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ENC2015-00203
F Print:Form4 ";"' CITY OF CAMPBELL DEPT.OF PUBLIC WORKS 70 NortFi First Street Campbell, CA 95008 Ph. (408) 866-2150 Fx. (408) 376-0958 ENCROACHMENT PERMIT (for working within the public right-of-way) Issued 5/31/2016 Permit Expiration Date 5/31 /2017 Permit No ENC2015-00203 X-Ref. File PLN2015-107 Application Date 9/22/2015 Application ExpiratiDat APN t�2 APPLICATION -Application is hereby made for a Public Works Permit in accordance with Campbell Municipal Code, Section 11.04. (Application expires in six (6) months if the permit is not issued. Application Fee is non-refundable.) A. Work Address or Tract No.: J3175 S. Winchester Boulevard (Barracuda Networks) Utility Trench Location: B. Nature of Work: Frontage Improvements (Paving, street trees, ADA compliant driveways) C. Attach four (4) copies of an engineered plan showing the location and extent of the work, and four (4) copies of the preliminary Engineer's Estimate of work. The plans shall show the relation of the proposed work to existing surface and underground improvements. When approved by the City Engineer, said plan becomes a part of this permit. D. All work shall conform to the City of Campbell Standard Specifications and Details for Public Works Construction; the General Permit Conditions listed on the reverse side; and the Special Provisions for this permit, listed below. Failure to abide by these conditions and provisions may result in job shutdown and/or forfeiture of Faithful Performance Sureties and cash deposits. (See General Permit Conditions 1 and 2.) E. The Contractor must have this permit and approved plans at the site and must notify the Public Works Department at least two days before starting work. Notice must be given to Public Works at least 24 hours before restarting any work. Name of Applicant: TODD TURLEY CONSTRUCTION Telephone: (408) 858-6816 Address: 251 CALLE MARGUERITA LOS GATOS CA 95032 E-Mail Address: Fo DD@TTCONSTRUCTION.BIZ 24-HOUR EMERGENCY PHONE NUMBER: (408) 858-6816 Is this work being done by the property owners at their own residence? F—I YES G NO The Applicant/Permittee hereby agrees by affixing their signature to this permit to hold the City of Campbell, its officers, agents, and employees free, safe and harmless from any claim or demand for damages resulting from the work covered by this permit. The Applicant/Permittee hereby acknowledges that they have read and understand both the front and back of this permit, and they will inform their contractor(s) of the informant' a,--Ap scant is advise ea-i ance of this permit, property owner, or property owner's successors, shall be responsible for any and Al al tl mages arising out of JFne condition of an rovements in the public right-of-way. Accepted: (Applicant 5/ (Contractor) (Print Name) 1,7 ? Date I SPECIAL PROVISIONS: 1. Street shall not be open cut for underground installations. Minimum cuts may be allowed for connections or exploration holes. Such cuts may be specifically approved by the Inspector prior to cutting. _2. Pavement may be cut for underground installations and must be restored in accordance with the Standard Details Trench Restoration Method "A", unless otherwise approved by the Engineer. 3. Work to be staked by a licensed Land Surveyor or Civil Engineer and two (2) copies of the cut sheets sent to the Public Works Department before starting work. ___X4. Per Section 4216 of the Government Code this permit is not valid for excavations until Underground Service Alert (USA) has been notified and the inquiry identification number has been entered hereon. USA Phone: 1-800-227-260b. USA TICKET NO. 5. Prior to any work, the property owner shall execute an Agreement for Private Improvements in the Public Right -of -Way, which shall be recorded. 6. Public Notification Requirements: 7 SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT FEES PERMIT APPLICATION FEE PLAN CHECK DEPOSIT SECURITY FOR FAITHFUL PERFORMANCE/LABOR & MATERIALS CONSTRUCTION CASH DEPOSIT PLAN CHECK & INSPECTION FEE EMERGENCY PERMIT FEE �> APPROVED FOR ISSUANCE AMOUNT s 395.00 s 500.00 — s 27.500.00 $ 1,100.00 s 3,850.00 RECEIPT NO. 260469 260469 261580 261580 261580 5/31 /2016 For ity Engineer Date Permit Expire Months After Date of Issuance City of Campbell Department of Public Works EI,'--OACHMENT PERMIT ISSUANCE CHE-`_; ,IST Encroach' j Permit No. ENC 20,15-00203' Tract No. N/A Address, S. Winchester Blvd: ITEMS REQUIRED FOR PERMIT APPLICATION: 1. ® Encroachment Permit Application complete, with applicant signature and date (front and back) 2. ® Permit Application Fee paid $395.00 - Receipt Number & Date260469 - 9/22/15 3. ® Plan Check Deposit Paid (2% of Engineer's Estimate, $500 min) $500.06Receipt Number 260469 4. ® Grading Plan Review Fee paid $1,655.00 - Receipt Number & Date: 260469 - 9/22/15 5. ® City Engineer's Estimate Completed and Submitted 6. ® Four (4) Sets of Street Improvement Plans 7. ® Four (4) Sets of Grading and Drainage Plans S. ® Check Lists (Grading and Drainage, Street Improvement) ITEMS REQUIRED PRIOR TO PUBLIC WORK CLEARANCE FOR BUILDING PERMITS 9. ® Plan Check & Inspection Fee: Engineer's Estimate (EE) = $27560:00;; if EE is <$250,000, then fee is 14% of EE. If EE > $250,000, fee is Actual Cost + 20%. $35,000 minimum deposit. Amount $3,850.00 Receipt No. & Date261580 12%8L1'S: 10. ® Security for Faithful Performance and Labor and Materials 100 /o each of Engineers Estimate, supplied or paid. Amount $27,500.00. Form Cash Receipt No. &Date 261580 12I8/15 11. ❑ Security for Monumentation Amount 0' Receipt No. & Date N%A 12. ® Construction Emergency Cash Deposit: 4% of Engineer's Estimate. ($500 minimum, $10,000 maximum) Amount $i1°�100.OQ Receipt No. & Date 261'S80 - 1-2/8/15: 13. ® Storm Drainage Area Fee Amount $954.00 Receipt No. & Date 261930 1/6/15 14.0 Street Improvement Agreement signed and notarized (proof of ownership submitted) 15. ® Sidewalk Easement for Winchester ADA Driveway upgrades. 16. ® All other Public Works requirements listed in the Conditions of Approval of the development. 17. ❑ N/A 18. ® Erosion Control Plan 19. ® C3 Certification 20. ®Covenant Agreement and/or Maintenance Agreement 21. ® Geotech Letter 22. ® Storm Water Management Plan ITEMS REQUIRED PRIOR TO ISSUANCE OF ENCROACHMENT PERMIT: 23. ❑ Contractor's signature added to the permit application (front and back) 24. ❑ Contractor's City of Campbell Business License # i =' 25. ❑ Worker's Compensation Insurance Information Sheet received from Contractor. 26. ❑ Certificate of Insurance with Additional Insured's Endorsement received from Applicant or Contractor. 27. ❑ One mylar set and six (6) or less sets of off -site plans signed by engineer, stamped APPROVED FOR CONSTRUCTION. ❑ Contractor, ❑ Inspector ❑ PW Superintendent (Service Center) ❑ EP File ❑ LD File ❑ Signals & Lighting Supervisor (Service Center) 28. ❑ Permit signed by City Engineer. 29. ❑' INITIATE CHECK REQUEST FOR PLAN CHECK DEPOSIT REFUND WHEN ALL OF THE ABOVE ITEMS ARE COMPLETE, PERMIT MAY BE ISSUED. Issuer: Initial and date and file with permit Documentl (Rev.07/11) Tt RE Ift CL ST TE; CHI CHI RE{ PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1, 2015 PUBLIC WORKS FILE NO. ENC2015-00203 PROPERTY ADDRESS 3175 S Winchester Blvd 471 & 485 Chapman) ��i followin monies: = AMOUNT I Major>_$10,000 $395.00 boo $225.00 f N/C o o Year Period $225.00 CITY OF CAMPBELL er Location $390.00 .CVD By- C=30 I SHEa osit Required) EARRAIPTJkS N/C i $500.00/tree WO eer's Estimate $500.00 min 21)4tR IDAY'S DATE: 01/06/10, I no deposit required :LISTER IfATE. 01106116 TIME: 00:00 S 'SCRIPTION Ai10tiNT $275.00 % ' 'ST IIf:ENC201$-00203 - !re $825.00 d $1,105.00 ORN IfRAIN FEES FN 2 $4'J4.!!0 $1,655.00 nit numeric sizing TOTAL DUE: $160.00 $954.00 lurneric sizing $954.00 5g. Ft to 1 Acre $690.00 WE:. $,00 Ir more $900.00 :CY $954.00 or review Consultant Cost +20% NUM. 47484 Ifacilities $300 ea Utility) 14% of Engineer's Estimate 1 <$500,000 $35 000 + 8% of Engineers Estimate $55,000 + 7% of Engineers Estimate 4% of En r. Est.* $500 min/$10,000 Max FPS Deposit 100% of ENGR. EST.* 100% of ENGR. EST.* i Acre R-1 $2,120.00 (Multi -Res $2,385.00) (All Other $2,650.00) _ $954.00 3,930.00 + $85/lot 4T1� �rtnu••-1,.J� 5 4,775.00 + 116/lot 2203 Monumentation Security 100% of Cit 's Monumentation Estimate 4920 Parkland Dedication Fee(Remaining 25% will be Due Upon Cert. of Occupancy) 4722 Lot Line Adjustment (Includes Certificate of Compliance) $1 856.00 4722 Vacation of Public Streets & Easements $2,480.00 4722 Certificate of Compliance $1,840.00 4722 Certificate of Correction $550.00 4722 Document Recording Fees $15.00/first page $3 ea. Additional 4722 Private Improvement in Public ROW $50.00 4722 Approved Plan Revision Fee $100/sheet 4722 Appeal Filing Fee $200.00 4722 Notary Fee(per signature) $10.00 4722 Assessment Segregation or Reapportionment First Split $877.00 Each Additional Lot $275.00 511.74241 Postage MISCELLANEOUS"�- __ �d _� _ _ ___.. ._.__... , _ _., __w• ___ _. ___ ,__ _ . _.. -.._ *Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $954.00 NAME OF APPLICANT BARRACUDA NETWORKS NAME OF PAYOR BARRACUDA NETWORKS PHONE ADDRESS 3175 S. WINCHESTER BLVD. CAMPBELL, CA ZIP 0 A 76 *8 JAN 0 6 2016'- FOR RECEIVED BY CITY CLERK .n p ONLY Date Recei t#l/ 11 P J.1aeffiWL n Check C—ts\1 - SWWc Pr jec s -HcUw Project In Prog-sMiechater Btvd S 3175 - BartacudatFeeriPoes..ds Lauri Avila � C/ '� From: Roger Storz <ro 6er@cityofcampbell.com> Sent: Tuesday, December 15, 2015 8:49 AM To: Lauri Avila Cc: Diane Honda; Cindy McCormick Subject: New Parking Lot Attachments: Storm Fee.pdf Good Morning Laurie, My apologies, but in my haste to get your permits approved, I missed collecting the Storm Drain Area fee for the two new parcels (formerly 471 & 485 Chapman Drive). This won't hold anything up, but if you could please process payment of this fee as soon as possible I would appreciate it. The invoice is attached for your use in paying the fee. You can either come in to our Finance section to pay the fee, or mail me a check made out to the City of Campbell and I can walk it down and e-mail you the receipt. Thank you, Roger K. Storz,.P.E. I Senior Civil Engineer City of Campbell I Public Works Department rogers@cityofcampbell.com 408.866.2190 70 N. First Street, Campbell, CA 95008 CAMPBELL ®A SUPER COMMUNI% 1 r�, PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1, 2015 TO: Finance PUBLIC WORKS FILE NO. ENC2015-00203 PROPERTY ADDRESS 3175 S Winchester Blvd Please collect & receipt for the following monies: ACCT. ITEM AMOUNT LAND 'DEVELOPMENT 7 4722 Encroachment Permit ApFlication Fee Non -Utility Encroachment Permit Major �:$l 0,000 $395.00 Minor Encroachment Permit <$10,000 $225.00 Initial R-1 Permit N/C Subsequent R-1 Permits within Two Year Period $225.00 Inspection Fee Minimum Charge per Location $390.00 Street Tree Planting/Removal N/C 2203 ($500 per Tree Planting Deposit Required) $500.00/tree 2203, Plan Check Deposit 2% of Engineer's Estimate $500.00 min Utility and R-1 Permits no deposit required 4722 Grading & Drainage Plan Review Single Family Lot $275.00 Site < 10,000 s.f. $825.00 Site �: 10,000 s.f. < 0.5 Acre $1,105.00 Site > 0.5 Acre $1,655.00 4722 NPIDES Review (C3 Requirements) For projects not required to submit numeric sizing $160.00 For projects required to submit numeric sizing Impervious Area 10,000 Sq. Ft to 1 Acre $690.00 Impervious Area I Acre or more $900.00 4722 For pr jects sent to Consultant for review Consultant Cost +20% 4722 Additional stormwater treatment facilities $300 ea $300.00 Plan Check & Inspection Fee (Non -Utility) 4722 Enqr. Est. < $250,000 14% of Engineer's Estimate $3,850.00 2203 Enqr. Est. �t$250,000 and :5$500,000 $35;000 + 8% of Enqineers Estimate 2203 Enqr. Est. >$500,000 $55,000 + 7% of Engineers Estimate 2203 Emergency Cash Deposit 4% of Enqr. Est.* ($500 min/$10,000 Max) $1,100.00 2203 Faithful Performance Security (FPS) Deposit 100% of ENGR. EST.* $27,500.00 2203 Labor and Materials Security 100% of ENGR. EST.* 4721 Storm Drainage Area Fee Per Acre R-1 $2,120.00 (Multi -Res $2,385.00) All Other $2,650.00) 4722 Parcel Map (4 Lots or Less) $':7"7H + $bbllot MO 4722 Final Tract Map (5 or More Lots) $4 5 + $1161lot 2203 Monumentation Security 100% of City's Monumentation Estimate 4920 Parkland Dedication Fee (Remaining 25% will be Due Upon Cert. of Occupancy) 4722 Lot Line Adjustment (includes Certificate of Compliance) $1,856.00 4722 Vacation of Public Streets & Easements $2,480.00 4722 Certificate of Compliance $1,840.00 4722 Certificate of Correction $550.00 4722 Document Recording Fees $15.00/first page $3 ea. Additional 4722 Private Improvement in Public ROW $50.00 4722 Approved Plan Revision Fee $1 00/sheet 4722 Appeal Filing Fee $200.00 4722 Notary Fee (per signature) $10.00 4722 Assessment Segregation or Reapportionment Split $877.00 -First Each Additional Lot $275.00 511.7424 Postage MISCELLANEOUS, *Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $32,750.00 NAME OF APPLICANT BARRACUDA NETWORKS NAME OF PAYOR BARRACUDA NETWORKS PHONE ADDRESS 3175 S. WINCHESTER BLVD. CAMPBELL, CA ZIP 95008 FOR RECEIVED BY CITY CLERK ONLY 2 4. Date 'Receipt J:\LandDWI.nCheck C\I - SP.Hic Projects- Act- Project In Plog\Willhlltll BId 5 3175 - BcudMFccT.,,I, ACOR -1 0 �. CERTIFICATE OF LIABILITY INSURANCE ATE (MM/DD/YYYY) r4/13/2016 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 endorsement(s). PRODUCER McGovern Insurance 1625 El Camino Real Belmont, CA 94002 CONTACT NAME: HEx : 650- -C No: 650-594-9130 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURERA: Ohio Security Insurance Company 24082 www.jemins.com INSURED Blacktop Paving Inc. P.O. Box 610084 INSURER B INSURER C INSURER D Redwood City CA 94061 INSURER E : INSURER F : rn%1PPAnGc rFRTIPWATF NIIMRFR• 70nrnn7) RFVI.glnN NIIMRFR 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 OF INSURANCE ADDTYPE INSD WvDSUBRI POLICY NUMBER MMIDDIYYrr CY EXP MMIDDIYYYY LIMITS COMMERCIALGENERALLIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAIE PREM SES� RENTED a occu .nos $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ �POLICY PRO JECT ❑ LOC PRODUCTS - COMP/OP AGG $ $ _IXTIWEEIIMR�� A ' CIMGBr E-ti ASIL ✓ BAO(16) 56 92 47 87 10/5/2015 10/5/2016 Ea BINEDtSINGLE LIMIT $ 1,000,000. BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ ✓ PROPERTY DAMAGE Per accident $ HIRED NON-OWNED' AUTOS ONLY ✓ AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Work performed @ Barracuda Parking Lot, 471-485 Chapman Drive, Los Gatos City of Campell, its officers, employees and volunteers sre named as Additional Insured: See Attached & Primary on Auto *30 day written Notice of Cancellation, except for non -pay of premium which is 10 days. VCR I Irm A I C riuLUCR %,A11I1L.CLLA I IUN City of Campell Public Works Dept 70 North First Street Campbell CA 95008 t SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE SteveSuissa�'I' @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 29450472 1 BLACK-1 1 15/16 - AU I MaryAnn Woman 1 4/13/2016 1:41:57 PM (PDT) I Page 1 of 9 ACOR" CERTIFICATE OF LIABILITY INSURANCE DAT5/26/2016 Y) 05126/2016 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 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 endorsement(s). PRODUCER Automatic Data Processing Insurance Agency, Inc. 1 Adp Boulevard NAME: PHONE FA Alc No Ext : A/C, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Roseland, NJ 07068 INSURER A : NorGUARD Insurance Company 31470 INSURED INSURER B : BLACKTOP PAVING INC Po Box 610084 INSURERC: Redwood City, CA 94061 INSURER D : INSURER E : INSURER F : rnVFRnrFC CFRTIFICATF NUMBER: 479103 REVISION NUMBER: 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 INSD WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MMIDDIYYYY LIMITS MMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR 4—lo PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO JECT LOC PRODUCTS -COMPIOPAGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NONE -OWNED HIRED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS_MADE AGGREGATE $ EXCESS LIAB DED RETENTION $ $ A fNMWO KERB OOMPEAiS,A-TION MP OYER�S' PIABILLITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F (Mandatory in NH) N/A Y BLWC669658 06/01/2015 06/01/2016 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) This certificate of insurance includes a Waiver of Subrogation in favor of the certificate holder. 471 Chapman Dr Campbell Ca CERTIFICATE HOLDER CANCELLATION City Of Campbell Attn: Joanna 70 N 1 st Street Steskt©n, CA 95208 C�&b SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1988-2014 All rinhfc racanrarl ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Important Information Blacktop Paving, Inc. PO Box 610084 Redwood City, CA 94061 A w/Berkshire Hathaway GUARDCompanies Insurance Agency AUTOMATIC DATA PROCESSING INSURANCE AGENCY, INC. 1 ADP Boulevard Roseland, NJ 07068 Changes to Your Workers' Compensation Policy with NorGUARD Insurance Company Policy Number BLWC669658 Policy Period From June 1, 2015 to June 1, 2016, 12:01 AM, standard time at the insured's mailing address. Party Requesting the Change and Type of Endorsement The Agent - Added Waiver of Subrogation effective 06/01/2015 Name: City of Campbell; Job Description: Grading & paving work The Agent - Changed Waiver of Subrogation Payroll effective 06/01/2015 State: CA; Code: 5201 CONCRETE WORK -NOT EQUAL/EXCEED $24; Payroll: $31,000 Premium change: $ 79.00 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective See Above Insured Blacktop Paving, Inc. Insurance Company NorGUARD Insurance Company Policy No. BLWC669658 Endorsement No. 4 Premium $79 Countersigned by Thank You Again for Choosing Berkshire Hathaway GUARD Insurance Companies! Call Customer Service at 800-673-2465 with any questions. Endorsement WC 99 00 13 WrORK.ERS COMPENSATION ANL,,_: .PLOYERS LIABILITY INSURANCE POLI',,WC 04 03 06 • (Ed.4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 1.05 _% of the California workers' compensation premium otherwise due on such remuneration. Person or Organization Robert A Botham Inc. AP -Build, Inc. City of Campbell Schedule Job Description paving work Natural paving. Grading & paving work This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Insured Policy No. BLWC669658 Insurance Company Countersigned By Endorsement No. ©1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. A CERTIFICATE OF LIABILITY INSURANCE 04/12/2o 6 PRODUCER (925) 674-1755 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Ferrante Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1401 Willow Pass Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 105 Concord CA 94520- INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Intnl Ins Cc of Hannover SE Blacktop Paving Inc. INSURER B: PO BOX 610084 INSURERC: INSURER D: Redwood City CA 94061- INSURER E: ^^11 :o A f1co 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR DD' RD TYPEINSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYV POLICY EXPIRATION DATE MM/DD/YYYY LIMITS A X, G,E�IGRAL1...) IS�T'�fi HAN 001729 16 03/01/2016 03/01/2017 EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY / / / / DAMAGE TRENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 CLAIMS MADE Fx_] OCCUR / / / / PERSONAL & ADV INJURY $ 1,000,000 / It/ / GENERAL AGGREGATE $ 2,000,000 GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ 2,000 000 / / / / X POLICY PRO LOC AUTOMOBILE LIABILITY ANY AUTO / / / / / / / / COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS / / / / / / / / BODILY INJURY (Per accident) $ HIREDAUTOS NON -OWNED AUTOS / / / / / / / / PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY / / / / AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO / / / / $ AUTO ONLY: AGG EXCESS I UMBRELLA LIABILITY / / / / EACH OCCURRENCE $ OCCUR F-ICLAIMS MADE / / / / AGGREGATE $ $ DEDUCTIBLE / / / / $ RETENTION $ / / / / WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE / / It / / I A IU OETH R E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) / / / / E.L. DISEASE - EA EMPLOYE $ If yes, describe under SPECIAL PROVISIONS below / / / / E.L. DISEASE -POLICY LIMIT 1 $ OTHER / / DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Campbell, its officers, employees & volunteers and Todd Turley Construction are named as additional insured with primary & non-contributory wording & waiver of subrogation applies per the attached endorsement forms CG 20 10 10 01, CG 20 12 07 98, HGL 1070 0912 & CG 24 04 10 93. RE: Barracuda Parking Lot, 471 Chapman Dr., Campbell, CA 95008 I.tFC I It -It A I t MULL)MM I.ANI.tLLA I IUN (408) 866-2150 (408) 376-0958 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Campbell & IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Todd Turley Construction REPRESENTATIVES. 252 Calle Marguerita Ste. C A 7RIZED REPRESENTATIVE L s Gatos CA 95032- ACORD 25 (2009/01) 919 �9A�QORPORATION. All rights reserved. 11J"'Lo tzuuy"'I The ACORD name and logo are registered marks of ACORD POLICY NUMBER: HAN 001729 16 COMMERCIAL GENERAL LIABILITY CG20101001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of Campbell, its officers, employees & volunteers and Todd Turley Construction 252 Calle Marguerita Ste. C Los Gatos CA 95032 RE: Barracuda Parking Lot, 471 Chapman Dr., Campbell, CA 95008 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II - Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily in- jury" or "property damage" occurring after: (1) All work, including_ materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 10 01 Copyright ISO Properties, Inc., 2000 Page 1 of 1 ❑ POLICY NUMBER EFFECTIVE DATE AND TIME INSURED HAN 001729 16 -03/01/2016 Blacktop Paving, Inc. DBA: Blacktop Paving, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTING INSURANCE (Third Party's Sole Negligence) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND PROTECTIVE LIABILITY COVERAGE FORM The following is added to the Owner Insurance conditions of SECTION IV - CONDITIONS:: Other Insurance: Third Party It is agreed that in the event of a claim or "suit" arising out of the Named Insured's sole negligence, this insurance shall be primary and any other insurance maintained by the additional insured named as the Third Party below shall be excess and non-contributory. The Third Party to whom this endorsement applies is: City of Campbell, its officers, employees & volunteers and Todd Turley Construction 252 Calle Marguerita Ste. C Los Gatos CA 95032 RE: Barracuda Parking Lot, 471 Chapman Dr., Campbell, CA 95008 Absense of a specifically named Third Party above means that the provisions of this endorsement apply "as required by written contractual agreement with any Third Party for whom you are performing work." All other terms, conditions and exclusions under this policy are applicable to this Endorsement and remain unchanged. HGL 1070 0912 Includes copyright material from Insurance Services Office, Inc. Page 1 of 1 POLICY NUMBER: HAN 001729 16 COMMERCIAL GENERAL LIABILITY CG 24 04 10 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of Campbell, its officers, employees & volunteers and Todd Turley Construction 252 Calle Marguerita Ste. C Los Gatos CA 95032 RE: Barracuda Parking Lot, 471 Chapman Dr., Campbell, CA 95008 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 0410 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 0 \6V INSURANCE REQUIREMENTS CHECKLIST Permit # CIP Project # Consultant/Contractor: The following insurance is required of all consultants/contractors working in the City of Campbell public right-of-way. Insurance certificates must be accepted by City staff before work can begin. These insurance requirements apply to work being performed under an Encroachment Permit and work being performed under contract for Capital Improvement Projects. Limits Commercial General Liability for bodily, personal injury and property damage: $1,000,000 per occurrence, and ❑ $1,000,000 general aggregate limit applying separately to the project, or $2,000,000 general aggregate limit. 1 )a' Policy expiration date L ITJ\e� QS\�,►`a Automotive Liability: ❑ "Any Auto" checked on certificate $1,000,000 per accident for bodily injury and property damage_ "'p� Policy expiration date Workers' Compensation and Employer's Liability Waiver of Subrogation clause $1,000,000 per accident for bo ily injury or disease O�, Policy expiration date Course of Construction (if required in Special Provisions) ❑ Completed value of the project ❑ Policy expiration date Required Endorsements to General Liability and Automobile Liability Policies - A ditional Insured Endorsement: e a� The City, its officers, employees and volunteers are named as additional insured. Reference Project Location/Permit Number) ,1t, f0,C,Jz•�. (J,< �,,�c� L& Ls -l� — 'h-6 S C,,.c-i�,> LxS C,o tos v The insurance coverage. afforded to the Additional Insured is primary insurance. f � _ ancellation area: ❑ Cancellation area of certificate edited to delete "endeavor to" and "but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives". OR should say: ❑ Should any of the above described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. pr Workers' Compensation Insurance Sheet Submitted For General Contractor o For Developer or Owner J:\FORMS\Ternplates\Insurance Requirements\Insurance Requirements Cklist.doc (Rev 02 14) Page 1 Acceptability of Insurer(s) ❑ Insurer(s) has current A.M. Best Rating of A:VII and is authorized to transact business in the State of California. 't b CJ Name: `N0� NAIC # Rating: Authorized in CA: Name: a _C `,5��j NAIC # ""'Rating: / Authorized in CA: Name: NAIC # Rating: Authorized in CA: /Name: NAIC # Rating: Authorized in CA: 2- � Expiration: Campbell Business License # p � Contractors License # -(. J .Z7 �1 Class: Expiration: Insurance Certificate Reviewed ( ` `� I(0- Initial Date ❑ Copy of Insurance Certificate placed in tickler file one month prior to expiration. J:\FORMS\Templates\Insurance ,Requirements\Insurance Requirements &ist.doc (Rev 08 14) Page 2 Apr 12 2016 17:10:29 Via Fax -> 4003760950 VGM90 Page 001 Of 003 FAX COVER SHEET To: From: Michael Glazer <afax4u@gmail.com> Company: Date: 04/12/16 05:08:58 PM Fax Number: 14083760958 Pages (Including cover): 3 Re: TODD TURLEY AUTO PROOF OF INS Notes: JOANNA, PLEASE SEE A'I°TACHED. CALL ME IF YOU HAVE ANY ISSUE WITH THIS, THE MICHAEL GLAZER 650.348.4700 V:a�'SFFI.i�•5.fi ,�•�". SLT$it;JF'9 JoAnna Thomason From: Jesse Takahashi Sent: Thursday, May 26, 2016 9:23 AM To: JoAnna Thomason Cc: Shannon Brangan Subject: RE: Auto insurance question JoAnna, I think their coverage should be adequate for the job. Thanks for your follow up. Jesse From: JoAnna Thomason Sent: Thursday, May 26, 2016 9:12 AM To: Jesse Takahashi Cc: Shannon Brangan Subject: RE: Auto insurance question Hi Jesse, just following up on the auto coverage question. They have $750,000 coverage, not 1 mil. None of their trucks will be used for the work. They are doing on -site concrete only. Thanks JoAnna JoAnna Thomason I Office Specialist Public Works Department Joannat@cityofcampbell.com Phone 408.868-2150 Fax 408.376-O958 70. N. First Street I Campbell, CA 95008 www.cityofcampbell.com From: JoAnna Thomason Sent: Tuesday, May 17, 2016 2:11 PM To: Jesse Takahashi Cc: Shannon Brangan Subject: RE: Auto insurance question The subcontractor is Blue Sierra Concrete and Landscaping. He is hired by the contractor doing work at the Barracuda parking lot. They will be replacing the sidewalk and driveway approach. He has never done any work for us in the past, however all of his insurance has high ratings. Per the contractor's email none of the trucks will be used, only on -site concrete will be done. Thanks JoAnna JoAnna Thomason I Office Specialist Public Works Department Joannat@cilyofcampbell.com 1 Phone 408.866-2150 Fax 408.376-0958 _. 70. N. First Street I Campbell, CA 95008 www.cityofcampbell.com From: Jesse Takahashi Sent: Monday, May 16, 2016 3:34 PM To: JoAnna Thomason Cc: Shannon Brangan Subject: RE: Auto insurance question JoAnna, Can you tell me a little more about what the permit is for and about the contractor? Is the contractor using vehicles as part of the job? Has he done work for us before? Having some background will help me understand what the risks are of this situation and what we can do. Thanks. Jesse From: JoAnna Thomason Sent: Monday, May 16, 2016 2:50 PM To: Jesse Takahashi Cc: Shannon Brangan Subject: Auto insurance question Hi Jesse, we have a contractor applying for a permit, but his auto insurance coverage is only for $750,000.00. All his other insurance is good and has high ratings. 1, I told him our limit is 1Million, but I would check with you regarding his lower amount of coverage. Please advise. Thanks JoAnna JoAnna Thomason I Office Specialist Public Works Department Joannat@ciiyofcampbell.com Phone 408.866-21.50 Fax 408.376-0958 70. N. First Street I Campbell, CA 95008 www.cityofcampbell.com OF c4M Ok CHA¢D CITY OF CAAgPBELL Public Works Department August 25, 2017 _ Ms. Diane Honda Barracuda Networks 3175 S. Winchester Blvd. Campbell, CA 95008 SUBJECT: PERMIT NO. ENC 2015-00203 3175 Winchester Blvd., Campbell, CA FINAL INSPECTION AND ACCEPTANCE To Whom It May Concern: The City. of Campbell has made the final inspection of the subject Public Works improvements and finds that no remedial work is required. Your warranty requirements and any surety, therefore, are hereby released. The remaining 25% of your Faithful Performance Security deposit in the amount of $6,875.00 is enclosed. F Sincerely, t Syed Wahidi Public works Inspector Enc.: Check # 263979 70 North First Street • Campbell, California 95008-1436 TEL 408.866.2150 - Fax 408.376.0958 • TDD 408.866.2790 .. -- �-I V."�" ..L , w j �',., -�. - -.� .�, ...�� �-�I''.�, -,� -1. .'- ,�,,� I.1, '� -- I , - , ., , �..�,,: ,-: � . I",� .�. � . r �1 . I, ,, F, . ,J .,��;� .�.I.,"-.:-���wI-�'",I.,,.-,z.,.1 "':,-�-I1-.,:�-�, '. I-11�..,I:. 1n-Y.,,",. . 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I ..-,1-.1"�-.1' .t,:-.:-�.�'I.-".,-'-.�,-.- ?, To Finance Director - ; , .', - ,,,-l..r , :-�Il-".. . , - Check Payable To Barracuda Networks , i �' { 4 - r1 v , - 3 ,. - , = - L _ Address-- Lme 1. 3175 S '-Winchester Blvd'_. , , - .', ,� _ 1 - r - T y Line 2 t - 4 s State CA' ZIP- '" -,, , r. City Campbell r _ F. !. - ; 1 . - - ', Description Barracuda - - - )i Account NlLriber , r 101 22D3r., Amount' r i--, , ,875 00 ,!, a' Account Number - 4101 540 7A48" - AmorJnf (Finance Dept only). rnterest. atned _ (E�riance Dept;only) . _ Total Payable r' Ex .r , . , w- ( act Amount}' Purpose . 25 "70 of FPS 1 } , . �, _ .:,. Y , G . } .) ' ' { Y ' Receip# # # ; 4i F Permit ENC 2015 00201.. r r, „� ' - _ 1 L Receipt # 261580 Date - 12/8/2015 •r_ I y . 1 Requestetl by � Title P/W Inspector Date $ -� i Syedt id: - ;,, ±t c-� Approved by - Title SrEngineer Date UJ �1l'� '111 Roadr'Storz s ;i ,. w _ t K- :� . . � , ; ,t ` .,1,-1�I,- ,--.�,.tI.,,-�I�,� ...,,,-,;. �,�., .,..6., I.-- � - .,-...�.-1,,, I., -.,-II . ..: .,-�. �,.,:. , i- 1.I1�.:,�- ,� ..--��� � � 1- �- ,.- ;.- -I�.,..- ,-.-.'I�1,.,:- -.".1��,--.,-.- I,.-,.%.� -.�---I L%1.-. �.�.:,1--. �I","-.�, %�., � .-IrI _-...,- V . 1':-:- , ,.,1, . .�_,-� _-,,- : "n.1-.1--ft1�,1, .-I.I : ., ;;..I --. ..- —I--I� . - ,. ;11.-�..� - ��� ."t.J ,""...,.. .'.- r,--... - I .I1�: 1l` -- ... l, —,.I . "..,,1."I, 1. 1I" .1'.;�I,,� -, :, I . ,� ,:- .-,, �� -,.'.)L- .- , .1, ; ."-, I.,,.!- -,,,�,17- .�,,.L I�L,!4., ,j. Finance Dept Qnly . , -. -� ,Verified by _ Title Accounting Clerk II _ 'Date- . Approved by Title Accountant Date Special In truct:ions For Handling Check t ' f :c. - k Mall AS is Mailyin Attached- py,oiope` Interim -Check: u Needed By 3 _ - y f t4.. - r. r .. .*. 1. . Return"To ;, J.oAnna"Thomason Public Works n " W h. (Name)' ` "> (Department) n' i' •r ,t ; , a , s l au Other `Please return check to Jo ,nna_ _ 7 ,a -' tr 't r '' j. I.. f/n:.Forms/exceUchkreq - Revised 05/00 ` / r - , - ° _ CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR ONE YEAR MAINTENANCE ACCEPTANCE LETTER Encroachment Permit # EENNC22^015-00203 Property Address 3175 S. Winchester Blvd. Date of Final Inspection: 8/4/17 On File: Bonds CD Cash f Faithful Performance 68 (ernai'ning �0l Labor and Material $ Construction Cash Deposit to be released: $ Other overdue deposits to be released (Description): Processed by: Reviewed by: Reviewed by: Administrator inspector Land\evelopm-L'At Engineer 0 J:UoAnnaTi Deposit refunds\Barracuda. doe (Rev. 10/11) Encroachment Permit Final Sign Off Encroachment Permit # Z'N c- 2 GI `� oc"203 Address: �17� S 1N13Uvlj Date of Final Inspection and Acceptance: N Inspected by: �� OK to release deposits: 100% `' 75% Cornments: ��� �� o(b 0 OF C 4'�1 URCHAR9 CITY OF CAMPBELL Public Works Department August 5, 2016 tAs • bkP4-�Ve 1kclll P Mr. Todd Turley Barracuda Networks 3175 S. Winchester Blvd. Campbell, CA 95008 SUBJECT: PERMIT NO. ENC 2015-00203 3175 S. Winchester Blvd. FINAL INSPECTION AND ACCEPTANCE Dear Todd: The City of Campbell has made a final inspection of subject Public Works improvements and finds the work to be acceptable and in conformance with City standards. Accordingly, the. City Engineer accepts the. improvements. The one-year maintenance period stated in the permit begins on August 5, 2016. The permittee is responsible for the repair and/or replacement of any defective work or failures that occur within one year. The City will inspect the improvements within one year and notify you, in writing, whether or not any repairs are required. 75% of your faithful security deposit in the amount of $20,625.00, your construction cash deposit in the amount of $1,100.00 and your plan check deposit in the amount of $500.00 are enclosed. We will continue to hold 25% of your FPS deposit as a maintenance surety. If you have any questions, please call me at (408) 866-2165. Sincerely, Syed Wahidi Public Works Inspector Cc: Inspector /Suspense Files IN'Ung ftdj�nc2015-00203 70 North First Street • Campbell, California 95008-1436 • TEL 408.866.2150 • Fax 408.376.0958 • TDD 408.866.2790 CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR ONE YEAR MAINTENANCE ACCEPTANCE LETTER Encroachment Permit: ENC2015-00203 Barracuda Networks Property Address: 3175 S. Winchester Blvd. Date of Final Inspection: 8/5/16 On File: Bonds CD Cash Faithful Performance 4-20=G2-!-004- 5% of 27,500.00) Labor and Material $ Construction Cash Deposit to be released:gq$,Ar1100muM6 Other overdue deposits to be released (Description): Pk n Cheek aer�v :t� 5`@R-0:0uphe Processed by: Administrator Reviewed by: \ Inspector Reviewed by: Land Development En r JAJoAnnaT\Deposit refunds\CHECKLISTS\Barracuda.doc (Rev. 10/11) of C4� r 9F GJh Ok CH AR9 CITY OF CAMPBELL Public Works Department August 5, 2016 Mr. Todd Turley Barracuda Networks 3175 S. Winchester Blvd. Campbell, CA 95008 SUBJECT: PERMIT NO. ENC 2015-00203 3175 S. Winchester Blvd. - FINAL INSPECTION AND ACCEPTANCE Dear Todd: The City of Campbell has made a final inspection of subject Public Works improvements and finds the work to be acceptable and in conformance with City standards. Accordingly, the City Engineer accepts the- improvements. The one year maintenance period stated in the permit begins on August 5, 2016. The permittee is responsible for the repair and/or replacement of any defective work or failures that occur within one year. The City will inspect the improvements within one year and notify you, in writing, whether or not any repairs are required. 75% of your faithful security deposit in the amount of $20,625.00, your construction cash deposit in the amount of $1,100.00 and your plan check deposit in the amount of $500.00 are enclosed. We will continue to hold 25% of your FPS deposit as a maintenance surety. If you have any questions, please call me at (408) 866-2165. Sincerely, Syed Wahidi Public Works Inspector Cc: Inspector /Suspense Files hirer fl8gdFpnc20l5-00203 70 North First Street . Campbell, California 95008-I436 • TEL 408.866.2150 • FAX 408.376.0958 • TDD 408.866.2790 10013960 BARRACUDA NETWORKS - - {-' _.----- - ------ ---- _ --.-'------ ._--- - --- -- ----------- - ------------ i - ---- - - - -- ----------------- - - ,CHECK CITY O CAMPBELL°°-,.. .. FARGO'BANK, N.A. 11 -24 CHECK -DATE NO 42A MONTGOMERY STREET 1210 4 70 NORTH,; FIRST STREET 08 258601 i , •" � � : , � -� t SAni FRANCISCO, CA 94104 C. r CAMPBELL: CALIFORNIA 95008 *.***22, 22;5 o. o .. AMOUNT 00*II 1 p kCHARV .. VOID. AFTER'90 DAYS oT asi > TWENTHUNDRED TWENTY PAY THE SUM OF TWO THOUSAND, TWO YO FIVE 03 LLARS & ZERO .CENTS. -DOLLARS' E TO THE BARRACUDA NETWORKS r" m I `'`/GF ORDER 317:5 S. WINCHESTER BLVD., 30," ►7 j CAMPBELL CA 9 5 0 0 8 n 2'S &EM r; L 2,4 O OD 2 L. g i; : 4 L 2lZ 5 5 4 ;�'S.n■ 5 :........... I .......... ................._........................................... ................................__._' _ _........._. .. *See Reverse Side For Easy Opening Instructions* �.. ---------- ---------- ----- ---- CITY OF CAMPBELL 70 NORTH FIRST STREET CAMPBELL, CALIFORNIA 95008 BARRACUDA NETWORKS 3175 S. WINCHESTER BLVD. CAMPBELL CA 95008 JoAnna Thomason From: JoAnna Thomason Sent: Wednesday, August 17, 2016 1:55 PM To: Syed Wahidi Cc: 'Todd Turley' Subject: RE: Trees Punch List Attachments: SKMBT_50116081713480.pdf Yes, the date of final acceptance is 8/5/16. The deposit return check request has been sent to finance, and the check should be ready sometime late next week or early the following week. I am attaching a copy of the letter. The original will be sent out with the deposit -return check. JoAnna JoAnne Thomason I Office Specialist Public Works Department Joannat@cityofcampbell.com Phone 408.866-2150 Fax 408.376-0958 70, N. First Street I Campbell, CA 95008 www.cityofcampbell.com From: Syed Wahidi Sent: Wednesday, August 17, 2016 12:39 PM To: 'Todd Turley'; JoAnna Thomason Cc: 'Jesus Toto'; Roger Storz; Bob Siudzinski Subject: RE: Trees Punch List I think we already signed off the project and started the process to release the deposit. JoAnna, can you please confirm? Also, please let us know what was the date on the final acceptance letter. Thanks. Syed Wahidi I Public Works Inspector City ofCampbell ( Public Works Dept. svedw(i)cityofcampbelLcom 408.806.2165 I r4 408.37Ei-09:58 70. N. First Street I Campbell, CA 95008 A_S�•_w.CitvofCa..n.1...h.bell.corn From: Todd Turley[ma iIto: todd@ttconstruction.biz] Sent: Wednesday, August 17, 2016 9:46 AM To: Syed Wahidi Cc: 'Jesus Toto'; Roger Storz; Bob Siudzinski Subject: RE: Trees Punch List Hi Syed I think we are all wrapped up at Barracuda, what do I need to do to final? Do we need to meet? Also want to confirm the city is taking over the watering of the new street trees Todd From: Syed Wahidi [mailto:SvedW@cityofcampbell.com] Sent: Tuesday, July 19, 2016 11:41 AM To:'todd turley' <todd@ttconstruction.biz> Cc: Jesus Toto <itoto@bluesierracorp.com>; Roger Storz <rogers@citvofcampbell.com>; Bob Siudzinski <BobS@cityofcampbell.com> Subject: RE: Trees Punch List Todd, City will take over watering 30 days after final trees acceptance. Please let us know when punch list is addressed. Thanks. Syed Wahidi I Public Works Inspector City of caonpbell I Public Works Dept. syedNYO.?cityofcampbell.com 0 408.806.2 t65 :44 408.376-0958 70. N. hirst Street ! Campbell, (.,A 95008 www.Cit�_�)fCam _bell.com From: todd turley[mailto:todd@ttconstruction.biz] Sent: Tuesday, July 19, 2016 7:52 AM To: Syed Wahidi Cc: Jesus Toto Subject: Re: Trees Punch List Yes Syed, the guys are working on fixes. We'll let you know when ready. Also when will city take over the watering of the trees? We only plane to do so for 30 days Sent from my iPhone On Jul 19, 2016, at 7:24 AM, Syed Wahidi <SvedW@cityofcampbell.com> wrote: Todd/Jesus, Please confirm if you have received this punch list and let us know when will you address them. Thanks. Syed Wahidi I Public Works Inspector City of Campbell ( Public Works Dept. svedw06tvofcampbelf.com 19 408.866.2165 1 3 408.376-0958 70. N. First Street I Campbell, C'A 95008 www.CityofCampbell.com From: Syed Wahidi Sent: Friday, July 15, 2016 8:16 AM To: 'Todd Turley'; 'Jesus Toto' Cc: Bob Siudzinski; Roger Storz Subject: Trees Punch List Hi Todd and Jesus, As per City Tree Dept, here are the items need to be addressed before we sign off. - Replace 2" dia post with 3" as per specifications for 24" box tree - Stakes are unstable. They need to be pounded into the ground deep enough to insure stability. - Cross brace is too low. Should be higher on the trunk, about 12-20 inches below the tree ties. - Cross brace is rubbing on the trunk. Position stakes or cross brace to prevent the trunk from rubbing on the cross brace. - Remove nursery stake and green tape ties - Cut off extra height of stakes to prevent damage to the canopy. Jesus, Did you loosen the roots before planting? Syed Wahidi I Public Works Inspector City of Campbell I Public Works Dept. sycdw(.citvofcam pbell.com `R 308.866.2165 1 Al 408.376-0958 70. N. First ;street I Campbell, (.:A 95008 wwwv.CitvofCainpbell.com 3 16, -V CD : \ \ y I�� � : � > >. \.. \ � � . , \� . : : $ ? \,�$ � � � � � � , � � \.� �� \ . \ � �/ � 2 f� \ \ \ { , . . . , ,�� .. � - � � ) ., z� \� \- [ A '1�3 HlS- 46 Iwo, r7- r- 4"t y. M, Z,- !M" w CD CD v CD 0, 190 _�HS .13 - S Nawl, I "wrip, pirfir. pjRnV Pull,. 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