HomeMy WebLinkAboutALL DOCS - 13-00094 - Omni Security Systems Annual Safety Certificationa
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OFFICE ADDRESS, QO
OFFICE PHONE NUMBER:
CONTACT PERSON: I'\ar \L CELL PHONE *, 8o-?7?to
PLEASE IDENTIFY SYSTEMS TO BE COVERED BY THIS PERMIT. CHECK ALL
THAT APPLY.
)(fIng AI-ARM SYSTEMS - Alarm Conftactors shall have a minimum of NICET Level 1
derttficanons or eq uivalent.
/ {.PLE,ASE, PROVIDE CERTIFICATIONS:
{.NICET Certification
*Panel Certification
*Proof of Liability Insurance
TNICET Level II requited fot design work
AUTOMATIC SPRINKLER SYSTEMS * Fire Sprinkler Conftactots shall have a
minimum of NICET Level I Cetifications ot equivalent.
' PLEASE PROVIDE CERTIFICATIONS:
i.NICET Cettification
{.Any Additional Certifications
*Proof of Liability Insurance
i. NICET Level II tequited for design work
FIRE EXTINGUISHERS
{.Proof of Cetification & Training
AUTOMATIC FIRE EXTINGUISHING SYSTEMS FOR COMMERCIAL
COOKING
SProof of training for commercial cooking heads
STANDPIPE SYSTEMS -SPECIAL HAZARD SYSTEMS
-FIRE PUMP-SMOKE CONTROL SYSTEMS
Ct,IY OII
REXBURG
Americas Familv Clmfilunitv35N l.tE
Rexburg, ID 83440
Rexburg -Mqdison Cou nly
Emergency Services
Phone: 208.372.2326
Fox: 208.359.3022www.rexDUrg.org
*A toftu Etstem certifcation perrnit is required to install, modtfi, maintain, or seruice a// new and existingfre
extinguishers,fre suppression ystemqfre alaryystems, and other lfe safery sltstens aithin the Ciry of Rexburg"
BUSINESS NAME:nri Sa,.,S
b34
-l -
*{C*PIEASE PROVIDE DOCUMENTATION OF TRAINING LEVELS,
INSTAI.IA,TION CERTIFICATIONS, LIABILITY INSURANCE, ETC. FOR ALL
DISIPLINES*r'{'
I certi$ that I have read this application and declare undet penalty of periury that the information contained
hetein is cottect and complete. I agree to comply with all city ordinances, adopted codes, and state laws
telating to the installation, modification, service, and maintenance of new and existing life safety systems. I
heteby authodze teptesentatives of this city to inspect any work for compliance purposes. I am either the
contractor tesponsible fot the wotk, ot I reptesent the ownet as signified above and am acting with the ownetts
PERMIT VALID UNTIL DECEMBER 31 OF THE CALENDAR YEAR APPLIED FOR.
*******************,N.*{.:1.*{.{.**********{.{.rl.{.{.****:1.*:1.:t{.*:N.:1.**********:tq:l.rl.***********rt
-2-
Au e. 27. 20 1 3 9: 00AM 0mni Securitv Svstems INC,No,7196 P,
ACORD'v'CERTIFICATE OF LIABILITY INSURANGE
AS.A MATTER OF INFORMATION ONLY AND CONFERS NO R,IGHTS UPOI{ THE CERTIFICATE HOLDER" THISCERTIFICATE DOES NOT AFFIR.I'ATIVELY OR NEGATIVELY ME}ID, EXTEND OR ALTER TI{E COVERAGE AFFORDED BY THE POL]CIES
?E!ow. rHts CERTIRC,ATE or insuRrxcE DoEs Nor coNsflTUTE A cor{TRAcr BETWEE}I rHE tssurxc tNsuRER(sl, AUTHoRTZEDREPRESENTATTVE OR. PRODUCER, AND THE CERTIFICATE HOLDER.
the terms and condltlohs of the pollcy, certaln pollcleo' may reqrJrr an andorsErDent. A staremeOl an lhls cefimodg doss not conter nght$- to the
Hanwell Corporation
Box 51q19
ro Fa[s, lD 83405.1019
$lsuRED Omni Security SyEtGm€ IncPO Box 309
Riguy, ID 8ArH2-0309
THIS IS TO CERNFY TFAT TXE POL}CIES OF INSURAITICE LISTED BELOW HAVE BEEN ISSUED TO,THE INSURED MMED AEOVE FOR THE P9LICY PERIOOINDICATED. NON^NTHSTA}IDING ANY REOUIREMENT. TERII OR CONDITION OF A^I'f COI{TRACT OR OTHER DOCUME}ff WITH RESPECT TO I^,|IIC}I TTIISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, '}tE INSURANCE AFFORDED BY THE POLICIES DESCRISED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOVVI{ MAY I-IAVE BEEN REDUCED BY PAID CIAIMS.
COMMERCIA GET€RA- LIABILITY
cLArMer{ADE. [Tl o"*
A^IY AUTO
ar_r, or+tED f-] 9CHEU,|_EDAr.JroS Ll AIJTOS
I I NOhTOWhEDHlREDAlrrOs t l aJroE
BODILY h{AnY [Ptr.Feilnl
oEBcRFTroftlOFoPERA'|1ONSrLoCATloN9rvEHlcLEB iAhchaCoRDlot.AddiloD{RonstrrSEh.dri.,fmEiDxElercquiro
AHOULD ANY OF ?}E ^BOVE DEI'CIIIBED POLICIEA BE C^I{CELLED BEFORE
]'I{E EXPRAT'ON DATE THERIO|. NOTICE WILL BE DELTVERED ItI
ACCORDAIICE WITH T}IE POLICY PROVIEIq{8..
A(JTHOREED REPRF€EMAi\G,e-, /"*,
: @ l9BB-2010 ACORD CORPORATION.' All righte reaerved.
ACORD 25 (2010/05)The ACORD nsme and logo are reglstered marks of ACoRD
Receipt Number: 1M149)
y Development
, rD. 83440
(208) 359-3022
lion
,grlginilfoe
$100.00
Total:
PAID
MAR I 5 2OI3
clTY Cr nEXBURG
$100.00
ts"
$ 100.00
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