Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
ENC2016-00115
PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1,2016 TO: Finance PUBLIC WORKS FILE NO. ENC2016-00115 PROPERTY ADDRESS 180 Redding Road Please collect&receipt for the following monies: ITEM F AMOUNT, vr LAND,,DEVEL,O,PMENT','-,,,,4,, 4722 Encroachment$er�"It App;cation Fee— Non-Utility Encroachment Permit Major�!$10,000 $403.00 Minor Encroachment Permit<$lo,000 $230.00 Initial R-1 Permit N/C Subsequent R-1 Permits within Two Year Period $230.00 Inspection Fee Minimum Charge per Location $398.00 Street Tree Planting/Removal . — N/C 22031 ($500 per Tree Planting Deposit Required) $500.00/tree 22031 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 $281.00 Site< 10,000 s.f. $841.00 Site 10,000 s.f.<0.5 Acre $1,127.00 Site 0.5 Acre $1,688.00 4722 NPDES Review(C3 Requirements) For projects not required to submit numeric sizing $163.00 For projects required to submit numeric sizing Impervious Area 10,000 Sq. Ft to 1 Acre $704.00 Impervious Area 1 Acre or more $918.00 4722 . For prooects sent to Consultant for.review Consultant Cost T-20% 4722 Additional treatment facilities $300 ea Plan Check&Inspection Fee(Non-Utilily) 4722 Engr.Est.<$250,000 . 14%of Engineer's Estimate $9,800.00 4722 Enqr. Est.�!$250,000 and :5$500,000 $35,000+.8%of Engineers Estimate 4722 'Enqr. Est. >$500,000 $55,000+7%of Engineers Estimate 2203 Emergency Cash Deposit 4% of Engr.Est.*($500 minl$10,000 Max) $2,800.00 2203 Faithful Performance Security(FPS) 100%of ENGR.EST.* $70,000.00 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) $859.00 All Other$2,650.00) 4722 Parcel Map(4 Lots or Less) $4009.00+$b Mot 4722 Final Tract Map(5 or More Lots) $4,871,00+$118/lot 2203 Monumentation Security 100%of City's Monumentation Estimate $6,000.00 4920 Parkland Dedication Fee(75%/25% Due Upon Cert.of Occupancy) $26,118.00- 4722 Lot Line Adjustment(includes Certificate of Compliance) 1,893.00 4722 Vacation of Public Streets&Easements. $2,530.00 4722 Certificate of Compliance $1,877.00 4722 Certificate of Correction $561.00 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 First Split $895.00 Each Additional Lot $281.00 511.7424 Postage 7� Other(Please Specify) *Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $115,577.00 NAME OF APPLICANT NAME OF PAYOR PHONE ADDRESS ZIP 4; . ............ FOR CITY CLERK. ONLY Date ece 0: JA—DMP-C hmk C I-Sp—plq� Aclry PrgectN FragresMRedd1mg Rd.18 GIF-1 Re d rgF—.W. PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT ��_p Effective July 1,2015 TO: Finance PUBLIC WORKS FILE NO. ENC2016-00115 PROPERTY ADDRESS 180 Redding Road Please collect&receipt for the following monies: -.,. ,,• ACCT: ITEM. AMOUNT' .LAND DEVELOPMENT ; 4722 Encroachment Permit App(cation Fee Non-Utility Encroachment Permit Major>_$10 000 $395.00 $395.00 ` Minor Encroachment Permit<sio,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 $1,400.00 Utility and R-1 Permits no deposit required 4722 Gradinq& 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 $1,105.00 Site>_0.5 Acre $1,655.00 4722 NPDES Review(C3 Requirements) For projects not required to submit numeric sizing $160.00 $160.00 For projects required to submit numeric sizing Impervious Area 10,000 Sq. Ft to 1 Acre $690.00 Impervious Area 1 Acre or more $900.00 4722 For projects sent to Consultant for review Consultant Cost+20% 4722 Additional stormwater treatment facilities $300 ea Plan Check& Inspection Fee Non-Utility) 4722 Engr. Est. <$250,000 14%of Engineer's Estimate 2203 Engr. Est.>_$250,000 and<_$500,000 $35,000+8%of Engineers Estimate 2203 Enqr. Est. >$500,000 $55,000+7%of Engineers Estimate 2203 Emergency Cash Deposit 4%of Engr. Est.*($500 min/$10,000 Max) 2203 Faithful Performance Security(FPS)Deposit 100%of ENGR. EST.` 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) $3,930.00+$85/lot 4722 Final Tract Map (5 or More Lots) $4,775.00+$116/lot $5,355.00 2203 Monumentation Security Deposit 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 $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 $275.00 511.7424 Postage 'MISCELLANEOUS_. - . --.-- - - - -- - -- 'Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $8,415.00 NAME OF APPLICANT NAME OF PAYOR PHONE ADDRESS ZIP FOR RECEIVED.BY l ` .Gl CITY CLERK ONLY ;Date Recei t`# 1- L J'.UWD,NI,n Check ConvnenM-Specific Projects-Active Project In PlogiesstR ding Rd.I801F—Fcoirl CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR ONE YEAR MAINTENANCE ACCEPTANCE LETTER Encroachment Permit # ENC2016-00115 Property Address 180 Redding Rd. Date of Final Inspection: 10/15/18 On File: Bonds CD Cash Faithful Performance $17,500.00 (Remaining 25%) Labor and Material $ Construction Cash Deposit to be released: $ Other overdue deposits to be released (Description): Processed by: Adm nlstrator Reviewed by: C/I'7 Inspe or Reviewed by: 9Y:5�� 1 Land Development Engineer JAJoAnnaT\Deposit refunds\Checklist-Clearance One Year Maintenance Acceptance.doc(Rev. 10/11) h 24045701 DEC 04 2010 Recording Requested By: ) Sa9 anClaara Counttya-Clerk-Recorder CITY CLEWS OFFICE, City of Campbell } 10/19/2018 08:25 AM And When Recorded Return To: ) Titles: 1 Pages: 2 Fees: 800 Taxes: Je- City Clerk ) Total: 8.00 ��.L.� City of Campbell 70 N.First Street ) Campbell,CA 95008 ) APN: 414-48-055 (Space Above This Line For Recorder's Use Only) ADDRESS: 180 Redding Rd.,Campbell,CA 95008 NOTICE OF RELEASE BY CITY OF CAMPBELL NOTICE IS HEREBY GIVEN concerning the real property located in the City of Campbell, Santa Clara County, California, and described specifically as follows: 180 Redding Road,Campbell,CA. That whereas, Access Development Group, Inc., a California Corporation, entered into a Street Improvement Agreement with the City of Campbell, recorded July 22, 2016, Document #23376908 in the Office of the County Recorder, County of Santa Clara, State of California. That,whereas, said conditions of said Agreement have been met to the satisfaction of the City. That,Now Therefore Access Development Group, Inc. is hereby released from all requirements contained in the agreement recorded July 22,2016,Document#23376908, in said County Recorder's Office. IN WITNESS WHEREOF, said City has caused its name to be affixed by its City Engineer and City Cleric, who are duly authorized by Ordinance 2059 adopted September 20, 2005. CI F C PBELL ATTEST: Amy ay City ngineer, Cit of Campbell t"W " endy ood, City Clerk 10 ¢ (Attach Notary Acknowledgment) Datea: °� CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 A notary public or other officer completing this certificate verities only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of On lreet-S, au1 before me, jav� C ���� 1 V b f IC, Date Here Insert Name and 71tie of the C')Ai er personally appeared a.\ Name(s)ofSigner(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s)is/are subscribed to the within instrument?nd.'acknowledged to me that he/she/they executed.the same in his/her/their authorized capacity(ies), and that by his/her/their signatures}on.the instrument the person(s), or the entity upon behalf of which tlheperson(s) acted,executed the instrument. I certify under PENALTY OF PERJURY under the JOANN THgMASON� laws of the State of California that the foregoing Commission#2110789 Lr -paragraph is true and correct z "� Notary Public-California z Santa Clara County n WITNESS my hand and official seal. My Comm-Expires May 9,2019 Signature 22�� Place Notary Seal ondlor Stamp Above Sig afore of Notary Public OPTIONAL Completing this information cah deter alteration of the document or fraudulent reattdchment of this form to an unintended document. Description of Attached Document Tifle or Type of Document: al` - Z ao A \n e, DocumentDate: 1 OT% ja NumberofPages: Signers)Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Corporate Officer—Title(s): o Corporate Officer—Title(s): ❑ Partner— ❑ Limited ❑ General ❑ Partner— ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact Cl individual 0 Attorney in Fact ❑ Trustee Ei Guardian of Conservator ❑ Trustee n Guardian of Conservator ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: 02017 National Notary Association r � �•1Y 1` - ` 9F a` Uk CHA0 . CITY of CAMPBELL Public Works Department' October 30, 2018 Mike Paydar Access Development 12385 Parker Ranch Rd. Saratoga, CA 95070 SUBJECT: PERMIT NO. ENC 2016-00115 180 Redding Rd.., Campbell, CA FINAL INSPECTION AND ACCEPTANCE Dear Mike: The City of Campbell has made the final one year maintenance 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. A check for the remaining 25% of your Faithful Performance Security Deposit in the amount of $17,500.00 is enclosed. Sincerely, Syed Wahidi Public works Inspector 70 North First Street Campbell, California 95008-1436 TEL 408.866.2150 FAX 408.376.0958 TDD 408.866.2790 {{ )i j ......_........__._....__...... ..........._............_......._.... ......_....._.,_..........._._.. ................._..........__.... i.......................................I '.................. .............. L........_._.........._..........f ................. .. ' _.__.-........ .............__._._-._ __-____ - __- ----------- _ --------------------------___ - ---- _ ----------------------..__.- .- _ __ _.--_ ----__._..___ CITY OF CAMPBELL ' VENDOR NO. 10014028 CHECK NO. 270338 ! I I Pi re a :Order Invoiee Number;; Amount Descri tcon 1'O1 2203 ; CR102218 17,500.00 ENC2016-00115 I - - I t, I � 10014028. ACCESS DEVELOPMENT GRP 7"�� CHECK DA CHECK NO / ! Q [✓IT F. �:F CPBELL WELCH$ FARGO'HANK,-N..A. • �E�,: t�1V1 �y 11-24 70 NOR3H,_FIRST STREETS MONTGOMERY STREET 1210 10/29/1H ' 270338 9All FRANCISCO CA 94104 L CA'MPBELL."CALIFORNIA 95008 I 0 0 7, 500 00* oI * v AMOUNT *** 1 I lr• �•' o oRclinR� VOID AFTER 90 DAYS I �l f M.PAY THE OF SEVENTEEN .,T-HOUSAND, FIVE HUNDRED DOLLARS -& ZERO m ti::,. 1 � I TO, THE ,ACCESS DEVELOPMENT GRP \ ! ORDER 2385 :PARKER RANCH RD;' SARATOGA CA 9 5 0 7 • 2 0 0 0 2 8 2'Lx8" o. .. �1 ! r................................_.: ........_.:..:...:....._..... ........................._................ .. ......._i..._..._.............. ... .............. _..__......_.._....... .� \\ - ............ € - ..I / ...........:.• :::_i i._.................................` - i 1.:............._._.... ...... ' ._.; :.....:..._ j � I *See Reverse Side For Easy-20pening Instructions* � CITY OF CAMPBELL 70- NORTH FIRST STREET - 1 CAMPBELL, CALIFORNIA 95008 .1 ! i I _ i I _ _ I I I ACCESS DEVELOPMENT GRP - 1�2385 PARKER RANCH RD _ SARATOGA CA 95070 - I � I I I I 1 CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR NOTICE OF RELEASE OF RECORDED STREET IMPROVEMENT AGREEMENT Encroachment Permit # ENCj`(� Property Address: 11 Date Street Improvement Agreement recorded 7 zz 1Co Date of Final Acceptance Letter: Date of One-Year Maintenance Acceptance Letter: C�) t-7 All deposits refunded (Date of last refund) `C4 rf Inspector's Encroachment Permit file merged with Main Permit File Date Permit archived in Permit Plan Processed by: K) Reviewed By: 7 l Inspector Reviewed by: Land Development Engineer 1 Date Check Request Submitted to Finance for Recording Fee / Date Notice of Release sent for recording: Z� \-� J:VoAnnaT\Deposit refunds\CHECKLISTS\I SIA Release.doc(Rev. 10/11) O BE RECORDED WITHOUT FEE ` SECTION 6103 GOVERNMENT CODE AT THE REQUEST OF CITY OF CAMPBELL DOCUMENT: 23376908 Pages: 11 Recording Requested by: ) 1 Fees. . . . - No Fees City of Campbell ) Copes. . . When recorded mail to: ) AMT PAID RECINA ALCOMENDRAS RDE ## 007 City Clerk ) SANTA CLARA COUNTY RECORDER 7/22/2016 City of Campbell ) Recorded-at the request of 8:37 AM 70 North First Street ) City Campbell, CA 95008 ) 4ECCECIVEr. AM 414-48-055 (Space above this line for Recorder's use only.) ADDRESS: 180 Redding Road,Campbell,CA 95008 SEP g 2016 STREET IMPROVEMENT AGREEMENT CITY CLERK'S OFFICE RECITALS THIS AGREEMENT, identified by File No(s). ENC2016-00115, is entered. into this s 5} 1 day of >t�\�4 c 2016, by and between ACCESS DEVELOPMENT ROUP, INC., A CALIFORNIA .CORPORATION, hereunder referred to as "Owner," and the CITY OF CAMPBELL, a municipal corporation of the County of Santa Clara, State of California,hereinafter referred to as "City." On June 7, 2016 the City Council granted. conditional approval of a Tentative Subdivision Map (PLN2015-306) and PIanned Development Permit (PLN2415-305) to allow construction of five new single family townhomes on that certain real property described in Exhibit A attached hereto and incorporated as though fully set forth herein, and commonly known as 180-Redding Road, which property is hereinafter referred to as "said real property." TERMS AND CONDITIONS Now, therefore, in consideration of the above referenced approvals, and in satisfaction thereof, the parties to this Agreement shall comply with the following terms and conditions: (1) The Owner shall provide, construct and install at his/her own proper cost and expense, street improvements as described in Section 11.24.040 of the City Code within 12 months from the date first mentioned hereinabove; provided, however, that in the computation of said 12 month period, delays due to, or caused by acts of God, viz., unusually inclement weather, major strikes, and other delays beyond the control of the Owner or his/her successors shall be excluded. (2) If the Owner fails to complete the work required by this Agreement within' the said 12 month period, the City, after giving ten (10) days written notice to the Owner, or his/her successors, may construct and/or install said improvements and recover the full cost and expense from the Owner, or his/her successors. J:llandDevlFornul2.AGREEMENTS-PIA S1A DEF SIA Maintenance Reimbursement DeveiopmentlSpecific Agreements-Street Improv and DeferredlWord Document of Agreements'Redding 180 SI.doc(Rev 0911 S) 1. STREET IMPROVEMENT PLANS (3) The Owner, shall cause to be prepared at his/her cost and expense street improvement plans for the construction and installation of said improvements prior to such construction or installation. Said plans shall be prepared by a civil engineer registered.by the State of California and submitted to the City Engineer for examination and approval. (4) ' All of said improvements embraced in this Agreement shall be constructed and installed in accordance with the plans approved by the City Engineer and shall be made under the inspection and to the satisfaction of the City Engineer. Said. construction and/or installation shall be in accordance with the existing ordinances and resolutions of the City of Campbell and all applicable plans, specifications, standards, sizes, lines and grades approved by the City Engineer, and all State and County statutes. Upon completion and acceptance of the improvements by the City, the Owner, shall provide reproducible as- built plans to the City Engineer. PLAN CHECK AND INSPECTION FEE (5) Prior to approval of the plans by.the City Engineer pursuant to Section (3) of this Agreement, Owner, or his/her successors, shall pay the City for plan checking of improvement plans, field inspection of construction of improvements and all necessary expenses incurred by City .in connection with said improvements, a sum calculated in accordance with Resolution No. 10494 as adopted by the City Council on May 3, 2005,or as may subsequently be adopted by the City Council. FAITHFUL PERFORMANCE SECURITY (6) The Owner, or his/her successors, shall file with City, prior to beginning construction, security acceptable to the City in amount equal to the City Engineer's estimated cost of the street improvements to ensure full and faithful performance of the construction of all the aforementioned improvement work. Said security shall guarantee that Owner, and his/her successors, will correct any defects which may appear in said improvement work within one (1) year from the date of acceptance of the work by City and pay for any damage to other work resulting from the construction thereof, as we'll as pay the cost of all labor and materials involved. This security shall remain in effect until one (1) year after date of final acceptance of said improvements by City. Said security amount may be reduced by the City Engineer in his/her sole discretion after the date of final acceptance to not less than twenty-five (25)percent of its full value. (7) Upon final release of said security by City, the obligations of Owner, and his/her successors, contained in this Agreement shall be considered null and void, except as otherwise provided by applicable law, or Sections 12 or 13 of this Agreement. FORMATION OF A SPECIAL ASSESSMENT (8) The Owner,when called upon by City to do so, shall execute a petition for the formation J:\LandDev\Forms\2.AGREEMENTS-PIA SIA DEF SIA Maintenance Reimbursement Development\Specific Agreements-Street Improv and Deferred\Word Document of Agreements\Redding 180 SI.doc(Rev 09/15) 2 of any special assessment district created pursuant to any special assessment act as provided in the Streets and Highways Code of the State of California created for the purpose of constructing and/or installing any or all of said improvements. Owner, or his/her successors, shall participate in and become a part of any special assessment district as described in Section (8)of this Agreement. (9) The Owner's, or his/her successors' obligations contained in this Agreement that are accomplished to the satisfaction of said City Engineer by said special assessment district shall be considered to satisfy those obligations. RIGHT-OF-WAY ACQUISITION (10) Owner at his/her own cost and expense, shall acquire any-easement and right-of-way Within or without said real property necessary for the completion of the improvements shown upon aforesaid improvement plans. It is provided, however, that in the event- eminent domain proceedings are required-for the purpose of securing said easement and right-of=way, Owner, shall deposit or cause to be deposited with City a sum covering the reasonable market value-of the land proposed to be taken and.to be included in said sum shall be a reasonable allowance for severance damages, if any. It is further provided that in addition thereto such sums as may be required for legal fees and costs, engineering and other incidental costs shall be deposited with the City. (11) The Owner, shall carry out any and all negotiations with all interested parties and shall perform or cause to be performed at his/her own cost and expense and to the satisfaction of the City Engineer any and all work required to abandon,remove, raise, lower, relocate and otherwise modify irrigation Iines within or without the boundary of said real property. INDEMNITY AND INSURANCE (12) The Owner, and his/her successors, to the fullest extent permitted by law, shall indemnify, defend and hold the City of Campbell, its agents, employees, attorneys, officers, officials and assignees harmless from any and all claims, _actions, causes of action, liabilities, damages, losses and expenses, including, but not limited to, attorneys' fees, arising out of, or resulting from, or alleged to arise out of or result from any negligent or intentional act or omission (including misconduct) of said Owner, or his/her successors, or any subcontractor, or anyone directly or indirectly employed by him, or anyone for whose acts any of them may be liable in the course of performance of the Agreement, .except for any claims, actions, causes of action, liabilities, damages, losses and expenses proximately caused by the sole negligence or willful misconduct of the City. (13) The Owner, and his/her successors, shall also indemnify, defend and hold the City of Campbell, its agents, attorneys, employees, officers, officials, and assignees harmless against and from any and all claims, actions, causes of action, liabilities, demands, losses, lawsuits, judgments, damages, costs and expenses (including, but not limited to, attorneys' fees and court costs, whether incurred at trial, appellate or administrative J':1LandDev\Formsl2.AGREEMENTS-PIA-SIA DEF SIA Maintenance Reimbursement Development\Specific Agreements-Street Improv and Deferred\Word Document of Agreements\Redding 180 Sl.doc(Rev 09/15) 3 F r' levels) which the City of Campbell may incur or suffer, or to which the City of Campbell may be subjected resulting from, or alleged to result from the failure of Owner, or his/her heirs, assignees, successors, grantees, agents, employees, subcontractors, or anyone performing services under him, to fulfill any of the obligations unposed under this Agreement, except for any claims, actions, causes of action, liabilities, judgments, damages; costs and expenses proximately caused by the sole negligence or willful misconduct of the City. (14) The Owner and his/her successors shall also indemnify, defend and hold harmless the City, its agents, officers and employees from any claim, action, or proceeding against.the City or its agents, officers or employees to attach, set aside, void or annul an approval of the City, its City Council, Planning Commission, Community Development Director, Public Works Director, Building Official, City Engineer, or other such City official concerning a subdivision, which action is brought within the time period provided for in California Government Code Section 66499.37. (15) In the event that this contract is subject to California Civil Code section 2782(b), the foregoing indemnity provisions shall not apply to any liability for the active negligence of the City. The foregoing indemnity provisions are intended to fully allocate all risk of liability to third-parties. No other rights of indemnity or contribution shall exist between the parties in law or in equity. The provisions set forth in this section shall survive the termination of this Agreement. (16) The City will promptly notify the Owner of any claim, action or proceeding to attack, set aside, void or annul any approval concerning a.subdivision of said real property, and will cooperate fully in the defense. (17) Owner and his/her/its successors shall maintain insurance for injuries to persons or damage to property conforming to the following specifications: A. Minimum Scope of Insurance Coverage shall be at least as broad as: i. Insurance Services Office(ISO) CGL form CG 00 01 11 85; and 2. ISO form G0009 11 88 Owners and Contractors Protective Liability Coverage Form—Coverage for Operations of Designated Contractor;and 3. Course of Construction Insurance covering all risks of loss;and 4. ISO CA 00 0106 92 including symbol 1 (Any Auto);and 5. Workers' Compensation insurance as required by the Labor Code of the State of California and Employer's Liability insurance. .I:.1LandDev\Formsl2.AGREEMENTS-PIA SIA DEF SIA Maintenance Reimbursement DevelopmentlSpecific Agreements-Street Improv and DeferredlWord Document of AgreementslRedding 180 SI.doc(Rev 09/15) 4 f}< B. Minimum Limits of Insurance Owner shall maintain Iimits no less than: 1. General Liability: $1,000,000 combined single limit per occurrence for bodily, personal injury and property damage. If Commercial General Liability Insurance or other form with a general aggregate limit is used, either .the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. 2. Automobile Liability: $1,000,000 combined single limit per accident for bodily injury and property damage. 3. Workers' Compensation and Employer's Liability: Workers' Compensation limits 'as required by the Labor Code of the State of California and Employer's Liability limits of$1,000,000 per accident. It is a requirement of this Agreement that any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or.limit s set- forth in this Agreement shall be available to the City as an additional insured. Furthermore,the requirements for coverage and limits shall be (1)the minimum coverage limits specified in this Agreement, or (2) the broader coverage and maximum limits of coverage of any insurance policy or proceeds available to the named insured, whichever affords greater coverage. The limits of insurance required in this Agreement may be satisfied by a combination of primary and umbrella or excess insurance. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary and non-contributory basis for the benefit of City(as agreed to in this Agreement) before the City's own insurance or self-insurance shall be called upon to protect it as a named insured. C. Deductible and Self-Insured Retention Any deductibles or self-insured retention must be declared to and approved by the City. At the option of the City, either.: the insurer shall reduce or eliminate such deductibles or self-insured retention as respects the City, its agents, officers, attorneys, employees, officials and volunteers; or the Owner shall procure a bond guaranteeing payment of losses related to investigations, claim administration, and defense expenses. D. Other Insurance Provisions The policies are to contain, or be endorsed to contain,the following provisions: 1. General Liability and Automobile Liability Coverage: a. The City, its agents, officers, attorneys, employees, officials and volunteers are to be covered as insureds as respects: liability 1:\LandDev\Forms\2.AGREEMENTS-PIA SIA DEF SIA Maintenance Reimbursement Development\Specific Agreements-Street Improv and Deferred\Word Document of Agreements\Redding 180 SI.doc(Rev 09/I5) 5 i arising out of activities related to this Agreement performed by or on behalf of the Owner, products and completed operations of the Owner,. premises owned, occupied or used by the Owner, or automobiles owned, leased,hired or borrowed by the Owner. b. The Owner's insurance coverage shall be primary insurance as respects the City, its agents, officers, attorneys, employees, officials and volunteers. Any insurance or self-insurance maintained by the City, its agents, officers, attorneys, employees, officials and volunteers shall be excess of the Owner's insurance and shall not contribute with it. G. Any failure to comply with reporting provisions of the policies shall not affect coverage provided to the City, its agents, officers, attorneys, employees, officials, and volunteers. d. The Owner's insurance shall apply separately to each insured against whom claim is.made or suit is brought except with respect to the limits of the insurer's liability. e. Coverage shall not extend to any indemnity coverage for the active negligence of the City in any case where an agreement to indemnify the City would be invalid under Subdivision (b) of Section 2782 of the California Civil Code. 2. Workers' Compensation and Employer's Liability Coverage: The insurer shall agree to waive all rights of subrogation against the City, its agents, officers, attorneys, employees, officials., and volunteers for losses arising from work performed by the Owner for the City. 3. Course of Construction Coverage: Course of Construction policies shall contain the following provisions: (a) the City shall be named as loss payee; and (b) the.insurer shall waive all rights of subrogation against the City. 4. All Coverages: Each insurance policy required by this clause shall be endorsed to state that coverage shall not be suspended, voided,-canceled by either party, reduced in coverage or in limits except after thirty (30) days prior written notice by certified mail_, return receipt requested, has been given to the City. E. Acceptability of Insurers Without limiting Owner's indemnification provided hereunder, Owner shall take out and maintain at all times during the life of this contract, up to the date of acceptance of the work by the City, the policies of insurance Iisted in Paragraphs 12 through 16 of this Agreement. insurance is to be issued by an issuer with a current A.M. Best Rating of ANII and be authorized to transact business in the State of California, unless otherwise approved by the City. J:\LandDev\Forms\2.AGREEMENTS-PIA SIA DBF S1A Maintenance Reimbursement Development\Specific Agreements-Street Improv and Deferred\Word Document of Agreements\Redding 180 Sl.doc(Rev 09/15) 6 F. Verification of Coverage Owner shall furnish the City with certificates of insurance evidencing coverage required by this clause. The certificates for each insurance policy are to be signed by a person authorized by that insurer to bind coverage .on its behalf. The certificates are to be on forms provided by the City. Where by statue, the City Workers' Compensation related forms cannot be used, equivalent forms approved by the Insurance Commissioner are to be substituted. All certificates are to be received and approved by the City before work commences. G. Subcontractors Owner shall include all subcontractors as insured under its policies or shall furnish separate certificates by each subcontractor. All coverage shall be subject to all of the requirements stated herein. MUTUAL BENEFIT COVENANTS BINDING ON HEIRS ASSIGNEES SUCCESSORS AND GRANTEES OF OWNER (18) It is acknowledged that the provisions of this Agreement constitute covenants for the improvement of the subject real property for the mutual benefit of Owner's property, commonly known as 1.80 Redding Road, and the City's property, commonly described as Redding Road where it adjoins Owner's property. These covenants shall be considered to affect rights in the above-described real properties, and shall be binding on the heirs, assignees, successors, grantees and agents of the Owner to said real property. UNVESTED INTERESTS (19) Nothing contained herein shall be construed to transfer any unvested interests in real or personal property for purposes of the rule against perpetuities. BREACH OF CONTRACT (20) The City, upon breach any of the terms, conditions, or covenants of this Agreement by the Owners, shall be entitled to recover from the Owner, in addition to any other reIief available in law or equity, all costs and compensation incurred in attempting to obtain enforcement of the Agreement, including reasonable attorneys'fees and court costs. ENTIRE AGREEMENT BINDING (21) This is the entire Agreement between the parties, and there are no representations, agreements, arrangements or understandings that are not fully expressed herein. This Agreement can be executed in counterparts by the parties hereto, and as so executed shall consist of one agreement,binding on all parties. J:1LandDev\Forms\2.AGREEMENTS-PIA S1A DEF SIA Maintenance Reimbursement Development\Specific Agreements-Street Improv and Deferred\Word Document of Agreements\Redding 180 S1.doc(Rev 09/15) 7 • F • f PRELIMINARY PLANS (22) Owner shall provide and construct public street improvements per preliminary plans titled "STREET IMPROVEMENT PLANS - OFFSITE - 180 REDDING ROAD" which are subject to approval by the City Engineer, prepared by SMP Engineers. IN WITNESS WHEREOF, said City has caused its name to be affixed by its Public Works Director and. City Clerk, who are duly authorized by Ordinance 2059 adopted September 20, 2005, and said Owner has caused his/her name to be affixed the day and year first above written. ACCESS DEVELOPMENT GROUP,INC., A CALIFORNIA CORPORATION a - By: Ale aydaffi, esi&n-t SEE A17ACHED ACKNOWLEDGEMENT FROM NOTARY CITE'OF CAMPBELL Todd Capurso,.Public Works Director City of Campbell (Notary Acknowledgment for above signatories) MUST be attached.) Attest: 4�Wendyoity Clerk J:\LandDev\Forms\2.AGREEMENTS-PIA SIA DEF SIA Maintenance Reimbursement Development\Specific Agreements-Street Improv and Deferred\Word Document of Agreements\Redding 180 S1.doc(Rev 09/15) 8 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California , ) County of ) Piyush Dave, Notary Public 7 J�!Z'Dt 6 before me, Date r� Here Insert Name and Title of the Officer personally appeared i It f- Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person whose name(K is/are- subscribed to the within instrument and acknowledged to me that he/sey executed the same in hislherAheir authorized capacity0es),and that by his/hertheir signature(s'}on the instrument the person(0), or the entity upon behalf of which the person(5)acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. OdW "WStt DAME WITNESS my hand and official seal. C®th�tit��Z08Ai32� Faim CI cow - Signature Sig ature of Notary Public Place Notary Seal Above OPTIONAL . Though this section.is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: '7AB 12 Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Ciai elf eygn�e(s} Signers Name: � Signer's Name: ❑Corporate Cificer — Titie(s): ❑Corporate Officer --- Title(s): ❑Partner — ❑Limited ❑General ❑Partner— ❑Limited ❑ General "ndividual ❑Attorney in Fact ❑Individual El Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: 02014 National Notary Association•www,NationaiNotary.org• 1-800-US NOTARY(1-800-:876-6827) item 45907 t CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County-of On 021 . �. Q before me, -7:Yc& ( ere nsen name and UU8' the o ce personally appeared who,proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. i certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. JOANN THOMASON CommlBslon 0 2110789 WI ESS my hand and official seal. Z .•� Notary puhtit:•calltorMa a Z . Santa Clara County M 'Comm.Expires MaX 9,2019. Nota ' Pub' Signature (Notary Public Seal) INSTRUCTIONS FOR COMPLETING THIS FORM ADDITIONAL OPTIONAL INFORMATION ni farmcompiles,vith current California statutes regarding notary wording and, ` DESCRIPTION OF THE ATTACHED DOCUMENT if needed,should be completed and attached to the document.Acknowledgments I from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary law. (Title or description of attached document) • State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her Number of Pages Document Date commission followed by a comma and then your title(notary public). • Print the names) of document signer(s)who personally appear at the time of ll notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(Le. he/shelgley;is/are)or circling the correct forms.Failure to correctly indicate this ❑ Individual(s) information may lead to rejection ofdocument recording. ❑. Corporate Officer • The notary seal impression must be clear and photographically reproducible. Impression must not cover text cr lines. If seal impression smudges,re-seal if a t (Title) sufficient area permits,otherwise complete a different acknowledgment form. ❑ Partners • Signature of the notary public must match the signature on file with the office of � ) the county clerk. ❑ Attomey-in-Fact Additional information is not required but could help to ensure this E ❑ Trustee(s) acknowledgment is not misused or attached to a different document E Other indicate title or type of attached document,number of pages and date. El Other the capacity claimed by the signer. If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). 2015 Version v.ww.NoiaryClassAw,ccm 1300-8734,18E5 Securely attach this document to the signed document with a staple. f�:.. EXHIBIT A LEGAL DESCRIPTION The land referred to herein is situated in the State of California, County of Santa Clara, City of Campbell and described as follows: BEGINNING ATA POINT OF INTERSECTION OF THE DIVIDING LINE BETWEEN LOTS 8 AND 9 WITH THE SOUTHERLY-LINE OF REDDING ROAD,AS SHOWN ON THE MAP HEREINAFTER REFERRED TO;THENCE RUNNING ALONG SAID LINE OF REDDING ROAD, SOUTH 89'39'20"WEST 60 FEET; THENCE LEAVING SAID LINE AND RUNNING PARALLEL WITH THE DIVIDING LINE BETWEEN LOTS 9 AND 10, SOUTH 00 30' EAST 257.944 FEET TO THE DIVIDING LINE BETWEEN LOTS 9 AND 12; THENCE ALONG SAID LAST MENTIONED DIVIDING LINE, NORTH 890 36' EAST 60 FEET TO THE CORNER COMMON TO LOTS 8, 9, 12AND 13;THENCE ALONG SAID DIVIDING LINE BETWEEN LOTS 8 AND 9, NORTH 00 30'WEST 257.82 FEET TO THE POINT OF.BEGINNING,AND BEING A PORTION OF LOT 9,AS SHOWN ON THAT CERTAIN MAP ENTITLED,"TRACT NO.23, SHELLEY SUBDIVISION",WHICH MAP WAS FILED FOR RECORD IN THE OFFICE OF THE COUNTY RECORDER OF THE COUNTY OF SANTA CLARA, STATE OF CALIFORNIA ON FEBRUARY 16, 1932 1N BOOK"Y"OF MAPS, PAGES 54AND 55. APN:414-48-055 (End of Legal Description) THE- MAP .CONNECTED HEREWITH IS BEING. PROVIDED AS A COURTESY AND FOR INFORMATIONAL PURPOSES ONLY, THIS MAP SHOULD NOT BE RELIED UPON. FURTHERMORE, THE PARCELS SET OUT ON THIS MAP MAY NOT COMPLY WITH LOCAL SUBDIVISION OR BUILDING ORDINANCES. STEWART ASSUMES NO LIABILITY, RESPONSIBILITY OR INDEMNIFICATION RELATED TO THE MAPS NOR ANY MATTERS CONCERNING THE CONTENTS OF OR ACCURACY OF THE MAP. File No.:01180-224236 Prelim Repori SCE _ Print Form r ENCROACHMENT PERMIT Permit No ENC2016-00115 CITY OF CAMPBELL DEPT.OF PUBLIC WORKS (for working within the public X-Ref.File PLN2015-305 70 North First Street right-of-way) Application Date Campbell,CA 95008 Issued ���� Application Expiration Date Ph. (408)866-2150 APN 414-48-055 Fx. (408)376-0958 Permit Expiration Date 4461 7 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.: TRACT NO.10376(180 REDDING ROAD) Utility Trench Location: B. Nature of Work: FRONTAGE IMPROVEMENTS FOR NEW SUBDIVISION ........ ............................_. .................. .............. 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: Mike Paydar, Access Development Group,Inc. Telephone: �p�3 p —Z Address: 12385 Parker Ranch Road ...... .... - _ ... .._ _ E-Mail Address: [ry-Cike_paydar@yahoo.com 24-HOUR EMERGENCY PHONE NUMBER:...... ......_..... ....... ..... _ .. Is this work being done by the property owners at their own residence? r YES F7 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. i 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 information. Applicant is advised that upon issuance of this permit, property owner, or property owner's successors, shall be responsible for any and all damages arisin out of e condi 'on of any private improvements in the public right-of-way. `/� Accepted: / / pplicant Pe m tee) (sicirJ Date zV11 4- L�2 G- (Contractor) (Print Name) Date 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. X 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. X 4. 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: 1-800-227-2600. 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 Tecorded. 6. Public Notification Requirements: 7. SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT FEES AMOUNT RECEIPT NO. PERMIT APPLICATION FEE $ 395.00 264489 PLAN CHECK DEPOSIT $ 1,400.00— 264489 SECURITY FOR FAITHFUL PERFORMANCE/LABOR&MATERIALS $ 70.000.00- 265222 CONSTRUCTION CASH DEPOSIT $ 2,800.00— 265222 PLAN CHECK&INSPECTION FEE $ 9,800.0.0 265222 EMERGENC-RE�nirG,E $ 100C•02- `ZZ APPROVED FOR ISSUANCE For City Engineer Date Permit Expires 12 Months After Date of Issuance [V �A � _ rC 7r \\Stet- �.1,L7f( _- �\c_�\� .,ALA C'1,- _T A 00 �4 i Y GENERAL PERMIT CONDITIONS I. A Construction Cash Deposit is required. Charges will be made against this deposit if there is an emergency call-out,overtime inspection or when City ordered barricading is required. Any such costs in excess of the deposit will be billed to the Permittee. 2. A one-year maintenance period and surety are required. Such period will begin on date of written acceptance by the City. 3. Refund or the cash deposit balance and refund or cancellation of the Faithful Performance Surety will be initiated by the written acceptance of the work by the City. 4. Submit project schedule 10(ten)days prior to proposed start of work.Special provisions may be required for work within City facilities and downtown Campbell. 5. The Permittee must request in writing a final inspection and acceptance of the work upon completion. Acceptance by the City will be made in writing to the Permittee. 6. Maintain safe pedestrian and vehicular crossings and free access to private driveways,bus stops,fire hydrants,and water valves. 7. A Construction Traffic Control Plan and a Construction Schedule are required for all lane closures,detours,and street closures. This plan must be reviewed and approved prior to any lane closures. 8. A Construction Traffic Control Plan shall conform to the Caltrans Manual of Traffic Controls for Construction and Maintenance Work Zones,dated 1990,available at Caltrans. Traffic control equipment shall include Type II flashing arrow signs if required. 9. Replace as directed by the City Engineer any damaged or removed improvements in accordance with City Standards and Specifications at the sole expense of the Permittee. 10. Sawcut for all PCC or AC removals. All PCC removals shall be to the nearest scoremark and shall be doweled to existing improvements. 11. Prior approval of inspector is required for any work done after normal working hours,on weekends or holidays and may require reimbursement of inspection costs at the current overtime rate. 12. Adequate signing and barricading is required on the job site. Failure to provide such signing and barricading may result in the City's providing signing and barricades and charging the cost(including all labor and materials)against the cash deposit. 13. Compaction testing of subgrade,base rock,and asphalt concrete by Permittee is required unless otherwise stated by the City Engineer. 14. The Contractor or Permittee will have a supervisory representative available for contact on the project at all times during construction. Contractor or Permittee shall provide a phone number at which they can be contacted outside the hours of 8:00 a.m.to 4:00 p.m. 15. No storage of materials or equipment will be allowed near the edge of pavement,the traveled way,or within the shoulderline which would create a hazardous condition to the public. 16. This permit shall not be construed as authorization for excavation and grading on private property adjacent to the work or any other work for which a separate permit may be required,nor does it relieve the Permittee of any obligation to obtain any other permit required by law. 17. This permit does not release the Permittee from any liabilities contained in other agreements or contracts with the City and any other public agency. 18. This permit is not transferable. Work must be performed by the Permittee or his designated agent or contractor as specified thereon. 19. Call back(call out)due to emeregencies regarding this permit shall be at the current overtime rate with a three(3)hour minimum charge per occurrence. 20. Pursuant to Chapter 14.02 of the Campbell Municipal Code,applicant shall not cause to be discharged any material into the municipal storm drain system other than storm water. Applicant shall adhere to the BEST MANAGEMENT PRACTICES established by the Santa Clara Valley Urban Runoff Pollution Prevention Program. 21. If the public interest requires a modification of,or a departure from the plans and specifications,the City shall have the authority to require or approve any modification or departure and to specify the manner in which the same is to be made for City-owned or maintained facilities. 22. Permitttee must provide advance notification to all parties that may be affected by the permit activities. Notification shall be reviewed by the City prior to distribution and include dates of work and a contact name and phone number. Applicant shall be responsible for ensuring that all those providing services under the applicant are aware and understand all of the above conditions. Applicant ' Mike Paydar,'Ad6ess Development Gro p, I c. Date: Contractor (Print Name) Date: J:\FORMS\Templates\Encroachment Permits\Encroachment Permit STATIC form2.pdf Rev.02/14 �� of c4�A�� _ G •0kCHARD CITY OF CAMPBELL Public Works Department .November 7, 2017 Mike Paydar 12385 Parker Ranch Rd: Saratoga, CA 95070 SUBJECT: PERMIT NO. ENC 2016-00115 180 Redding Rd., Campbell CA FINAL INSPECTION AND ACCEPTANCE Dear Mike: 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 as of October 25, 2017. 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. Enclosed are the deposit refunds for the following: 75 % of your Faithful Security Deposit for $52,500.00 P1an,,Check Deposit for $1,400.00 Construction Cash Deposit for $2,800.00 and Monument Security Deposit for $6,000.00 If you have any questions, please call me at(408) 866-2165. Sincerely, Syed Wahidi Public.Works Inspector Cc: Inspector/Suspense Files Permit File ENC2016-00115 Enc: Check# y(,,5 p 53 70 North First Street • Campbell, California 95008-1436 TEL 408.866.2150 • FAX 408.376.0958 TDD 408,866,2790 i ! ! L................................. .............................._.._... .............................__.._... ............_.............. .............. ................._..._...... ..............................._f a_.................................... ....-..._......_..........__.. ..... . CITY OF CAMPBELL VENDOR No. 10014028 CHECK NO. 265053 Acconnt Purchase.Order InvorceNumber< . Amount Descri ttan. I 101 2�03 CR103017 G2,700.00 ENC201GO0115 DEP RFND - I l i l I s� 10014028 ACCESS DEVELOPMENT i — Q CITY Q CAMPBELL.. :': W g FMGO BANK, N.A. I CHE K DATE : CHECK NO. c -24 42{I,MONTGOMERY STREET 1210 11/0 6/17' 265053 70 NORH,FIRST STREET SAN�FRANCISCO CA;94104 , - 0 0 "" s AMOUNT **:**6'2=, 700`. 00* !!. L CAMPBE( CALIFORNIA '5008 AFTER 90 DAY ,ol; J PAY.THE SUM OF SIXTY"-TWO THOUSAND;, SEVEN HUNDRED DOLLARS, t CENTSrz TO.THE ACCESS DEVELOPMENT i i ORDER 12385 'PARKER RANCH RD � I 'OF; SARATOGA.:CA 95070 • 1 n' 26 50 L000 2�,8� 4 2 L8 5 5Ll L 5iI' . . �. .. . ------- - --- -- --- _......_..__...........__._ __....__.........._,. ._ _.... _.._.. .. -.............._... -._..._........_... _....._....__ ° i I4 , I ............ _ *See rse Side For)E sy Openinginstructions* -I -------------- -------- ------ -- ------- CITY OF CAMPBELL 70 NORTH ,FIRST STREET CAMPBELL, CALIFORNIA 95008 ACCESS DEVELOPMENT j 12385 PARKER RANCH RD SARATOGA CA 95070 Encroachment Permit Final Sign Off Encroachment Permit# Address: Date of Final Inspection and Acceptance:_/f 5/i b Inspected by: OK to release deposits: 100% V 75% Coniments: Refundable "Deposit, Check Request To: Finan.ce Director41 , Check Payable To Access,.DeyelopmentGrp As--Li n-e 1` 12385'Parker Rarich Rd Line 2 :City Saratoga' State::CA 'Zip:,95070 ={ .,` ; Description ENC201.6 001:1:5 Account.Number:. 101;2203 . Amount:'$1'7�500 00, Account Number 101.2203 Amount. T Acbount.Numb'er 101 540 74.8.: •Amount; (Finance Dep't'onlyf intetcifEaini d (F np Dept only) Total,Payable (Enact Amouni), Purpose: 25°Io FP.S deposit;refund .� Permit#: ENC2016 0011'S Receipt,# 265222 Dates 814'/2016 - ! Requested'by Title Inspector Date Sy.ed:lNah'idf A roved-b '_ Title: Sr. Engineer Date �':a d. i Roger$torn L. Finance Dept OnIY Verified:6y Title Acco"untimg Clerk ll' mate: . Approved'by: Title:` _ Accountant :Date S, ecial Irtstruc ions For Handlin Checyk . Mail As is : Mau n Attached Envelope Interim Check Needed.By •; Return Ta. :JoAnne TtioSmason; Pu.blic.Works .- (Na.me) (Depaitment) - Ofh'er Please return check to<JoAnna r City of Campbell Department of Public Works 70 North First Street Campbell,CA 95008 SUBJECT: MONUMENT BOND RELEASE TRACT MAO NO. 10376 Recorded in Book 897 of Maps,at page(s) 1 and 2 Dear City Engineer: In conformance with the requirements of Section 66497 of the Subdivision Map Act,please be advised that the Engineer/Surveyor has been paid in full for setting the monuments within the above described subdivision. It is requested that Monument Bond Number...` .(�,. ...�'�1A............... be released. Developer/Agent Date of signature of this document CERTIFICATE OF ENGINEER OR SURVEYOR 1, Sarkiss Parvin certify that all monuments as shown on the map of the above described subdivision are now set and tha in full for this work has been recei dNO Land Surveyor 0 8261 PLS 8261 License number ��ATFO� Date of�ign��e�a�hi this \\ CALVE MOTE: Proeessing of the bond release cannot occur unless all of the above information is complete CITY OF CAMPBELL City Inspector Date Comments: OS l COIF 20 Z Z cc: Bonding Company Rev.09/2014 PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1,2016 TO: Finance PUBLIC WORKS FILE NO. ENC2016-00115 PROPERTY ADDRESS 180 Redding Road Please collect&receipt for the following monies: wg� ��,q 11E 21A,11�1�i,,,� !E.41,?4Y,1,,1 11i"11,115", H� P� gR 4722 Encroachment Permit Application Fee Non-Utility Encroachment Permit Major a$10,000 $403.00 Minor Encroachment Permit-1$10,006 $230.00 Initial R-1 Permit NIC Subsequent R-1 Permits within Two Year Period $230.00 Inspection Fee Minimum Charge per Location $398.00 Street Tree Planting/Removal N/C 22031 (t500 per Tree Planting Deposit Required) $500.00/tree 22031 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 $281.00 Site<10,000 s.f. $841.00 Site 10,000 s.f. <0.5 Acre $1,127.00 Site Z 0.5 Acre $1,688.00 4722 NPIDES Review(C3 Reguirements) For projects not required to submit numeric sizing $163.00 For projects required to submit numeric sizing Impervious Area 10,000 Sq. Ft to 1 Acre $704.00 Impervious Area I Acre or more $918.00 - 4722 For projects sent to Consultant for review Consultant Cost+20% 4722 Additional treatment facilities $300 ea Plan Check&Inspe6tion Fee(Non-Utility) 4722 Engr.Est.<$250,000 14%of Engineer's Estimate $9,800.00 4722 Enqr. Est.z$250,000 and:5$500,000 $35,000+8%of Engineers Estimate 4722 Engr. Est. >$500'000 $55,000+7%of Engineers Estimate 2203 Emergency Cash Deposit 4%of Engr. Est. ($600 min/$10,000 Max) $2,800.00 2203 Faithful Performance Security(FPS) 100%of ENGR.EST.* $70,000.00 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) $859.00 (All Other$2,650.00) 4722 Parcel Map(4 Lots or Less) $4009.00+$871lot 4722 Final Tract Map(5 or More Lots) $4,871.00+$118/lot 2203 Monumentation Security 100%of City's Monumentation Estimate $6,6-0-0.00 4920 20 Parkland Dedication Fee(75%/26%Due Upon Cert.of Occupancy) $26,118.00 4722 Lot Line Adlustment(Includes Certificate of Compliance) $1,893.00 4722 Vacation of Public Streets&Easements $2,530.00 4722 Certificate of Compliance $1,877.00 4722 Certificate of Correction $561.00 4722 Document Recording Fees $15.00/first a e$3 ea.Additional 4722 Private Improvement in Public ROW $50'.00 4722 Ap proved Plan Revision Fee $1 00/sheet 4722 A eal Filing.Fee $200.00 4722 Notary Fee(per si nature $10.00 4722 Assessment Segregation or Reapportionment First Split $895.00 Each Additional Lot $281.00 511.7424] Postage A T§18nm SAM-,01 Other(Please Specify) *Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $115,577.00 NAME OF APPLICANT NAME OF PAYOR PHONE 'ADDRESS ZIP l A M FOR A g N Ke�e N E" AIR CITY CLERK " , ONLY . . Ga OF G++w . . RECVb BY: CASHIER, WON 5222 : (am; kC a +v POP m+ve «6; 08$gQ gAmDA- J St'70 DESCRIPTION U+W mS D:a Sa+GD . 7R & qA!( GEq& F 9,mm03 . . . mA q: Gam! R'F DEPOSIT m1 2.m%m mg D= bm0 REF DEPOSIT - q! 90 mGm . ' mS D: Gme STORM ma§ FEES q2 mS.m • . 0ST D: 1. Q . . ' . / DEPOSIT - S! my Dem +AIm 2 . § . • PARKLAND DEDICATION FE : TOTAL DUE; #±,q«m Ia+aa aalgmm . ' 2 PORE . g S.gGm . 7E mb G+ ,--;," Ref i .: a '_.� .b: I C ��,"-:. � Check �,.- , m- .._.., e -_-c ,9 . tII,--,1., " .'.�. i � �! . -, 1- . . L,- :, ., ,- -,1-�,'. � . L � I,q ."-i , % ' L t _ Y I o; mance b fedt6t - y , h Check 1 yable M AqcesslUeypjopmqnt I ;, $ll 1 i � '. , ' Addresstih6-1 f2i6&OArkit;RA4ph Rd X , me Z 4 p i- - - " City S?egtOgA = sfpt6 t li sbtb � f N _ - bPScrp iofi ., twdift0_461-49'� Account Number IOl 4 9pa ? A6punt-, $629700.60 L .- -�_ , .� ... ,.. -. 1 - ., .:._ :..-I. -- q� -- . ' .I _ , -- v- �.'.. - % - _I, :,. , � � .- .:. f. �.1.. a � i, 1 ; , '3 )j. .,. ,II1 !� �;. , i Account,Nyn�6t �_ IQl.2203 Amount: ,� "Abc6bM'Wu6UerI ' 1 1 5401448 Amount:' {,Finance Dopt,on,y) lh�ere _X�rn' , 1 r : (Fnan6e'Pop(qfilf� ' ` I _ - 'i - Toti VP�Payable I, (ExEctAmount) ` Purpose E O lQjl��P6p ,R Refunds II j ` ,- Permit EN626*115! Receipt k&622� A .60�$�� O- 0 ba g14/26I - iso `99 (7 %,V 7OR , , , iR6p! jpf# , #2044- $t A QQ� O Date 6111/�d l" a I"L , iRe uested'by title 'Inspector ?af6 A Syed W hidr , -; I— 1, pprove �" Title Sr Engineer, D t0 (� Roger Sfoz k p _ , l, APpOV6d,bY / Title O Mbit Director Date: Todd'Cap rsq r Ir I I FI aj64 Dept 6bly Verified by �itJ6 , 6 dM i g0etk 11 M 6 :r � I Approved;by ifitl Adc6ufijj�j DatA � "' ' I Special1 [ ln " t 0hs, �:For" Handling Ch 4 " ,_ii W il 64i ; � ,Wi ft-AttadhmiE Envelope Interim Cho.W' - . I - _ ddd6i6y I eturp, , �JbAh a_T-10 a- public v o > (Name) (Department) ,, her: PleaOe retuftlich&Ck*o-JdA6 a " . - � a _ j� -",- ,I , .,, ,. ,l. ; �* , � � CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR FINAL INSPECTION AND ACCEPTANCE LETTER Encroachment Permit#: ENC 2016-00115 Name: Access Development Property Address: 180 Redding Rd. Date of Final Inspection: On File: Bonds CD Cash Labor and Material: $ Construction Cash Deposit to be released:q �!,-BDA9610- Faithful Security Deposit: $70,000.00 (75% Other overdue deposits to be released (Description): Monumentation Deposit`$000.00 Plan Check Deposit QV1A0 ):^ . r1 Processed by: `O Zoo I Administr for Reviewed by: G /( Inspector / Reviewed by: cs 2� Land Development Engi teer JAJoAnnaT\Deposit refiinds\CHECKLISTS\Redding 180..doe(Rev. 10/11) Encroachment Permit Final Sign Off Encroachment Permit# �4�1C G�'( < S Address: C) p III Date of Final Inspection and Acceptance: Inspected by: OK to release deposits: 100% 75% V Comments: `ZAV, �C �, l0/2j/20\7 Fees Associated With 4:16:32PM <X&CEL - ? Cssm#: ]BNC2016-00115 Start n ran' xeAtLd escribtidn MOU Oy t ate AF02 7/1/2015 6/30/2016 ajur-EugE 101.730.4722 JT 6/202016 395.00 0.00 PCDP 7Y1/2015 6802016 1012203 JT 6/20/2016 UI0M1WDy0W" 0.00 GRA3 7/1/2015 6/30/2016 Grdng&DruioPloBev>= 101.740.4722 }T 6/20/2016 1,105.00 0.00 FMTM 7/1/2015 6/30/2016 TructMupFoo=>5Loto+$l 101.740.4722 JT 6/20/2016 5,355.00 0.00 PCl) 7/)/2015 6/30/2016 YJon'CKU Plan Ck/loop<$ 101.740.4722 JT 8/10/2016 9`800.00 0.00 CASH 7/1/2015 6/30/2016 � 1012203 }T 8/10/2016 0.00 F98D 7/1/2015 680/2016 1012203 }T SDC 7/1/2015 6/30/2016 Storm Drain200.715.4721 JT M0N-LJ 7/1/2015 6/30/2016 1012203 JT 0.00 Total Due: $0.00 r�) c��� \ // /C� ~- 4' -� ^~ `^-- \�' / '� ' / l �� ���� ��u ��t[� � ` L�^\ \ b� ' ^ ��'7 '�- `_- � � ` -, "7 ("� � �~ ~~ =` 9/26/2016 , Fees Associated With 10:03:51AM E�,/- Case #: ENC2016-00115 Fee .Start End s 5, Trans b Revenue. _°< Created . " T e ' ° .Dafe Date Dept. A Descr�ptian Code ___ AecountNuigber BY .a Date r Amoun"t Due I Y . 4 RF d AF02 7/1/2015 6/30/2016 PrmtAppFee-Major-Eng E 101.730.4722 JT 6/20/2016 395.00 0.00 PCDP 7/1/2015 6/30/2016 Plan Check Deposit 101.2203 JT 6/20/2016 1,400.00, 0.00 GRA3 7/l/2015 6/30/2016 Grdng&Drain PlnRev>= 101.740.4722 JT 6/20/2016 1,105.00 — 0.00 FMTM 7/l/2015 6/30/2016 TractMapFee=>5Lots+$1 101.740.4722 JT 6/20/2016 5,355.00 0.00 PCI1 7/1/2015 6/30/2016 Non-Util Plan Ck/Insp<$ 101.740.4722 JT 8/10/2016 9,800.00 — 0.00 CASH 7/1/2015 6/30/2016 Construction Cash Deposi 101.2203 JT 8/10/2016 2,800.00— 0.00 FPSD 7/1/2015 6/30/2016 it ful Perf. Security/De 101.2203' JT 8/10/2016'—�10,000.00 0.00 SDC 7/1/2015 6/30/2016 Storm rain - 209.715.4721 JT 8/10/2016 859.00 0.00 MONU 7/l/2015 6/30/2016 Mon.Sec.Dep I 00%ofCity 101.2203 JT 9/26/2016 6,000.00 0.00 Total Due: $0.00 Page I of 1 CaseFees..rpt ENCROACHMENT PERMIT ISSUANCE CHECK LIST City of Campbell Encroachm 'ermit No.ENC 2016-00 1 1 5 Department of Public Works Tract No. 10376 Address180 Redding Road 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&Date264489 6/l7/16 3. ® Plan Check Deposit Paid(2%of Engineer's Estimate,$500 min)$`1,400.00''Receipt Number 264489-"6/17/v16 4. ® Grading Plan Review Fee paid$1,105.00-Receipt Number&Date:264489-6/17/16 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 8. ® 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)=$70,000.00; 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$9,800.00 Receipt No.& Date 265222-08/04/16 10.® Security for Faithful Performance and Labor and Materials, 100%_each of Engineer's Estimate, supplied or paid. Amount$70:000.00 Form Cash Receipt No.&Date 265222-08'/04/16 11.® Security for Monumentation Amount Receipt No.&Date 2652221-08/04/16 12.® Construction Emergency Cash Deposit: 4%of Engineer's Estimate. ($500 minimum,$10,000 maximum) Amount$2 800:00 Receipt No. &Date 265222 08/04/1.6 13.® Storm Drainage Area Fee(Paid to San Jose for connection to their system) 14. 0 Street Improvement Agreement signed and notarized(proof of ownership submitted) 15. ❑ Tract Map recorded. 16.❑ All other Public Works requirements listed in the Conditions of Approval of the development. ❑ PG&E App(SL) 17.® Park Fees Amount$2018.00 Receipt No.&Date 265222 08104/16' 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# 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) TO: Roger K.Storz .0 -CA� � Mike Paydar Senior Civil Engineer City of Campbell 70 North First Street r ENC2016-00115 Campbell, 95008 ® © Phone: (408)866-216-2190 Fax:(408)376-0958 TRACT NO. 10376 E-Mail: roeers(a7cityofcampbell.com . "'?CHARD * Date: August 18,2016 Public Works Department Land Development Division The Returning Redlined Plans are: Plan Check Status: Submittal Package from: ❑ Grading and Drainage ❑1" Submittal Date: ❑ Public Works ❑ Off-Site Street Improvement ❑ 2nd Plan Check Date: ❑ Landscaping Plans ❑ 3`d Plan Check Date: ❑ Planning Department ❑ Public Service Easement ® Final Date: ❑ Lot Line Adjustment ❑ Building Department ❑ Vacation of Excess of Right of Way ❑ Parcel Map ❑ Other Department ❑ Final Map Project Address: 180 Redding Road Campbell, CA 95008 Enclosure(s): ❑ Redlined plan check comments ® Off-site Street Improvement Plan ❑ Plan check comments list(s) ❑Preliminary Title Report(last 6 months)—via e-mail ❑ Itemized response letter to each item ❑Approved Tentative Parcel/Final Map ❑ Structural Calculations ❑Public Works Conditions of Approval ❑ Stormwater Management Plan ❑Deeds&Referenced Documents ❑Hydrology and hydraulic calculations with ❑Plat&Legal Description hydrology maps ❑Assessor's Parcel Map ❑ Soils Report ❑ Other Please make 4 copies of the attached approved Off-site street improvement plans for our use in issuing out your encroachment permit. Please also fill out the attached encroachment permit application and sign the front and back. Once you have selected a contractor to do the street work, have them come in with their insurance paperwork to pull the permit. Sincerely, Roger J:\LandDev\Plan Check Comments\1-Specific Projects-Active Project in Progress\Redding Rd. 180\SI\Transmittal to Owner.doc Rev 11/13 A R' CERTIFICATE OF LIABILITY INSURANCE 09/2 i 0 Y� 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 CONTACT NAME: AU Insurance Services PHONE (877)234-4420 FAX (877)234-4421 10825 Old Mill Rd (A/C,No,Ext): (A/C,No): Cniaha, NE 68154 E-MAIL ADDRESS: PRODUCER (877)234-4420 CUSTOMER ID# INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: California Insurance Co. E:ctreme Elackhoe Service, Inc. INSURER B: dba Ebitreme Backhoe Service, Inc. 9900 Guibal Ave INSURER C: Gilroy, CA 95020 INSURER D: INSURER E: CTL 1273 1233454 INSURER F: COVERAGES CERTIFICATE NUMBER: 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY ❑ ❑ DAMAGE TO RENTED CLAIMS PREMISES(Ea occurrence) $ MADE OCCUR MED EXP(Anyoneperson) $ PERSONAL&ADVINJURY $ GENERAL AGGREGATE $ GEN'LAGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OPAGG $ POLICY PROJECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO ❑ ❑ (Ea accident) $ ALL OWNED AUTOS BODILY INJURY Perperson) $ SCHEDULED AUTOS BODILY INJURY Per accident $ 2 PROPERTY HIRED AUTOS DAMAGE/ Per accident $ NON-OWNED AUTOS $ v $ UMBRELLA LIAB OCCUR , EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE ❑ ❑ \� AGGREGATE $ DEDUCTIBLE � ,�'1 JJ $ RETENTION $ /)`�_t VVV $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY y//TNER/ N� TORY LIMITS ER A EXECNY UTIIVEOFFFIICERMEMBER N/A 46-007286-01-12 06/01/2016 06/01/2017 E.L.EACH ACCIDENT $ EXCLUDED? — LJ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ CR1 L OP.E f0�t"-�T/IITOC Tip YX tt 1.LES ch Aco d 0 ,Addi Tonal Rem ks Sche I i mor s ce r uir �1pBb>� ® dittg Rd C"amf11BBI[ �950 ave a >�u�roga�ion in avor o '�i y oef amp�egg re�ative to work performed under oa,ra.4s>�ct. CERTIFICATE HOLDER CANCELLATION City of C m Abell SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 70 Mrth First Street EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH Carirpbell, CA 95008 THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Attn: ProjectManagerO D 7 8 3 3 6 ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD ©1988-2009 ACORD CORPORATION. All rights reserved. sA . k M � 1 as•.�Ra x �G`aaL• `R .•a a t }, > ; r r a ha }a .Ra `a Raaa ry a't RR a ♦ • R Ra"Ra` 'R 1r'`'a`it' S'i at a, S a R, C• .a\•:as r�.: . �,,•aa•''a.,i> \ :`�`•• •"}va`Z, `� :�� a � a s \ aaa .�,• a`la `>j'i 1 \ 'r. \o,� x:,''�1Z, *air M�.. r�'1. /r ir:'• //• �i. �/�./*.}rra*/rra r/r a'-rr'i L.r+.r.%!r.♦•ern:r i >✓t3a Tir`a4 ya i R sr���iiilt r/i i*i *Ij jg'ai t/. T.C/ !ti •sS �, ,.T/ ;* y/.. r_pr',-y } aai i, .a - a•S-L C4 Z2\ ,* Sr a,� 4 a•rr2♦• ♦ `+ a ±a.G a as vaa a. \ R a ♦ .a a,. ab a � ya jaR a p �a �` a•L a aV Z• �.•}.. •::r�� 4�r.1.a.r �\..-•�a"a a\�}� \jrrr�\aa •aa'R rw'♦.a 2x a\*rj.a�,�j:L'•i a a ra�.yAa r..'a`�bySrrr,a�,y .�wy ,�f.��}}r}�Y a\���''rir�ai��' R�.j\\ro \ �•*t,".a Wig• rr /��•� x`pt rf� -/j �i �p r/i STr�` ,r/f a`/J:rrfp ,p /rta*N.J-,i•./ ti/. C�Ct:;x t���t�pr.•n(r ry';,n'/✓//.•.� +�r,/rTT.h�rfy h•.rjr��j k/.r •r'� 1S'. ,,Ra.a`. , a , i S a .�. S a S r,'Sa.a :al S., f a ♦`.`..,.'a• , t •' Y a`fa .4".aa `:t ya a a at ~'agarr \ a a aaa a a .aa aaa.aE �a,tfas as .,is a' > .a:'iZ� as fi r` rr:a"Ir.;.r>* r1.a �, rr.a:s r•a Zrj'•Z,\ra syalt „�at a�,�r•a p r/.a`\Sr Ra. f pr Sy r,/r a:/ • fM. r� ./p. rrr.:.rpr 'ir rss:f•rrrj,,gip .r r r / xT f 7r. �r •�p..*'h l.' f/'L'. .'. 5 •i'aS% ,r1� �/ �,�f•rtfp r .•J✓'t :•bra 4a * r,`�aC �.+••aa aa.:'a+'`a r=�.q:;aa�rS'r 'i a,C. aar'� ` ..tea ,�Ma:,`.r"rR+i,�.+'Sa,+r i•, v S"`'.� .1*a a.v. ` 'S'Fa'a a.k .ate •'•a� •iZ a RS'♦ ,ryw ag :�» . ar}va..r: XxaKraja,:a`awj .+ar,''. \a*.rF `ra•aa /r �,rT":'• r/ • :r'y_.,Ty r L` a�nr/ .r,�r?•arv/�}+'al r�' h i i *':* "*Z♦Zrp'e`vCyS�_+ r ;t r ;S.arr�..rprW'r,rrfr�� p, as`sp*xa try% 'ir o/N' s3 .err•f r/•SrFSat Jj..ypti ,r Ja 'r ://n S ,:SJ*.✓/r,M-mr.•, `3,ia• rJS?:Sj+;C T•-,K. ^ai'•S •., C+-. G w a G.+ 3..a>rr . .!�w. C'r a'� S a i i.r arL`•aa>rr +*L.0 S vaa•r •`*a ; �'* -// f/ r/je•r/pr<. a�::aaa S:•'1,r.a•Na. r j taya.\:.••a� ...\j'Fw"::a l''�a�\ \::i aM1a '':� �\a i1:i ~*`a\t''•aa,t�.`j `as' 2 1, 'r',a,�a tali:•:\a'r,.t'Sa•i ";;Ztrx.:,Sr tS:r.Za�S �,•rrrZ..•r y:;r>r ,arr r4 ••yr>'rr'•-`•firer'r•a'Sp•�• j.:Ti <�'.:vp•y`�w,rp.y>Z *.*>+x 9�rr;`i'rr+� '�+-:,a+'r .:%*'ax". a>:r Sw!r. (' r: r/ .r S✓s.,r r?$:gyp ,•r .,..r i-< fir• .t,�. t r r .i S�pr : hS/ rr, s %x f �f?`faT-r•. "CRr`t':a:. `Sf '�.6>!,',S'�i�`.}"+'+•�tii< „$�£"Y.i a� S vs;'.� +Cf. d f tir`'`i`#_A"S�S•.a-'�:•d x r"�l � 'fir.a.�S �ri3+.. ,.h a Y S n.as�, 4, •w`'ra. a,R � i �E+:fit a' •a•r•a�.w, .;aa .`<ss `� '\ ?. ""l�. av•� 4.�` �'.�,� �3 h a aa>rh• `+r3 r a i ryu;r vri ,q.aarria.r �;x a 2 r:a ar:a ra a>y \Z>t r`*a„a n• aar a �'¢a. r+,.� R nr y+r r+ rr:•/ r:l�*T /: / rJi r 7�, 1:`i "..T s*r., r.'!7 .rr 4 '`K* tr �`•T a rk`._y r rjrs•,♦`• �'r rF,i .ray:� ''r7�,` ai ;elm.. J' `C/fF' .. f. ' X.51" y�y«.'s ,.,yrf .rr 1�' S•�. n { 'r »r`"rr' •`�-S$�' ' ' � <y A. Y s r'$'7 a..��',a`"Gr,,f.., l•aaa t' a ,r.� r +<!w'�.a+• -ar S> �'w•• \. � Sa'�� '\ :.aay.•: .Yi+'`�*..�i,. X� .��'. tF {Sa \.. a a: ♦.•• a s.r. ,a a yr.�a a a,'.�,aa. . 1a+'2;y'v, a�c.w.„r•4�`'� iL' a'`a '`':�a �$�•r`.�'y,�•y}X�`'i'+:�>�"a:'�:r••e e�•a}+.•4�r rhirw��r= a x'�`yr'•>aa. :� ..a `r�Rh-li%:`}''i.�•}a'�r•: t ��'".`�Y•`aw4>?•.`+ *� .�>,is}y;..�a�:�t�1�aS a'�y�.r x"!r�"� /:•:Ira Tirr•Ti•/ra•"rrir' //.r r/i -�/r'�S Trlr2 /✓i r'...*lr rrf*6a+*i...n.�yr.S'Sr'*rl rrr •S/ a 1'r/'.ay`; ,yr. �lt•,. *aS.R'RC•;:•♦is:::a\w,r h.at :•v. yara•T'•*,^7 r aa"a`r/::;a $a Say•4`.a$ +a•".`` i'•/.' 'raa v, �r�•.F �.y 3:`;:7;Fa.'l,;"dt �fj :s; a}re.L...�LiSFC`•,,'� .G`�• \a.•..�:t"LF,aa\: ataa ..�ja; ♦ at.` \j a h,� ;>a ..�j.Z:♦ tai a, aR\j,:i a aKyi. a`\�t+:. c' R\s.`aa\>DrF.a\\a# a .•a\a:•a 3..` > as v* a.:. rj -✓iatl},r,*, i•♦ r r•r,!3.r� 4r/ •"•` 'N.S :>ta>,. :rrr 4".} r •a* `/a i�i�rqa' R4 .Tas�rrr,`v�yrrr aS'rri♦}.1 .• v'tx,{T:dirG•+ r i � frF asftri: rr }i gr�Yj. ry .t`:'1*'•S:MSj. •fir .- ✓.. jar r/'.Jlt r,a✓.."j.eS•t.' '.s^�`sw'� :lrS,. •.':rlre•, '::J/st�3/`..r.1t. ,y ' a\;;+.a•aa a,.raZ,a a`.-aaa L Rat>1a .tarr•l..l.aNOR.ai„t`a., rSfa'+i'rrw `ati'yfa�L a ..:•.'r"a ''. ararrdaa��.ta'�«'•"t ak �••• l r� \S..i \ r�at • ,��V.'»;LS �:. *aa ta• \aaa Y `\a•:�'a r h,a a ✓R� a R.a\ \ t .r`l 'S•!�'ai•" RSa":a:r :\_�y "r:a,f• • Saar . r;♦y rTr$7*r,1'a y ti •♦}r✓h_ +Pr r/I ri.r rR axr / vrn �•�_ S } y ..�. •s/. r� / l '*i :/ r r r r 3 r✓ r r r sr'i +r f �r r / r ai, ' <;•lrf7 t'l ."�3 .. r .�l: 'rlat r. t r :i r.a•.. lr; S in �J a.l''i�' ':'is`,'.':N f r ..lr a"• ..Fa a -.wtr aKr" a a :aka :,• .lf •C`> C a �. i r a r-ia7Z.` } C "ra a$ rr'f 3 wrSi2' « S f a fy S a is :.. `'a ..•aaj'r '��r:,aar.Y�a ' \.a..:Za`a.•a\a'L;4aaa. .asa 7haaa�` "k lr �a.: aa "i\a� ♦aa \j'F aa.sY Via.. /r 11'�rr�l',� ,` x�- /a:*ixw':r Ti i!rrA !•r�'` �.a r a :S r a�.r. red a x a er+ rr>,ea�r?j: rr\•.r aa: "x :Tyr C� *; ar rr a� y�' r r:Sa :r r•s"a :' .i{..,/. r/ r- .. r .!/.• ... .�fp rr/ t t/ 'S.r ,yr/iv jar ya ri f r-r lTi via..r arty aRa 'a a" r` a• -.a,. a•.:`a: 'a a a = RRa` •a 'aa" r'v 4a.: a caz ♦\ra";, �\....a` +: .a '• Caa A \ `�a.;x,4•jY. a ..r.,♦ a\ r Z} " ;rrr 7♦a M1 v,�a-rFaa u Y. a�• aaa>r+\��rra�`i i♦\x h'$`�'S' \:ri•:. / �• xr rj • . '' " / * F R, ry. /,. / 'INN r. /. r r ry. *J +} ±y !'tr xr •L r '/. ar✓ a.�•A.fr r•+.�.. rrr a�p. r Si raS ry�ra< �r.�q r�i. r�• Ti�`f �i •r,r. �' rr: �pY rJi•� rlrrr _M�r r i• 1r�i i� ;'c'/ S/. Lr r :�'r''a`T%t, E}}.,Rf__���� �ri.,rk,_ 'rr ru:a r,.a. .r•, r C t'a �+ i.�of 1 r a r a •a L �` j': �r+S. aea g/airr,i.}.:.•\♦:\:•j ayZS..aNa a=}•rar�'sl;r,h•g.•.��S.rTr."i.�•.��.a'.?'.\`':a.a:.•,rhv.�•s;2Sia.�r•y:r:.rrr/r:.,r.irf+a.a�a,.�,#'\�aS•a'•a._•a`sr'✓r.f•r p rrr:�:'•�',,a,R_{+r♦raar'r r•:,x'r/rr'":•aaaai\J\•"'fa•':*v".1alrSS t.,,:"r'.r%STS:a,•R a'y;a aLoNr/.rf rrr�`.s•q`Ra\\.r+`c.r•/r,'/r'.•S�r.'a,Z.,s aaaa',+as+•:r*ir/'"r ixNas a:�\�`+_Rawarr.r`,,L+y�'r••r"*C�.`.arr�4..i i/.%9..�Za.S,r.rtr.4�.i.r�':•a`'}.aa�4.rrt�i>•ya„:`.*/.�.lrr:pr..r:r•:'a a R�'Zaa•N rrj✓/.•hR{1+aat i1 rjr*l+.t*•:-:a*-,l+aryia'a.♦'`i.r�/�i"r".'..Rj.r'Rj.,v*�'!iy'+�y t1a aa�'aA'„rr x*a ara"a.hl`r Fr:-�La�•.aaJ�."��e`:'i•:.t'slrr+t:.:'*•a.�aah.°v!rrrJ/�r"`S�.a•"\`a Sajl;.•>`%rr:rY.r pr:..ir):rt'.r'.S•`aa y a a`aaT'S'..r7•ai rFSy:"rtri:•.r:ax.,���`".�ttM ar:iN} \�•ara! J � s7KL4 / NaIP; > ✓ • r • ;a,a�,yd5�ri ya.:.a r./sra'r rr•.,:rse+'C..,•�a'ftia.S:y.'.��k•i'r.,Graf;i'r';A"''�'.'S'�♦•rw.4'n rx,'r..ryr.�,ar�i"rr rs''.i.��1�.a 4..Gy'.'..r/S•at al..M . #♦f ,iR aa+ya�"aa%1`4 aa\'+.r'/i r p/•'rrl/p'Ffr':ir�:VitiS,�, iy. r � �1:ir tj . :i �Nt %i ` , y Ry> `Ra Ai 4 Sa>.1♦ : � dYir jtiiT\a���^a.,a'..:•s'r r�;!i,r/f'M.•:r.:"aaa aaa�it,a r•yi a}a+�..�v`f.i rfN♦�.3'r:r�',�!' aa'au\•raa+i:c `•'iw.'Z 5ilr,•Ss rr '� Cla rZx �ara K "� '"a rffrsax.=a r",~++ira�` C:t"aaa•• r '"L.•`'rs:'� ""��''L.aM Taaaw.r+a`�a k%�`taav a�:::ja� awa R:4aa r!��aak rX,r2 aa.zs`'.L L.'C"aaa.•ai�.'.i?a.✓, �a •v:'a'Sr+e �},a.`•t . _x.aw.yr.ta'a"�r tyaaari.S' r as.. aaa" :.�`•-�'a+:ei 4\• -\~ `\ `♦ r'h�wa •yr+awaa r'aR�• a a'afiLaa. R\'••aa 'aai\v.a • ,\ a N;` \•r♦ r �.R aaa r* L.y .:x''r: rr /x c r r -rrJ_ �.:al r rr •.r<i'r r rr.4r ., rx r aarrx a3 a t 'r" " atr 'rrr.a. r.. a. ,1S•`LCT i rri -/r. rah r rr r/rr i 9/r Sfr•'a' .''s*Tx trd/ �;rS•.S/' x'*` fir r4•t ar rf' ter,-.a. 0 re /t �. r s r• /••. S r r..�J r ./� p rrJ• i av C h •• :ti Cr2'• r RA ,KR R Lr xti x"ra`ta•. `" C r• r a.; a r2$• a aa".:eif. aaa.a�a4 a art• �. a} a. ,Rt•+' a . "�"a a:'atw aF�at aa+ aat ,•aa..�a ,,aa Raa .aa...a ;aaa>aaa.R4`R� RRl at :Raga as -.as a zh. r `r`r� it> y r r•a.r. .rr. ri3$`r•5�..r"♦:.r;rR Z r y". a*�ar: a*�: *•r`ap \ :a .a:.rx"` .`a'i"a S>;\aa, r.a\ a�• \.�:,a rl..r.eJ�/rS grt .Yj .y trio r. Ti/r •tarYpF .1.,•l/'ri. rra. .ram rr/r.. /r r,�..r� ic'/..,Srjt• Ir!r. r N✓,<i.-rp/r.y yfj. pr T.,J�/ r r r/.ut r!r4 r./,r rr!j4 ai •p a r2 � Ct•C fa f iai an r.ia a r2 a r 1^Ri\iSirw,'a 1 a r Sh +-' aa•. ..+'. R \a:a a .Sa'a`':a`:a '`aZ: ar'}aa as i a aa,,at. a +7i 't a ,•aa ♦ Sa aa. \ .x•;�apr ZSrr$,a ✓ S�.a r---------- as'. - Sr'.`.• .air/ v 2x'.:Trr� .rJ a.rr.r'':.l a.•.ri�'iay a✓� �Z.r aa\`x•x a ar rZ * `+2i'4 r/............. `Si*ar} A'/*• / rr /: rrs'r'•R.iji rrr ./w �f rr. �p•.rr f �� r/i fi: �r �'�!r'�k..r p�.o r r ♦ .•'7 r ar • � s *i .Coe ♦ t .` :^• C i::i C f a �:r.'Sa aiC,r '.- /•, / Y x`%a/"• a\'a;`.ila \a:.ta�Z•rti'� aR \a: mar'' \e -.aya Fiaa..�a aaa .aaa �a .�a : as aha ��:SSaar`i aaa a�aS \a aTav \=aa:.` as aaa -,t _as;i. Z`�a +aaa Faa'^."l\ \ •a � a •aaaa a ♦a. \ ♦a •.avSa, ♦ ♦ a ♦ a ../.\ aa/ R. .• ra `a*/ra //♦:ir\ rr�T rR>/�•*�'.? r S/r+F"i :. / r !'/ r / r ! j a• �. r / S r � / rr r / J" r / •✓ r• / !rj rp r /.-''St/;./i.. Sr.rpf r..a r= ::/j,. .rr aT/r.rdr.el/p. ''ri. 'Lr r, r J r �.s / try .J. r}�' /if"ri' rr�j t'1fr .rF -r �l•.it"S:r�>3 a* *F,a> Qr^a aa.�♦ ♦ a a a j •.` '. ra,�i� �aa Spa.`:+a�\ Z ja �•4! i.�l.� Rae,.•r a`• a,ara a r} "a a R,a•r a a L x as a( •a aer.`ai R as Ras a �`R a a\ L+t' a ✓ .• a { c 5 \ �s aaa a tc� •�1Z.r.ar �>�a ar••R\ +� �.r/„� ,�Ra a�aaa a wa r ♦ t1� a �J.\ "al� � ^♦ .a ,S a /r I:t /xr:.� '/.,..'S.`y r/ ,r `rra / jS,ary+ .r. r. rp rr :.,pr..•J racy rrr.ii+. �rr';i al r*�aesi*♦ r•` �• ra' as a �.� ,r`rar a\a•. �' a,Z n 3 a _rr* Sr tr<r� urrx r v�j;} :L••a•a. a`ea�ar/,.aa rri s%a 'r =�•�rr/�...�.a*'�r y;:ta *r i♦ r rrwatr a*t'irriL.is;�•..�r.a:' i:: �a..r. � ,ts raC:�, ` "M•�v�C r lfiSi'7� �rd",i t a.Ra R 'a '� a aaa .a a.•tLa.q :�, ._a,\ wt .aaR:" a+.,�aa. .. a. :.aa as aa��ti,�i r��++,,,,���5� L a a a a. •,i: Sx iiu� Y`R`,�, rr v.r•a•Zi✓•�riiZ K �`�:i +r. .rry.ar r f:r ♦4r•...ja+.r� ahyRia•} N*ra'Z'a a\i'j�'a a\r� :�'•icaFrt�.4:•: \ia•�}. ,CtiaS.,a�v`y.*oC'a•a .a'�i // •r rr /ti r/r . /r j /a•a` j / •e./ f r / r" / .' a:l e•,r•*j-;TTMj1e yZ r/ ,•xrr S r `.*pf'•r r :il Ttrr• /%;tiT/r<'�f� r a .,pf, F,ra� � r� !�. r/�i ,...,.r�,� r r � 1 rr -� `S rr,a yi'•'t a� �: r ..tea a�'S+':J.*, a a r a �aR_✓' a .a• � Sa ar• ,�r6,C ,i a ih.a a r *�' r a r�`\r..r. aZ�qt� a S�Z.aZ's,'kaa:•L�• as ay w pats � R\L�; _.,i � aY.a, \�y as "�•, �a^r"7}�a a ,at e Z�a r�,, a••r±y� Yana•t .to s a `'� a a . .�>"• ?.°a�y YZa >�,`>a a a -'ajaG �a .� raa�"�"..a�a�.Na �a`�r. a +�>i y a.,:a13'Rt.a x..i.�a^aa r a�^+.w �TrRrs' +r j'1.�.'�i` a1 :� r.''To>�2'aa ry�S i / •xr/rs r•' ri,"yr.. rr::rr.e•Ti t•.l�%.rt :•`S . T .•s,�2/•T rr�.,� �..{' wTSr •le�/r:i ."" yf�J.+..r.r rr T..."'r ..r." .:x/�'x•+.rJ:`.".•: '.x%.a'"�:rr. REED & GRAHAM, INC. TAG No: 589074 CONTRACTORS OILS sPH LTS O ERKOTE PRODUCTS IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIN 690 SUNOL STREET - SAN JOSE,CA 95126 STt-589074 TELEPHONE(408)287-1400 FAX(408)294-3696 WEIGHED AT: 9 690 SUNOL STREET WWW.RGINC.COM SAN JOSE, CA 95126 WEIGHMASTER CERTIFICATE CUSTOMER: EXTREME BACKHOE SERVICES THIS ISTO CERTIFY that the following described (005817) 9900 GUIBAL. AVE. commodity was weighed measured or counted GILROY CA 95020 by a weighmaster,whose signature is on this certificate,who is a recognozed authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business and Professions Code administered by JOB NO the Division of Measurement Standards ofthe California Department of Food and Agriculture. JOB SC.: 180 REDDING D. REED &GRAHAM, INC. WEIGHMASTER PURCHASE ORDER: CUSTOMER TRUCK: 16 X JOSE ESPINOSA R&G JOB NUMBER: 382804 R&G TRUCK NO.: RG-2801 DEPUTY WEIGHMASTER TARE IN: 11:02AM -09/07/2017 GROSS TONS 37.69 LOAD OUT: 11:10AM -09/07/2017 TARE TONS 25 .95 JOB LOADS JOB TONS NET TONS 1 1 .74 DAILY 2 21 .76 TOTAL 5 37.33 DRIVER- ON DESCRIPTION UOM QUANTITY PRICE TOTAL ASPHALT 1/2 MEDIUM TON 11 .74 ABOVE LINE CONY. TO METRIC TONS MT 10.66 SS-1 H EMULS IN OUR PAILS GAL 5 ABOVE LINE CONV. TO LITERS LIT 19 WARNING THE ABOVE RECEIVED BY: X Products may contain chemicals which are known to the State of California to cause " CUSTOMER/YARD COPY* cancer,birth defects or other reproductive harm. CA Health&Safety Cade Section 25249.5 REED & GRAHAM, INC. TAG NO: 589123 REE- , ' ROAD OILS R-ASPHALTS OVE KOTE PRODUCTS IIII IIIIIIIIIII II IIIII IIIIIIIIIIII{IIIIIIIIIIIIIIIII 690 SUNOL STREET - SAN JOSE,CA 95126 ST1-SSS123 TELEPHONE(408)287-1400 FAX(408)294-3696 WEIGHED AT: 690 SUNOL STREET WWW.RGINC.COM SAN JOSE, CA 95126 WEIGHMASTER CERTIFICATE CUSTOMER EXTREME BACKHOE SERVICES THIS IS TO CERTIFY that the following described (005817) 9900 G U I BAL. AVE. commodity was weighed measured or counted by aweighmaster,whose signature ison his GILROY, CA 95020 certificate,who is a recognozed authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business and Professions Code administered by JOB NO.: the Division of MeasurementStandards ofthe California Department of Food and Agriculture. JOB DESC.: 180 REDDING RD. REED & GRAHAM, INC. WEIGHMASTER PURCHASE ORDER: CUSTOMERTRUCK: MARKSTANLY X RENE RASCON R&G JOB NUMBER: 382804 R&G TRUCK NO.: RG-1249 DEPUTY WEIGHMASTER TARE IN: 01:20PM -09/07/2017 GROSS TONS 24.22 LOAD OUT: 01:20PM -09/07/2017 TARE TONS 11 .35 JOB LOADS JOB TONS NET TONS 12.87 DAILY 3 34.63 TOTAL 6 50.20 DRIVER- ON DESCRIPTION UOM QUANTITY PRICE TOTAL ASPHALT 1/2 MEDIUM TON 12.87 ABOVE LINE CONY. TO METRIC TONS MT 11 .68 WARNING THE ABOVE Products may contain chemicals which are RECEIVED BY: X known to the State of California to cause " CUSTOMER COPY* cancer,birth defects or other reproductive harm. CA Health&Safety Code Section 25249.5 REED &GRAHAM. �N.0 ,...,L_..� �:.._W._,,,- TAG�No: 589068 REED &GRAHAROAD OILS-I ASPHAOLTS-OVERKOTE PRODUCTS IIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIII IIIII 1I1IN 690 SUNOL STREET - SAN JOSE,CA 95126 ST1-5e9066 TELEPHONE(408)287-1400 FAX(408)294-3696 WEIGHED AT: E2 690 SUNOL STREET WWW.RGINC.COM SAN JOSE, CA 95126 WEIGHMASTER CERTIFICATE CUSTOMER: EXTREME BACKHOE SERVICES THIS IS TO CERTIFY that the following described (005817) 9900 GUIBAL AVE. commodity was weighed measured or counted G I LROY CA 95020 by a weighmaster,whose signature is on this certificate,who is a recognozed authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business and Professions Code administered by JOB NO.: the Division of Measurement Standards of the California Department of Food and Agriculture. JOB DESC.: 180 REDDING RD. REED & GRAHAM, INC. WEIGHMASTER PURCHASE ORDER: CUSTOMER TiWbK: 16 X JOSE ESPINOSA R&G JOB NUMBER: 382804 R&G TRUCK NO.: RG-2801 DEPUTY WEIGHMASTER TARE IN: 10:50AM -09/07/2017 GROSS TONS 25. 95 LOAD OUT: 11:01 AM -09/07/2017 TARE TONS 15.93 JOB LOADS JOB TONS NET TONS 10.02 DAILY 1 10.02 TOTAL 4 25.59 DRIVER- ON DESCRIPTION UOM QUANTITY PRICE TOTAL ASPHALT 3/4 MEDIUM TON 10. 02 ABOVE LINE CONY. TO METRIC TONS MT 9.09 WARNING THE APOVE Products may contain chemicals which are RECEIVED BY: X known to the State of California to cause * CU STOMER/YARD COPY* cancer,birth defects or other reproductive harm. CA Health&Safety Code Section 25249.5