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Home My WebLink About5071 144 West Yarmouth Rd Daycare License'`4}+ a t:�,Pk: THE COMMONWEALTH OF MASSACHUSETTS GovernorMaura T. Healey r DEPARTMENT OF EARLY EDUCATION AND CARE Regular License to Provide Family Child Care Services Program Number: P-2568571 8037473 License Number: 9119587 In accordance with the provisions of Chapter 15D of the General laws, and regulations established by the Department of Early Education and Care, a license is hereby granted to: Program Name: Address: Total Capacity: Floors/Rooms: Issue date: Expiration date: Schenkel Roos, Jessica 144 West Yarmouth rd, West Yarmouth, MA 02673 6 1ST FLOOR: KITHCHEN, LIVING ROOM, BASEMENT: BASEMENT 03/17/2023 03/16/2026 License printed on: 03/17/2023 Licensor: Nadia Pereira Please Post Conspicuously 1r a 0 Depa tma`�9d o Amy Kershaw, Acting Commissioner This License is Not Transferable DATE(MMOONYYY) A�� o CERTIFICATE OF LIABILITY INSURANCE 06/21/2023 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 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 endorsements . PRODUCER UUMAUr NAME: PHONE (g55) 222-5919 FAX A/C No : Next First Insurance Agency, Inc. PO Bax 60787 Palo Alto, CA 94306 E-MAILsupport@nextinsurance.com INSURERS AFFORDING COVERAGE NAIC R INSURER A: Next Insurance US Company 16285 INSURED INSURER B INSURERC: jessica roos enchanted dream child care INSURERD: 144 W Yarmouth Rd West Yarmouth, MA 02673 INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER- 635827632 RFVISION NIHMRFR- 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POUCY NUMBER POLICY EFF M tYYYYY POLICY EXP MMrDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EACH OCCURRENCE 5500,000.00 DAMAGE TO RENTED PREMISES a occurrencd 5100,000.00 MED EXP Any one person) $25,000.00 PERSONAL aADVINJURY $500,000.00 A X NXT37PRXQ7-00-GL 06/09/2023 06/09/2024 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $500,000.00 X POLICY E JERC LOC PRODUCTS - COMP/OP AGG $500,000.00 $ OTHER: AUTOMOBILE LIABILITY COMBI a aridNED SINGLE LIMIT .", $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPE DAMAGE er accilerd i 3 UMBRELLA LIAB OCCUR EACH OCCURRENCE S I AGGREGATE $ A EXCESS UAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y i N ANYPROPRIETORIPARTNERIEXECUTI VE OFFICERIMEMBER EXCLUDED? ❑ NIA STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE $ (Mandatory in NH) If yyees, descnbe under pESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ Each Occurrence: $500,000.00 A Professional Liability NXT37PRXQ7-00-GL 06/09/2023 06/09/2024 Aggregate: $500,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The Certificate Holder is Lucas Vielra. This Certificate Holder is an Additional Insured on the General Liability policy Per the Additional Insured Automatic Status Endorsement. All Certificate Holder privileges apply only If required by written agreement between the Certificate Holder and the insured, and are subject to policy terms and conditions. Lucas Vieira LIVE CERTIFICATE 144 W Yarmouth Rd i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE West Yarmouth, MA 02673 1r THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE Click or scan to view ACORD 25 (2016103) %) ACORD CORPORATION. All rights reservea. The ACORD name and logo are registered marks of ACORD OIRSDEPARTMENT OF ETREASURY INTERNAL REVENUESERVICE CINCINNATI ON 45999-0023 003517.509498.375766.8880 1 ME 0.531 532 �11��1�IIIIj:11�11111"Il'��'�I'1111�"��I1�1'I"I��III'I�111'�'I JESSICA LICIANE SCHENKEL ROOS ENCHANTED DREAM 144 W YARMOUTH RD WEST YARMOUTH MA 02673 517 Date of this notice: 04-07-2023 Employer Identification Number: 38-4259350 Form: SS-4 Number of this notice: CP 575 G For assistance you may call us at: I-800-829-4933 IF YOU WRITE, ATTACH THE STUB OF THIS NOTICE. WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER Thank you for applying for an Employer Identification Number (EIN). We assigned you EIN 38-4259350, This EIN will identify your entity, accounts, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent records. Taxpayers request an EIN for their business. Some taxpayers receive CP575 notices when another person has stolen their identity and are opening a business using their information. If you did not apply for this EIN, please visit, www.irs.gov/ einnotrequested. When filing tax documents, making payments, or replying to any related correspondence, it is very important that you use your EIN and complete name and address exactly as shown above. Any variation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than one EIN. If the information is not correct as shown above, please make the correction using the attached tear -off stub and return it to us. A limited liability company (LLC) may file Form 8832, Entity Classification Election, and elect to be classified as an association taxable as a corporation. If the LLC is eligible to be treated as a corporation that meets certain tests and it will be electing S corporation status, it must timely file Form 2553, Election by a Small Business Corporation. The LLC will be treated as a corporation as of the effective date of the S corporation election and does not need to file Form 8832, IMPORTANT REMINDERS: * Keep a copy of this notice in your permanent records. This notice is issued only one time and IRS will not be able to generate a duplicate copy for you. You may give B copy of this document to anyone asking for proof of your EIN. * Use this EIN and your name exactly as on all your federal tax forms. they appear at the top of this notice * Refer to this EIN an your tax -related correspondence and documents. * Provide future officers of your organization with a copy of this notice. Your name control ass information, ociated with this EIN is ROOS. You will need to provide this along with your EIN, if you file your returns electronically. Safeguard your EIN by referring to Publication 4557, Safeguarding Taxpayer Data: A Guide for Your Business. You can get any of the forms or websitn at wany of. publications mentioned in this letter b gov/forms-pubs or by calling 800-TAX-FORM (80p_ y Visiting our If you have questions about 829-3676), address listed at Your EIN, you can contact us at the the bottom of thisthe top of this notice. If you write phone number or write us, do not complete and include it with your letter Please tear off the stub at Complete, and return this stub. If You do not need to Thank you for your cooperation, on . nsc National Safety Council Name: Jessica Roos Address: Address: 144 West Yarmouth Rd City, State, Zip: West Yarmouth, MA 02673 OSHA 1910.151 NSC CPR Course Adult, Child, Infant, FBAO & AED Security Control No. 964924 Course Completion Date: 02/1512023 Training Center: Cape Cod Safety Training Expiration Date: 0211512025 Instructor Name: Rick Todd Instructor Number: 1040918 Jessica Roos has successfully completed the NSC CPR Course based on the current Guidelines for CPR and ECC. The National Safety Council is America's leading nonprofit safety advocate We focus on eliminating the leading causes of preventable injuries and deaths so people can live their fullest lives. We create a culture of safety to not only make people safer at work but also to make people safer beyond the workplace. For more life-saving courses from NSC please visit nsc.org/fatraining THIS DOCUMENT IS VOID IF REPRODUCED OSHA 1910.151 NSC First Aid Course Name: Jessica Roos Address: ,address: 144 West Yarmouth Rd City, State, Zip: West Yarmouth, MA 02673 Course Completion Date: 0211512023 Expiration Date: 0211512025 Jessica Roos Includes Pediatric and Epi Pen Security Control No. 213461 Training Center: Cape Cod Safety Training Instructor Name: Rick Todd Instructor Number: 1040918 has successfully completed the NSC First Aid Course. The National Safety Council eliminates preventable deaths at work, in homes and communities, and on the road through leadership, research, education and advocacy. For more life-saving courses from NSC please visit nsc.org/fatraining THIS DOCUMENT IS VOID IF REPRODUCED