ST. JOHNS COUNTY, FLORIDA
CERTIFICATE OF COMPETENCY
H. H. BLOCK EXAM NO.recp
Ernest Lee is duly certified
to practice as General Contr-A
in St, o? ns County, Fla. until O
September 30,__ unlessss sooner disqualified.
EXAMINATION BY H. H. BLOCK
City of .t. Augustine
(city, county, municipality)
CITY OF ST. AUGUSTINE, FLORIDA
Si l is to alertifg tlat
Ernest E. Lee
HAS BEEN ISSUED A CERTIFICATE OF COMPETENCY
A General Contractor
ISSUE, 9/29/87 Expires 10/31/88
CITY BUILb FICIAL
\ ; .'' '* tn *-, ,..:! v'."'-: y *' - *1
STATE OFp FLORIDA' ,rfr nl of ilfrsi I ru laIl -.
CO NSTRUCILO N j NU S R Y,; E N I RD .D.
06117/87i. ,>RG'0052441,'1, u 08650
THEREGISTERED. GENERALi CONTRACT OR J
NAMED BELOW 'HASi REGISTERED D ,'?. ,
UNDER THE PROVISIONS OFCHAPTER 89 -FOR
THE YEAR EXPIRING '- JUNE 43 0 1 989~C MUST t ,:
MEET lALLILOCAL LICENSING 64R REQUIREMENTS .
PRIOR TO CONTRACTING6-IN ANY AREA)~ l :i;
.LEE& -ERNESTrE\-E *
SINDIVIDUALIK ,l -. .. :.
228.LCHARLOTTE;i.ST, ) n vry- I
ST AUGUSTINE FL,320.84, :
ao .0. 4v DISPLAY IN A CONSPICUOUS PLACE
STATE OF FLORIDA DPepartmttt of Professiotnal 'E14 itiol
'i CONST. INDUSTRY LICENSING BOARD 1
SREQ. PRIORi TO CONTR -IN I ANY areaE)
REGISTERED ,GENERAL CONTRACTOia
HAS PAID TIIE FEE REQUIRED BY CHAPTER 489 ,
FOR THE YEAR EXPIRING_ JUNE 30o -1989
PLEAS.E R.A. IMPORTANT
INFORMATION ON REVERSE
OVNO WALLET CARD FOLD HERE
CONSTRUCTION)INDUSTRYLICE SING BOA
POST OFFICE BOX'2
JACKSONVILLE, -FL 32201
I1AUJT ONTrO N. LIOCNb E N. A TCH NO. E E AMou0
148 RG0052441 08650 $50.
w-~n~P F1 ir541119Z H -
THIS LICENSE IS FURNISHED IN PURSUANCE OF
CITY ORDINANCE CODES.
ACCOUNT NUMBER NAME OF BUSINESS
L-04900-7' LEEI-ERNEST E
STATE CITY CODE 4jOCC ACTION CLASS FICTION
FL 038-001' CTO '
/- ITG. A T.S
THIS LICENSE MUST BE
s AT ALL TIMES.
IS HEREBY LICENSED TO ENGAGE IN THE BUSINESS PROFESSION
OR OCCUPATION AS STATED ABOVE FOR THE PERIOD BEGINNING
ON OCTOBER 1 AND ENDING ON SEPTEMBER 30.
( itV noflt Augustine
FINANCIAL SERVICES DEPARTMENT
75 KING STREET P.O. DRAWER 210
SAINT AUGUSTINE, FLORIDA 32085-0210
LICENSE NO. DATE ISSUED CODE LICENSEAMOUNT
010924 1-29q17 F $100.00
ADD PENALTY AMOUNT DUE $
TOTALAMOUNTPAID $ 100.00
v -/. -' i
flIRFflTfl FINANFIAI ~FRVIflF~ flIPAEI~hTkA
ATALLTIMES. IRECTOR FINACIAL SERVICE DEPiPTKAMPU
ST. JOHNS COUNTY OCCUPATIONAL LICENSE
BEGINS 10/01/87 EXPIRES 09/30/
SLEE9 ERIE ST E ;,.
LEE, -ERNEST E.
'.,"'.'*. ..^ ^
,8 AVILES STREET ST., AUGUSTINE, FL
*' """i Y': .' .. 'PET *C
2 CONTRACTOR ,1 .GENERAL.CITY COMPETENCT CARD
SLEE, ERNEST. E.
228 CHARLOTTEE STREET '
ST. AUGUSTIIE, FL:32084
S- . -- APPLICATION IS HEREBY MADE FOR AN
OR OCCUPATION HEREIN DESCRIBED AND
A-. 4 h, w B ^ RELATING TO NUMBER OF DEVICES, NUMB
PAYMENT RECEIVED AS CERTIFY
DENNIS W. HOLLINGSWORTH
TAX COLLECTOR, ST. JOHNS CO
ST. AUGUSTINE, FLORIDA 32085
OCCUPATIONAL LICENSE FOR THE PRIVILEGE OF ENGAGING IN THE BUSINESS.
I SOLEMNLY DECLARE UNDER PENALTY OF PERJURY THAT THE FOREGOING II
ER OF ACCOMMODATIONS OR EMPLOYEES. IS TO THE BEST OF MY KNOWLEDGE
;" PENALTY PAYMENT REQUIRED
10% PENALTY IF PAID AFTER SEPTEMBER 301h
-15% PENALTY IF PAID AFTER OCTOBER 31st
20% PENALTY IF PAID AFTER NOVEMBER 30th :
25% PENALTY IF PAID AFTER DECEMBER 31st
ALL LICENSES UNPAID AFTER JANUARY 31st ARE SUBJECT TO FURTHER
' PENALTIESASPRESCRIB. BY CTY9ORDINANCES. -
m-- c"$ Uallflljlfd mttJ.,vl!iliig Fiam _13_91:9fim kI
-.o. :i, ,8T CUi'C ' INSUMANCE CO. #795
o. 0 01727 "-09 ,,. A TOCK COMPANY.
.". ", INSURANCEE COMPANY.. ..~"
S,, ; .,.. ' .. . Boca Raton, Florida ,.. :. . .. i'. ." ." . "` *
DECLARATIONS ." . .. .
Item 1. Named Insured and Address: (No., street, Town or city, county, State)
1 ,-, .ERNESTE. LEE, : .
.,,.,228 CHARLOTTE STREET ." :,"+ '
S:T, A+UGUSTINE,,i FLORIDA -32084 .....'
I lt Z.. Policy Periqd:. (Mo. Day Yr.)...: .. .,
om f 1-21-87 to 11-21-88.:
12i01 A.M., standard time at the address of the nmed Insured as stated herein. ., .. .. . .
..The named Insured Is: .
... Individual O Partnership O Corporation
Business of the named insured is: ( r.. amiw)
... . . . . . .... .. :,, ...., ... ,. .
j point Venture :' Other '
Audit Period: Annual, unless otherwise stated. -( wrci a ow), Ui i
Item 3. The insurance afforded is only with respect to the Coverage Part(s) indicated below by specific premium charges) and attached to and forming a part of
this policy. ..I . .... .....
Advance Coverage Coverae PaDrt(s) Advance Cverlae Coverage Part(s)
S' Premiums j, Part No(s). ,, ,. Premiums Part No(s) .....
$ .. . Hospital Professional Liability Insurance
$ .. $ 35500 Manufacturers' and Contractors' Liability
.. .... .. .. L6407 Insurance
S. Completed Operations and Products Liability $ Owner's and Contractor's Protective Liabilty
S..:' Insurance Insurance
$ .. $ Owners',.Landlords' and Tenants' Liability
$ .; Comprehensive General Liability Insurance Insurance. ...
$ .. Comprehensive Personal Insurance $ Personal Injury Liability Insurance .' -
$ Contractual Liability Insura9ce $ Physicians', Surgeons'and Dentists' Professional
$ '. .- Druggists' Liability Insurance ..... Liability Insurance
$ Elevator Collision Insurance $S Premises Medical Payments Insurance
$ Farm Employers' Liability and Farm Employees' $ SpecialProtectiveandHighwayLiabilitylnsurance
Medical Payments Insurance New York Department of Transportation
$ Farmer's Comprehensive Personal Insurance:- Storekeeper's Insurance
$ Farmer's Medical Payments Insurance $
'1 L0 IL0928(5-86)GL9918(3-83)GL0032(4-84)IL0018(10-84)L9294(1-73) Form numbers of endorsements
s$ I TT 4 (1 -R ) T,640'7 (1 -73) 38F( 2-75 )L203 (10-77 )GL2104 (7-66) Coverage Part(s), attached at issue
$ 5-c_ nn
Total Advance Premium for this policy, I
*f the Policy Period is more than one year and the premium is to be paid in Installments, premium is payable on: : .:
; :,.Effective Date .. 1st Anniversary 2nd Anniversary
$ 355.00 $ :' $
' '".' :!u .. ..:12-17-87
Countersigned: ALTAMONTE SPRINGS, FL '
*Not applicable In Texas
OKP6322(0)-X-iA ;1-:? ?. ., ..,
Ptd. In U.S.A.
NCE AGENCY, INC.
AMENDMENT-UMITS OF LIABILITY
(Indivdual Coverage Wurpte Limit)
Coverages Limits of Liability
S $. 500 ,000 each occurrence
Bodily Injury Liability and Property Damage Liability $ 500 .000 ea
$ 500 .000aggregate
It is agreed that the provisions of the policy captioned "LIMITS OF LIABILITY"
to read as follows:
UMITS OF ABILITY
Regardless of the number of (1) insureds under this policy, (2) persons or
organizations who sustain bodily injury or property damage, (3) claims made or
suits brought on account of bodily injury or property damage or (4) automobiles
or units of mobile equipment to' which this policy applies, the company's lia-
bility is limited as follows:
Bodily Injury Liability and Property Damage Liability:
(a) The limit of liability stated in the Schedule of this endorsement as appli-
cable to "each occurrence" is the total limit of the company's liability for
all damages because of bodily injury or property damage as a result of any
one occurrence, provided that with respect to'any occurrence for which
notice of this policy is given in lieu of security or when this policy is
certified as proof of financial responsibility under the provisions of the
Motor Vehicle Financial Responsibility Law of any state or province such
limit of liability shall be applied to provide the separate limits required
by such law for Bodily Injury Liability and Property Damage Liability to
the extent of the coverage required by such law, but the separate applica-
tion of such limit shall not increase the total limit of the company's
(b) if an aggregate amount is stated in the Schedule then subject to the above
provision respecting "each occurrence", the total liability of the company
for all damages because of all bodily injury and property damage which
occurs during each annual period while this policy is in force commencing
from its effective date and which is described in any of the numbered
subparagraphs below shall not exceed the limit of liability.stated in the
Schedule of this endorsement as "aggregate":
(1) all property damage arising out of premises or operations rated on a
remuneration basis or contractor's equipment rated on a receipts basis,
Including property damage for which liability is assumed under any
incidental contract relating to such premises or operations, but exclud.
ing property damage included in subparagraph (2) below;
relating to Bodily Injury Liability and Property Damage Liability are amended
(2) all property damage arising out of and occurring in the course of opera-
tions performed for the named insured by independent contractors and
general supervision thereof by the named Insured, including any such
property damage for which liability is assumed under any Incidental
contract relating to such operations, but this subparagraph (2) does not
include property damage arising out of maintenance or repairs at prem-
ises owned by or rented to the named insured or structural alterations
at such premises which do not involve changing the size of or moving
buildings or other structures;
(3) if Products-Completed Operations Insurance is afforded, all bodily injury
and property damage included within the completed operations hazard
and all bodily injury and property damage included within the products
(4) if Contractual Liability Insurance is afforded, all property damage for
which liability is assumed under any contract to which the Contractual
Liability Insurance applies.
Such aggregate limit shall apply separately:
(i) to the property damage described in subparagraphs (1) and (2) and
separately with respect to each project away from premises owned
by or rented to the named insured;
(ii) to the sum of the damages for all bodily injury and property damage
described in subparagraph (3); and
(iii) to the property damage described in subparagraph (4) and separately
with respect to each project away from premises owned by or
rented to the named insured.'
(c) For the purpose of determining the limit of the company's liability, all
bodily injury and property damage arising out of continuous or repeated
exposure to substantially the same general conditions shall be considered
as arising out of one occurrence.
This endorsement must be attached to the Change Endorsement when issued after the policy is written.
FL 1.ST. COAST *INS AGCY
'775 U.S. I SOUTH
ST AUGUSTINE FL 32066
FAC, REINS RATE PLAN SPEC. ACCT. SAFETY GROUP TARGET RISK PAR CLASS COMMISSION
YES NO Rt~ PLN. CO, PERIOD YES NO YES NO YES NO NUMBER PER CENT AMOUNT
X CON C 12 X x P 4256
Item1. JRNLS L LEL (PAGE I LAST PAGe>
The 228 CHARLOTTE STREET SYM POLICY NUMBER
Insured ST AUSUSTINE, FL 32084 0QC [QJ ?1 B87 37 55 e''
Mailing l Individual 0 Partnership
Address L_ O Corporation O
Other workplaces not shown above: STATE .OF FLORIDA
Item 2. Policy period from 4 0- 2 2-7 to 1 0- 2 .- 12:01 A.M., standard time at the insured's mailing address.
Item 3.A.Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here:
B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3. A.
The limits of our liability under Part Two are: Bodily Injury by Accident $ !. 0 0 00 Cj each accident
Bodily Injury by Disease $ 5)D 0 0 0 0 policy limit
Bodily Injury by Disease $ 1 00 n00 each employee
C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: ALL STATES EXCEPT
NVtNDOH,WA WV~rbY.STATES DESIGNATED IN ITEM 3.A OFINFORMATION PAGE AND.
Item 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information
required below is subject to verification and change by audit.
Classifications Premium Basis Rate
Code Estimated Total Per $100 of Estimated
No. Annual Remuneration Remuneration Annual Premium
CONTRACTOR-EXECUTIVE SUPERVISOR 0,R
CONSTRUCTION SUPERINTENDENT 5 StOb 500.1. p.94 447.
ESTIMATED STANDARD POLICY PREMIUM .'7
(INCLUDED IN POLICY PREMIUM OF 5 2) ..: .* .. ..r om-
EXPENSE CONSTANT r,9o t : : 3 of I 5
Minimum Premium Total Estimated Annual Premium $ 532.
;If Indicated here, interim adjust- i T AGE
a., New' O Renewal; O Rewrite of; (AuthorTied. 'ent)
SYM PREVIOUS POUCY NO. PRODUCER:
Minimum Premium $ 48ON7. Total Estimated Annual Premium $ O6 6t 532
If Indicated here, interim adjust- t LO / P AG E)
ments of premium will be made: c Semi-Annually r Quarterly n Monthly- -Deposit Premium W$ /
This policy includes. these endorsements and schedules: LC12"6 (Kc:J95 CK^S67 / / /
Employer's Identification No.: / // f /, /
Interstate Identification No.: Countersigned By / / /L (Autho d .4Lent '
El New r Renewal; D Rewrite of, ( '/d
I PREVIOUS POLICY NO. PRODUCER: L /C
|l ,MARKETING OFFICE: fiA'IION;IL WC. RE.. POOL. 87307 VOC 62*76)-RCY'
(E-4266 Ptd. In U.S.A.. Copyright 1982 National Counil on Compenation Inuranc. PRODUCER
'----- -- .. .. . .. .. ... . ...... .. . ... .'. .. .. . .. . ... ...... .. " ..... . . .
WORKERS COMPENSATION AND EMPLOYERS
LIABILITY INSURANCE POLICY
WC 00 00 01~
NAM( ANID ADDIISS Of AGENCY
HERBIE WILES It
P.O. DRAWER 30(
NAMI ANI) Al.nl;U bS Of INSMII: I)
ERNEST E. LEE
228 CHARLOTTE STREET
ST. AUGUSTINE, FL 32084
3 . l. ,, . .
COMPANIES AFFORDING COVERAGES
C -I.MPANy A
1" 'fi" A CONTINENTAL INSURANCE CO.
fni.' PANY 0
S'""11 L. F. EVERETT CO.
C FLORIDA HOME BUILDERS
II If L..
I his is to certify that policies of insurance listed below have been issued to the insured nrame'd above and art: in force at this time n.wthst.i,'i ,ny ri'i.n'mnt ', 1 .
of any contract or other document with respect to which this certificate may bfi issued or may p.rtatn. the in.stran(c afforded by, the poli;;.:n-' .t ri t: i ; ::; ..
Storms, r cllsions and conditions of such policies.
I '?A I vt
IYI'I (O INSl'h AN( If I Y NI! I fi
lxi i'I' ll'i .11,S_9I r Il" II lo!1
F i) 'I (V ON A l ti nr Alt
I I l '.I Iii.I I JAL 1%/.l IF
[ic I ki
,~ Iu III N i NI I iiN1 1011.,
LIII itiiNAI. IN.01
[l CLO.MI'tI III NSIV[ I 0'.',
L-1 COl Ntf 1)
L_J OMI0I I
r.1 N' N ('.VNI I)
l 1F i P11, I I A I)urk.u
LICENSE & PERMIT
!~, -, 1 ;~~i~zi2~~~i'Zfc~2. -, '''
OPt P14A 1ONS, I (.K.A 1NSNE IIICL I S
Lir. its o( i.ihiility in 1 r ur n tidi ('K0
.... 100 100
(I'll'( If f P, I O lr, }" .
( l A i:,i At( ,Il N'; .' ;
i ll i l I IN '* I h I" "
,O l Y irI '1 ."
I A I M i
: *. i ,. . . I
-_ i-; 100
A([Clil,' ZS (1.7'l)
Should any of the above described policil, Io .i l,.!for1( thl.' o*'xpr,]tinOI lt ti r, lli ,'u ; i, '-
pany will endeavor to m ail 10 days v,., t'i, e to n h, lnofw nj, d t(,1t'( ,t,, l;,l !,'i,. lt I t :!lit ')
m ail such notice shall im pose no ob(tli'i lton'.ol 1. blil;i ()I ,iny k.ld ui..,n II:< t);p:,..:II.
NA.ML AN A) ADRSS Ot (.1.1 I IC A1 ( 1101.IO)L
CITY OF ST. AUGUSTINE
P.O. BOX 210
ST. AUGUSTINE, FL 32085
i.. _______ ........
I i..ih ,,,_. .. 09/25/87
m Jiu- ..
NAME AN AAI)ID[SS O1 AGENCY
HERBIE WILES INSURANCE
P.O. DRAWER 3067
ST. AUGUSTINE, FL 32085
COMPANIES AFFORDING COVERAGES
C,'',^ A CONTINENTAL INSURANCE CO.
"(nN EB L. F. EVERETT CO.
NAME AND AlID M(bS Of INSUIIl)
":'""Y FLORIDA HOME BUILDERS
ERNEST E. LEE
228 CHARLOTTE STREET "'""
ST. AUGUSTINE, FL 32084 ", r
This is to certify that policies of insurance listed below have been issued to the insured namedd above and are in force al this time P;t'.withtallnrn' iny ri'rI.:'l'r.r',alrt ,- w' I: ":
of any contract or other document with respect to which this certificate may bei issued or may prlrtlin. the insurance afforderl by tite IpohUl: ,;, ,.'l : it'.rl' I ;:; .; : ;: : .
terms, erclusions and conditions of such policies.
I ill 'll
IYPI (11 ItSLIIWANCI
191 COMP~llIII N.'.IV I OW.1-
[ii II 't 017 I IOP
PIf 0NI WIA Ii AL 4,01.111 111
F C] r ) NIPCtI INI AII1
[ I I'I ICSOIJAL. IN .ii liy
[. COMPI!ItI NSIV- 10.M
1.i N,1 (,VNI Il)
[IA ti.'. tI^A I,:1.'1.
I7] 1 lll I 4AlH tUl ,illIA
A LICENSE & PERMIT
l)LSC ( PTll'(O OF Of or AT IONS, L(iCAIIONS/EIIICL ES
1101 ICYV NI IMill 14
I l' l II. 1 i' .
Linlits p I l~ill~iY ill 'I flWnI~Ii~~( S(WAI
111411 Ill Pt P('.* I
rI i WY A I 6
BND 2210886 09/30/88 $3,000
Should any of the above described policies Ito' i..tnir .l; l l,.clore th'e *'xliralion l.ite Ilh.:r.;:l. .th I'.,ir n;' cr' .
pany will endeavor to mail 10 days wt,'it; -il ) nlII lo I hi: ihelm lw nlli d ( ietificl t l;dr.l. I'. l .i:iuiJ !.i )
m3ll such notice shall impose no oblli;gatiol.or li.i'bliityof y 1,kind ui:f.n hll: I:.uii,...n'l.
NAML AN) ADDRESS 01COf .lI I ICA 1 HI1OLI.L L
CITY OF ST. AUGUSTINE
P.O. BOX 210
ST. AUGUSTINE, FL 32085
A(.OO O5 (!.7t)
Alr Is.,, u. : 09/25/87
-------- (-- -- -- --------- --------------- -----I ------- ---------P