Not sure exactly what you are after, but I have this... I could customize it if you wish or you could hand write your information. If you wanted something else entirely, please give me a more detailed idea of what you would like and I might be able to help you.
This is not exact but I made some changes to a tag I already had. I am hoping that this is what you had in mind. If you would Like me to customize it or change the border colors that is an easy fix. I also wasn't sure if you wanted Hollywood or Florida. That could be changed as well.
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