HomeMy WebLinkAbout10301 Wyndham Crest BlvdRECEIVED
MAY 18 2011
BY: CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: I I 4q Documented Construction Value: $ i t( J
Job Address: 3 u Historic District: Yes NoeI
Parcel ID:
Description of Work: LD(.J
Zoning:
Plan Review Contact Person: SC4 136 (Title:
Phone: iC%% 12-('lG Fax: -C1-7 12.' 1 ji 6 E-mail: 2V-u t'C t 1 1<ciYvt
II
Property Owner Information
Name `'(.3e j&YI -4 -St X.1 L) Phone:
Street: ( F 2GResident of property? : V'7-0 City,
State Zip: :P,,,Z(a07, nn
Contractor
Information Name
T Z&vrivt_- Phone: 4(57 ^-7IZ"-ncc Street:
l'r 45 V/rvtnn.TAO iCj Fax: City, State
Zip: n` ayl(., C Z: State License No.: r fJ ( t" Name: Street: City,
St,
Zip:
Bonding Company: Address:
Architect/Engineer
Information
Phone: Fax: E-
mail: _
Mortgage
Lender: Address:
PERMIT INFORMATION
Building
Permit Square
Footage: Construction
Type: No. of Dwelling
Units: 'Flood Zone: Electrical Plumbing New
Service - No.
of AMPS: Mechanical 11 (Duct
layout required for new systems) No. of Stories:
New Construction - No.
of Fixtures: Fire Sprinkler/Alarm
No. of heads:
Applicati
work or
meet star
must be
air condi
is hereby made to obtain a permit to do the work and installations as indicated. I certify that no
allation has commenced prior to the issuance of a permit and that all work will be performed to
ds of all laws regulating construction in this jurisdiction. I understand that a separate permit
ured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and
iers, etc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be done in' compliance with all applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT i N YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE
OF COM MNCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE. RECORDING YOUR NOTICE OF COMMENCEMENT.
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 districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida
Lien Law, FS 713.
The City
to calcub
plan rev
construct
permit is
Sanford requires payment of a plan review fee. A copy of the executed contract is required in order
a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
fee based on past permit activity levels. Should calculated charges exceed the documented
value when the executed contract is submitted, credit will be applied to your permit fees when the
Signature of Owner/Agent Date
Print Owner/Agdnt's Name
Signature of Notary -State of Florida Date
Owner/Agent is
Produced ID
APPROV
GOMME
Personally Known to Me or
Type of ID
ZONING:.. UTILITIES:
ENGINEERING: FIRE:
Signature of Contracto nt Date
Print Name
of Froyrde Date
SAMANTHA L FURBOTOR
L"kl'air ES WWI, 2013 ,
Produced ID Type of ID
WASTE WATER:
BUILDING:
511(,/ tI
to Me or
Rev 11.08
POWER OF ATTORNEY
Date:
I/
Lb /. r
I hereby name and appoint 1 n Tr
of ADT Security Services to drop off and pick up permits at the
ILA Building Department on my behalf for
a LOW VOLTAGE SECURITY permit for work to be performed at a location described as:
Parcel 4-ZG - 36 -306 - 6CA—:0 " r 006
Subdivision
Address of job W 3G-1
Owner \ (.V
George Manfinelli EF0001121
Type or Print Name of Certified Contractor
r
Signature ontractor
The foregoing instrument was acknowledged before me this 6 //.__dayof20t
by ':E CzQ ! 1 C4I'll i ias
dentificationandwhodidnottakeoath. State
of Flo----- -:M"
1,4A otyof .=3,, :1M R10:0'TERlirsot4 in3
o
Public, Seminole , FloridCA a IQ F SAMANTHA
L FUR®OTER 4.
Y COMMISSION 0 D08661 Sn7 EXPIRES
March 01, 2019 t'`
F loe.com
G 1
RESIDENTIAL SERVICES
C t dry-
CONTRACT
i 04UEi 7
CONTRACT DATE: I -?J TOWN NO: ts: z' CUSTOMER JOB NO: LEAD SOURCE-
ADT Security Services, Inc. (ADT) Customer Name
You" or "Your") 1 a 0k1 ka D- C-1\Ck icI QWe" or "Us" or "Our") Office Address p QAddress ) (,tiCQrv,(-e\+.lS•(f
0.v- ` ( - l City JC cI GYP'.
1 :
Affinity Name & No.
State / Zip '. Tax Exempt No.
Protected Premises' Telephone :Tax Expire. Date
Traditional Phone Other (Qualified) Other (Non -Qualified)
Tel: 1-800-ADT-ASAP -=•.. 1-800-238-2727 Alternate Telephone 1 - L403 (Circle one) Home /(Cell is Work w/ ext.
IF FAMILIARIZATION PERIOD -IS Alternate Telephone 2 (Circle one) Home / Cell / Work w/ ext.
REJECTED INITIAL HERE_ ;EMAIL
Communications Authorization: You hereby authorize ADT to furnish information and/or updates regarding your security system and new ADT and/or
third party.,products and services available to ADT customers to the contact inforrrgation provided by you. You may unsubscribe or opt -out by emailingdonotcontact@adt.com or by calling 888-DNC4ADT (888-362-4238). Initial here
Confirmation of Appointments: You hereby expressly authorize ADT to call you using an automated calling device to deliver a prerecorded message to
set/confirm a service/installation appointment at the telephone number(s) shown above._ Initial here
System Ownership: Customer -Owned E-ADT-Owned
Monthly Service Charge• Municipal Construction Permit FeetandardMonthlyService, Burglary P
Service includes: Customer Monitoring Center Signal Receiving and _ Customer to obtain construction permit
Notification Service for Burglary, Manual Fire, and Manual Police Emergency . , cf other
Standard Monthly Service, Fire/Smoke Detection Installation Price - l Service includes: Customer Monitoring Center Signal Receiving and ----- -- - -----
Notification, Service for Fire, Manual Fire, and Manual Police Emergency Taxable Amount
Carbon Monoxide _Flood Low Temp Non -Taxable Amount
Medical Alert _ Connection Fee — -
afewatch Cellguard° Sales Tax on Installation*-
SecurityLink° Total Installation Charge* p i J, _ ,•_
E Extended Limited Warranty/Quality Service Plan (QSP) ,s-r_. c Deposit Received^_; , _ :,- ; • r . ;'
4
Guard Response Service
Balance Due upon Installation* .;
Monthly Recurring Municipal Fee (Subject to change based on local law)3--
0 Customer to obtain and pay for municipal alarm use permit If applicable sales tax not shown, it will be added to your first invoice.
Other
Total Monthly Service Charge ,
r- ——
Initial/Annual Recurring Municipal Fee -billed separately Initial/
Subject to change based on local law) AnnualFee. Customer
to obtain and pay for initial/annual municipal alarm use Estimated. Start Date permit
Your failure to obtain and Provide ADT with your municipal alarm
use permit registration number could result in no municipal fire/ police
response to an alarm from your premises and/or a fine. _-_ _ Estimated Completion Date YOU
ACKNOWLEDGE AND ADMIT THAT. (1) WE HAVE EXPLAINED TO YOU THE FULL RANGE OF EQUIPMENT AND SERVICES AVAILABLE TO YOU; (2) ADDITIONAL
EQUIPMENT AND. SERVICES OVER THAT DESCRIBED HEREIN ARE AVAILABLE AND MAY BE OBTAINED FROM US AT AN ADDITIONAL COST ro
YOU; (3) YOU -HAVE CHOSEN'AND HAVE CONTRACTED FOR ONLY THE EQUIPMENT AND THE SERVICES DESCRIBED IN THIS CONTRACT; (4) THE INITIAL TERM
OF THIS CONTRACT IS FOR THREE (3) YEARS; AND (5) YOU SHOULD MANUALLY TEST YOUR SYSTEM MONTHLY WITH ADT AS WELL AS UPON 4NY
CHANGE TO THE TELEPHONE SERVICE IN YOUR PREMISES TO CONFIRM PROPER TELEPHONE LINE SEIZURE AND THAT SIGNAL TRANSMISSION IS UNCTIONING
PROPERLY BY CALLING ADT AT 1-800-ADT-ASAP (AND FOLLOW THE PROMPTS), WE ARE NOT A SECURITY CONSULTANT. YOU
ACKNOWLEDGE AND ADMIT THAT BEFORE SIGNING YOU HAVE READ THE FRONT AND BACK OF THIS PAGE IN ADDITION TO THE ATTACHED PAGES JHICH
CONTAIN IMPORTANT TERMS AND CONDITIONS FOR THIS CONTRACT. YOU STATE THAT YOU UNDERSTAND ALL THE TERMS AND CONDITIONS OF rHIS
CONTRACT, INCLUDING, BUT NOT LIMITED TO, PARAGRAPHS 5, 6, 7, 8, 9, 10 AND 22. YOU ARE AWARE OF THE FOLLOWING: NO ALARM SYSTEM CAN 31JARANTEE
PREVENTION OF LOSS; HUMAN ERROR IS ALWAYS POSSIBLE; WE MAY NOT RECEIVE ALARM SIGNALS IF THE TELEPHONE LINE OR OTHER ALARM rRANSMISSION
SYSTEM IS CUT, INTERFERED WITH, OR OTHERWISE DAMAGED OR IF TELEPHONE OR ELECTRICAL SERVICE IS UNAVAILABLE FOR ANY REASON. THIS
CONTRACT- REQUIRES FINAL APPROVAL OF AN ADT AUTHORIZED MANAGER BEFORE ANY EQUIPMENT/SERVICES MAY BE PROVIDED. IF APPROVAL IS ENIED,
THIS CONTRACT WILL BE TERMINATED AND ADT'S ONLY OBLIGATION TO YOU WILL BE TO NOTIFY YOU OF SUCH TERMINATION AND REFUND ANY MOUNTS
PAID IN ADVANCE. SECOND
AND THIRD PAGES ACCOMPANY THIS PAGE WITH ADDITIONAL TERMS AND CONDITIONS 0_
Rep.: Rep'.ID No.: CUSTOMER'S A-PPROvAL: `, ` DATE: - ep.
License No. (If Required): r' NOTICE
OF CANCELLATION OU,
THE CUSTOMER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO 'MIDNIGHT OF THE THIRD USINESS
DAY AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN KPLANATION
OF THIS RIGHT. of
r
Seminole County Property Appraiser Get Information by Parcel Number Page 1 of 2
Personal Property I Please Select Account
PARCEL IDUTAtL
DAvn3 JOHNSON, C'FA, ASA
PROPERTY
l Yww1.t A
J <'/'•, '+
APPRAISER
SEMINOLEC:OUNTYFL
s d
1 tol E. RRST,ST
SANFORD; FL3277t-146B
407.665-7506
J
a
Yid.• i
VALUE SUMMARY
VALUES
2011
Working
2010
Certified
GENERAL Value Method Income Income
Number of Buildings 12 12
Parcel Id: 14-20-30-300-0080-0000
Depreciated Bldg Value 0 0Owner: TWC SEVENTY-SIX LTD
Depreciated EXFT Value 0 0MailingAddress: 655 N FRANKLIN ST STE 2200
Land Value (Market) 0 0City,State,ZipCode: TAMPA FL 33602
Land Value Ag 0 0PropertyAddress: 1500 WYNDHAM CREST BLVD SANFORD 32773
Just/Market Value 5,734,689 . 6,550,040FacilityName: WYNDHAM PLACE
Portablity Adj 0 0TaxDistrict: S4-SANFORD-17-92 REDVDST
Exemptions: Save Our Homes Adj 0 0
Amendment 1 Adj 0 0Dor: 03-MULTI FAMILY 10 OR M
Assessed Value (SOH) 5,734,689 " 6,550,040'
Tax Estimator
Income Approach used.)
2011 TAXABLE VALUE WORKING ESTIMATE
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund 5,734,689 0 5,734,689
Amendment 1 adjustment is not applicable to school assessment) Schools 5,734,689 0 5.734,689
City Sanford 5,734,689 0 5,734,689
SJWM(Saint Johns Water Management) 5.734,689 0 5,734,689
County Bonds 5,734,6891 0 5,734,689
The taxable values and taxes are calculated using the current years working values and the prior years approved millage rates.
SALES
2010 VALUE SUMMARY
Deed Date Book Page Amount Vac/Imp Qualified
WARRANTY DEED 12/2000 03983 1635 $2,000,000 Vacant No
WARRANTY DEED 01/1996 03019 170 $900,000 Vacant Yes
2010 Tax Bill Amount: $131,570
2010 Certified Taxable Value and Taxes
DOES NOT INCLUDE NON -AD VALOREM ASSESSMENTS
Find Sales within this DOR Code
LEGAL DESCRIPTION
LAND SEC 14 TWP 20S RGE 30E ALL NW 1/4 OF NE 1/4 E OF RD
Land Assess Method Frontage Depth Land Units Unit Price Land Value
LOT 1 & NLESSN
CD S
FT)
J
14-20& LOT1- (LESS1/2 OF VACD ST ADJ ON S &LOT 2 (LESS BEG NW COR
LOT 0 0 260.000 5,000.00 $1,300,000 RUN E 200 FT S 134.12 FT W 262.68 FT N 25 DEG 47 MIN E
148.05 FT TO BEG) & S 1/2 OF VACD ST ADJ ON N BLK A
SUNLAND ESTATES PB 11 PG 17
BUILDING INFORMATION
Bid Num Bid Class Year Bit Fixtures Gross SF Stories Ext Wall Bid Value Est. Cost New
1 MULTIFAMILY 2001 144 24,432 3 WOOD SIDING WITH WOOD OR METAL STUDS $1,365,084 $1,421,963
Subsection / Sgft OPEN PORCH FINISHED / 3504
2 MULTIFAMILY 2001 72 15,408 3 WOOD SIDING WITH WOOD OR METAL STUDS $842,930 $878.052
Subsection / Sgft OPEN PORCH FINISHED / 2976
3 MULTIFAMILY 2001 144 24,432 3 WOOD SIDING WITH WOOD OR METAL STUDS $1,365,084 $1,421,963
Subsection / Sgft OPEN PORCH FINISHED / 3504
4 MULTIFAMILY 2001 144 24,432 3 WOOD SIDING WITH WOOD OR METAL STUDS $1,365,084 $1,421,963
Subsection / Sgft OPEN PORCH FINISHED / 3504
5 MULTIFAMILY 2001 144 24,432 3 WOOD SIDING WITH WOOD OR METAL STUDS $1,365,084 $1,421,963
http://www.scpafl.org/web/re_web.seminole_county_title?parcel=1420303 0000800000&c... 5/16/2011
Seminole County Property Appraiser Get Information by Parcel Number Page 2 of 2
Subsection I Sqft OPEN PORCH FINISHED / 3504
6 MULTIFAMILY 2001 144 24,432 3 WOOD SIDING WITH WOOD OR METAL STUDS $1,365,084
Subsection I Sqft OPEN PORCH FINISHED / 3504
7 MULTIFAMILY 2001 120 20,000 3 WOOD SIDING WITH WOOD OR METAL STUDS $1,138,206
Subsection / Sqft OPEN PORCH FINISHED / 3504
8 MULTIFAMILY 2001 144 22,272 3 WOOD SIDING WITH WOOD OR METAL STUDS $1,205,771
Subsection / Sqft OPEN PORCH FINISHED / 3360
9 MULTIFAMILY 2001 144 24,432 3 WOOD SIDING WITH WOOD OR METAL STUDS $1,365,084
Subsection / Sqft OPEN PORCH FINISHED / 3504
10 MULTIFAMILY 2001 72 15,408 3 WOOD SIDING WITH WOOD OR METAL STUDS $842,930
Subsection / Sqft OPEN PORCH FINISHED / 2976
11 MULTIFAMILY 2001 144 22,272 3 WOOD SIDING WITH WOOD OR METAL STUDS $1,205,771
Subsection / Sqft OPEN PORCH FINISHED / 3360
12 WOOD BEAM/COL 2001 20 5,217 1 STUCCO WITH WOOD OR METAL STUDS $390,471
Subsection / Sgft OPEN PORCH FINISHED / 555
Subsection / Sqft OPEN PORCH FINISHED / 645
Subsection / Sqft OPEN PORCH FINISHED 1922
Permits
1,421,963
1,185,631
1,256,011
1,421,963
878,052
1,256,011
446,253
EXTRA FEATURE
Description Year Blt Units EXFT Value Est. Cost New
POOL GUNITE 2001 1.306 19,590 26,120
CUSTOM PATIO/TILE/MARBLE ETC 2001 4,038 21,200 28,266
SPA 2001 1 3,669 5,500
ALUM FENCE 2001 1,232 2,772 3,696
POLE LIGHT STEEL 1 ARM 2001 15 14.460 14,460
STUCCO WALL 2001 6,594 19.782 26,376
STUCCO WALL 2001 675 2,025 2,700
GATE OPENER 2001 3 2,250 3,000
IRON FENCE 2001 1,436 5,385 7,180
IRON GATE 2001 65 244 325
V CHAIN LINK FENCE 2001 1,326 4,422 6,630
SEAWALL 2001 6,500 32,526 39,000
CONCRETE WALKWAY 2001 17,860 33,488 44,650
COMMERCIAL ASPHALT DR 2 IN 2001 177,725 121,298 161,730
NOTE: Assessed values shown are NOT certified values and therefore are subject to change before being finalized for ad valorem tax purposes.
http://www.scpafl.org/web/re_web.seminole_County_title?parcel=14203030000800000&c... 5/16/2011
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CERTIFICATE OF LIABILITY INSURANCE
DATE11/9/22010 rn
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsements .
PRODUCER
Marsh, Inc.
1166 Avenue of the Americas
CONTACiNAME:
PHONE Ext : 212 3 00 A/C No
New York, NY 10036 ADDRESS:
PRODUCER
CUSTOMER
INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: AGCS Marine Insurance Company (Allianz)
ADT Security Services, Inc. INSURER B: CHARTIS CASUALTY COMPANY
3160 Southgate Commerce Blvd INSURER C: Commerce & Industry Ins Co.
Ste 38 INSURER D: Illinois National Insurance Co.
Orlando, FL 32806 INSURER E: Nat'l Union Fire Ins Co. of Pittsburgh, PA
United States INSURER F: New Hampshire Ins. Co.
COVERAGES CERTIFICATE NUMBER: 827805 -A REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSRLTR OF INSURANCE ADDLTYPE1NMwvo
SUER
POLICY NUMBER MM/JDDY EFF POLICYEXP
LIMITS
F GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
OWNER'S & CONTRACTOR'S
GL 4360884 (Primary GL) 10/1/2010 10/1/2011 EACH OCCURRENCE 1,000,000.00
MAGE TO
PRAEM SES EaEocarrrence 1,000,000.00
MED EXP (Any one person) 10,000.00
PERSONAL & ADV INJURY 1,000,000.00
GENERAL AGGREGATE ZODO,000.00
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY
PRO
LOC
PRODUCTS - COMP/OP AGG 2,000,0DO.00
E
E
E
F
AUTOMOBILE LIABILITY
ANYAUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
CA 3976576 (VA)
CA3976575 (AOS)
CA 3976577 (MA)
CA 3976624 (NH) (Primary AL)
10/1/2010
10/1/2010
10/1/2010
10/1/2010
10/1/2011
10/1/2011
10/1/2011
10/1/2011
COMBINED SINGLE LIMIT
Each accident
1,000,000.00
X
BODILY INJURY (Per person)
BODILY INJURY (Per accident
PROPERTY DAMAGE
Per accident) X
X NEW HAMPSHIRE (CSL) 250.000
UMBRELLA UAB
EXCESS LIAB CLAIMS -MADE
EACH OCCURRENCEHOCCURAGGREGATE
DEDUCTIBLE
RETENTION $
PRODUCTS-COMP/OP AGG
NEW HAMPSHIRE (CSL)
B
C
D
E
F
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFIC(Mandatoryain NH) EMBER
EXCLUDED? If
yes, describe under DESCRIPTION
OF OPERATIONS below NIA
4
WC
026149514 (FL) WC
026149516 (MI) WC
026149513 (CA) WC
026149518 (MA, ND, NY, OH, W
WI 10/
1/2010 10/
1/2010 10/
1/2010 10/
1/2010 10/
1/2010 10/
1/2011 10/
1/2011 10/
1/2011 10/
1/2011 10/
1/2011 X
WC STATU- OTH- EL
EACH ACCIDENT 2,000,OOO.DD E.
L. DISEASE- EA EMPLOYEE 2,000.000.OD E.
L. DISEASE - POLICY LIMIT Z000,000.00 A
A
Builder'
s Risk/installatiordContract Works Rental
Equipment/Contractors Equipment OC &
OCW 91128600 OC &
OCW 91128600 115/
1/2011nv 5/
1/2010 5/
1/2010 5/
1/2011 5/
1/2011 USD $
1,000,000.00 per jobsite USD $
1,000,000.00 per jobsite DESCRIPTION
OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Please
refer to attached ACORD 101 for further remarks. IRI;
K41112 1.10111t=111 i 01111131 =1 11111111111LIf110LhAIII WG11Lei 0 City of Sanford
300 N Park
Ave Sanford, FL 32771
United States SHOULD
ANY OF
THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
POLICY PROVISIONS. AUTHORIZED`DRREPRESENTATIVE MARSH
USAINC,
BY: Franklin Heliork, Global Marine 1988-2009 ACORD
CORPORATION. All rights reserved. ACORD 25 (2009/
09) The ACORD name and logo are registered marks of ACORD Generated by EXIGIS
LLC. For more information visit www.exigis.com.