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APP-E-23-215628Victor Loth 277/480–1Ø120/208–1Ø 120–1Ø Notes: Brk BrkDescription Description 1Ø Electrical Panel Schedule Manufacturer:Model:Serial: A B A B A B A B A B A B E N G I N E E R S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 240–1Ø 480–1Ø 277–1Ø120/240–1Ø 208–1Ø Project Name: DCE Project No:Date:Feeder: Panel:Fed From:Conduit: Voltage &Phase Mounting Surface MLO–or–Main Breaker: Flush Semi 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 Curtis Residence - (Replace existing FPE panel) 125amp #2/0alu Meter 2" MLO 50 50 20 20 15 15 20 20 20 15 20 20 30 30 AHU 15 15 15 20 Space Range Range Fridge Kitchen Den Living Room Disposal Dining Room Bedroom W Heater W Heater AHU Bathroom Bathroom Kitchen lights Microwave Existing Meter with 125amp breaker Replace 125amp FPE panel with new 125a MLO Existing #2/0alu w/ #6cu ground in 2" conduit SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 01/03/2023 Next First Insurance Agency, Inc.PO Box 60787Palo Alto, CA 94306 VFL Services LLC10183 Lexington Lakes Blvd NBoynton Beach, FL 33436 (855) 222-5919 support@nextinsurance.com 152762155 A X X X 01/03/2023 01/03/2024 1,000,000.00 100,000.00 15,000.00 2,000,000.00 2,000,000.00 A City of Delray Beach Building DepartmentBuilding Division100 NW 1st AveDelray Beach, FL 33444 1,000,000.00 01/03/2023 NXTFTCCJQH-01-GL 01/03/2024 Each Occurrence: Aggregate: $25,000.00 $50,000.00NXTFTCCJQH-01-GLContractors Errors and Omissions X X Next Insurance US Company 16285 Certificate Holder is an Additional Insured on the General Liability policy on a primary and non-contributory basis. All Certificate Holder privileges apply only if required bywritten agreement between the Certificate Holder and the insured, and are subject to policy terms and conditions. LIVE CERTIFICATE Click or scan to view EFFECTIVE DATE: PERSON: BUSINESS NAME AND ADDRESS: SCOPE OF BUSINESS OR TRADE: VICTOR LOTH VFL SERVICES LLC 10183 LEXINGTON LAKES BLVD. N BOYNTON BEACH, FL 33436 FEIN: JIMMY PATRONIS CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * IMPORTANT: Pursuant to subsection 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to subsection 440.05(12), F.S., Certificates of election to be exempt issued under subsection (3) shall apply only to the corporate officer named on the notice of election to be exempt and apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to subsection 440.05(13), F.S., notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850) 413-1609E01463927 Electrical Wiring Within Buildings and Drivers Carpentry Installation Of Cabinet Work or Interior Trim Contractor-Project Manager, Construction Executive, Construction Manager or Construction Superintendent CONSTRUCTION INDUSTRY EXEMPTION 1/4/2022 EXPIRATION DATE:1/4/2024 590469974 EMAIL:VFLSERVICESINC@GMAIL.COM This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. Melanie S. Griffin, SecretaryRon DeSantis, GovernorSTATE OF FLORIDADEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATIONELECTRICAL CONTRACTORS' LICENSING BOARDTHE ELECTRICAL CONTRACTOR HEREIN IS CERTIFIED UNDER THEPROVISIONS OF CHAPTER 489, FLORIDA STATUTESLOTH, VICTORDo not alter this document in any form.VFL SERVICES LLCLICENSE NUMBER: EC13008545EXPIRATION DATE: AUGUST 31, 2024This is your license. It is unlawful for anyone other than the licensee to use this document.10183 LEXINGTON LAKES BLVD NBOYNTON BEACH FL 33436Always verify licenses online at MyFloridaLicense.com