/1 WC 500 612037505627 So Much Proud 2/1 LC7505 705108530106 Spectacular 2/1 P5301 705108539802 Speed Racer 4/1 P5398 705108535606 Super Kung Fu 4/1 P5356 705108538904 Super Sized 2/1 P5389 705108539000 Swam Gator 4/1 P5390 80525313289 Taste of Heat 6/1 WC 500 687985208814 Tears From Heaven 16 Shots 2/1 BP2088 805253150485 The Big Dog 2/1 WC 500 805253130753 The Big Package 4/1 WC 500 805253431966 The Chosen One 4/1 WC 500 70�108534203 The Giant 4/1 P5342 612037591996 The Final Winner 1/1 LC7591 612037564693 The New Frontier 6/1 GL-LC7564 612037516166 The Next Generation 4/1 LC7516 680149016331 The Power of the Ring 4/1 LBM24 612037503302 The Road to July 4th 3/1 LC7503 805253450431 Time Is On My Side 2/1 WC 500 687985228614 Triple Whammy 4/1 BP2286 805253432345 Twice as Nice 8/1 WC Cake 687985202218 Uncle Sam's Answer 4/1 BP2022 705108534500 USA Conquerer 1/1 P5345 754471299714 Wake The Neighbors 4/1 FOA2997 805253151086 War Dance 2/1 WC 3" 687985221219 Wave Machine 2/1 B-500 687985230716 Wee Beastie 2/1 BP2307 754471297611 What A Blast 4/1 BP2022 687985225118 Whirling Dervish 6/1 BP2251 687985220717 Wicked Cool 4/1 BP 2221 805253132245 Widow Maker 4/1 WC 500 000000001526 Winter Blast 1/1 Y63-029 805253150515 XXL 3" 2/1 WC 500 fnv. # FIRE CRACKERS Item Number 680140008823 Bad Boy Crackers 100/100 SWB100A 000000001001 Celebration Crackers-1388 12/1 T765 000000001002 Celebration Crackers-2492 6/1 T766 000000001009 Firecrackers-1000's 4/4 T733 000000001006 Firecrackers-100's 8/20 T724S 805253005242 Firecrackers-16000's 1/1 T737 000000001010 Firecrackers-2000's 8/1 T734 000000001007 Firecrackers-200's 8/10 T727 000000001003 Firecrackers-40/12 32/40 T714S 000000001004 Firecrackers-40/16 (Gorilla) 24/40 GP-T716 000000001011 Firecrackers-4000's 4/1 T735 000000001012 Firecrackers-8000's 2/1 T736 705108100804 Five Stage Bomb 10/6 P1008 000000001515 Gorilla Burst 12/1 GRL-35-078 80525300554 Jumbo Crackers 120/4 000000001014 Jumping Jacks 80/12 T3500A 680149002365 Jumping Jacks (Shogun) 20/48 SGW3500-12 000000001527 Junior Burst 12/12 Y35-075 000000001016 Ladyfingers 32/40 532 000000001017 M-1000, Assorted (36) (Galaxy) 40/36 M88 Inv. # ROMAN CANDLES Item Number 000000001129 Biue Thunder 24/6 K2255C 687985304929 Crazy Aces 24/4 BP3049 805253018389 Excitement 8 Ball 24/4 WC R.C. 680149003874 Flash Thunder 24/4 RC302 000000001400 Galaxy Special Rom. Candle 18/4 GP-RA01 680149022257 Power Candle Asst. (Starlight) 8/8 SRC4008 805253418417 Pyramid of Power 12/12 WC R.C. 705834450341 Pyro Gun 8/9 Y25-034 687985309429 Pyropaint Balls 21/10 BP3094 687985309528 Rocketing Stars 11/7 BP3095 000000011105 Roman Candle - 5 Ball 48/6 GP-T6513 000000001111 Roman Candle - 5 Ball (w/rpt) 72/4 0527-5 000000011140 Roman Candle 10 Ball 24/6 GP-T6515 0000000011150 Roman Candle 10 Ball (w/rpt) 36/4 0529-10 000000001113 Roman Candle 8 Bail (w/rpt) 54/4 0528-8 000000011129 Roman Candle-8 Ball 48/6 GP-T6514 680149015983 Sky Thunder 24/6 RC138R 705834250392 Smash Tactic Candle 24/4 GG-3001 705108400409 Super Galaxy Candle 18/4 P4004 16932352130019 Turbo Boost 24/4 GG-3001 Inv. # WINGED & PARACHUTE NOVELTIES Item Number 000000001100 Artificial Satellite (Comet) 10/12/12 0428 000000001101 B-3 Bomber 72/6 L504 000000001102 B-52 Bomber 72/6 L507 000000001103 Bombing Planes 60/6 0432 705108508303 Military Parachute 24/2 P5083 680149008374 Parachute Battalion 12/1 SSD160 000000001106 Reconnaissance Plane 60/6 0433 000000001119 Two Color Space Ship 36/6 W538A Inv. # MISSILES Item Number 705834210280 8" Missile 18/12 Y21-028 705834210266 12" Missi{e 12/6 Y21-026 676551050018 Saturn Battery 25 shot 120/1 GP-113007 000000001117 Saturn Battery-100 shot 30/1 GP-1130C12 000000015028 Saturn Battery-300 shot 12/1 GP-1130C300 000000015356 Saturn Battery-750 shot 2/1 GP-11300750 680149017758 X Wing Double Strike 12/12 MS410 Inv. # ROCKETS Item Number 000000001226 Artillery Shell Rocket 20/4 Y21-040 000000001200 Bottle Rockets (Gorilla) 25/12 GP-0440S 000000001212 Cluster Bee 72/6 T0508 676551033523 Display/Jumbo Jet 24/4 T0642 000000001228 Emerald Meteor 96/6 T0004 000000001229 Floral Rocket 72/6 T0069 000000001215 Flying Color Butterfly 72/6 T0510 70,5108202409 Galaxy Explosion Rocket 20/4 P2024 612026121210 Galaxy Explorer 10/9 LB6121 705108200801 Galaxy Rocket 18/4 P2008 676551071143 Jumbo 20 Rockets 36/4 2�2 705108201204 Midnight Flashing (Rocket Fight) 18/4 P2012 805253001411 Need for Speed Rocket 24�4 WC 000000001221 Parachute Rocket 96/6 T0513 000000001213 Red Meteor Rocket 96/6 T0009 805253001428 Ring Shell Rocket 24/6 WC Rkt. 000000001204 Rockets 2oz 54/12 T0022 000000001205 Rockets 4oz (Galaxy) 36/12 GL-T0023 000000001206 Rockets 6oz (Galaxy) 36/12 GL-T0024 000000001207 Rockets 8oz (Galaxy) 36/12 GL-T0025 8052534016480 Rockets in Motion 6/8 WC 676551051150 Saturn 22 Rocket 36/4 216 687912345678 Scorpion Rocket 36/4 BP 1188 680149017451 SRA4 Shogun Rkt. Asst. 12/17 SRA4 000000001218 Sky Rocket/ 60 Salutes 24/6 213 805253401556 Smiling From Ear To Ear 20/5 WC Rkt. 680149017451 Star Blitz Rkt. Asst. 10/4 SVR12 687985121021 Super Genesis 24/6 BP 1210 0921432100338 Whistle Bottle Rockets 20/12 GP-0445 000000001203 Whistle Bottle Rockets-3 20/12 0445D 000000001214 Wild Geese 48/6 T0512 Inv. # RELOADABLES Item Number 687985226221 Air Control Mortar Kit 6/1 BP 2262 705108481200 Amazing Ballet Reloadable 2/1 BS4812 612196486485 America On My Mind 1/1 LS648 676551071181 Artillery Shell 12/1 GL-W515B 705108481309 Attack Force 1/1 BS4813 612196110038 Battlefield 2/1 LS611 612194022647 Big Buster 4/1 LS402 687985905126 Bite the Bullet 3/1 BP-A051 754471296515 Bullet Bombs 12/1 FOA 676551071198 Crackling Artillery 12/1 GL-W518A 687985904228 Critical Mass 1/1 BP-A042 805253131545 Excalibur 6�� WC 016879852090 Fear No Evil 6/1 BP2090 612196030022 Galaxy Eagle Eye Artillery 2/1 GL-LS603 612194054051 Galaxy's Cutting Edge 6/1 GL-LS405 612198024364 Galaxy's Star Cruiser 4/1 GL-LS802 000000001344 Ghost Killer Shells 6/1 P8007 �000000001341 Goliath 4�� WC 000000014021 Gorilla 12 Shot Artillery 12/12 GP-506 754471296911 Heavy Artillery 3/1 FOA 000000001525 Invasion Artillery 1/1 Y23-233 805253414921 King Arthur 8/1 . WC 705108480203 Magnitude Gold 2/1 BS4802 000000001364 Mega Howitzer 1/1 Y23-232 000000001351 Merlin WC 000000005000 MOAB 2/1 WC 676551071204 Ninja Shells 12/1 GL-W519E G12192182183 Power Man 12 6/1 GL-LS218 676551033455 Prime Artillery Shells 6/1 GCRS005 705108802005 Salute Over America 3/1 P8020 612192100668 Shark Slayer 8/1 LS210 680149012333 Sky Mines 8/1 SW655 000000013024 Sma�l Festival Ball 15/1 GP-0008-6 687985903627 Smoke � Mirrors 4/1 BP-A036 612196050013 Space Attack 1/1 LS605 687985210428 Stars and Stripes Forever 3/1 BP2104 687985904433 String O' Pearls 3/1 BP-A044 70510880308 Super Bomb 6/1 P8003 000000001363 Super Howitzer 2/1 Y23-231 805253414082 Super Magnum �2�� WC 705108801800 Swordman 6/1 P8018 612196461642 Tribute To Our Flag 3/1 LS646 000000001342 Trilogy 6�� WC 612196188884 Truly Cool 2/1 LS618 016879859018 United America 2/1 BP-A018 000000001365 United We Stand 3�� wC 612196070196 Untamed Terminator 2/1 LS607 612194010057 War of the Galaxy 6/1 GL-LS401 687585210527 White Night 6/1 BP2105 Inv. # BOARDS, TUBES Item Number 000000001317 #100 Assorted Tubes 24/1 Y60-100 705834382123 #200 Assorted Tubes 24/1 Y60-200 000000001357 #300 Assorted Tubes 16/1 Y60-300 705108507917 #400 Assorted Tubes 16/1 P5079 705834231698 #5 Floral Assorted Tubes 8/4 Y23-169 705834231643 # 900 Assorted Tubes 4/1 Y60-900 i . . , � . , . ;� . . � �� ,�� , ��e 204 E:.l�arfi€n ]G. �gg Jr.��vd. �; '�`�mpa,�'F. 33�Q3 �. sr3-�3¢z�s4� �� 813-234-1516 (Fa�) ��. �� . , . � F1aX COVE�R SS�ET:� �age�s)total including cover sheet. .�'z'x.�rr�'zo�: � . 1� SENT FROM: �G L��U -;��r�wU/�f G - ��l � S�J�CT: � �-�,�� .�,4�� . 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Tf1IS CER'ClFiCAT� OF INSURANCE DOES NOT CONSTITUTE q CON'1'RACT BETVYEEN 1'N� ��gUINO INBURER(3j, AUTHORIZED REPRESENTA�QR PRODUCER,AND THE C�RT�FICATH NOLDER. �NIPORTANT: If tbe cartiflCatg holder is an A�DITIONqL INSURED,the ppli�y(ies)must be andorsed. If SUBROGATtON 16 WAIyEp�subjsct tp!he terms and�ondiqpns of the poiley,earta;n pclicies may;require an end�omonL A stratement on lhls coetlficat�does no!w�er rights to tbe ceK18e�1Le holder in Iiau of such endorsement(s). aiwouc�t BRaWN&BRpW�OF FLORIDA • M.D�CKER Y NGMAN!H 220 S R(DG�W�OpD AVE ' p N�` FAX E�IA� No• , AD . DAYTONA B�ACH FL 32114 � �� GE NAIC A' �NSURERA: �� G�CYFlREWORF(S(NCORPORATED , �nsu�B: 204 6 AAARTIN LUTFiER KING BLVD tNSURds c: . TAMPA F� 33603 �NSUR£ItD; FElN:593p9z878 � �R E: COVERqGEg �"s��: CERTIFICATE NUNIapZ;�2�iyg001 REl/ISION NUMBER: 7'Ii1S IS TO CERTIFY Tt�qT TME POLICIES OF'INSURqN(CE lJST�D BELpyy F{qVE gEEN ISSlI�D TO THE JNSURED NAMEb ABOVE FOR TH�POUCY PERIOD INDICATED. 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T�PA Fl 33603 �N UR£R D: FElN:553qQ�g7g INSURER E; �`i��GES INSURBR K': CERTiFJCATE NUM#3ER:1211260D9 REYISIdN NUMBER: 'rlil3 15 TO CER'fIFY ThW7 7'p�pOLECIES OP tNSURANCE tJSTEO 6ELOW HAVE BEEN ISSU�D TO THE tNSUREQ NAMEp qgOVE FQR THE POItCY PERIOD INUIGATED. NOTiM1ll7yg'YANDING ANY REf��lq;�ENT, TERM pf7 C4NDl710N QF qMY GONTRAC7 OR pT�jER DOCUMEAI7 WITH RESP�CT TO WHICH TF{�g ��RTIF'iCATE MAY BE iggUED QR MAY PER7AtN, THE tNSURANCE RFFORDEO BY THE POl1�IES OESCRlBEO HERElN IS SUBJECT TO EXClUS10NS ANQ GONlDl1'IONS OF SUCH P(y��GES.lIMlTS SHQVVN MAY HAVE BEEN REbUCED BY PAfp CLAIMS. � T�'�E TEF(MS, MsR TypE0FIN3i/RANCE AOl1CY NilM@EFt p0� Y E� POLiCY EXp G,ENERat uwe��7y M D MlRlbb L1Mi73 COMM�RGIAL OENERAL LlABRiTY �CH OCCVRRENCE S CL'AIMS-MADE �QCCUR �'REMISES!a � � ___�`�� a MED ExP{My ono taon) S • �RSOWpt,&ADV fN,1URY ; GEN'LqGGRF�ATEUMRAPPUESpER; , RENERALAG�REGATE 3 POLtGY pR� LOC pRODUCTS.COMP/appp� g AUTOmOe1lE UABfl.iN S mnineea StNGIE U °-- ,rWy quTO Ea acCkfent S AU705�E� SCHEDULED BODILYINJURY�POrpareon} S �� _—' N4µOWNEp BODILYtNJURY(Perarriden!) a NIREP AUY05 A�Og { PROPERSY p Per eccitlen i Ua'te�W UAB S OCCUa FXCESS 1lqg GtA1MS•MADE ' F�tCH OCCURREntCE a �4 R ENTIOH S AGGREC�q7E ''� $ w0 KERSCOM fNSAT10N y ANDEMPLOYERS�uaeanv 2$46C1fi5 X sraru• onr. A ANY PROPAIETOR1PAttTNERlE)fECUTlVE Y� ot'��c�nE�,e�vccwoeo? Y Nra� 1/18/2012 i1�8120t3 ��•�CNACCtDENT s !!�! (M�ntlatory in NH) xY�•��"�""d°r � �.L.DISEASE•EA EMPLOYE S 5O0 QQQ,OO E.L.01$EqSE-POLICYUMIT s500,000.a0 ��' OESeq1o17pN OF OPEFurpka!I.QCATIONB!VPNICLC3(petaen qcpRD'l01,AtlClUOne�xamarfca ScAedula,ilmore spxea lo reqwntl) CERTIfiCATE HOLDER CAWCELLATfdN i CITY OF 2Ep}iYF2HiLLS 5953 GAIL BLVfl. THE uEXptR�AT pN DATC VTH�RL'O e HOT(CE�yYltl BE CDELIVEREU��tN ACCOROANC6 WlTH TKE COttCY PROVISFONS, ZEPHYRHfLLS FL 3ssa2 AUTNORJZPD K6p(t�gENTA7IVE PhOh Numb2r 893-780-0000 ��Z�,�� ACORD 25 2010/OS O 1988-2090 ACpRd Cl}RPORATIdN. All rights reserved. C 3 The ACCJRD natrie and logo are registered marks of ACqRD ' ' 'd '4CO°� C E RT I F I C DATE(MM/DO/YYYY ATE OF LIABILITY INSURANCE ' THIS CERTIFICATE IS ISSUED AS ,A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE1H0 DER. THIS CERTIFICATE DOES NOT A,FFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CEhTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement s. PRODUCER NTA Britton-Gallagher and Associates, If1C. NAME: 6240 SOM Center Rd. P"o"E F� Cleveland OH 44139 e-nnai� - ac No• _ _ ADDRESS. INSURER S AFFORDING COVERAGE NAIC# INSURED INSURER A: INSURER B: I P � n m Galaxy Fireworks Inc. 204 E. Martin Luther King Blvd INSURERC:(v m In r � Tampa FL 33603 INSURER D: INSURER E: COVERAGES INSURER F: CERTIFICATE NUMBER:1688712575 REVISION NUMBER: THIS IS TO CERTIFY THAT THE OLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTIMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSR WVp pOLICY NUMBER POLICY EFF POLICY EXP A GENERAL LIABILITY MMro��Y MMID�n'n'Y LIMI7S 4200908-02 /10/2012 /10/2013 X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $1,000,000 D MA R N CLAIMS-MADE a OCCUR i �PREMISES(Ea occurcence) 550,000 MED EXP(Any one person) $ IPERSONAL&ADVINJURY $1,000,000 GEN'L AGGREGATE IIMIT APPLIES PER. I , GENERAL AGGREGATE $2,000,000 POLICY PRO- X �� PRODUCTS-COMP/OpAGG 52,000,000 C AU70MOBILE LIpBILITY $ CA0661444302 /f0/2012 /10/2013 x ANYAUTO � Eaaccident $1,000,000 ALL OWNED SCHEDULED I BODILY INJURY(Per person) $ AUTOS AUTOS ' BODILYINJURY Peraccident) $ X HIRED AUTOS X AONO-0WNED i I PROPERTY DAMAGE Per accident $ B UMBRELLA LIAB X $ OCCUR EAU753159 /10/2012 /10/2013 X EXCESS LIAB CLAIMS-MADE EACH OCCURRENCE $4,000,000 DED RETENTION$ AGGREGATE $4,000,000 WORKERS COMPENSATION $ AND EMPLOYERS'UABIUTY WC STATU- OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED� ❑ N I A I E.L EACH ACCIDENT $ (Mandatory in NH) � If yes,descnbe under I E.L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below I i I E.L.DISEASE-POLICY LIMIT $ � I DESCRIP710N OF OPERATIONS!LOCqT10NS/VENICLES (Attach ACORD 101,qddkional Remarks Schedule,if more s Stand Location. 5943-5953 Gall Blvd.Zephyrhills, FI 3542 ��S reQ��.�a� Additional Insured: City of Zephyrhills, Pasco County Board of County Commissioners, Mark Ayer and all their agents, representatives and subsidiaries CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Zephyrhilis, Pasco County Board of County CCORDANCE WITHDTHE PO CY PROVIS ONISE W��L BE DELIVERED IN Commissioners and Mark Ayer 7162 Reading Rd. Suite 730 Cincinnati OH 45237 AUTHORIZED REPRESENTATIVE �� ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD RD CORPORATION. All rights reserved. LEASE AGI2�EIVIENT This Lease Agreement is�entered�into as of the 10`h day of March � Fireworks,Inc.a Florida Corporation,having its principal place of busine ast Dr1Martin Luther Kin�,JrhBou evardnTa npa Floarni a 331603 ("I.essee(s)")for the purpose of establishing tl�e terms and conditions by which Lessor leases certain properry to Lessee. In consideration ofthe following covenants and conditions,and of other consideration the receipt and suffciency ofwhich are acknow]edged,Lessor and Lessee agree as follows: 1 Premises Location:The property that is the subject of this Lease Agreement(the"Premises")is located at the following address 5943 Gall Blvd Zephrvhills Fl 2.Occupancy:Lessor represents and warrants that it owns the Premises,and Lessor hereby grants Lessee tl�e exclusive right to occupy and use the Premises undisturbed during each Term(as hereinafter defined),access thereto(including the right to cross surrounding properiy belongingto Lessor,if any),along with all other rights provided to a tenant under the laws of the state of Florida. 3 Term: The periods during which Lessee will be entitled to occupy the Premises("Terms")are as follows: Term 1 is from June 15th 201 I until Julv 7th 201� Term 2 is from Dec. 15th 2011 until_Januat�°i2012("InitialLeasePeriod")2011- 2016 Thereafter occupancy will be determined by Lessee's e]ection pursuant to Section 11 This Agreement shall continue in ful(force and effect until the Option Periods identified in Section 1 I below expire; 4 Use:Lessee may use the Premises to sell seasonal products,including but not limited to fireworks and items incidental thereto. 5 Rent:Lessee wi]I pay Lessor the sum of $2.000 00 for Term 1 and$I.500 00 for term 2 which will be due and payable on the first day of the applicable Term. 6 Permits:Lessee agrees to acquire any and all permits required by goveming authorities for Lessee's intended use ofthe Premises. Tfthe permits are not approved for any reason,this Agreement will be null and void,and atl deposits will be refunded to Lessee. If,after any necessary permits have been issued to Lessee,Lessee is prevented from using the Premises for the intended purpose of se]ling fireworks during any part of a Tenn because of an act of God,war,executive order,ordinance,change in law,or other reasun beyond Lessor's or Lessea's control,Lessee will be relieved of its obligation to pay rent for tliat Term,and any rent paid for that Term will either be refunded to Lessee or applied to the next Term,as Lessor chooses. Lessor shall make that choice and notify Lessee within ten days.of being informed by Lessee that it has been prevented from using the Premises. 7 Indemnification:Lessee shall indemnify and hold Lessor harmless from any and all actions and claims resulting directly and solely from Lessee's use of tlie Premises,including but not limited to claims by Lessee's licensees,or invitee,and trespassers. 8. Fixtures:All structures(including tents)shal]be placed on Uie Premises under the approval of Lessor Any placement shall not inferPere with Lessor's use of property surrounding the Premises. Any installation shal]not damage any of the Lessor's improvements on the Premises. 9 Insurance:Lessee shall provide Lessor with prooFof liability insurance before the Term begins. Liability insurance shall be in an amount ofnot less than$1,000,000 for each occurrence. 10 1Vlaintenance:Lessee shail maintain the Premises in an orderly manner and will haul away any and a11 trash made by Lessee,its customers,and vendors prior to vacating the Premises. 11 Option:Following the Initial Lease Period,this Agreement will remain in effect for an additional f ve yeazs("Option Period"). However,if Lessee notifies Lessor 30 days in advance of a particular year during the Option Period that L.essee elects to not exercise its option for that year,Lessee wi11 not be required to pay rent for that year,and Lessor will be free to rent the Premises to someone else for that year,subject to Lessee's right of frst refusal set forth below Such election will not affect subsequent years. In tl�e event that Lessee elects to not exercise its option for a particular year,Lessee has the exclusive riglit of refusal to match any and all offers to lease the Premises during that year Lessor shall notify Lessee in writing of any such offer and die terms thereof,and provide Lessee thiriy days to elect to exercise or waive the right of first refusal. 12. Non-compete:Lessor agrees to not se11 or permit the sale of fireworks by anyone other than Lessee on any properry owned or leased by Lessor within 2 miles of tlte Premises. "'�l 13 Cancellation: If the Premises is sold,master]eased on a long term basis other than for tUe sale of fireworks,or the law is changed to prohibit the sz?e of fireworks for all remaining Terms,this Agreement may be canceled by eiYher party providing thirty days written notice to the other party IN WIT'NESS WHEREOF,Lessor and Lessee have each caused this Agreement to be executed and to take effect as of the date first above writYen,as evidenced by the signatures of their respective duly authorized representatives appearing below y Fireworks,Incorporated(Lessee) ' �� ` (I,essor) BY� � G/\,'1 1' V�------- Signature �--� BY�_- Signature Rickv Johnson.Vice-President ,rp , A t•� � �� r��a � Na c and Tttle �v� f-7z _ � �� Namc and Title Date Si�gn¢tl `� ��- �� Date Signed ' ! Before me,the unfiersigned Notary Publiq persona:ly appeared C- U �; executed the foregoing Lease Agreement,and sheMe acknowledged to and before me that she/he executed such instrum nt a d agr es tto fnlly oomply therewith. q �' �e � � � � �� a �� k' :�:. � . � R '�, ! � �.` � ,��'� .S� LI C - _ � � � 7 � �k. u4 � � �rilfY�lR.. �• �l3`� ' �3' 1l l� Jeff Atwater CHIEF FINANCIAL OFFICER Casia Sinco Jnlius Halas BUREAU CHIEF DIVISION DIRECTOR Keith McCarthy �p.��c' SAFETY PROGRAM MANAGER FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE MARSHAL 200 East Gaines Street -Tallahassee,Florida 32399-0342 Te1.850-413-3644 Fax.850-410-2467 Galaxy Fireworks 204 E Martin Luther King Blvd Tampa FL 33603 ��II��II��II��II��II� CERTIFICATE OF REGISTR.A.TION RETAILER THIS CERTFIES THAT: Galaxy Fireworks 5953 Gall Blvd Zephyrhills FL 33542 Has registered pursuant to the provisions of Florida Statues to engage in the business of selling sparklers to consumers at retail at the following fixed place of business: 5953 Gall Blvd, Zephyrhills, FL 33542 Pasco Issue Date: 02/O1/2012 Type= 07 Class: 64 County: Pasco License/Permit Number: 186104-0008-2010 Expu ation Date: O 1/31/2013 � �� Chief Financial Of�cer �H��.��FI1vA'VCIAL OFFICER Julius Ha►as Casia Sinco Dj�'ISION DIRECTOR BUREAU CHIEF ^ Keith McCarthy FLORIDq pEPARTMENT O FINANCIA SAFETY pROGRAM MANAGER D I V I S I O N O F S TATE FIRE MA L S E R V I C E S 2�East Gaines Street -Tallahassee,Flon da 3R239�q Te1.850-413-3644 Fax.850-410-2467 Galagy Fireworks Inc. 204 E Martin Luther King Boulevard Tainpa FL 33603 ��11��16�11��11��11� ----�.----�-r--�----.-____._--�-,.___�_________-�_ CERTIFICATE OF RE ISG TitA OIT N T�TT� �. WHOLESAI,ER OF SPARI{LERS THIS CERTFIES THAT: Galaxy Fireworks Inc. 204 E Martin Luther King Tampa FL 33603 Has registered pursuant to the provisions of Florida Statues to en a e ' retailer, g g in the business of selling sparklers to a Issue Date: 02/O 1/2012 Type' 07 Class: 62 County; Hillsborough License/Permit Nurnber: 725840-0001-2006 Expiration Date: O1/31/2013 / �' " r.. Chief Financial Officer Jeil HTW3tCT CHIEF FINANCIAL OFFICER Casia Sinco Julius Halas - BUREAU CHIEF , DIVISION DIRECTOR Keith McCarthy ��,�' SAFETY PROGRAM MANAGER FLORIpA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE 1bIA125gAL 200 East Gaines Street -Tallahassee,Florida 32399-0342 Te1.850-413-3644 Fax.850-410-2467 Galazy Connection Inc. 204 E Martin Luther King Blvd Tampa FL 33603 ��Ii��ll��ll��ll��li� CERTIFICATE OF REGISTRATION DISTRIBUTOR OF SPARKI,ERS THIS CERTFIES THAT: Gaiaxy Connection Inc. 204 E Martin Luther King Blvd Tampa FL 33603 Has registered pursuant to the provisions of Florida Statues to engage in the busines wholesaler. s of selling sparlclers to a Issue Date: 02/O1/2012 Type' 07 Class: 61 County: Hillsborough License/Permit Nurriber: 725841-0001-2006 Expiration Date: O1/31/2013 � .Y , �� Chief Financial Officer Jacqueline Boges To� Verne Riggall Subject: RE:fire work inspection Thank you will note in permit. Jackie Boges (ext 3513) What Greater love can a man give...... From: Verne Riggall Sent: Monday, December 17, 2012 5:25 PM To: Jacqueline Boges Subject: RE: fire work inspection Completed this on 12/17/12 at 1730 hours. Approved. From: Jacqueline Boges Sent: Monday, December 17, 2012 2:47 PM To: Verne Riggall Cc: Lori Hillman Subject: fire work inspection Schedule tent firework inspection for Galaxy at 5943 gall blvd —Tuesday 11:30am on calendar. Thanks Jackie Boges (ext 3513) What Greater love can a man give...... i � a' TENTIVENDOR CHECKLIST The AIiT shall be permitted to regulate all outdoor events such as carnivais and fairs as it pertains ta access for emergency vehicles; a.�cess to fire protection equipment; placement of stands, conceasion booths, and exhibits; and�e control of hazardous conditions dangerous to Iife and property.NFPA 1, Section 10.16.2 Ever�t caordinator(s)shall provide the vendors a cbecklist of what is expected af tbem at the event.However,individual vendors within the special eve� shall be held responsible far their individual vending space. Those that do not comply with the guide�ines of this checklist for their vending arrangement are subject to immediate denial wit.�in participation of the permitted event. ✓ Plot Plan showing setup. If part of an overall event,this shall be supplied by the event coordinator. Notarized letter from property�wner stating their approval. ,�/' Pro�f of liability insurance. � If tent is grea#�r than 10 x 10, flame retardant cert'ification is rcquired. If multiple 10 x 10 tents arc placed together to create one large space under canopy,than a t}ame retardant�cation shall be required an all te�ts. ,�� No smol�ng signs must be p�aced outside entaances. _,� If there is to be wire feacing or chain tink fencing,this fen�ce shsll be set � back fram the#eart at least S�eet and have st teast2.exits_ If te�xt has sides, the sides shall be in the up position untess there is inclement weather,tban 2 sides must be in the up pos�tion. Adjacern teats sball be spaced a minimum of five{5)feet to provide an area to be used es a means of emergency egress. If stake lines are used to secure the te�t,thau the five(5)feet shall be mtasured from ths stake line. ✓� The ground enclosed by sny tent and ground not less than 120" outside the tent shall be cleared c�f all flammable or combustible material or vege�ation t�at is not used£or ner.�ssary support equipment. 4l If lighting is installed in tent, it shall be in the way that bulbs are aot in direct contact with the tent.Buib/lainp cages sha11 be used. ffpovi►er is supplied by genesator,generator shall be a minimum of 5 feet from th�te�t and shall be isolated from con#act with the public bq either . physical guards, fencing, or an enclosure.Fuel comain�ers shall not be � stored within close proxuni#y of any igzution source. Aany extension corde used shali be placed or posi�ioned to not cause a � trip/fall bazard. A minimum of one portable fire ex,tinguishe.r with a rating of not less than 2-A:10-B:C shall be provided. (See note at battom) If an LP(prapane)tank is used by the vendor it shall be positioned outside the footprint of the tent. .� , �4 If COO�1S lIIVO�V�: A mi.n.imum of one Class K portable fire eartinguisher shall be provided for each concession stand that utilizes vegetable or animal grease cooking oils or any othex process that produces grease laden vapors. (See note at bottom) Concession stands utilized for c�oking shall have a m�inimum of 10 ft(3 m)of clearance on ta►o sides and shall not be located within 10 ft(3 m) of amusement rides or devices. If cooking is taki.ng place under any tern, a flame retardant c,�rtification is required. Any apptiance used for cooldng that utilizes a vent,tbat appliance shall be positioned to veat oirtside the tent. Cooking equipment used in fixed, mobile, or temporary concessions, such as trucks, buaes,trailers, pavilions,tents,or any form of roofed enclosure, shall comply with this standard uniess all or part of�he installation is exempted by the AHI. - NFPA 1, Se�tion 50.2.9 NOTE: 5tate of Florida requires all exiinguishers to be certified by an aut�►orized and licensed fire extinguisher company. 3/7/08 kti