... ;.., I OMB No. 1660-0008u.s. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE Exoires Februarv 28. 2009Federal Emergency Management Agency

National Flood Insurance Program Important: Read the instructions on pages 1-8.

SECTION A - PROPERTY INFORMATION For Insurance Company Use:

A1. Building Owner's Name: Six Mile Cypress Office Park Policy Number

A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number 10461 Ben C. Pratt Six Mile Cypress Parkway

City. Fort Myers State. FI ZIP Code 33966

A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Six Mile Office Park, Phase V, Official Records Book 2634, Page 3796

A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) -!.:!N!Jo!o!.!:n-:!,;R~e~s!-,!id.Ee!..!JntO!.Sia~I _

AS. Latitude/Longitude: Lat. 26'35'38.6"N. Long. -81 '48'38.3'W. Horizontal Datum: DNAD 1927 [8JNAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number_1__ A8. For a bUilding with a crawl space or enclosure(s), provide: A9. For a building with an attached garage, provide:

a) Square footage of crawl space or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage

enclosure(s) walls within 1.0 foot above adjacent grade N/A walls within 1.0 foot above adjacent grade ""N",,/A.l.-_ c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in

SECTION B· FLOOD INSURANCE RATE MAP (FIRM) INFORMATION

B1. NFIP Community Name & Community Number I B2. County Name I B3. State Lee County 12071C Lee Florida

B4. Map/Panel Number B5. Suffix B6 FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone Date Effective/Revised Date Zone(s) AO, use base flood depth)

12071 C-0431 F August 28, 2008 August 28, 2008 AE 19

B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.

OFIS Profile I8IFIRM DCommunity Determined OOther (Describe) _

B11. Indicate elevation datum used for BFE in Item B9: ONGVD 1929 I8INAVD 1988 OOther (Describe) --=...._--=--------­B12. Is the bUilding located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? DYes 1:8:1 No

Designation Date DCBRS DOPA

SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)

C1. Building elevations are based on: DConstruction Drawings" OBuilding Under Construction" I:8:IFinished Construction "A new Elevation Certificate will be required when construction of the building is complete.

C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARiA, ARiAE, ARiA1-A30, ARiAH, ARiAO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized: Site Benchmark Vertical Datum: !.:!N!!;;A!.!!V..!=D,-1L,;9!.!=8~8 _

Conversion/Comments Converted from NGVD 29' to NAVD 88' using U.S. Army Corps of Engineers Corpscon 6.0.1 conversion program Check the measurement used.

a) Top of bottom floor (including basement, crawl space, or enClosure floor) 20.0 18I feet 0 meters (Puerto Rico only)

b) Top of the next higher floor l!l&­ 0 feet 0 meters (Puerto Rico only)

c) Bottom of the lowest horizontal structural member (V Zones only) .J:YA­ 0 feet 0 meters (Puerto Rico only)

d) Attached garage (top of slab) N/A. [J feet 0 meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 19.4 I8J feet D meters (Puerto Rico only)

(DeScribe type of equipment in Comments)

f) Lowest adjacent (finished) grade (LAG) --1M IZI feet 0 meters (Puerto Rico only)

g) Highest adjacent (finished) grade (HAG) ~ I8J feet 0 meters (Puerto Rico only)

SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information on this Certificate represents my best efforts to interpret the data availab/e. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001.

[8JCheck here if comments are provided on back oHorm.

Certifier's Name License Number A. Lee Hayne LS 6338

Title Company Name Professional Surveyor & Mapper Banks Engineering

Address City State ZIP Code tJ· eL-JJ-. r10511 Six Mile Cress Parkwa Fort M ers Florida 33966 Date Telephone 3-16-2009 LB 338Signature a. e­3-16-2009 239 939-5490

FEMA form 81-31, February 2006 See Reverse side for continuation Replaces all previous editions

IMPORTANT: In these spaces, copy the corresponding information from Section A.

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 10461 Ben C. Pratt Six Mile Cypress Parkway

For Insurance Company Use: Policy Number

City Fort Myers

State Florida

ZIP Code 33966

Company NAIC Number

SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATiON (CONTINUED)

Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner.

Comments Job # 1368-5

Item C2.e) is an air conditioning pad

Date 3-16-2009 0 Check here if attachments

SECTION E - BUILDING EL

Signature

VATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)

For Zones AD and A (without BFE), complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.

E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawl space, or enclosure) is . _ D feet D meters 0 above or 0 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is . _ D feet 0 meters 0 above or D below the LAG.

E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9 (see page 8 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is . _ 0 feet 0 meters 0 above or 0 below the HAG.

E3. Attached garage (top of slab) is . _ 0 feet 0 meters D above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is . _ 0 feet 0 meters 0 above or D below the HAG.

E5. Zone AD only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? DYes 0 No D Unknown. The local official must certify this information in Section G.

SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION

The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AD must sign here. The statements in Sections A, e, and E are correct to the best of my knowledge.

Property Owner's or Owner's Authorized Representative's Name

Address , City State ZIP Code

Signature Date Telephone

Comments

o Check here if attachments

SECTION G· COMMUNITY INFORMATION (OPTIONAL)

The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8. and G9.

G1. D The infonnation in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)

G2. 0 A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AD.

G3. 0 The following information (Items G4.-G9.) is provided for community floodplain management purposes.

G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued

G7. This permit has been issued for: D New Construction 0 Substantial Improvement

G8. Elevation of as-built lowest floor (including basement) of the building: [J feet D meters (PR) Datum _

G9. BFE or (in Zone AD) depth of flooding at the building site: 0 feet 0 meters (PR) Datum _

Local Official's Name Title

Community Name Telephone

Signature Date

Comments

D Check here if attachments

81-31, February 2006 FEMA Form Replaces all previous editions

Building Photographs Continuation Page

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 10461 Ben C. Pratt Six Mile Cress Parkwa

City State ZIP Code Fort M ers Florida 33966

For Insurance Company Use:

Policy Number

Company NAIC Number

If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View."

Right Side View

Left Side View

Building Photographs See Instructions for Item A6.

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 10461 Ben C. Pratt Six Mile Cress Parkwa City State ZIP Code Fort M ers Florida 33966

For Insurance Company Use:

Policy Number

Company NAIC Number

If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following.

Front View

Back View

U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE Federal Emergency Management Agency National Flood Insurance Program Important: Read the instructions on pages 1-8.

SECTION A - PROPERTY INFORMATION

OMS No. 1660-0008 Exoires Februarv 28. 2009

For Insurance Company Use: A1. Building Owner's Name: Six Mile Cypress Office Park Policy Number

A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 10471 Ben C. Pratt Six Mile Cypress Parkway

Company NAIC Number

City: Fort Myers State: FI ZIP Code 33966

A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Six Mile Office Park, Phase IV, Official Records Book 2634, Page 3794

A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) ~N=on"--"-R=e=si:.::d=-en""'t,,,,ia,,-I _

A5. Latitude/Longitude: Lat. 26°35'38.1"N. Long. -81°48'39.1'W. Horizontal Datum: DNAD 1927 I8INAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number_1__ A8. For a building with a crawl space or enclosure(s), provide: A9. For a bUilding with an attached garage, provide:

a) Square footage of crawl space or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage

enclosure(s) walls within 1.0 foot above adjacent grade N/A walls within 1.0 foot above adjacent grade ""N/!",-A,,--_ c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in

SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION

B1. NFIP Community Name & Community Number B2. County Name B3. State Lee County 12071 C I Lee I Florida

B4. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone Date Effective/Revised Date Zone(s) AO, use base flood depth)

12071 C-0431 F August 28, 2008 August 28, 2008 AE 19

B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. DFIS Profile 181 FIRM DCommunity Determined DOther (Describe) _

B11 B12.

Indicate elevation datum used for BFE in Item B9: DNGVD 1929 I8INAVD 1988 DOther (Describe)

Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date DCBRS DOPA

DYes 181 No

_

SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)

C1. Building elevations are based on: DConstruction Drawings* DBuilding Under Construction* IZIFinished Construction *A new Elevation Certificate will be required when construction of the building is complete.

C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, ARlAE, ARlA1-A30, AR/AH, AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized: Site Benchmark Vertical Datum: :...:N""'A"'-V=D_1'-"9:.::8".8 _

Conversion/Comments Converted from NGVD 29' to NAVD 88' using U.S. Army Corps of Engineers Corpscon 6.0.1 conversion program Check the measurement used.

a) Top of bottom floor (including basement, crawl space, or enclosure floor) 20.0 IZI feet D meters (Puerto Rico only)

b) Top of the next higher floor l1!&...- D feet D meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member 0J Zones only) ~ D feet D meters (Puerto Rico only) d) Attached garage (top of slab) l1!&...- D feet D meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 19.4 IZI feet D meters (Puerto Rico only)

(Describe type of equipment in Comments) f) Lowest adjacent (finished) grade (LAG) ---.JM ~ feet D meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) -----ill IZI feet D meters (Puerto Rico only)

SECTION 0 - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information on this Certificate represents my best efforts to intetpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code. Section 1001.

IZICheck here if comments are provided on back of form.

Certifier's Name License Number A. Lee Hayne LS 6338

Title Company Name Professional Surveyor & Mapper Banks Engineering

Address City State ZIP Code 10511 Six Mile Cvpress Parkwav Fort Mvers Florida 33966

3-16-2009 LB 6338Signature a. e.-~ Date Telephone 3-16-2009 1239\ 939-5490

FEMA form 81-31, February 20b6 See Reverse side for continuation Replaces all previous editions

IMPORTI>:NT: In these spaces, copy the corresponding information from Section A. '.

For Insurance Company Use: Building Street Address (including Apt., Unit, SUite, and/or Bldg. No.) or P.O. Route and Box No. 10471 Ben C. Pratt Six Mile Cypress Parkway

Policy Number

City State ZIP Code Fort Myers Florida 33966

Company NAIC Number

SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)

Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner.

Comments Job # 1368-4

Item C2.e} is an air conditioning pad

Signature a. {2..; Date 3-16-2009 0 Check here if attachments

SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)

For Zones AO and A (without BFE), complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.

E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawl space, or enclosure) is . _ 0 feet 0 meters 0 above or 0 below the HAG. b} Top of bottom floor (including basement, crawl space, or enclosure) is . _ 0 feet 0 meters 0 above or 0 below the LAG.

E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9 (see page 8 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is . _ 0 feet 0 meters 0 above or 0 below the HAG.

E3. Attached garage (top of slab) is . _ 0 feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is . _ 0 feet 0 meters 0 above or 0 below the HAG.

E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? 0 Yes 0 No 0 Unknown. The local official must certify this information in Section G.

SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION

The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, e, and E are correct to the best of my knowledge.

Property Owner's or Owner's Authorized Representative's Name

Address , City State ZIP Code

Signature Date Telephone

Comments

n Check here if attachments

SECTION G • COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s} and sign below. Check the measurement used in Items G8. and G9.

G1. 0 The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)

G2. 0 A community official completed Section E for a building located in Zone A (Without a FEMA-issued or community-issued BFE) or Zone AO.

G3. 0 The following information (Items G4.-G9.) is provided for community floodplain management purposes.

G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued

G7. This permit has been issued for: 0 New Construction 0 Substantial Improvement

G8. Elevation of as-built lowest floor (including basement) of the building: 0 feet 0 meters (PR) Datum _

G9. BFE or (in Zone AO) depth of flooding at the building site: 0 feet 0 meters (PR) Datum _

Local Official's Name Title

Community Name Telephone

Signature Date

Comments

___________________________________________ 0 Check here if attachments

81-31, February 2006 FEMA Form Replaces all previous editions

Building Photographs See Instructions for Item A6.

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 10471 Ben C. Pratt Six Mile C press Parkwa City State ZIP Code Fort M ers Florida 33966

For Insurance Company Use:

Policy Number

Company NAIC Number

If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following.

Front View

Back View

~~. - -.-"';r

Building Photographs Continuation Page

For Insurance Company Use:

Policy Number Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 10471 Ben C. Pratt Six Mile C press Parkwa

City Fort M ers

State ZIP Code Florida 33966

Company NAIC Number

If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View."

Right Side View

Left Side View

, . U.S. DEPARTMENT OF HOMELAND SECURITY OMS No. 1660-0009ELEVATION CERTIFICATE Federal Emergency Management Agency Exoires Februarv 28. 2009 National Flood Insurance Program Important: Read the instructions on pages 1-8.

SECTION A· PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name: Six Mile Cypress Office Park Policy Number

A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number 10481 Ben C. Pratt Six Mile Cypress Parkway

City: Fort Myers State: FI ZIP Code 33966

A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Six Mile Office Park, Phase III, Official Records Book 2634, Page 3792

A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) -,-"N",-onu:-,,-,R>£e:2.si~d£.en!.!Jt.lliia!!..I _

AS. Latitude/Longitude: Lat. 26°3S'37.S"N. Long. -81°48'41.5'W. Horizontal Datum: []NAD 1927 l8lNAD 1983 A6. Attach at least 2 photographs of the bUilding if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number_1__ A8. For a building with a crawl space or enclosure(s), provide: A9. For a bUilding with an attached garage, provide:

a) Square footage of crawl space or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage

enclosure(s) walls within 1.0 foot above adjacent grade N/A walls within 1.0 foot above adjacent grade ....,N'-'./A-,--_ c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in

SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION

B1. NFIP Community Name & Community Number B2. County Name B3. State Lee County 12071C I Lee I Florida

B4. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone Date Effective/Revised Date Zone(s) AO, use base flood depth)

12071 C-0433 F August 28, 2008 August 28, 2008 AE 19

B10 Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. OFIS Profile l8lFIRM DCommunity Determined DOther (Describe) _

B11. B12.

Indicate elevation datum used for BFE in Item B9: DNGVD 1929 l8lNAVD 1988 DOther (Describe) Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date DCBRS DOPA

DYes l8lNo _

SECTION C· BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)

C1. Building elevations are based on: DConstruction Drawings" DBuilding Under Construction" IZIFinished Construction "A new Elevation Certificate will be required when construction of the building is complete.

C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, ARlAE, ARlA1-A30, ARlAH, AR/AO. Complete Items C2.a-g below accordinil\to the building diagram specified in Item A7. Benchmark Utilized: Site Benchmark Vertical Datum: ....,N"-.A"'V....D:..1....9"'8""8c-- _

Conversion/Comments Converted from NGVD 29' to NAVD 88' using U.S. Army Corps of Engineers Corpscon 6.0.1 conversion program Check the measurement used.

a) Top of bottom floor (including basement, crawl space, or enclosure floor) 20.0 l8l feet 0 meters (Puerto Rico only)

b) Top of the next higher floor ~ 0 feet 0 meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) ....lli&.- 0 feet 0 meters (Puerto Rico only) d) Attached garage (top of slab) ~ 0 feet 0 meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 19.2 l8l feet 0 meters (Puerto Rico only)

(Describe type of equipment in Comments) f) Lowest adjacent (finished) grade (LAG) ----.1U l8l feet 0 meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) ~ 181 feet 0 meters (Puerto Rico only)

SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. / certify that the information on this Certificate represents my best efforts to interpret the data availab/e. / understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.

I8ICheck here if comments are provided on back of form.

Certifier's Name License Number A. Lee Hayne LS 6338

Title Company Name Professional Surveyor & Mapper Banks Engineering

Address City State ZIP Code a.tL~10511 Six Mile Cypress Parkway Fort Myers Florida 33966

Date Telephone 3-16-2009 LB 6338 3-16-2009 (239) 939·S490

FEMA form 81-31, February 2006 See Reverse side for continuation Replaces all previous editions

IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 10481 Ben C. Pratt Six Mile Cypress Parkway

Policy Number

City Fort Myers

State Florida

ZIP Code 33966

Company NAtC Number

SECTION D • SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)

Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner.

Comments Job # 1368-3

Item C2.e) is an air conditioning pad

Signature /} ~ Date V' - t:O.-- 3-16-2009 0 Check here if attachments

SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)

For Zones AO and A (without BFE). complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.

E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawl space, or enclosure) is . _ 0 feet 0 meters 0 above or 0 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is . _ 0 feet 0 meters 0 above or 0 below the LAG.

E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9 (see page 8 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is . _ 0 feet 0 meters 0 above or 0 below the HAG.

E3. Attached garage (top of slab) is . _ 0 feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is . _ 0 feet 0 meters 0 above or 0 below the HAG.

E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? 0 Yes 0 No 0 Unknown. The local official must certify this information In Section G.

SECTION F· PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION

The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, S, and E are correct to the best of my knowledge.

Property Owner's or Owner's Authorized Representative's Name

Address , City State ZIP Code

Signature Date Telephone

Comments

o Check here if attachments

SECTION G - COMMUNITY INFORMATION (OPTIONAL)

The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8. and G9.

G1. 0 The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)

G2 0 A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO.

G3. 0 The following information (Items G4.-G9.) is provided for community floodplain management purposes.

G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued

G7. This permit has been issued for: 0 New Construction 0 Substantial Improvement

G8. Elevation of as-built lowest floor (including basement) of the building: _ o feet 0 meters (PR) Datum _

G9. BFE or (in Zone AO) depth of flooding at the building site: o feet 0 meters (PR) Datum _

Local Official's Name Title

Community Name Telephone

Signature Date

Comments

___________________________________________ 0 Check here if attachments

81-31, February 2006 FEMA Form Replaces all previous editions

t .' .. :

Building Photographs See Instructions for Item A6.

For Insurance Company Use:

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 10481 Ben C. Pratt Six Mile Cress Parkwa

Policy Number

City State ZIP Code Fort M ers Florida 33966

Company NAlC Number

If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, follOWing.

Front View

Back View

Building Photographs Continuation Page

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 10481 Ben C. Pratt Six Mile Cress Parkwa

City State ZIP Code Fort M ers Florida 33966

For Insurance Company Use:

Policy Number

Company NAIC Number

If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View."

Right Side View

Left Side View

OMS No. 1660-0008 II(EP';RTMENT 0' MOME"'"" .ECUM'" ELEVATION CERTIFICATE Exoires Februarv 28. 2009

~deral Emergency Management Agency National Flood Insurance Program Important: Read the instructions on pages 1-8.

SECTION A - PROPERTY INFORMATION For Insurance Company Use:

A1. Building 'Owner's Name: Six Mile Cypress Office Park Policy Number

A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 10491 Ben C. Pratt Six Mile Cypress Parkway

Company NAIC Number

City. Fort Myers State. FI ZIP Code 33966

A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Six Mile Office Park, Phase II, Official Records Book 2634, Page 3790

A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) -!.:!N:>!o!..!:n-:J..:R~e:2s~id!£e!..!.nt~ia!l.I _

AS. Latitude/Longitude: Lat. 26°35'36.8"N. Long. -81°48'42.6'W. Horizontal Datum: DNAD 1927 IZINAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number_1__ A8. For a bUilding with a crawl space or enclosure(s), provide: A9. For a building with an attached garage, provide:

a) Square footage of crawl space or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage

enclosure(s) walls within 1.0 foot above adjacent grade N/A walls within 1.0 foot above adjacent grade ....,N",,/A,,--_ c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in

SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION

B1. NFIP Community Name & Community Number I B2. County Name

TB3. State

Lee County 12071 C Lee Florida I

B4 Map/Panel Number I B5. Suffix I B6. FIRM Index B7. FIRM Panel Date Effective/Revised Date

12071 C-0433 F August 28, 2008 August 28, 2008

B8. Flood B9. Base Flood Elevation(s) (Zone I Zone(s) AE I

AO, use base flood depth) 19

B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. OFIS Profile IZIFIRM OCommunity Determined OOther (Describe) _

B11. Indicate elevation datum used for BFE in Item B9: ONGVD 1929 I8lNAVD 1988 DOther (Describe) --==--__=- _ B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? OYes ~No

Designation Date DCBRS DOPA

SECTION C • BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)

C1. Building elevations are based on: OConstruction Drawings· OBuilding Under Construction· I8lFinished Construction ·A new Elevation Certificate will be required when construction of the building is complete.

C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, ARlAE, ARlA1-A30, ARlAH, ARIAO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized: Site Benchmark Vertical Datum: ....,N!!:A!..J<V-,=D,-1.!..>9!,l,8~8~ _

Conversion/Comments Converted from NGVD 29' to NAVD 88' using U.S. Army Corps of Engineers Corpscon 6.0.1 conversion program Check the measurement used.

a) Top of bottom floor (including basement, crawl space, or enclosure floor) 20.0 I8l feet D meters (Puerto Rico only)

b) Top of the next higher floor ~ 0 feet D meters (Puerto Rico only)

c) Bottom of the lowest horizontal structural member 0! Zones only) ~ 0 feet D meters (Puerto Rico only)

d) Attached garage (top of slab) ~ 0 feet D meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 19.8 I8l feet 0 meters (Puerto Rico only)

(Describe type of equipment in Comments) f) Lowest adjacent (finished) grade (LAG) ~ I8l feet D meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) ----1.22 I8l feet D meters (Puerto Rico only)

SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the infonnation on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001.

I8lCheck here if comments are provided on back of form.

Certifier's Name License Number A. Lee Hayne LS 6338 Title Company Name Professional Surveyor & Mapper Banks Engineering

Address City Slate ZIP Code 10511 Six Mile Cypress Parkway Fort Myers Florida 33966

Signature a. ~ Date Telephone 3-16-2009 239 939-5490

FEMA form 81-31, February 2006 See Reverse side for continuation Replaces all previous editions

IMPORTANT: In these spaces, copy the corresponding information from Section A. BUilding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No 10491 Ben C. Pratt Six Mile Cypress Parkway .

For Insurance Company Use7 -

Policy Number

City Fort Myers

State Florida

ZIP Code 33966

Company NAIC Number

SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)

Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner.

Comments Job # 1368-2

Item C2.e) is an air conditioning pad

Signature /l,. ~ Date VI t::C.-- 3-16-2009 0 Check here if attachments

SECTION E - BUILDING LEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)

For Zones AO and A (without BFE), complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.

E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawl space, or enclosure) is . _ 0 feet 0 meters 0 above or 0 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is . _ 0 feet 0 meters 0 above or 0 below the LAG.

E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items a and/or 9 (see page a of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is . _ 0 feet 0 meters 0 above or 0 below the HAG.

E3. Attached garage (top of slab) is . _ 0 feet 0 meters 0 above or 0 below the HAG.

E4. Top of platform of machinery and/or equipment servicing the building is . _ [] feet 0 meters 0 above or 0 below the HAG.

E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management

ordinance? 0 Yes 0 No 0 Unknown. The local official must certify this information in Section G.

SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION

The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.

Property Owner's or Owner's Authorized Representative's Name

Address , City State ZIP Code

Signature Date Telephone

Comments

o Check here if attachments

SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items Ga. and G9.

G1. 0 The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)

G2. 0 A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO.

G3. 0 The following information (Items G4.-G9.) is provided for community floodplain management purposes.

G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued

G7. This permit has been issued for: 0 New Construction 0 Substantial Improvement

G8. Elevation of as-built lowest floor (including basement) of the building: 0 feet 0 meters (PR) Datum _

G9. BFE or (in Zone AO) depth of flooding at the building site: 0 feet 0 meters (PR) Datum _

Local Official's Name Title

Cemmunity Name Telephone

Signature Date

Comments

o Check here if attachments

81-31, February 2006 FEMA Form Replaces all previous editions

..;'. Building Photographs

See Instructions for Item A6.

Building Street Address (including Apt., Unit, SUite, and/or Bldg. No.) or P.O. Route and Box No. 10491 Ben C. Pratt Six Mile Cress Parkwa City State ZIP Code Fort M ers Florida 33966

For Insurance Company Use:

Policy Number

Company NAIC Number

If using the Elevation Certificate to obtain NFIP flood insurance. affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following.

Front View

Back View

.. .. ~ . -,

Building Photographs Continuation Page

For Insurance Company Use:

Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 10491 Ben C, Pratt Six Mile C press Parkwa

City State ZIP Code Company NAlC Number Fort M ers Florida 33966

If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View."

Right Side View

Left Side View

OMS No. 1660-0008U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTI FICATE Exoires Februarv 28. 2009Federal Emergency Management Agency

National Flood Insurance Program Important: Read the instructions on pages 1-8.

SECTION A • PROPERTY INFORMATION For Insurance Company Use:

A1. Building Owner's Name: Six Mile Cypress Office Park Policy Number

A2. Building Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. 10501 Ben C. Pratt Six Mile Cypress Parkway

Company NAIC Number

City. Fort Myers State. FI ZIP Code 33966

A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Six Mile Office Pari<, Phase I, Official Records Book 2634, Page 3788

A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) --,-"N""on,-,---,-,R""e""si""d.>:.en~t",iao:..l .......... _

A5. Latitude/Longitude: Lat. 26°3S'3S.6"N. Long. -81°48'43.2'W. Horizontal Datum: DNAD 1927 I8INAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number_1__ AB. For a building with a crawl space or enclosure(s), provide: A9. For a building with an attached garage, provide:

a) Square footage of crawl space or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage

enclosure(s) walls within 1.0 foot above adjacent grade N/A walls within 1.0 foot above adjacent grade ....,N""/A..:..-_ c) Total net area offlood openings in AB.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in

SECTION B· FLOOD INSURANCE RATE MAP (FIRM) INFORMATION

B1. NFIP Community Name & Community Number I B2. County Name I B3. State Lee County 12071 C Lee Florida

B4. Map/Panel Number BS. Suffix B6. FIRM Index B7. FIRM Panel BB. Flood B9. Base Flood Elevation(s) (Zone Date Effective/Revised Date Zone(s) AO, use base flood depth)

12071 C-0433 F August 2B, 2008 August 2B, 200B AE 19

B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. OFIS Profile I8IFIRM DCommunity Determined DOther (Describe) _

B11. Indicate elevation datum used for BFE in Item B9: DNGVD 1929 I8INAVD 1988 DOther (Describe) _

B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? [JYes IZINo Designation Date DCBRS DOPA

SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)

C1. Building elevations are based on: OConstruction Drawings* OBuilding Under Construction* ~Finished Construction *A new Elevation Certificate will be required when construction of the building is complete.

C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARiA, ARiAE, ARiA1-A30, ARiAH, ARiAO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized: Site Benchmark Vertical Datum: !.:!N!:lAcl!V.!<Dc..1L;i9!S18~B _

Conversion/Comments Converted from NGVD 29' to NAVD B8' using U.S. Army Corps of Engineers Corpscon 6.0.1 conversion program Check the measurement used.

a) Top of bottom floor (including basement, crawl space, or enclosure floor) 19.9 181 feet 0 meters (Puerto Rico only)

b) Top of the next higher floor ~ D feet 0 meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member 01 Zones only) ~ D feet 0 meters (Puerto Rico only)

d) Attached garage (top of slab) ~ D feet 0 meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the bUilding 19.6 181 feet 0 meters (Puerto Rico only)

(Describe type of equipment in Comments) f) Lowest adjacent (finished) grade (LAG) ~ IZI feet 0 meters (Puerto Rico only)

g) Highest adjacent (finished) grade (HAG) ~ 181 feet 0 meters (Puerto Rico only)

SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION

This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.

[8ICheck here if comments are provided on back of form.

License Number Certifier's Name A. Lee Hayne LS 633B

Title Company Name Professional Surveyor & Mapper Banks Engineering

Address City State ZIP Code a. 6L~-:r--Fort M ers Florida 33966

Date Telephone 10511 Six Mile C

3-16-2009 LB 6338Signature a. 3-16-2009 239 939-5490

FEMA form 81-31, February 2006 See Reverse side for continuation Replaces all previous editions

IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 10501 Ben C. Pratt Six Mile Cypress Parkway

For Insurance Company Use:

Policy Number

City Fort Myers

State ZIP Code Florida 33966

Company NAIC Number

SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)

Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.

Comments Job # 1368-1

Item C2.e) is an air conditioning pad

Signature /l. /) ~ Date VI • ~ 3-16-2009 0 Check here if attachments

SECTION E - BUILDING ~LEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)

For Zones AO and A (without BFE), complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.

E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawl space, or enclosure) is . _ 0 feet 0 meters 0 above or 0 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is . _ 0 feet 0 meters 0 above or 0 below the LAG.

E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 andlor 9 (see page 8 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is . _ 0 feet 0 meters 0 above or 0 below the HAG.

E3. Attached garage (top of slab) is . _ 0 feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery andlor equipment servicing the building is . _ 0 feet 0 meters 0 above or 0 below the HAG.

E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? 0 Yes 0 No 0 Unknown. The local official must certify this information in Section G.

SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION

The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, S, and E a~ correct to the best of my knowledge.

Property Owner's or Owner's Authorized Representative's Name

Address City State ZIP Code

Signature Date Telephone

Comments

o Check here if attachments

SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, S, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8. and G9.

G1, 0 The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date ofthe elevation data in the Comments area below.)

G2, 0 A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO.

G3, 0 The following information (Items G4.-G9.) is provided for community floodplain management purposes.

I G4. Permit Number I G5. Date Permit Issued I G6, Date Certificate Of CompliancelOccupancy Issued

G7. This permit has been issued for: 0 New Construction 0 Substantial Improvement

G8. Elevation of as-built lowest floor (including basement) of the building: 0 feet 0 meters (PR) Datum _

G9. BFE or (in Zone AO) depth of flooding at the building site: 0 feet 0 meters (PR) Datum _

Local Official's Name Title

Community Name Telephone

Signature Date

Comments

o Check here if attachments

81-31, February 2006 FEMA Form Replaces all previous editions

BUilding Photographs See Instructions for Item A6.

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 10501 Ben C. Pratt Six Mile Cress Parkwa City State ZIP Code Fort M ers Florida 33966

For Insurance Company Use:

Policy Number

Company NAIC Number

If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, foHowing.

Front View

Back View

Building Photographs Continuation Page

For Insurance Company Use:

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 10501 Ben C. Prall Six Mile Cress Parkwa

City State ZIP Code Company NAIC Number Fort M ers Florida 33966

If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View."

Right Side View

Left Side View