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Home My WebLink About2701 Ridgewood BlvdCity of, Sanford WBuilding84FireF1owe 'vw off Vvi- I-b-n Fire Patria Review SeMce Fees Tel- 407.688.5050 Fax: 407,688,5051 Date:_ 10- Pera Business or Project Name: Address: 9k Contact Name: _C O_ ContactPh.- A7_ Plan Review Information EJ Construction 0 C/O El Fire Alarm D Fire Sprinkler 0 Hood 0 Tank EJ Paint Bo'oth Sep,02 03 01:57p John Stuart 407 330-5616 p.2 CITY OF SANFORD FIRE DEPARTMENT FEES FOR SERVICES PHONE # 407-302-1091 * FAX #: 407-330-5677 DATE:. 1 0-07-1 0 PFRMI't'N: BUSINESSNAME/PROIFCT:Orlando Special Effects, Inc—.— nDDRFSS: 14222 Lake Mary Jane Rd., Orlando FL 32832 407-648-1867 office PRONE No.:407=42.1 1 68_--c-e.l.l. E:AX No: 40.7=273,-0328 - CONST. INSP. [ ) C! O INSP.:[ ] REINSPECTION [ ) PLANS REVIEW 1 ] F. A. ( ] F.S. ( I HOOD [ ] PAINT BOOTH [ I BURN PERMIT ( ] TENT PERMIT I. ] YANK PERMIT [ 1 OTHER 1X1 Y—ire =k$ i 1,p1 ,--- TOTAL FEES; $ 75. 09 —_ __ (PER t1Ni-f SEE.. BELOW) COMMENTS:_ Class "C" 1.42 fireworks , disp,la for, _5aM nQ,Le High School ,.Homecomin g_See Address B(d . # I Unit # Square Footage Fees Nr W& Unit 4. — - — 5. f 7: _.._ 9. 10. --- - - __ 12. 14. 17. _ 19.__- 20.-- Fees must be paid to Siutl'ord Building Urpanmcnt, 300 N. Park Ave.. Sanford, Fl, 32771 Phone N -407- 330-5656. Proof of Payment must be made to Fire Prevention division bet•ore any further services can take Place. I ccnil"y that the above is tine and correct and that I will comply with all applicable icwdes and ordinances of the City of Sanfordignaw, Florida, Sanford —Fire Prcvcnlion Division Applicant'se Andrew Nicholls PURCHASING I certify that this is a trueissuedtometoengaged Thelicensee/permlttee ;named herein shall usi Ilcenseipermit°ao assist a transferor of explosfv andstatusofthegcensee/pennitta as provld ThesignatureoneachreproductionmustbeanATF F 5400-1415400.15, Part 1 (8/89) rig Addfass CHANGI $4 You must nou(y me FELC at least 10 days before the ct IVD4' SPE 3AL.EFFECTS INC 2 ( qKE MRR`f JANE ROAD PRODUCER Debbie Merlino Combined Specialties International, Inc. 205 San Marin Drive, Suite 5 Novato California 94945 INSURED Orlando Special Effects 14222 Lake Maryjane Road Orlando Florida 32832 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND ERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE i NOT AMEND, EXTEND OR LATER THE COVERAGE AFFORDED BY THE INSURERS AFFORDING INSURER A: Underwriters, Uoyds of London INSURER B: INSURER C: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NAMED INSURED ABOVE FOR THE PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 INCLUDING, BUT NOT LIMITED TO THOSE FOLLOWING LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDITIONAL CONDITIONS AND EXCLUSIONS: 1) THE INSURANCE EVIDENCED BY THIS CERTIFICATE IS LIABILITY INSURANCE ONLY, IT IS NOT A BOND OR ANY FORM OF SURETY AGAINST WHICH SOMEONE OTHER AN "INSURED" MAY ASSERT A CLAIM OR BRING ANY ACTION. SUBJECT TO POLICY TERMS, CONDITIONS, DEFINITIONS AND EXCLUSIONS THE INSURANCE ONLY INDEMNIFIES AN INSURED AGAINST CERTAIN LEGAL LIABILITY. 2) THE INSURANCE DOES NOT COVER CLAIMS FOR BODILY INJURY OR PROPERTY DAMAGE OF THE NAMED INSURED'SSHOOTER(S) ASSISTANT(S) OR ANY OTHER PERSON(S) INCLUDING ANY VOLUTEER(S) PARTICIPATING IN ANY WAY IN, ANY DISPLAY OR SPECIAL EFFECT PERFORMED OR EXECUTED BY THE NAMED INSURED. 3)COVERAGE DOES NOT APPLY TO CLAIMS FOR BODILY INJURY OR PROPERTY DAMAGE, ARISING OUT OF THE INSUREDS FAILURE TO FOLLOW NFPA OR OTHER APPLICABLE REQUIREMENTS, LAWS OR RECOMMENDATIONS, INCLUDING THOSE RELATING TO POST DISPLAY OR SPECIAL EFFECT SEARCHES OR CLEAN UP. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE M/ DATE (MDD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY 1141317457/010 March 07, 2010 March 07, 2011 EACH ACCIDENT 2,000,000 CLAIMS MADE MEDICAL EXP 5,000 any one person) FIRE LEGAL LIABILITY 50, 000 GENERAL AGGREGATE 2,000,000 PRODUCTS-COMP/ OPS AGG 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) ANY AUTO BODILY INJURY ANY OWNED AUTO SCHEDULED AUTOS Per person) BODILY INJURY HIRED AUTOS NON - OWNED AUTOS Per accident) PROPERTY DAMAGE Per person) EXCESS LIABILITY EACH ACCIDENT FOLLOWING FORM AGGREGATE WORKERS COMPENSATION WC STATU- OTHER AND EMPLOYERS' LIABILITY TORY LIMITS E.L. EACH ACCIDENT E. L. DISEASE - EA EMPLOYER E.L. DISEASE -POLICY LIMIT OTHER TION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS High School and City of Sanford are Additional Insured as respects the November 5, 2010 Special Effects on Seminole High School football field, 2701 d Avenue, Sanford, FL. CERTIFICATE HOLDER CANCELLATION Seminole High School SHOULD ANY OF THE ABOVE DESCRIBED POLICIESBECANCELLED BEFORE THE EXPIRATION DATE 2701 Ridgewood Avenue THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN; NOTICE TO THE Sanford, FL 32773 CERTIFICATEHOLDER NAMED TO THE LEFT, BUT FAILURE, TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES e Tuno rn ocoo cc rcnnv Aoo 4 Ao CERTIFICATE ®F LIABILITY INSURANCE DATE`°°",," 9/13/2010 PRODUCER (281) 999.-5544 ' FAX: (281) 577-2678 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Main Street America MGA, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 21977 East Wallis Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Porter TX 77365 INSURERS AFFORDING COVERAGE NAIC # INSURED Harbor America East, Inc. IISuRERA,Ullico Casualty Company Orlando Special Effects, Inc. INSURER B: Bus: (407)648-1867 Fax: (407)208-9285 INSURERC: 14222 Lake Mary Jane Road INSURER D: Orlando FL 32832 INSURER I - 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 W41CH 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 05UCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR MWLNS I TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVEDATEffaypynyyy) POLICY EXPIIRATION-LI& DATE (MMMOnnnM LIMITS GENERAL L.IABUM EACH OCCURRENCE AGE TO RE D PREMISES ooaurerrceCOMMERCIALGENERALLIABILITY CLAIMS MADE F-I OCCUR MED EXP (Arty are person) PERSONAL & ADV INJURY GENERAL AGGREGATE GEWL AGGREGATE LIMIT APPLIES PER PRODUCTS -COMPIOPAGG RO- LOCPOLICYIPIFrT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT Ea acddent) BODILY INJURY P-P—) ALL OWNED AUTOS SCHEDULEDAUTOS i BODILY INJURY Per accident) HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Pera«3dent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT OTHER THAN EA ACCANYAUTOiIAUTOONLY: AGG EXCESS UMBRELLA LIABILITY I EACH OCCURRENCE AGGREGATEOCCURCLAIMSMADEI DEDUCTIBLE RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERJEXECUTIVE OFFICERIMEMBER EXCLUDED? X WCSTATU- OTl+ E.L.EACH ACCIDENT 1,000,000 E.LDISEASE -EAEMPLOY S 1,000,000 MandateryInNH) tI yes, describe under WCS- 113000-01 4/1/2010 4/1/2011 EL DISEASE - POLICY LIMB I s 1,000,000 SPECIALPROVISIONSbekwOTHER DESCRIPTION OFOPERATKOSt LOCATIONS IVEHICLESIEXCLUSIONS ADDED BYEND WTI SPECIAL PROVES Workers' Compensation coverage is extended to all payroll active employees of Harbor Smerica Bast, Inc. leased to Orlando Special Effects, effective 12/28/2009. insured is afforded workers' Compensation & Employers Liability as a co -employer under the policy for employees leased from Harbor America Bast, Inc. Project information: Proof of WC Insurance Only. vr...vc us uvrti q.DANYOFTHE ABOVE DESCRIBEDPOLKASBECANCELLEDBET=MTHEEXPIRATION Seminole High School DATE THEREOF, 7W ISSUING INSURER WILL ENDEAVOR To MUL 30 DAYS WRITTEN 2701 Ridgewood Ave. NOTICE To TRE. CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Sanford, FL 32773IMP4DSENOOBLIGATION OR Lumam OF ANY K= UPON THE INSURER, ITS AGENTS OR ACORD 25 (2009101) AUTHORIZEDREPRESEWrATIVE Rick Walker/ MTV— —_ 01988-2009 ACORD CORPORAnOM- All riahL, re_served- J°" (zouqo') The ACORD name and logo are registered marks of ACORD 7436 Narcoossee Rd., Suite 320, Ortando FL 32822 Phone 4071648-1867 Fax 4071273-0328 Web Site http:/Avww.oHandospfx.com E-mail: ose@orlandospfx.com October 7, 2010 Marshal Tim Robles City of Sanford Fire Dept. P.O. Box 1788 Sanford FL 32771 Dear Marshal Robles: As we discussed, enclosed is the information requested for Seminole High School's Homecoming Fireworks; scheduled for Nov. 5, 2010 @7:30-PM. Also enclosed is our check for 75.00 for the permit°fee and inspection. This is the same show we have been doing, for the past few years with the addition of the concussion cannon. If you have any questions, please contact me at the number below. I work from home and cannot be reached at the main office. Thank you for your help with this. Sincerely, ORLANDO SPECIAL EFFECTS, INC. Lucie Nicholls Phone/Fax: '407-208-9285 E-Mail: lucie@orlandospfx.com ORLANDO SPECIAL EFFECTS, INC. fox Seminole High School Homecoming Firdworks Display School Road Discharge Site 1 LL, Baseball Field X I 00F(MD 11 50' `Radius Road F- pi 0 0 n` N Basketb 11 ement Pad 7436 Narcoossee Rd., Suite 320, Orlando FL 32822 Phone 407 / 648-1867 Fax 407 / 273-0328 Web Site http://Www.ortandospfx.com E-mail. ose@odandospfx.com October 13, 2010 Marshal Tim Robles Sanford Fire Dept. PO Box 1788 Sanford FL 32771 Dear Tim: Enclosed is our check for $75:00 that is owed on the fees for Seminole High School's Homecoming .fireworks scheduled for Nov. 5, 2010. Our original check No. 11428, dated 10-07-10, was only $75.00 and should have been $150. Thank you for your help with this. Regards, Lucie Phone/Fax: 407-208-9285 E-Mail: lucie@orlandospfx.com