92-114
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- Permit No.
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RECErP'l' NO.
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RRCROlu::rmmrr PERXI'l'
(for worJt1nq within tl:1e
public riqht-of-vay) X-Ref. fUe
Issued t,- -"5-- <':; L Application Date
Permit expirew in- 12 mas. Application expires in 6 IIIOS.
APPLICA'1'ION - Application is hereby _de for a Public Wora Permit in accordance with campbell
MUnicipal COde, Section 11.04. (Application expires in 6 IIIOnths if permit not PD!led) _ ,
A. Work address or tract, 'i'l f ' '1/ (h ( -- 1/1" I"! ~.. -, l d C'\ .4vJ{ ~ (. /1.-- '-71 /"-_J,. r:.
DEPT. OF PUBLIC WORKS
70 Nortb First St.
C&IIpbell, CA 9!50"
(408) 866-2150 ..
B.
utility trench location
Nature of work: ") - f , , ,- c '.1-
I." .//-, l ~/ __-,\ co., :1 J
C.
Attach five (5) copies of a drawinq sbowinq the location, extent and c:liIIensions of the work
The drawinq sball show the relation of the proposed work to existinq surface and underqround
iJIIproveaents. When approved by the City Enqineer, saiel drawinq becOJlu a part of this permit.
The General COnditions for all permits are listed on the revene side. Special Provisions for
this permit are listed below. Failure to abid. by these conditions and provisions _y result
in job ahut-down and/or forfeiture of Paithful Performance Sureti_ and ca.b deposita. (See
General COnditions 1 and 2).
D.
E. An application fe. must accompany this application.
Name of Applicant r:z l-J S S if L ;;: )" J.-I I
Addre.s C; / (;. A . (: '#l" {) r. c::;, "'7
This fee i. non-refundable.
Telepbone: ( (( ("'6) i ll/--
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F"~lo(... -z.;""7...4 - ~ tt
Is this work beinq done by the property owner at their own r88ielence? ..-/ ves _no
Complete and attach Workers' COJIpensation and Contractor Information forma.
The Applicant/Permittee hereby aqrees by atfixinq their siqnature to thill permit to hold the City at
campbell, ita otficera, aqenta and employees free, sate and harmless trom any claiJII or demand for
clamaqe. r88ultinq trom the work covered by this permit.
The Applicant/Panaittee hereby acJcnowledqes that they have read and understand both the front
back ot this permit, and that they will in,form their contractor(s) of the information.
J ;"",
ACCEPTED .<-" ~ J J(L ~~ ( Cr /[c _J tL l 'l- - '3 -? 2.
Applicant (Permittee) print/siqn Date
NOTES: ALL WORK SHALL CONFORM WITH THE ATTACHED, APPROVED PIANS AND ALL APPLICABLE CAMPBELL
STANDARD DRAWINGS AND CONDITIONS.
THE ~CTOR HOST HAVE THIS PERHIT AND APPROVED PIANS ON-SITE AND MOST MEET WITH THE P.W.
INSPEC1'OR ON THE SITE AT LEAsT TWO DAYS BEFORE STAR'1'ING WORK. APPLICANT HOST CONTACT THE INSPECTOR
TO ARRANGE FIELD MEETING.
NOTICE MOST BE GIVEN TO PUBLIC WORKS AT LEAST 24 HOORS BEFORE RESTARTING ANY WORK.
SPECIAL PRovrsroNs
_1.
Street shall not be open cut for underqround in.tallation.. Minimum cuts may be allowed
tor connections or exploration holes. Such cuts must be sneciticallv annroved bv the
Inllbee1:ar nrior 'to c:ut:t:ina.
paveaent -y be cut tor underqround installations and IIIWIt be restored in accordance with
the Utility Trench Restoration Standard Drawinq. .
Work to be staked by a licensed Land Surveyor or Civil Enqineer and two (2) copies ot the
cut sheets sent to the Public Work Department before~tartinq work.
The hours ot work are limited to outside the hours ot 7-9 a... and 3-6 p.m. for any work
affectinq a traffic lane.
_2.
_3.
_4.
_5.
STANDARD
,"'!{'
AMOUNT
/OJc.~
PERHn' APPLIQ'l'IOX FEE
PLD aB:a DBl'OSn'
stJRE'n F01l FAn'BPUL PERFoRlWfa:
$105.00
$500.00
(loot OF ERG. EST.)
$
~} ~:-
$ bet :..-1-/ t., 1:.'-- 17
$7c.; 3".:::. Co
'$ ') Ci: I 7 '"" I
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$... 7/(.' ~i: C (;
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r/t:;, iLl' '
, /"' 7
) --.<-/
- <--
Date
CASH DBl'OSn' (n OF SURE'1'lr, $500 KIH)
PLD CBECIt , IN8PEc:nON FEE. ($0-$100,000 lOt,
$100,000 - $!500,000 /~'. $500~...~0 and ~e 7t, $100 KIH)
APPROVED FOR ISSUANCE I ~~ /C "- ~~
or City Enqineer
f: PW PERHIT
Revised 10/91 (SEE OTHER SIDE)
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9-"
CITY OF CAMPBELL
October 24, 1995
Public Works Department
Mr. Russ Aleshi
548 Hacienda Avenue
Campbell, CA 95008
.--
.-
SUBJECT: PERMIT: #92-114, 8 151
LOC f TION: 548 CIENDA AVENUE
FIN INSP ON AND ACCEPTANCE
Dear Mr, Aleshi:
The City of Campbell has made a fInal inspection of subject Public Works improvements and
fmds the work to be acceptable and in conformance with City standards. Accordingly, the City
Engineer accepts the improvements,
Due to the length of time which has transpired since the improvements were originally
constructed, the one year maintenance period will be considered to have been met. No
maintenance is required, Your warranty requirements and any surety, are hereby released,
Please fmd attached your original Performance Bond which we are returning to you.
Additionally, your cash deposits of $2,012,00 for Permit #88-151 and $800.00 for Permit #92-
114, plus any interest due, are now being processed and will be sent to you under separate
cover.
If you have any questions, please call Randy Westfall, Public Works Inspector, at (408) 866-
2165.
Sincerely,
/deJ:?II, ~
Robert M. Harary
City Engineer
~
Attachment
cc: First Assurance & Casualty Co" 16901 N, Dallas Parkwy, Suite 210, Dallas, TX 75248
h:aleshi(mw)6,0
70 North First Street. Campbell, California 95008.1423 ' TEL 408.866.2150 . FAX 408.379.2572 . TOD 408,866.2790
NEW PW FAX #
408-376-0958
To: Accounts Receivable
Please Issue Check
Payable to:
Address - Line 1:
Line 2:
City:
Description:
Amount Payable:
Account Number:
ate and Receipt No:
Permit No:
Purpose:
Requested by:
Approved by:
FINANCE ONLY:
Verified by:
Approved by:
Mail As Is:
Return To:
Other:
rev: 3/25/95
City of Campbell - Check Request
Mr. Russ Aleshi
548 Hacienda Ave.
Campbe 1 1
State: CA Zip: 950 0 8
REFUNDABLE DEPOSIT
$2012.00
101.2203
1/20/89, #2619
88-151
Finance Only:
INTEREST EARNED
101.540.7448
Refund Cash Deposit
Randy Westfall ~
~ 1iJI.~
Robert Harary
Title: City Engineer
Title: Pub. Wks . Inspector Date:
Title:
Title:
Date:l0 / 24 /95
Date:
Date:
Special Instructions For Handling Check
Mail in Attached Envelope:
Marlene Pomeroy
(NAME)
Public Works
(Department)
To: Accounts Receivable
Please Issue Check
Payable to:
Address - Line 1:
Line 2:
City:
Description:
Amount Payable:
Account Number:
ate and Receipt No:
Permit No:
Purpose:
Requested by:
Approved by:
FINANCE ONLY:
Verified by:
Approved by:
Mail As Is:
Return To:
Other:
rev: 3/25/95
City of Campbell - Check Request
Mr. Russ Aleshi
548 Hacienda Ave
r.nmphp 11
State: CA
Zip: 95008
REFUNDABLE DEPOSIT
Finance Only:
INTEREST EARNED
$800.00
101.2203 101.540.7448
5/14/92, #41853
92-114
Refund Cash DeposiT
Randy Westfall ~
RObert1f:/af:' ~
Title: Pub. Wks . Inspector Date
Title: City Engineer DatelO/24/95
Title:
Date:
Title:
Date:
Special Instructions For Handling Check
Mail in Attached Envelope:
Marlene Pomeroy
(NAME)
Public Works
(Department)
'-,
Pe.tnUt 'lZ-)l ~
THE AMERICAN INSTITUTE OF ARCHITECTS
AlA Document A312
B)ND NO FA 190845
Performance Bond
Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable.
CONTRACTOR (Name and Address):
JRT Construction Company
18191 Los Gatos Saratoga Rd....
Monte Sereno Ca. 95030
SURETY (Name and Principal Place of Business):
First Assurance & Casualty Company
16901 N. Dallas Parkway Suite 210
Dallas, Tx. 75248
OWNER (Name and Address):
Ci ty of Campbell
70 North First St.
Campbell, CA. 95008
CONSTRUCTION CONTRACT
Date: December 13, 1991
Amount: Seventy Thousand Three Hundred & 00/100 ($70,300.00)
Description (Name and Location): Offsite Improvements at 548 Hacienda Ave., Campbell, Ca.
BOND
Date (Not earlier than Construction Contract Date): May 11, 1992
Amount: Seventy Thousand Three Hundred & 00/100 ($70,300.00)
Modifications to this Bond: ~ None
o See Page 3
CONTRACTOR AS PRINCIPAL
Company:
JRT Construc
Signature:
Name and Tit
SURETY
Company: (Corporate Seal)
First Assur. ~ & 1~~
~,. \
Signature: : {):L. "y
Name and Title: tomeY-1n-Fact
(FOR INFORMATION ONLY-Name, Address and Telephone) ,
AGENT or BROKER: OWNER'S REPRESENTATIVE (Architect, Engineer or
other party):
AlA DOCUMENT A312 . PERFORMANCE BOND AND PAYMENT BOND' DECEMBER 1984 ED, . AlA @
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE.. NW" WASHINGTON, D.C. 20006
THIRD PRINTING. MARCH 1987
WARNING: Unlicensed photocopying violates U.S. trademark laWlland Is subject to legal prosecution.
A312-1984 1
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1 The Contractor and the Surety, jointly and severally,
bind themselves, their heirs, executors, administrators,
successors and assigns to the Owner for the performance
of the Construction Contract, which is incorporated herein
by reference.
2 If the Contractor performs the Construction Contract,
the Surety and the Contractor shall have no obligation
under this Bond, except to participate in conferences as
provided in Subparagraph 3.1.
3 If there is no Owner Default, the Surety's obligation
under this Bond shall arise after:
3,1 The Owner has notified the Contractor and the
Surety at its address described in Paragraph 10 below
that the Owner is considering declaring a Contractor
Default and has requested and attempted to arrange a
conference with the Contractor and the Surety to be
held not later than fifteen days after receipt of such
notice to discuss methods of performing the Construc-
tion Contract. If the Owner, the Contractor and the
Surety agree, the Contractor shall be allowed a reason-
able time to perform the Construction Contract, but
such an agreement shall not waive the Owner's right. if
any, subsequently to declare a Contractor Default; and
3,2 The Owner has declared a Contractor Default and
formally terminated the Contractor's right to complete
the contract. Such Contractor Default shall not be de-
clared earlier than twenty days after the Contractor and
the Surety have received notice as provided in Sub-
paragraph 3,1; and
3.3 The Owner has agreed to pay the Balance of the
Contract Price to the Surety in accordance with the
terms of the Construction Contract or to a contractor
selected to perform the Construction Contract in accor-
dance with the terms of the contract with the Owner.
4 When the Owner has satisfied the conditions of Para-
graph 3, the Surety shall promptly and at the Surety's ex-
pense take one of the following actions:
4,1 Arrange for the Contractor, with consent of the
Owner, to perform and complete the Construction
Contract; or
4,2 Undertake to perform and complete the Construc-
tion Contract itself, through its agents or through inde-
pendent contractors; or
4,3 Obtain bids or negotiated proposals from
qualified contractors acceptable to the Owner for a
contract for performance and completion of the Con-
struction Contract. arrange for a contract to be pre-
pared for execution by the Owner and the contractor
selected with the Owner's concurrence, to be secured
with performance and payment bonds executed by a
qualified surety equivalent to the bonds issued on the
Construction Contract, and pay to the Owner the
amount of damages as described in Paragraph 6 in ex-
cess of the Balance of the Contract Price incurred by the
Owner resulting from the Contractor's default; or
4,4 Waive its right to perform and complete, arrange
for completion, or obtain a new contractor and with
reasonable promptness under the circumstances:
,1 After investigation, determine the amount for
which it may be liable to the Owner and, as
soon as practicable after the amount is deter-
mined, tender payment therefor to the
Owner; or
.2 Deny liability in whole or in part and notify the
Owner citing reasons therefor.
5 If the Surety does not proceed as provided in Paragraph
4 with reasonable promptness, the Surety shall be deemed
to be in default on this Bond fifteen days after receipt of an
additional written notice from the Owner to the Surety
demanding that the Surety perform its obligations under
this Bond, and the Owner shall be entitled to enforce any
remedy available to the Owner. If the Surety proceeds as
provided in Subparagraph 4.4, and the Owner refuses the
payment tendered or the Surety has denied liability, in
whole or in part. without further notice the Owner shall be
entitled to enforce any remedy available to the Owner.
6 After the Owner has terminated the Contractor's right
to complete the Construction Contract, and if the Surety
elects to act under Subparagraph 4.1, 4,2, or 4.3 above,
then the responsibilities of the Surety to the Owner shall
not be greater than those of the Contractor under the
Construction Contract, and the responsibilities of the
Owner to the Surety shall not be greater than those of the
Owner under the Construction Contract. To the limit of the
amount of this Bond, but subject to commitment by the
Owner of the Balance of the Contract Price to mitigation of
costs and damages on the Construction Contract, the Sure-
ty is obligated without duplication for:
6.1 The responsibilities of the Contractor for correc-
tion of defective work and completion of the Construc-
tion Contract;
6,2 Additional legal, design professional and delay
costs resulting from the Contractor's Default, and re-
sulting from the actions or failure to act of the Surety
under Paragraph 4; and
6.3 liquidated damages, or if no liquidated damages
are specified in the Construction Contract, actual dam-
ages caused by delayed performance or non-perfor-
mance of the Contractor.
7 The Surety shall not be liable to the Owner or others for
obligations of the Contractor that are unrelated to the Con-
struction Contract, and the Balance of the Contract Price
shall not be reduced or set off on account of any such
unrelated obligations. No right of action shall accrue on
this Bond to any person or entity other than the Owner or
its heirs, executors, administrators or successors.
8 The Surety hereby waives notice of any change, includ-
ing changes of time, to the Construction Contract or to
related subcontracts, purchase orders and other obliga-
tions.
9 Any proceeding, legal or equitable, under this Bond
may be instituted in any court of competent jurisdiction in
the location in which the work or part of the work is located
and shall be instituted within two years after Contractor
Default or within two years after the Contractor ceased
working or within two years after the Surety refuses or fails
to perform its obligations under this Bond, whichever oc-
curs first. If the provisions of this Paragraph are void or
prohibited by law, the minimum period of limitation avail-
AlA DOCUMENT A312 ' PERFORMANCE BOND AND PAYMENT BOND. DECEMBER 1984 ED. ' AlA :Fil
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., NW.. WASHINGTON, D,C 20006
THIRD PRINTING. MARCH 1987
WARNING: Unlicensed photocopying violates U,S, trademarl< iaws and is subject to legal prosecution,
A312-1984 2
able to sureties as a defense in the jurisdiction of the suit
shall be applicable.
10 Notice to the Surety, the Owner or the Contractor shall
be mailed or delivered to the address shown on the sig-
nature page,
11 When this Bond has been furnished to comply with a
statutory or other legal requirement in the location where
the construction was to be performed, any provision in this
Bond conflicting with said statutory or legal requirement
shall be deemed deleted herefrom and provisions con-
forming to such statutory or other legal requirement shall
be deemed incorporated herein. The intent is that this
Bond shall be construed as a statutory bond and not as a
common law bond,
12 DEFINITIONS
12.1 Balance of the Contract Price: The total amount
payable by the Owner to the Contractor under the
Construction Contract after all proper adjustments
have been made, including allowance to the Con-
MODIFICATIONS TO THIS BOND ARE AS FOLLOWS:
,,' ,
tractor of any amounts received or to be received by
the Owner in settlement of insurance or other claims
for damages to which the Contractor is entitled, re-
duced by all valid and proper payments made to or on
behalf of the Contractor under the Construction Con-
tract.
12.2 Construction Contract: The agreement between
the Owner and the Contractor identified on the sig-
nature page, including all Contract Documents and
changes thereto.
12.3 Contractor Default: Failure of the Contractor,
which has neither been remedied nor waived, to per-
form or otherwise to comply with the terms of the
Construction Contract,
12.4 Owner Default: Failure of the Owner, which has
neither been remedied nor waived, to pay the Con-
tractor as required by the Construction Contract or to
perform and complete or comply with the other terms
thereof,
(Space is provided below for additional signatures of added parties, other than those appearing on the cover page.)
CONTRACTOR AS PRINCIPAL
Company:
(Corporate Seal)
Signatu re:
Name and Title:
Address:
SURETY
Company:
(Corporate Seal)
Signature:
Name and Title:
Address:
AlA DOCUMENT A312 . PERFORMANCE BOND AND PAYMENT BOND' DECEMBER 1984 ED, . AIA~R;
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE" N.w., WASHINGTON, D.C. 20006
THIRD PRINTING. MARCH 1987
WARNING: Unlicensed photocopying violates U,S, tnldemark laws and Is subject to legal prosecution,
A312-1984 3
.,.
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, '~':.'?:~_-'~" - :,::,:,t':I':'NI))".~~ji,'
1,:'0.;.: ~ - ~'\' ,\,';:~ t-'
~:\-:' _\\ \\\\:1/1
l~~~;if'}~; POWFUF ATIORNEY
, ., ", -,/-: -""1', 'KNOW ALL MEN BY THESE PRESENTS: That the FIRST ASSURANCE AND CASUALlY COMPANY, LTD" Ordtoa HOUle,
..".2f~ f
i ;,..:.'.;.;,,:\t~ ",' Duke Street, Orand Tulk, Tum and Caicoa BWI, by Jcsscl, Maynard, Managing Di~ in ~ of 8Uthority gflllltcd by a Board ,,','
',," . ..'::~\:~:~: .of Directors Resolution dated July 1st, 1990, which is set forth below hereof and which RcaoIutioa itbcrcbf to boin full force and effect' j ;-:[J
i.;~> .:-si::' /-i,j, on the date hereof, do hereby nominate, consti1utc and appoint: "'; ~~.
:~~%.. ;~~f1, Merle L. noger ~~?~
',' " ,...' , ;a' 2300 Contra Costa Blvd. 1 :~,.
,(~~~?~J,i\::~t ' ~_Dt mn, CalltorDia 94523 ..; .~;
~,~,..;,;,;..".,..,~1.:.:,~,;,!,~,I".,'; :: ':...":' ::.,"'::...::~~,;',':;. ':.~-;_.:;;':::;.;"'- ..~..,_.... by..... ;~~
- - - -" I' ~:.:~:\~ ~ ~ ~.t/
',/,'f;.))~ "",','!,:~..' and execution of such bonds or undertakings in pursuance of ~ p~ts;~ibc as binding upon aaiciClllllpal\, -~, IS fuJ1y and amply ".,"', ~C(-:'i~'i'
()/' , . "r~\\,~ .to all intmta and purpoaea, of the rcspcc:tive COII1pllDy at their orrlCCSin()rand Tum and Caicoa, in tbcir;OIIIDpcnona, Oreuoo HOUle, "iiff .. "'5;~~~
", I,' ..>)'/"'''':1' Duke Street, Orand Tulk, Tum and Caicoa BWI, '. fL.. '. .,
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:: "C'{~*'! .!;~ f. Prairie Village orr_ Center 7301 Miaaion Road, Suite 3t2 ,~.~....~~
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CERTIFICATE BC..JJ , ~ ;lri ~~::~~: _.~~::\
I, the undersigned certify that I am the Managing Director of Fint Assul'lUlCe and Casualty Company Ltd., and that the :.' ~" ' :N~j ":~! r1
'attached Power of Attorney remains in full force and effcct, and has. nol been revoked: And furthermore is DO\V in full forc~ and effect. .' j tfl.,,</t}' .;{~j
IN TESTIMONY WHEREoF, 1 have hereunto subscnbcd my name and arrlXed the Corporate Seal of the said Company .\W ':.y;..J:
.this ll!L day of December . C:";~..- ~':
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Bond No,FA
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70 NORTH FIRST STREET
C AMP BEL L, C A L I FOR N I A 9 5 0 0 8
(408) 866-2100
FAX # (408) 379-2572
Deparfment:
Public Works
March 15, 1994
Bob Bailey
1100 Concord Building
15 North Robinson
Oklahoma City, Oklahoma 73102
Subject:
PERMIT NUMBER: 92-114
WCA nON: 548 Hacienda Avenue
SURETY BOND NO. FA190845
Dear Mr. Bailey:
The City has made several unsuccessful attempts to have deficiencies corrected in the work
performed under the above encroachment permit. A list of these deficiencies is attached
for your reference. I understand from my conversations with Bill Hazelwood of Frontier
Administrator in Scottsdale, Arizona that the company which issued the bond for this
project, First Assurance and Casualty, is in bankruptcy. I also understand that you are the
trustee handling this bankruptcy. The applicant for this permit, Mr. Russ Alesbi, and the
contractor, JRT Construction, have both been unresponsive in correcting these deficiencies.
The City now wishes to call upon the bond to have these deficiencies corrected. Please
contact me and advise me of the steps necessary to have these deficiencies corrected.
I have enclosed a copy of the performance bond for your reference. H you need any
additional information, please do not hesitate to call me at (408)866-2158.
Very trul}! ~2-ll:rs'l!k
-/~
~y;/!1:l<:(..~ {. I
Michael A Fuller
Assistant Engineer
~\\cchments: Deficiency List dated 7/30/93, Bond
.J cc: JRT Construction, 18191 Saratoga-Los Gatos Road, Monte Sereno, CA 95030
File: Permit #92-114
h:alesbi(6.0)nnp
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70 NORTH FIRST STREET
C AMP BEL L, C A L I FOR N I A 9 5 0 0 8
(408) 866-2100
FAX # (408) 379-2572
Department:
Public Works
September 23, 1993
FINAL NOTICE
Mr. Russ Aleshi
548 Hacienda Avenue
Campbell, CA 95008
SUBJECT: PRELIMINARY INSPECTION REPORT-DEFICIENCIES-FINAL NOTICE
PERMIT NO. 92-114
LOCATION: 548 Hacienda Avenue
SURETY BOND NO. FA 190845
Dear Mr. Aleshi:
As previously reported, we have made a preliminary inspection on subject construction
work. There are deficiencies in the work which were indicated on the attached deficiency
list dated July 30, 1993. These deficiencies must be corrected in accordance with City
standards before we can make a final inspection or acceptance of the work. If these
deficiencies are not corrected within 30 days, the City will call on the performance surety
you have posted to complete the work.
Upon completion of the corrective work, please submit a written request for a final
inspection and acceptance. Prior to final acceptance of the work, you will also need to
make the necessary arrangements to provide the one-year maintenance surety which will
be used to replace the surety currently held by the City.
Sincerely,
~a~
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Michael A. Fuller
Assistant Engineer
11
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Attachment: Deficiency IiSj L~ I ! l Z.
cc: First Assurance & Casualty Co., 16901 N. Dallas Pkway., #210, Dallas, TX 95248
Suspense - 30 days
File (Encroachment Permit No.92-114)
JRT Construction Co., 18191 Saratoga-Los Gatos Road, Monte Sereno, CA 95030
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H:92-114.LTR(JD)
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70 NORTH FIRST STREET
C AMP BEL L, C A L I FOR N I A 9 5 0 0 8
(408) 866-2100
FAX # (408) 379-2572
Department:
Public Works
July 30, 1993
Mr. Russ Aleshi
510 Beth Drive
San Jose, CA 95111
SUBJECT: PRELIMINARY INSPECTION REPORT - DEFICIENCIES
PERMIT NO: 92-114
LOCATION: 548 Hacienda Avenue
Dear Mr. Aleshi:
You have requested a final inspection on subject construction work. There are deficiencies
in the work which are indicated on the enclosed preliminary inspection report dated
July 30. These deficiencies must be corrected in accordance with City standards before we
can make a final inspection or acceptance of the work. Please call for a field review of the
inspection report as soon as possible.
Upon completion of the corrective work, please submit a written request for a final
inspection and acceptance. Prior to final acceptance of the work, you will also need to
make the necessary arrangements to provide the one-year maintenance surety which will be
used to replace the performance surety currently held by the City.
Sincerely,
J] j' .
: i /
. _'7 ( "-. L- '- -\..C
Don King ?
Assistant Engineer
MAF:hr
Attachment: Deficiency List
WVSD Letter to Aleshi
cc: Jeff Taylor, JRT Construction
Building Division
File (Encroachment Permit # 92-114)
A: \ALESI lID 6.INS (Ianddev.disk)
N:k,s tdW 4.. 7-1~ t, f: ()erl-~II
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CITY OF CAMPBELL
INSPECTION DEFICIENCY LIST
GENERAL:
11)
~2)
1,3)
14)
(5)
j 6)
17) Remove storm sewer manhole lids, clean rims and replace.
8) Have water valve raised. ?
\V9) Paint stop bar, stop legend and 50 ft. double yellow stripe on Walnut.
UO) Replace center line stripe on Hacienda.
i'iI) Flow test curb and gutter.
/12) Remove concrete spillage on sidewalk.
-13) Provide "As Built" reproducables? A<G 6"'~/'~ IMf. It'Ic.IJ
<14) Submit compaction test results on subgrade and on A.C.
LANDSCAPING: I ~. PftfN. .J.W- ~/rJ~'rius tall ""'It ; (.pi.; .
)V ALNUT
viI) Replace 80% of turf which is dead. ~ ~ - e)C
/. 2) Regrade entire parking strip. , )
· 3) Backfill around sprinkler heads.rrt1:~ ltrJ,1 ~j rto/A.ituf .
'4) Adjust sprinkler heads to grade. %'t( Hlf 6aG~frl~ ~
A Replace southerly tree. ~ JJ~f r~f,44Yi./! ".v; 1/ U/ #.
Trim asphalt at lip of gutter.
Patch face of curb mid lot on Hacienda. (l-li~L ~/fO""; e,f.~ It:tfJ....)
Remove barricade post at west end of project and finish sidewalk. (!;.If w,;!Iv)
Repair end of curb on Walnut.
Clean paint from concrete.
Clean storm sewer line.
CITY OF CAMPBEll
Inspection Deficiency List/9Z-114/548 Hacienda Avenue
Page 2
... 6)
~ 7)
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. 3)
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A;
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,II)
. 8)
Install watering tubes both trees.~t -I.flu
W~ri
All ties are to be in figure eight.
,
1"')
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HACIENDA
Regrade both parking strips.
/1, P'~b PJ! AtJ.(,r/.,'.. '/"I:,')L.
/1. vi r:1J:r,.,..dj:,. ,( ...<<tf ft, e irl.~ L. of- {,.C r~;
Replace dead turf.
Backfill around sprinkler heads.
Install watering tubes. (all trees)
Remove 1" soil from root crown and move mulch back to 4" dia. from tree
base. (all trees)
All ties to be in figure eight.
Remove all nursery stakes.
All planting stakes are to be plumb and parallel to sidewalk.
· 9) Adjust all sprinkler heads to grade. N
/i G ) ~11M-,." I J J1L 5-1. ~~ w~ t .-L. P J.^^Cl U"4 f,.t t - tJ/( ~ Ifl fl (Q .
STREET LIGHTING:
~ 1)
Number pole on Walnut (Z54~) M:l~-.ref tvJ S1-
/Z) Number pole on Hacienda (Z5454)
h) Grout under both poles,
Pay P.G.& E. connection fee. 1 ft.;",'l-Y. tUbf.
s) :)k1o'1 ~ f v..lIl..). /, foe. hl}L ~+ ~1I(,t-,f ""&tl~ .
A:\ALESHlDE.INS(landdev.disk) ") 'J} /l~ JI1~+- 1(lI\J,..~ ~.
, · 4)
WEST VALLEY SANITATION DISTRICT
OF SANTA CLARA COUNTY
SERVING RESIDENTS OF
CITY OF CAMPBELL
TOWN OF LOS GA TOS
CITY OF MONTE SERENO
CITY OF SARA TOGA
UNINCORPORA TED AREA
100 East Sunnyoaks Avenue
Campbell, California 95008
Telephone (408) 378-2407
July 29, 1993
IiECEiVL:D
JUL S 0 1993
Public W orb I Engineoring
Mr. Russ Aleshi
510 Beth Drive
San Jose, CA 95111
RE Townhouse Development
558 Hacienda Avenue, Campbell
Dear Mr. Aleshi:
At the request of City of Campbell, the district performed an
~~~ inspection of the referenced development on July 23, 1993.
~ 91u.r inspector discovered the following deficiencies:
~~r~ ~1 1221 Walnut Ave.: Replace the cleanout box with a cristy G-5
't.- I box.
v1)/2. 548 Hacienda Ave.: Raise the cleanout box and install a lid.
~, r
~~~~! 3. 558 Hacienda Ave.: Cut down the stack and install cleanout
box.
Please proceed with the repair. A clearance will be issued as soon
as the above items are corrected. Contact our inspector, Bob
Moehle, if you have any questions.
Very truly yours,
Reid
. stric~~neer
athan K. Lee
istant Civil Engineer
by
cc
Don King, campbell~
'.
IFORMERL Y COUNTY SANITATION DISTRICT NO 4\
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CITY Of CAMPBELL
l
70 NORTH FIRST STREET
CAMPBELL, CALIFORNIA 95008
(408) 866-2100
FAX # (408) 379-2572
Public -,Works
Department:
June 4, 1993
Mr. Russ Aleshi
510 Beth Drive
San Jose, California 95111
Subject: Permit Number 92-114, 548 Hacienda Avenue
Dear Mr. Aleshi:
Please consider this letter Amendment No. 1 to Permit Number 92-
114. The asphalt paving on your proj ect shall be constructed
according to the grades shown on the attached plan, which shall
replace the grades on the original approved plan for your project.
since no agreement could be reached regarding the City's funding
the portion of the improvements beyond the centerline of Hacienda
and Walnut, your are hereby authorized to construct the asphalt
paving per the attached plan to the centerline of Hacienda Avenue
and Walnut Drive. AC conforms are required at the limits of the
work to allow for safe passage of cars until the portion beyond the
centerlines is complete.
The city currently has no vehicle insurance certificate on file
from your general contractor or your paving subcontractor. A
certificate which meets the attached requirements for vehicle
insurance must be submitted before this work can begin.
Please attach this amendment to your copy of
permit #92-114. Please notify our Public Works
Gomez, at 866-2150 when this work is scheduled.
questions, please call me at 866-2158.
:it:?t~ol~ 1
Michael A. ~~
Assistant Engineer
the encroachment
Inspector, Chuck
If you have any
cc: Chuck Gomez
File (Permit #92-114)
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City of Campbell
...
70 N. FIRST STREET CAMPBELL, CALIFORNIA 95008
(408) 866-2100
To .
Petersen construction Company
.,$53 "tcGlincey :..ane
campbell ~, 95303
CITY OF CAMPBELL
70 N. FIRST ST_
CAMPBELL. CALIF. lllIOO8
.
.
VENOORPHONE'< 409 371-7049
DEPARTMENT
IlClNATURE
..! (,; t JiK
H.Puller~t.Quinney
1 L.S. Provide equipment, ma:t.erials aDd labor
necessary and cons~ruct street i rovemen a
as described -.n the attached
8al as
amended. A 1;)' retention will be held fo 6S
days after of a Notice Qf
completJ..on b t:he ci tv.
Final p"
IS? ~~ () L.o-
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0-
All INVOICES ARE TO BE ADDRESSED TO
CITY OF CAMPBEll, FINANCE DEPARTMENT
70 N, FIRST ST., CAMPBEll, CA 95008
o
AUTHORIZED SIGNATURE
DATE DEUVE~ED.
CERTIFICATION ~
SIGNATURES ..
,..
"'\. .- ...~
, 4;,., .. .,
Only employees so designated are authorized to sign for the
receipt of the materials and/or services indicated on this
order,
The above signed certifies that the
quantities and quality are received as
indicated,
f.
I f
"~-_.,
:~NVOICE
[prnJU:rn01]~ ~m~0iJ1]rn(gj]nm~ ~m~[p(j]~~~
563 McGlincey Ln., Campbell CR. 95008 ... '0
CA. L1C, # 478388 (408)377-7049
CUSTOMER #: 204
INVOICE #: 10546
INVOICE DATE: 11/09/93
BILL TO:
JOB: 92011
CITY OF CAMPBELL
70 N.FIRST STREET
JRT CONST-548 HACIENDA
CAMPBELL
CAMPBELL, CA 95008
YOUR REFERENCE #:
OUR REFERENCE #:
DUE DATE: 12/09/93
-------- ------------------------------ ------------ --------- ----------
-------- ------------------------------ ------------ --------- ---------- ---
CODE DESCRIPTION QUANTITY PRICE AMOUNT TAX
-------- ------------------------------ ------------ --------- ----------
-------- ------------------------------ ------------ --------- ---------- ---
RETENTION BILLING ON CONTRACT COMPLETED (9,200.00)
920.00 N
~~
TOTAL:
920.00
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FINANCE DEPT.
4 - oog8
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KAY TO fAY
/J1I1 ~ ~ Ill/1/73
CITY OF CAMPBELL.
PUBLIC WORKS iJ dtl....2
ACCT #I 00).23,710 ,--"'T'T;/"
TERMS: NET 30 DAYS
MAKING THE GRADE I
@pnnted on recycled paper.
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70 NORTH FIRST STREET
C AMP BEL L, C A L I FOR N I A 9 5 0 0 8
(408) 866-2100
FAX # (408) 379-2572
Department: Public Works
November 10, 1993
Frontier Administrator
Attn: Bill Hazelwood
8283 North Hayden Road, Suite 128
Scottsdale, AZ 85258
Subject:
Notice of Nonperformance - Permit No. 92-114
Applicant: Mr. Russ Aleshi
Location: 548 Hacienda Avenue
Surety: Bond No. F A190845
Contractor as Principal: JR T Construction Co.
Dear Mr. Hazelwood:
The City of Campbell has made several unsuccessful attempts to have Mr. Russ Aleshi fulfill
the provisions of Permit No. 92-114. A deficiency list dated July 30, 1993 is attached for
your reference. The City must now call on the surety that was posted to guarantee this work
in order to correct these deficiencies and complete the provisions of the permit. The surety
posted for Permit No. 92-114 is bond number FA190845.
Please take the steps necessary to have the deficiencies as outlined on the attached list
corrected. The work must be done under the supervision and to the satisfaction of the City
Engineer. Please contact me within 30 days of this letter and present your proposal for the
completion of these items.
Very truly yours,
~1~
Michael A. Fuller
Assistant Engineer
/t~
1/
Attachment: Deficiency list dated July 30, 1993
Letter of September 23, 1993
cc: Russ Aleshi, 548 Hacienda Avenue, Campbell, CA 95008
JRT Construction, 18191 Saratoga-Los Gatos Road, Monte Sereno, CA 95030
file: Permit no. 92-114
.L.U~V"tO
~._"2Br:'L~J)Sfl~J:_\': T[l~S ccct!ment t.
n"'"" r!~..i' '.', -', ,..,'" ',-" l~i;.ti'''' -?-'.'"lr:\ origtnal.
vi. t..J ~ '~.f ,_ '. ...' . . i ~ . ...-."'~, \&. I Ii \0. Io--
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s.[,~r~'k-}""'~ '~""'__" i1IJ ~ ~-lli.:.' ~ ~...,~
JJL[D FuR Ht{m~D
At fH~QUEst 9f
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SEP 15 9 47 M1 t93
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Above space for recorder
NOTICE OF COMPLETION
NOTICE is hereby given that CITY OF CAMPBELL as OWNER, and Michelle
Quinney, the undersigned, as City Engineer caused
street
improvements to be constructed upon the property described.
That the work on said street
improvements was
actually accepted on the day of
, 1993
That the name of the contractor
for said owner
is Petersen Construction
That the nature of title of said City to said
street improvements
is that of owner in
fee simple, and the names and addresses of all owners of said
property are:
NAME
ADDRESS
City of Campbell
70 N. First Street
Campbell, CA 95008
That the property herein referred to and on which said
street improvements
are located is situated in the
City of Campbell, County of Santa Clara, State of California and
described as follows:
IN AND NEAR THE INTERSECTION OF HACIENDA
AVENUE AND WALNUT AVENUE
1 of 2
and having the following address:
548 HACIENDA AVENUE. CAMPBELL
Dated
Av~ lIP ,19~.
'1
Michelle Quinne , P.E.
Acting city Eng1neer
STATE OF CALIFORNIA
ss
COUNTY OF SANTA CLARA
I, Michelle Quinney, being duly sworn, says: That I am the Acting
City Engineer for said City of campbell, The owner of the property
described in the foregoing notice; that I have read the foregoing
notice, and know the contents thereof; and the facts therein stated
are true of my own knowledge.
Subscribed and sworn to before me this
day of
, 19
Notary Public in and for said County
of Santa Clara, State of California
;::T~[:~~E~:~f:~;~~:;::::',
'.:;F'.,~-- .'~OB. ~~c~~~''''~..~''~._. ~~ (\\fa n.eJll
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H:\NOTICE(DR)
2 of 2
.
CALlFORN.A ALL-PURPOSE ACKNOWLEDGMENT
~,*",,~_<;S$! ~............-....,.-~~
i County of Santa Clara }
\
On 9/14/93
DATE
before me,
Anne G. Bybee
NAME, TITLE OF OFFICER - E,G" "JANE DOE, NOTARY PUBLIC"
personally appeared
Michelle Quinney
NAME(S) OF SIGNER(S)
[] personally known to me - OR - 0 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 ac-
knowledged 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.
wu:::#~
SIGNATURE OF NOTARY
OPTIONAL SECTION
THIS CERTIFICATE MUST BE ATTACHED TO TITLE OR TYPE OF DOCUMENT
THE DOCUMENT DESCRIBED AT RIGHT:
Though the data requested here is not required by law,
it could prevent fraudulent reattachment of this form, SIGNER(S) OTHER THAN NAMED ABOVE
NUMBER OF PAGES
DATE OF DOCUMENT
No. 5193
- OPTIONAL SECTION -
CAPACITY CLAIMED BY SIGNER
Though statute does not require the Notary 10
fill in the data below, doing so may prove
invaluable to persons relying on the document.
o INDIVIDUAL
o CORPORATE OFFICER(S)
TITLE(S)
o PARTNER(S) 0 LIMITED
o GENERAL
o ATTORNEY-iN-FACT
o TRUSTEE(S)
o GUARDIAN/CONSERVATOR
o OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSQN(S) OR ENTITY(IES)
@1993NATIONALNOTARY ASSOCIATION' 8236 Remmet Ave" P,O. Box 7184. Canoga Park, CA 91309-7184
-",' .. -- ,~
CONTHACl
[nIUllmb3[I~ ~m~mnnOJa:rrDm~ ~OJ[KJ[prn~CUJ ,l T"i'
565 MC611.u:ey Ln., campbell (;8. 9~DD8 ~:~~\
\("108' 377-7049 ,~OMIl;j;
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'10: City of~ampoe'l Reference: pei':r'll t U 9l-1 14
70 N. First Street Hacienda & Walnut Or.
Campbcl1~ CA9~OU~ C~mp~ell ,eA
! (Auult.l urlCsl fo(ettueste<.l wurk.)
I
I ,. ..
Subject. 'toth" 'terms ClltO cona1t10ns pr1nted on back horeO...f, ,wtllch' arc referred to
Clnd hereby lIapea part. or tn1s contract we, PElfRSEN CONS1RUC1JON:COMf'lANY, vil1
provide the f~11ow1ng listed items. , .
I
I
1. pr'uvi~e dt!IIlolitton of add1t1onal aspnalt street s~r.1i:lceat ttle lnter'sectlon
of ~af1enda Avenue & Walnut or1ve, approx. 1,600 Sf. , '
I '
2. l:)i\CClvtl.t!1.0 pT'oposetl 5uograde elevatlons, approx. 1,600 ~f.
3. SUbgrtde& compact to 95%, additional street suriac~,;~pprox. 1,600 SF.
I
4. Prov1~e. .place & compact 9" AC sect10n at HaCienda, appr6x.500 SF.
I
5. prov1~e. place & compact 6" AC sect10n at walnut, apprQx..~1 ,100 ::if.
6. prov1be & pldce tack & fog seal at etlges only.
7. prOY1~e trafric control as required.
i
8. provi.e saw cutting, approx. 84 Lf.
Excludes! 1. Permits, fees.
!,. ~. Str1pes, markers.
:- I
13. lesting. <f---- ~ ro_s.s' ~ _w--rs___
Note: pr,po~ed work dr~d colored in green, per attached Sheet.
I
,
I
CONTRACT!TOTAL: $9,200.00 (lncluslons 1-~ above)
I
F~ Pau /T) uCt IAt-+--:
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en-y OF rpUUJ
Uy____ i
PETfRSENCONS H<UGIIUN COMPANY
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MAKING THE GRADE I
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CITY OF ~BELL
HACIENDA/WALNUT
PAVEMENT REPAIR PROJECT
ITEM APPROX. UNIT
NO. ITEM UNIT QUMrrITY PRICE TOTAL
1. Saw/Wheel Cu t /T'(~c.. ~ ,-ht\.. L. F . 480 SW 24m 6U
2. Excavation C.Y. 130 20 IJ) Lf.:,OO ,)~'fI
3. Class 2 Aggregate Base T. 210 1.2. ~ 4hWe
~ 00 ~1"Oo;
4. Type B Asphalt Conmcrete T. 77 o -
TOTAL BID $ \. 57 ~ 0 . CD
I
Bidder CAU--LOl~U gearHett-S
/
....
~.
NOTE: All quantities are "Final Pay Quantities"
RECEIVED
JUl 08 1993
iublic Works/Engineering
,&~I,~I'
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CITY CF CPMBEIL
~
PAVEMN' REPAlR ImJEI:r
TIEM APfR]{. lliIT
N.J. TIEM rnIT Q.lANITIY HUCE 'IDfAL
1. SAWMHL arr LF. 400 $ 3.~ $ 1,6ro.00
2. EXCAVATICN C.Y. ~ lOS.oo 9,4~.OO
3. 1(j' rm lm -8''tEEP lm
2" SlEFp(E 'l.tN) 105 73.00 7,035.00
4. l' DEEP lm - rs' rm
2" SlJRFp(E 'l.tN) 38 73.00 2, Tl4.00
'IDI'AL BID $ 20,939.00
NJIE: AlL q.IANI'ITIES ARE ''FIN\L PAY
r
1dd3779404
JSHMAN CaNST co
06/30/f 5: 10
POI
CITY OF CAMPBELL
HACIENDA/WALNUT
PAVEMBN'l' REPAIR PROJECT
ITBM APPRox. UNIT
NO. lTEN UNI'!' QUAN'.rI'l"l PRICE TOTAL
1- Saw/Wheel Cut L.F. 480 $1.51 $724.80
2. Excavation C.Y. 1* 80 $46.27 $6,015.10
3. Class 2 Aggregate Base T. 210 -0- -0-
4. Type B Asphalt Conmcrete T. * 163 $61.39 $10,006.67
Bidder i;:;;a I
CUshman Construction cacrparlr
2200 Blossom Crest Way
San Jose, CA. 95124
NOTE:
All quantities are "Final Pay Quantities"
Poet-It.. brand fax transmittal memo 7871 .ot...... ~ /
'I'D ,.....
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r
WEST VALLEY SANITATION DISTRICT
OF SANTA CLARA COUNTY
SERVING RESIDENTS OF
CITY OF CAMPBELL
TOWN OF LOS GA TOS
CITY OF MONTE SERENO
CITY OF SARA TOGA
UNINCORPORA TED AREA
100 East Sunnyoaks Avenue
Campbell, California 95008
Telephone (408) 378-2407
July 29, 1993
RECEIVED
JUL S 0 1993
Public Works I Engineoring
Mr. Russ Aleshi
510 Beth Drive
San Jose, CA 95111
RE Townhouse Development
558 Hacienda Avenue, Campbell
Dear Mr. Aleshi:
At the request of City of Campbell, the district performed an
inspection of the referenced development on July 23, 1993.
Our inspector discovered the following deficiencies:
1. 1221 Walnut Ave.: Replace the cleanout box with a Cristy G-5
box.
2. 548 Hacienda Ave.: Raise the cleanout box and install a lid.
3. 558 Hacienda Ave.: Cut down the stack and install cleanout
box.
Please proceed with the repair. A clearance will be issued as soon
as the above items are corrected. Contact our inspector, Bob
Moehle, if you have any questions.
Very truly yours,
Reid
',stric~~neer
athan K. Lee
istant civil Engineer
by
cc
Don King, camPbell~
(FORMERLY COUNTY SANITATION DISTRICT NO.4)
Of' c."4t
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.O.tCH ",,0
CITY OF CAMPBELL
Public Works Department
March 29, 1994
Clerk of the United States Bankruptcy Court
201 Dean A McGee Avenue
Oklahoma City, Oklahoma 73102
Subject: First Assurance & Casualty Company
U.S. Bankruptcy Court/Western District of Oklahoma
No. 93-16187-TS, Chapter 11
Permit Number 92-114, 548 Hacienda Avenue
Bond No. F Al90845
To Whom It May Concern:
The City of Campbell has made several unsuccessful attempts to have deficiencies corrected
in the work associated with the above development. A list of these deficiencies is attached
for your reference. The applicant for this encroachment permit, Mr. Russ Aleshi, and the
contractor, JRT Construction, have both been unresponsive in correcting these deficiencies.
The City now wishes to call upon the performance bond to have these deficiencies
corrected. A copy of the performance bond is attached for your reference.
Please contact me and advise me of the steps necessary to have these deficiencies corrected.
H you have any questions, I can be reached at (408)866-2158.
";;;lrdffi
Michael A Fuller
Assistant Engineer
Attachments: Deficiency list dated 7 /30/93, Bond
cp
cc: JRT Construction, 18191 Saratoga-Los Gatos Road, Monte Sereno, CA 95030
File Permit #92-114
h:jrt(mp )6.0
70 North First Street. Campbell, California 95008.1413 . TEL 408.866.1150. FAX 408.379.1571, TDO 408.866.1790
LAW OFFICES
MCCLELLAND, COLLINS, BAILEY, BAILEY & BELLINGHAM
BRUCE McCLELLAND
ROBERT C, BAILEY
RICHARD R, BAILEY
JAMES H. BELLINGHAM
WILLIAM F. COLLINS, III
JOHN J, LOVE
DAVID A KASERMAN
JANICE D, LOYD
LESLI A. BAILEY
11 TH FLOOR COLCORD BUILDING
15 N. ROBINSON
OKLAHOMA CITY, OKLAHOMA 73102
(405) 235-9371
WILLIAM F. COLLINS, JR
OF COUNSEL
TELECOPIER
405-232-1003
March 24, 1994
tc.tl'ltO
tl (\4
~~~ 2 CO '9;1
Mr. Michael A. Fuller
city of Campbell
70 N. First street
Campbell, CA 95008
vv"...... ;'\tp."not<.
A.oW\\tl\S
Re: First Assurance & Casualty Company, Ltd.
U.S. Bankruptcy Court/Western District of Oklahoma
No. 93-16187-TS, Chapter 11
Permit #: 92-114
Location: 548 Hacienda Avenue
Surety Bond #: FA190845
Dear Mr. Fuller:
This is will advise that First Assurance & Casualty Company
is in Chapter 11 bankruptcy proceedings in the united States
Bankruptcy Court for the Western District of Oklahoma. Any and all
claims should be filed with the Clerk of the united States
Bankruptcy Court at 201 Dean A. McGee Avenue, Oklahoma City,
Oklahoma 73102.
This company is out of business and has few, if any, assets
which are primarily disputed receivables.
Should you have any questions, please contact the undersigned.
Yours very truly,
!~ . .'
c:t<\uPd f c&~~
Robert C. Bailey /
For the Firm :
RCB/V
,..... A.~.~ltlte:i_RI1IIIIIIII&II~IIR.:R...................................:..y..<<...:...
~oDilCl~j{'.. .
--'--'--------' (.... DO )
............:}..::...>>.<< ISSUE DATE ......1 IVV
RHH of Northern Cal ifornia
One Market
Spear Street Tower Ste. 2100
San Francisco, CA 94105
415-543-9360
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE CO VERAGE AFFORDED BY THE
POLICIES BELOW,
COMP ANIES AFFORDING COVERAGE
CA
95008
COMPANY A
LEll~R T an america In urance CO.
COMPANY B
LEllER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
T HIS IS TO CERTIFY THA T THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURW NAMED ABovE FOP THE POLICY PER!OD
INDICA TED. NOTWITHST ANDING ANY REOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED ORMAY PERTAIN, THE !NSURANCE 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 CLAMS.
Petersen Construction Company
563 McGI incey Lane
Campbe I I
TYPEOF INSURANCE POLICY NUMBER POLICY I!I'I'I!CTIVI! POLICY I!XPIRATI LIMITS
DATE (MM/DD/VV) DATI! (MM/DD/VV)
GENERAL AGGREGA IE
COMMERCIAL GENERAL lIABllI TY PROOUCTS-COMP/OP AGG
CLAIMS MADE D OCCUR PERSONAL & ADV. INJURY
OWNER'S & CONTRAClDR'S PROl EACH OCCURRENCE
fiRE DAMAGE IAny one lire)
MED EXPENSE IAn one erson $
AUTOMOBILI! LIABILITY COMBINED SINGLE
ANY AUTO LIMIT
ALL OWNED AUlDS BODilY INJURY
SCHEDULED AUlDS IPer person)
HIRED AUTOS BODll Y INJURY
NON-OWNED AUTOS IPer accident)
GARAGE lIABllI TY PROPERTY DAMAGE
EXCESS LIABILITV EACH OCCURRENCE
UMBREllA fORM
OTHER THAN UMBREllA FORM
WORKER'S COMPENSATION
A AND aC~71529 1/01/94 1/01/95 EACH ACCIDWl 1000000
EMPLOYI!RS'LIABILITY DISEASE-POLICY lIMIl 1000000
DISEASE-EACH EMPLOYEE
OTHI!R
DESCRIPTION OF OPERATIONS/LOCATIONS/VI!HICLES'SPECIAL ITEMS
RE: Permit #92-114 (548 & 550 Hacienda Av~.. & 1221 Walnut Dr.
Campbe I I . Ca. 95008)
City of Campbel I
70 N. 1st St.
Campbel I, Ca. 95008
Attn: Mike Fuller
......;.:.:.:::.:::::.::::::::::::::;:;:;:;:;:;:;:;:;:;::::::::::::::::::::::::::::::~~:::::::j:::::::::::::::::::::::::~~~~~~~A[J9~:::::]]]:::::::::::::::::::::i~~::::::~::::::]::::::::::::::::::"::i:::]:::::::::::::::::::::::~::~:]::::::::::::::::.:::::.::::::::::::::::::::::::::::'.:::::::::::::::::.::::::.::::::::::::::::::::':::::::::::::::":":::::::::::::::::::
.. .......................SHOULO...ANVOF..THE.ABOVEOESC;RIBEOPOLICIE:S .BEC; ANCELLEO..ElEF ORE: ..THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL
........ MAIL ~ DA YS WRIT TEN NOTICE TO THE CERTIFICA TE HOLDER NAMED TO THE
<<LEFT. BUT "AILUR[ TO MAIL SUOII rJQTIO[ :iIIALL IMrOC[ tJO ODLlCATIOtJ OR
<~IABILlT',' or ArJ',' 1(ltJD Uf'OtJ TII[ OOMPm'.', IT3 AODHG OR R[F'R[3DH A T1'vT3
9~"ll..'9~r~~p!;.R!;~..............................
......~~<l.~li}.~E~n'~~).........}....................<........ .....
.< AUTHORIZED RI!PRESI!NTATIVE
........ ~()( ~ 155422000
<<.......HI?:....::::.I)'~P.<l~iP.<l:~~~~rl<lNJ..~
02-28-199402:13PM FROM HAMILTON/MERIDIAN INS
TO
3792572 P.01
BARLOCKER INSURANCE SERVICES
P.O. Box 6300, San Jose, CA 95150
408-288-6262 408-280-0821 Fax
RECEIVED
FEB 28 1994
DATE:
2/28/94
NUMBER OF PAGES (including cover):
TYPE OF DOCUMENT:
1
PUBLIC WUKI\,)
.ADMINISTRATION
NAME OF ACCOUNT:
JRT Construction Corp - Permit No. 92-114
TO: FAX t:
379-2572
NAME: Mike fuller/Qo~ King
COMPANY: City of Campbell - Public Works Dept.
CITY: Campbell
Dear Mike & Don: Mr. Taylor of JRT Construction Corporation
ordered coverage through our agency back in April in order to
co~ply with t.he City of Campbell's insurance requirements. We
were given a deposit of Sl. 334.QO from Mr. Taylor to order and
secure this coverage whereby we issued you a Certificate of
Insurance. Since the payment from this client did not clear
their bank. our coverage was cancelled due to non-payment of
premium whereby we notified your office. Since coverage was !n
force from 4/30/93 throu9h 6/21/93 there is an outstanding earned
premium due us of $1.367.75 which has never been cleard by
Mr. Taylor. Is there anyway we can file a lien against this
project since coverage was cancelled and premiums not paid?
l~ease advise. we thank you fo{ your assistance.
Yours truly,
Sandy Brown
cc: JRT Construction Corp.
1- 15
FEE 28 '94 16:40
FROM RTC-RDMIN RND CONTRRC
PRGE,001
CHI
SI<C:FEORPT#
T~:
INQUIRY FUNCTION SNO DATE: / / TRN:940225-000447
~: 1~J,600.00 CURUSD
VAL~ I I TYP:FTR MTP: FNDS:S CHC;DS CDS COMN CSLN
D.._"Af121000358
BK ~ SF
COT 0{0093505/ AOV LTR
RTC NATIONAL SECURITIZATION OFFICE
ATTN:VALERIE MCCONNELL
1655 N. FORT MEYER DRIVE, 2ND. FL.
ARLINGTON, VA. 22209
SPECIAL INSTRUCTIONS
CDA CUSTOMER
BNF / CM: BK?
SNDR REF NUM 2219
ORDER eNK f
MTS CORPORATE CALLS
REF NUM
ORIG I
CITY OF CAMPBELL
TT 11
Ol25LILFBA3C0007560Z251351rT1LN 022~G1QG780C00021202251351fT1GP'
071004501 Type: 1000
121000158 Rp.f~ "19 Amt: 153,600.00 Asot:
~K AM SF IORG=CITY OF CAMPBELL OGB-MTS CORPORATE CALLS
FED HOME LN CHGO /CTR/BNF~RTC AS RECIEVER-CONSERVATOR-NSC/AC-9S50-5 OBI~REF: RE
CARDING LfLSI WINCM~~T~~ DRIVEN LAND BBI-ADV: SCOTT MUMA 202-416-7016
Alt-Z-FOR H~LPI VT220
I FOX I 9600 N81 I LOG CLOSED I PRINT OFF ION-LINE
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** TOTAL rAGe,OOI **
CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL, CALIFORNIA 95008
(408) 866-2100
FAX # (408) 379-2572
Department:
Public Works
June 7, 1993
Russ Aleshi
510 Beth Drive
San Jose, California 95111
Subject: Permit number 92-114, Hacienda & Walnut
Dear Mr. Aleshi:
We received a notice from Barlocker Insurance Services that the
insurance coverage of your general contractor, JRT Construction,
has been canceled. Please have your contractor submit a
certificate of insurance which meets the cities requirements, which
are attached. No work shall continue on this proj ect until
insurance coverage is restored.
If you have any questions, please do not hesitate to call me at
866-2158.
Very trul~our~J.1~
~i-~
Michael A. Fuller
Assistant Engineer
Attachment: insurance requirements
cc: Chuck Gomez, City of Campbell
JRT Construction, 18191 Saratoga-Los Gatos Road, Monte Sereno,
California, 95030
h:\92-114a
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TO:
Mike Fuller
FROM:
Jessy Pu
DATE:
June 28, 1993
RE:
Walnut/Hacienda Construction
Please advise the contractor to resubmit the traffic control plan to conform with the
Caltrans standards. A copy of the applicable standard traffic control plan is enclosed.
Also enclosed is a construciton signing plan prepared on the aerial. Hope it will be
helpful for the contractor. The following are some other comments:
. If the traffic control is to stay over night, prepare it accordingly.
. Access to homes need be provided.
. Inform the residents on Walnut Dr when the road will be closed.
. Notice for parking prohibition shall be installed 2 days in advance.
. Pedestrian access need be provided.
. Direct the contractor's attention to the notds in the attached Caltrans standard
plan.
....
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CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL. CALIFORNIA 95008
(408) 866-2100
FAX # (408) 379-2572
February 12, 1993
Mr. Russ Aleshi
510 Beth Drive
San Jose, California
95111
Subject: Permit Number 92-114, 548 Hacienda Avenue
Dear Mr. Aleshi:
On February 4, 1993 the City received a copy of a bid from Petersen
Construction Company to JRT Construction dated January 4, 1993.
This bid is for the City's portion of the improvements in the
intersection of Hacienda Avenue and Walnut Drive. A copy of the
bid is attached for your reference. The City has several comments
regarding this proposal:
1) The proposal should be broken out with unit prices and
quantities, rather than a lump sum.
2) Based on estimates prepared by the City, the price on this bid
is higher than should be available. At least two other
competitive bids must be submitted to the City.
3) The section shown on the proposal for Walnut Drive is 3.5" AC
on 6.5" of base. The correct section is 4" AC on 6" of base.
Please submi t a proposal which satisfies the above concerns,
including the submittal of three separate bids. This proposal must
be from you, as the permittee, to the City.
The ci ty has some addi tional concerns wi th this proj ect. We
received a letter from West Valley Sanitation District dated
January 15, 1993, stating that one of the building sewers installed
with this project is in need of repair. This repair must be made
in advance of paving to avoid cutting the new pavement.
The sanitary sewer trenches on Hacienda Avenue have settled to an
unacceptable level. The City is currently working with the
permittee, West Valley Sanitation District, to havet:Qis problem
corrected. .
. ... ...
The City does not have an insurance certificate from your general
contractor, JRT Construction, which meets the .... City' sinsurance
requirements as listed on the attached sheet. Please have an
appropriate certificate submitted by your contractor immediately.
CITY OF CAMPBEll
Russ Aleshi
Page 2
February 12, 1993
If you have any questions, please do not hesitate to call me at
866-2158. We are anxious to see this project completed.
Very t~ly you~~
~??/? d~ ~4tfLJ
Michael A. Fuller
Assistant Engineer
~~:djr
File:
Permit 92-114
h:92-114.1tr
CON1'I(ACl
!
LPrnm;rn~fI~ ~O)~rnnnOJu:r.roOJ~ (hm~[PUJ[k)'L? .~.,.~'
56' MC6llnr.:ey I.n., tampbell lll. 9~U08 ~":l ~i\
i (~08) 377-704' ,-~~:;J;
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'fO: City Of~lilllpDe'l Reference: Perlll'lt t19~-114
70 N, f1~st Street H~Ciinda& ~alnut Dr.
Campbel1~ CA9~OUB Campbell I CA
i (AlhJIt..luIH11 Reque~i"Le(j WorK)
I
I ' , " ,
SUbJect. t01.h~ terms ana conal t tons pr1 nted on back horeo,',' f" ',tl/tI1chare referred to
and hereby ma~ea part of th1 s contract we. PEHRSEN CON~lRUC1JONCOMf'ANY , will
prov1de the f~11ow'nu listed Hems. " .,"
I
I , ' ,
1. r~T'ovl~e delll(J"1 ition of add1t10nal aspnalt stre~ts~~'!aceat Ute lnlersectlon
of Hafiendd Avenue & Walnut Urive, approx. 1,600SP., .
I
2. EXcdvtle to proposed sUDgrade elevat1ons, approx. 1,609 Sf.
3. SUbgr~de & compact to 95%, additional street surface,;~pprox. 1,600 SF.
I
4. prov1~1f.!, ,place & compact 9" AC sect10n at HaCiendatapprox.500 SF.
I
5. proV1~e, pl~ce & compact 6" At section at Walnut, approx. ~'I ,100 S~.
6. prov1~e & pldce tack & fog seal at edges only.
7. prOV1~e traffic control as required.
i
B. Pf'ovi~e saw cutting, approx. 84 LF.
i
Excludesl
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,
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Note: p,'~po~e~1
I
,
CONTRACriTOT'AL:
I
1. Permits, fees.
2~ Str1pes, markers.
.3. lestl flg.
work drea colored in green. per attached sheet.
$9.200.00 (lnCluslons 1-~ above)
r
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'tERMS OF PAY..~NT:__ 1001 UPON COMPLETION
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RHH of Northern Cal ifornia
One Market Plaza
Spear Street Tower Ste 2100
San Francisco. CA 94105
415-543-9360
. ..E:~-.:::::::!:III:::::.:;!;~-!IIBIIIII;&:.::::::;;:::~~:::'!.::'" nlSsul! DATI!7 (/MM, ISOO/19VV3)
..::~:::::~~::~::::::::::;:::::::::::::::::::::::::::::::::::.:...:.:.:.:.:.;.:.:.:.:.:.:.:.:.:.:.:.....:.:.:.:.:.:.:.:.:.".:.:.:.:.:.;.;.;.:.;.:.;.:.;.:.:.:.:.;.:.:.;.:.:.;.:.;.:.;.;.;.:.:.
b~~FERS No'RiGHTS .UPONLI THE CERTIFICATE HOLDER, THISCERT~IC~T~
DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BV THE
POLICIES BELOW.
CO~ANIES AFFORDING COVERAGE
CA
95008
COt.6>ANV A
LETTER
COt.6>ANV B
LETTER
COt.6>ANV C
LETTER
COt.6>ANV 0
LETTER
COt.6>ANV E
LETTER
Fairmont Insurance Company
IN5UIlU
Petersen Construction Company
563 McGI incey Lane
Campbe I I
THIS IS TO CERTIFY THA T THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICA TED, NOTWITHST ANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUvlENT WITH RESPECT TO WHICH THIS
CERTlFICA TE MA Y BE ISSUED OR MA Y PERT AIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LMITS SHOWNMAY HAVE BEEN REDUCED BY PAID CLAMS_
co
Ln
TYPl! Of INSURANCI!
POLICY NUIo48EA
POLICY I!I'RCTIVI! POLICY I!XPIRATION
DATI! (MM/OO/VV) DATI! (MM/OO/VV)
LIMITS
Gl!Nl!RAL LIABLITY
-
GENERAL AGGREGA IE .
PROOUCTS-ClJI,lP/OP AGG_ .
PERSONAL & AOI/. INJURY .
EACH OCCURRENCE .
FIRE DAMAGE (Any one fire) .
MED. EXPENSE (Anv one person .
ClJI,lBINED SINGLE .
LIMIT
CCMAERCIAL GENERAL LIABILITY
. .: I CLAIMS MADE D OCCUR.
_ OWNER'S & CONT~CTOR'S PROY.
AUTOhlO8U LIABLITY
-
_ Am AUTO
_ All OWNED AUTOS
_ SCHEDULED AUTOS
HIRED AUTOS
-
_ NON-OWNED AUTOS
GARAGE LIABILITY
-
BODILY INJURY
(Per personl
BODILY INJURY
{Per accidenO
PROPERTY DAMAGE
I!XOI!SS L1ABLITY
I Lt.1BRElLA FORM
I OTHER THAN 1MBRElLA FORM
EACH OCCURRENCE
AGGREGA TE
::::::::::
A
WORKER'S COhlPl!NSATION
AND
EhlPLOYEAS'LIABLITY
80571529
7/01/93
I STATUTORY LIMITS
1/01/94 EACH ACCIDENT
DISEASE-POLICY LIMIT
DISEASE-EACH EMPLOYEE
:::
.
.
.
::;::>
1000000
1000000
1000000
OTHI!R
~
Dl!SCAPTION Of OPI!RATIONSILOCATIONSIVI!H JCLI!S/SPI!CIAL ITI!hlS
RE: Permit #92-114 (548 & 550 Hacienda Ave. & 1221 Walnut Dr
Campbell. Ca 95008)
II EXPIRATiON DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO
:.:.:.:. MAIL 30 DA YSWRITTENNOTiCE TO THECERTIFICA TE HOLDERNAMEDTO THE
!j!::::: LEFT, BUT FAILURE TO MAIL SUCH NOTiCE SHALL MPOSE NO OBlIGA TiON OR
/? LIABUTY OF ANY KIND UPON THE COMPANY,ITS AGENTSORREPRESENT A TiVES
:::~;:: ~
Camp be II. Ca. 95008 ::j1j::: AUTHOR~ ATIVI!
Attn: Mike Fuller )) 1. (\",
::::;\I"9:~::~~~:(?~~9):}::~:~::=::;}::~:::::::::::m:f::;::::::::}:::m:::::::::::j::::::~:~:::~:::jf:::m::::~::::::::::=mfl::::::j:::::::::~:::llili:I::::::::~:::::::::::::m:m::;:1m::~:..::):@~l~:f~i~:"~:m::
Ci ty of Camp be II
70 N 1 s t S t
R" 155422000
~:~t:@~j~l;(jW~9'~AtlON:-;;'O..
...........-..,........-........-.-.-..-.. ...-......-....... ...... -,..
.
RECEIVED
JUL 2 0 1993
Public W orkslE .
ngln.ering
13 7 -' 1 3 -' 9 3 1 1 , 3 9
:!: 1139 133 1E;57
132
CKRTI~I~TE OF INSURANCE
This it to certify f'.hat. the policies of insurance listed below have been iuued to t.he
insured named below for the policy pe~iod indicated notwithstanding any requirem.nt. term
or condition of any contract or other dOcUM@nt with respect to which this certificate may
be iSluld nr may pertain, the insurance afforded by the Vullcies described herein io
subject to all th~ terms, exclusions' conditione of such policieg, Limit- _hown may
have bun reduced by paid claime. Thh c@rd BeaU does not amenQ, extend or a1 ur tlut
e~vp.ra8e afforded by the policies below.
TTPE OF IISURAICt
_'EMERAl LIABILITY
I!I pre.'ses-Operatlons
III Product' - Completed
_ Operations.
IAI personll Ind
AdvertIsIng Injury
-
III "edl~.l [apeni.
III FIr. Dlmlat Leaal
_AUTOMOBILE LIABilITY
I!I C~rehenilve Form
Insured's Name anO A04res81
PKTKlSEI CONSTRUCTION COMPANY.
s,~ KoCl1ncey Lane
Campbell, CA g~OO~
Descrtptton of Oper.tlons/Lor.~ttnnl/
Yehlcles/Kestrlctton,/SpeelI1 Item
a[; Pe~it f9!-114
548 . SSG Haelenda Avenue Ind
Illl .alnut Drive, Ca~bell, CA
Subject to the terms and conditions of the policy.
Date CertIfIcate Issued: 07/1]/9]
Certificate Holder's Name and Addrfss:
CIty or CAMPBBLL
70 "o~th FirlL Street
Campbell. CA 05008
ATTNI Mike Fuller
11I5urence In forte only for haurds Indtcated by .X.
I POI -, AND I POlIty POlleT
I ISSUlli I EffECT lYE ElPIRATION
I COMrAIIY I DATE I DATE
I NATIONWIDE MUTUAL INSURANCE co.
I I I
173PR511098-60021 12/15/92 I 12/15/93
I I I
I I I
I I I
I I I
I I I
I I I
I NAHOIIWllIE MUTUAL INSURANCE CO.
I I I
_ I 73BA511098-00021 12/15/9' I "/15/93
111 Owned I I I
I _ I I I
I I!l Mtnd I I I
I III lion-Owned I I I
I I I I
I _ EXCESS LIABILITY I NATIONWIDE MUTUAL INSURANCE CO,
I I!I UlIDrella FOrlll I 73CU511098-00031 lZ/15/9Z I 12115/93
I I I I
I _ I I
I U workers' COlllPenllltloll1 I
I _ and I I
I LI FlIP 1 oyers, Uab111ty I I
I I I
I I I
1 I I
I LI Other I I
I I I
Should any ot the above described policies be cancelled befor~ th~ ~~plt.llon date
Lheulo!. the insurance company will endeavor to mail 30 daye writt.en notice to the
certificate holder nam.d abov., but failur~ tn m~jl Auch notice shall impose no obligation
or liability of any kind upon the company. ita agents or r~pr~~enlalives.
DESCRIPTIVE SCIIF.1ll11 F
I
I LIMITS or LIABILITY
I
General Aggregate
Product,-Complcted/
OrArAtlnns Aggregate
Pers. & Advert151ng Injury
Elleh Occurronc,
Any One Person
Or OrgolltuLlulI
^n1 One P8rson
Anv One Flre
BOd Ily Injury
(Each Person)
Budl'y Injury
(Each Accident)
Proper t.v Damaae
8udlly Injury and
Property Combined
BOdIly Injury and Property
Domoge Dec.
Combln~~ Ann.
STATUTORY LIMITS
Dodlly Injury Eath ^ccldent
by Accl~Ant S
80dlly Injury Polley LI.lt
by DI'lIosc S
Rndlly Injury Each E~ployee
by DISease S
INC.
I
I)
1
S2,ODO,OOOI
I
$2.000,0001
$1.000.000 I
I
I
$I ,000,0001
S ~.nonl
s 50.0001
I
OCCURRENCE I
I
1
I
I
I
51_000.0001
I
I
51.000.0001
I
I
I
I
I
I
I
I
I
Author ed Slgnot ro
NAYIO.VIDE MUTUAL INSURANCE COMPA-'
RATIURWIUt ~lKt INSURANCE CONPART
tOLUMBUS, OUIO
Agent: Ertc Hoffner '2393/7fi~~&
Counterslcned- at: "llp'us, CA
1)7,'13.'9311:39
z: 11)8 133 1~57
1)3
POLICY .uKBKRI 73 PR 511098-5002
I!WIKD I_SURKD I PBTBRSD COlt5TRtJCTIOll COMPANY
mIS KNDORSRMRNT CHANGES THK POLICY. PLEASE READ IT CARBP'ULLY.
ADDITIONAL INSURED -- OWNERS, LESSEKS OR CONTRACTORS
(PORII B)
This endorsement modifies insurance provided under t"P. following'
COMMERCIAL GENERAL LIABILITY COVERAG! PART.
SCHBDULlS
Name of Person or Orqanizationt CITY OF CAMPBELL, Its Officers, Agents
and Employees
70 North Pirst Street
Campbell, CA 95008
WHO IS AN INSURlm (Sect.ion II) 1s amended to include as an inlSured the
person or Orqanization 1n the Schedule, but this insurance with respect to
8uch Person or OrganiBation applies only to the extent that Rur.h Person or
Organi12ation i. halt1 liable for your acts or omissione arising out. of and
in the course of uperat.lone performed for such Person or Organization by
you or your subcontractor.
COVERAGE PROVIDED TO THE Additional Insured under this endorsement is
primary, but only with respect to act. or omissions nf t.he Named Insured.
Any oth9r insurance maintained by the Additional In~ured is deemed to be
excess.
THIS INDORSIMENT EXPIRES 12/15/93
Cas. 4190
13 7 .' 1 3 .' 9 3 1 1 : 1 13
:.'.: 113B 133 1657
131
THIS BIIDORSBMBwr CliANGBS 'l'HB POLICY. PLEASE RRAD IT r..ARKFULLY.
POLICY CHANGES poliCy Change
Number
POLICY NUMBER
73PRS1109B-5001
POLICY CHANGES
EFFECTIVE
07/13/93
COMPANY
NATIONWIDE lNSURANCE CO.
NAMED INSURED
AUTHORl~ED REPRESENTATIVE
ERIC X. HOFFNER, ere
.2393176536
MILPITAS, CA
PET~RSEN CONSTRUCTION COMPANY, INC.
563 McClincey Lane
CampbAll, CA 95008
COVERAGE PARTS AFFECTED
GENERAL LIABILITY
CHANGES
IT IS HEREBY AGREED ANn UNDERSTOOD THA'l' OWNERS, LESSEES OR CONTRACTORS
FORM CAS 4190 IS ADDED FORI
Name 8nd Addr.s. of Add1~o1nal In8ureds
CITY OF CAMPBELL, Itl Officers, A9~ntA and Employees
70 Noreh F1rBe Streee
Campbell, CA 95008
IL 12 01 11 85
~'t ;{/1
CERTIFICATE OF INSURANCE
This is to certify that the policies of insurance listed below have been issued to the
insured named below 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 & conditions of such policies. Limits shown may
have been reduced by paid claims, This certificate does not amend, extend or alter the
coverage afforded by the policies below.
Certificate Holder's Name and Address:
CITY OF CAMPBELL
70 North First Street
Campbell, CA 95008
ATTN: Mike Fuller
Insured's Name and Address:
PETERSEN CONSTRUCTION COMPANY, INC.
563 McGlincey Lane
Campbell, CA 95008
Insurance in force only for hazards indicated by "X"
I POL.# AND I POLICY POLICY
I TYPE OF INSURANCE ISSUING I EFFECTIVE EXPIRATION
I COMPANY I DATE I DATE
I GENERAL LIABILITY NATIONWIDE MUTUAL INSURANCE CO,
I I!I Premises-Operations I I I
I IXI Products - Completed 173PR511098-50021 12/15/92 I 12/15/93
I _ Operations I I I
I I!I Persona 1 and I I I
I Advertising Injury I I I
I _ I I I
I I!I Medical Expense I I I
I I X I Fire Damaqe Leqa 1 I I I
I _AUTOMOBILE LIABILITY NATIONWIDE MUTUAL INSURANCE CO,
I IXI Comprehensive Form I I
I 73BA511098-00021 12/15/92 I 12/15/93
I IXI Owned I I
I _ I I
I I!I Hired I I
I I!I Non-Owned I I
I I I
I EXCESS LIABILITY NATIONWIDE MUTUAL INSURANCE CO,
I I!I Umbrella Form 73CU511098-00031 12/15/92 I 12/15/93
I I I
I I I I
I U Workers' Compensat i on I I I
I _ and I I I
I U Employers' Liability I I I
I I I I
I I I I
I I I I
I U Other I I I
I I I I I
Should any of the above described policies be cancelled before the expiration date
thereof, the insurance company will endeavor to mail 30 days written notice to the
certificate holder named above, but failure to mail such notice shall impose no obligation
or liability of any kind upon the company, its agents or representatives.
Description of Operations/Locations/
Vehicles/Restrictions/Special Item
RE: Permit #92-114
548 & 550 Hacienda Avenue and
1221 Walnut Drive, Campbell, CA
Subject to the terms and conditions of the policy.
Date Certificate Issued: 07/13/93
DESCRIPTIVE SCHEDULE
I
I LIMITS OF LIABILITY
I
I
I
I
I
I
I
I
I
I
I
I
$2,000,000
General Aggregate
Products-Completed/
Operations Aggregate
Pers. & Advertising Injury
Each Occurrence
Any One Person
Or Organization
Any One Person
Any One Fire
$2,000,000
$1,000,000
$1.000,000
$ 5.000
$ 50,000
I
OCCURRENCE I
I
I
I
I
I
$1. 000 , 000 I
I
I
$1,000.0001
I
I
I
I
I
I
I
I
I
Bodi ly Injury
(Each Person)
Bodi ly Injury
(Each Accident)
Property Damage
Bodily Injury and
Property Combined
Bodily Injury and
Damage Occ.
Combined Aqq,
STATUTORY
Property
LIMITS
Bodi ly Injury
by Accident
Bodi ly Injury
by Disease
Bodily Injury
by Disease
Each Accident
$
Policy Limit
$
Each Employee
$
Author' ed Signat re
NATIONWIDE MUTUAL INSURANCE COMPANY
NATIONWIDE FIRE INSURANCE COMPANY
COLUMBUS, OHIO
Agent: Eric Hoffner #2393/76536
Countersigned at: Milpitas. CA
POLICY NUMBER: 73 PR 511098-5002
NAMED INSURED: PETERSEN CONSTRUCTION COMPANY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS
(FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
Name of Person or Organization: CITY OF CAMPBELL, Its Officers, Agents
and Employees
70 North First Street
Campbell, CA 95008
WHO IS AN INSURED (Section II) is amended to include as an insured the
Person or Organization in the Schedule, but this insurance with respect to
such Person or Organization applies only to the extent that such Person or
Organization is held liable for your acts or omissions arising out of and
in the course of operations performed for such Person or Organization by
you or your subcontractor.
COVERAGE PROVIDED TO THE Additional Insured under this endorsement is
primary, but only with respect to acts or omissions of the Named Insured.
Any other insurance maintained by the Additional Insured is deemed to be
excess.
THIS ENDORSEMENT EXPIRES 12/15/93
Cas. 4190
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
POLICY CHANGES Policy Change
Number
POLICY NUMBER
73PR511098-5001
POLICY CHANGES
EFFECTIVE
07/13/93
COMPANY
NATIONWIDE INSURANCE CO.
NAMED INSURED
AUTHORIZED REPRESENTATIVE
PETERSEN CONSTRUCTION COMPANY, INC.
563 McGlincey Lane
Campbell, CA 95008
ERIC K. HOFFNER, CIC
#2393/76536
MILPITAS, CA
COVERAGE PARTS AFFECTED
GENERAL LIABILITY
CHANGES
IT IS HEREBY AGREED AND UNDERSTOOD THAT OWNERS, LESSEES OR CONTRACTORS
FORM CAS 4190 IS ADDED FOR:
Name and Address of Additoinal Insured:
CITY OF CAMPBELL, Its Officers, Agents and Employees
70 North First Street
Campbell, CA 95008
IL 12 01 11 85
INSTRUCTIONS
INSURANCE
COMPANY
NAME AND .
ADDRESS
OF INSURED.
CANCEL-
LATION
~~
I
NON-
RENEWAL
RENEWAL
OF
POLICY
IMPORTANT
NOTICES
REFER TO "COMPANY'S COpy" FOR
INSTRUCTIONS ON COMPLETING AND MAILING THIS NOTICE
~ - - --
.00ICE OF CANCELLATION, NONRENEWAl O~ c NEWAl
(California)
t] 7/\ (1
KIND OF POLICY:
General Liability'
Monticello Insurance Compamy
POLICY NO.:
CANCELLATION OR TERMINATIONWILUAKE EFFECT AT:
12:01AM
City of Campbell
Dept. Of. Public Works
Campbell, Ca. 95008
Attni Don King
>REC E IVE D
JUL - 7 1993
7-19-93
(DATE)
DATE OF MAILING: '-'-~J '.
ISSUED THROUGH AGENCY OR OFFICE AT:
Bliss & Glennon
(HOUR-STANDARD TI M
PUBLIC WORKS
-i.....- _".i
~';~JIl,\41ii1'"
~
!Applicable item marhd @
you are hereby notified in accordance with. the terms and conditions of the above mentioned policy that your insurance will cease at and from the h
and date mentioned above,
If the premium has been paid, premium adjustment will be made as soon as practicable after cancellation becomes effective.
If the premium has not been paid, a bill for the premium earned to the time of cancellation will be forwarded in due course.
D
You are hereby notified in accordance with the terms and conditions of the above mentioned policy that your insurance will cease at and from the h
and date mentioned above due to nonpayment of premi urn.
A bill for the premium earned to the time of cancellation will be forwarded in due course,
You are hereby notified in accordance with the terms and conditions of the above mentioned policy, and in accordance with law, that your insura
will cease at and from the hour and date mentioned above.
If the premium has been paid, premium adjustment will be made as soon as practicable after cancellation becomes effective,
If the premium has not been paid, a bill for the premium earned to the time of cancellation will be forwarded in due course.
D Reason for cancellation: Nonpayment of premium,
Reason(s) for cancellation (other than for nonpayment of premium):
D
See the "Important Notices" section below for Additional Information Regarding the Reason(s) for Cancellation.
D
You are hereby notified in accordance with the terms and conditions of the above mentioned policy, and in accordance with law, that the above Il'_
tioned policy will expire effective at and from the hour and date mentioned above and the policy will NOT be renewed,
Reason(s) for nonrenewal:
o
See the "Important Notices" section below for Additional Information Regarding the Reason's) for Nonrenewal.
You are hereby notified in accordance with California law that the above mentioned policy, which will expire on the above indicated date, will not be renew
by us, however, we are offering to replace your insurance with the same or broader coverage under another policy issued by an affiliated insurer. It v
be assumed that our offer to renew your insurance through an affiliated company will be acceptable to you unless you advise otherwise.
You may obtain in writing the reason{s) for the change in insurers by writing to us not more than one month following the expiration date of the poli,
Automobile Insurance Plan Information: You have been notified herewith that this Company does not desire to carry your automobile insurance ;
longer. You are possibly eligible for automobile insurance through another insurer or under the California Automobile Assigned Risk Insurance PI
Additional Information Regarding the Reason(s) for Cancellation/Nonrenewal: You have the right to know the specific items of information that supp
the reasons given for this decision and the identity of the source of that information. You also have the right to see and obtain copies of documel
relating to this decision.
If you ask us to correct, amend, or delete any information about you in our files and if we refuse to do so, you have the right to give us a conci
statement of what you believe is the correct information. We will put your statement in our file so that anyone reviewing your file will see it.
If you would like additional information concerning this action, state law requires that you submit a written request within ninety (90) business days
the date this notice was mailed to you. Please send your request to:
(Name and address of the person or department to contact for additional information)
o Consumer Report: In compliance with the Fair Credit Reporting Act (Public law 91-508), you are hereby informed that the action taken above is bei
taken wholly or partly because of information contained in a consumer report from the following consumer reporting agency.
Barlocker~nsurance C~2-~X SerVices .
1299 Del Mar Ave. -San Jose,
(ADDRESS)
95128
..-/ .. ~ ..~/ ~'-.
(/ ;(~u'~riiecj-~
,~~lIlilGUiJP~l~"", _
lZ-1I1
TO:
Mike Fuller
FROM:
Jessy Pu
DATE:
June 28, 1993
RE:
Walnut/Hacienda Construction
Please advise the contractor to resubmit the traffic control plan to conform with the
Caltrans standards. A copy of the applicable standard traffic control plan is enclosed.
Also enclosed is a construciton signing plan prepared on the aerial. Hope it will be
helpful for the contractor. The following are some other comments:
. If the traffic control is to stay over night, prepare it accordingly,
. Access to homes need be provided.
. Inform the residents on Walnut Dr when the road will be closed.
. Notice for parking prohibition shall be installed 2 days in advance.
. Pedestrian access need be provided,
. Direct the contractor's attention to the notes in the attached Caltrans standard
plan.
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Ref. No.
TELEPHONE
CALL
RECORD
DATE
b 1e-1?:3
/CJ ; /'"~
~ PLACED CALL
C RECEIVED CALL
TIME
PROJECT '72 ' / /'7'
M A F OF C of'C SPOKE WITH
NAME
f'~ 6lJ C"NS"To
COMPANY
rbZrz V P~7b2S~AI
NAME
OF
TELEPHONE NO.
ITEM DISCUSSED/ ~crION REQUIRED -clW C I '1( P fle(/tD-:::>6' TfZ IIFF/c CcntfT7'4:::?(. )
$m~/Nr; f CUT 5"~E~75::: ~ 7?Jl1> VCJe/l!y' 77-1/4 r tv~
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DISTRIBUTION:
CONTINUED:
eYES
Q1 NO
t A IllCK . SAND - CEMENT
llOILDING MATERIALS
J. E eEl V E a 0, BOX 360003
MILPlTAS. CALIFORNIA
95035-0003
MILPITAS MATERIALS c~~y 2 4 19~j
TRANSIT MIX CONCRETE Public Works/Engineering
IIllS NORTH MILPITAS BLVD.
DAlE
PLANT
SALESMAN
MIX NO
5-~l=q3
Mi 1 .
t
C601AC
q '""2.-- \ \ ~
AMERICAN CONCRETE
548 W. HACIENDA
CAMPBELL, CA.
MIX NOMMC601AC PRODUCT NO. Ii" . :,' 'MATERIAL SPEC, GRAV. ABS, VOL SSO WEIGHTS
, " '. -'.
CLASS: X 114
A 1 2.69 10.72 1,800
USE: SAND 2.68 5.93 991
REG TOP
28 DAY STRENGTH: SAND 2.60 2.54 412
3000 SR. BLEND
WIC RATIO: /
6.17 0.55
CEMENT-SACKS: 6.00 CEMENT: TYPE II 2.87 564
I CEMENT BRAND: KAISER ASTM C-150 FLY ASH:
, SLUMP: 4" WATER: 37 GAL 4.94 308
WRDA: ADMIX:
AEA: ADMIX: 0
-"
MAX, SIZE AGGREGATE: 1 Max I .....:.TOTAL8 27 4,076
v
lYI'IC,^L MJA! Y',I',I'IIH [in 1''-, " liJI,I" :f,',[IMII1<;IIVf';^VMMHI'Uf'ONnEQUEST
NOTE: TIlE ABOVE MIX IS BASED ON THE CONSIDEMTlON THAT THE COMPRESSIVE STRENGTH RESULTS WILL EQUAL OR EXCEED THE STRENGTU SIIOWN
ABOVE WHEN CYLINDERS ARE CURED IN ACCORDANCE WITH AS'. C-SI. IF SPECIMENS ARE NOT SAMPLED, MADE, HANDLED, CURED, TESTED
IN ACCORDANCE WITH APPLICABLE AlT. STANDARD PROCEDURES. OR IF THE SLUMP OR W/C RATIO ARE El<CfEOED, liltS MIl< AS SHOWN
ABOVE CANNOT BE EXPECTED TO PRODUCE THE DESIRED PROPERTIES.
SPECIAL INSTRUCTIONS:
DELIVERY INSTRUCTIONS:
SALES FilE:
t . IQ.CK - SAND - CEMENT
llUILDING MATERIALS
p, 0, BOX 360003
MILPITAS, CALIFORNIA
95035-0003
MILPITAS MATERIALS CO.
TRANSIT MIX CONCRETE
ItZS NORTH MILPITAS BLVD,
DAlE
PLANf
SALESMMJ
MIX NO
C601AC
q-'L- ~- \. \.4.-
AMERICAN CONCRETE
548 W. HACIENDA
CAMPBELL, CA.
MIX NOMMC601AC PRODUCT NO. ,- . \ MATERIAL SPEC, GRAV, ABS, VoL SSD WEIGHTS
. ,
CLASS: X 114
A 1 2.69 10.72 1.800
USE:
REG TOP SAND 2.68 5.93 991
28 DA V STRENGTH:
3000 SR. BLEND SAND 2.60 2.54 412
WIC RATIO: /
6.17 0.55
--
CEMENT -SACKS: 6.00 CEMENT: TYPE II 2.87 564
---
CEMEN r BRAND: KAISER ASTM C-150 FL V ASH:
-
SLUMP: 4" WA TER: 37 GAL 4.94 308
WRDA: ADMIX:
AEA: ADMIX: 0
-----..
MAX. SIZE AGGREGATE: 1 Max I..:'TOTALS 27 4,076
.... -
lYI'IL^L MJAI y',I', 1'1 Hi.[ rnl'.\', IIJ" (" :rl',:JM1[J 'il[ VI~; AVM Afllf'LJrON nEQUEST
NOTE: THE ABOVE MIX IS BASED ON THE CONSIDERATION THAT THE COMPRESSIVE STRENGTH RESULTS WILL EOUAL OR EXCEED THE STRENGTIl SHOWN
ABOVE WHEN CYLINDERS ARE CURED IN ACCORDANCE WITH AS'I C-31. IF SPECIMENS ARE NOT SAMPLED. MADE. HANDLED, CUREO. TESTED
IN ACCORDANCE WITH APPLICABLE ASTM STANDARD PROCEDURES. OR IF THE SLUMP OR W/C RATIO ME EXCEEDED. HilS MIX AS SHOWN
ABOVE CANNOT BE EXPECTED TO PRODUCE HIE DESIRED PROPERTIES.
SPECIAL INSTRUCTIONS:
DElIVERV INSTRUCTIONS:
SALES FILE:
ROCK. SAND. CEMENT
BUILDING MATERIALS
AAA
1" x #4
Jamieson Co.
Pleasanton, CA
lVIILPITAS MATERIALS CO.
TRANSIT MIX CONCRETE
1125 NORTH MllPITAS BLVD,
MllPIT AS, CA 95036
q"""'L - l '- 4-
sieve
1"
3/4"
1/2"
3/8"
#4
#8
G r a d a t i o n
----- - - - -
% %
Retained Passing
2 98
16 84
52 48
78 22
99 1
2 98
13 87
41 59
66 34
82 18
93 7
99 1
0 100
0 100
2 98
19 80
65 35
92 8
size
Reg. Top Sand #4
Jamieson Co. #8
Pleasanton, Ca.#16
#30
#50
#100
#200
Blend Sand
Kaiser
Felton, CA
#4
#8
#16
#30
#50
#100
The specific gravity:
1" x #4 - 2.69
Reg. Top Sand - 2.68
Blend Sand - 2.60
(408) 262-0656
(415) 656'2619
FAX (408) 942.0826
!~I;;:J}X}XJkt\rt;_ _Of __.JJ~~~~J~NCJ~ _ ___ ___ __ __ ___ _ _~~.._.___, u_.___~._u_~__ _u_,_~. u-.----.~-""".'f. n~- ...!~~CJ ~,~~,g- - -- \~
"w'~6-gy I nsur anc e Ser vi c I~ ! ~r~;~rq~r ~[~~~:TT:~:C~~~~~~;&T~~ r ~ ':~rB'~\;r ~~~!g~~(;t~~~~~~\Jf'~AMEND, : q t'\
f". o. [lg~ ~~Ogt1
~~~5~~S@' CA
PHONe
COMPANIES AFFORDING COVERAGE
'"~;'P", LE~~U' A Financial Indemnity Company
II
IC-.T~
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~H~S IS TG ;=:~F:I;:'Y TH;\T ?O~ICIES DF INSUk~ANCE LiSTED BELJ~J HAVE BEEN lSSU~J 10 ~f;E :~\SUPEC ~~A:'i:D h~'~i~:C~ (-'up 8e,l"D
PER:OD IN~ICAT[Cr XGTWITf{STANDING ANY RCQUIREMENlj TERM G~ CONDiTION OF ANY CONTRACT OR GTHER DOCUME~~ ~ITH TO
~~ICU_~:';:; ~~~G~~Cf~~~~ ~~y ?; .ISS~~D_GB_M~X_fEfT~!~, ~t!E INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS 3ljBJECT ~C
~__ itRM~, tICLU~IUN5, ANU LUNDITluN~ Jt jLLH HOLIUIEj, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
U-;~:Ui",t.1J
: r'~'~"H>.~,~i\'
I '.''-'in n:\ I
~E-'U' B
Larry Shadle
378 Rutland Ave.
San Jose, CA
95128
T'ffE Of INSURANCe
, '..Ji....i.'..;
~~U~BEF:
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f :.H....i '.'; ,-i'-
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peLley E;:~;-
r-",,:::-
iiM1L
A,-~ LIMITS IN THOU3AND~
-j ,_...._...-.
..----.--------'------------1--.
I GENERAL LIABILITY
: GE~~~AL AGGREGATE
: COMMERCIAL GEN LIABILITY
;-'?;:;D~ ::OMf'/:::-':: ~,:;G, :
1 L] CLAIMS MADE [ 1 oce,
PEPS. .~ AD\hj. lN~U;;::";;
: GW~~R'S & CONTRACTORS
:-,~.r,7 ,";-.;;'; i,-
r r;.u i Cj~. i 1 t't:
EA:::h OCCU?F;ENCE
... --,'" "".".,. ,-,-
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,
i MEDICAL EX~~~SE
: (ANY ON: PERSON;
- - -". -"-~ - -~----- __H' -."--,-..-.-.---~~---"- 1----'
: AUTOMOB I LE L I AB
A C 'j ANi' ;;:j-:-::
~ 1 ALL OWNt} AUTOS
[XJ SCHEDUL[D AUTDS
LX~ ;; I ~:~~D A..n CiS
[ J NON-OWNED AUTOS
[ ] GARAGE LIABILITY
:C 7031502
02/04/93 07/30/93 f.ODIL IiUJRY
! (PER PEESJN::'
15
BODILY INJ'Ur.:\'
(F'E~: ACCICE~~T:;
30,
?t~:OPE:~~ T Y
10
: EXCESS LIABILITY
J J?~[T:=~.LA ;-J~:~:
: [J OTHER THAN UMBRELLA FORM
EACH oce ~bb~Lah c
ST A TUTO~,'';''
WORKERS' COMP
AND
EMPLOYERS' LIAB
tAe!1 Ace
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~: ,;,.",.:;..il:J1- ; uL..--.- I '-.!. ,/... I
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OTHER
DCSCf:IPTiON OF JF'E?AT iGNG/LOCA T IJN>icHlj::LE':;;GF[:~iA_ I iE~G All Cal i for ni a Oper at ions
, Peymit I 92-114, City of Campbell, its officers, agents and employees
as additional insureds
.. CERTIFICATE !1CLDER ===============================; CANCE~~A;IO~ (============~================ -=============================
~r'0~'c.i; Tr.E ABOVE DESCRIBED F-ULIC:ES BE CANCELLED BE~ORE T~!E EX
~ti-~: 0 ~ugrT~b~~; ks Depar t ment ~ ~lvr ~~y T~~i/ N~YY2~O~b n1~ ;~~~~WIc~~~F'~~~ D~:[L~A~~~E~,~G~HlG ~2i~ Bt9
, 70 North First Street :: FA:~JRE TO MAiL SU,:.:, '.jiEE SJ\cL iMFSSt: fiC! jBLICAiION OF ~iABILI;\' OF
.~.~~::~::::..:: L e.ex........_ . ...._........... .';;:':; ::u";::,ii:,c:;;::' '.' T:2'2JiZJ~ A ;'.:S :... _ ... ....... ..i
MA' '-28-'93 FR I 1 1 : 5'9 BARLOCKER INSURANCE
P.02
Barlocker Insurance Services
C\L-.- \ 14--
/299 Del Mar Avenue. San Jose, California 95128 · (408) 288-6262 Fax (408) 280.082/
RECEIVED
JUN 2 199J
May 28, 1993
Public Works/ Engineorin"
Carol Marquez
Bliss & Glennon
P.O. Box 3783
San Jose CA 95156
Re: JRT Construction Corp.
Policy No. MBL420606
Dear Carol:
Please have the carrier issue an immediate notice of cancellation
for non-payment of premium on this April 30, 1993 effective policy.
Thank you for your assistance.
Yours truly,
BARLOCKER INSURANCE SERVICES
SANDY BROWN
Account Executive
cc: Don King - City of Campbell (Faxed)
,?Z-II(/
Ref. No.
TELEPHONE
CALL RECORD
DATE 512./7.3
TIME It) ~ 2- .s-'
PROJECT '1 Z - ( t 'i
~ PLA~ED CALL
C RECEIVED CALL
Mil F
NAME
COMPANY
OF C of"C SPOKE WITH tilL s e-L t6UI/JdlN
NAME
25;2-(// /
TELEPHONE NO.
OF
ITEM DISCUSSED/A.CTION REQUIRED .r I?Jl'j:> gILL q;, m //IT I HIl1/6
A r;~l1JttllJ'JL CON7/2IQC72/Y2 IAJHO cti'llV/lIo/ P#fJtll D~
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t) tJ IV . 7 IJ PI (/6 fI / (7(:J~) crp-ZJ ' I
DISTRIBUTION:
CONTINUED:
eYES
C NO
MAY-10-93 MON 9:13
r",,_:,~"""'" ,..r.e,..,'" Vb.
LITLE / NEAL REALTORS
FAX NO, 4083796992
p, 02
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DWt... fIX I: .
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~ fAX I'
T~'",LI ~~ ~.mulallll~~""'i
, ' '
-'
WHeN RECORDED 'MAIL TO:
City of Campbell
10 North Firat Street
Campbell, CA 95008
. MASa.:'"1'AK ST~TEMINTS' TOI
. "
.'1 I
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.I .'AU AIOVI THIS "INI 1110" "'~OAOI.'I US.
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FOR A VALUAILI CONSIDeRATION, receIpt of -"ltIt Is h~+W' _nowledied,
who ae~ulred title a$ VERON.lCA STONEk :f \
::.! I ' ' '
h.tby OftAHT(J) to the elTV OF CAHPelELL. . l1untc\p., C9rporuton of the County of
Sant. Cia,., Itete of Calltornle, for publl~ s~teet purposes and to become I plrt
of UnIon A'Ionue ,.:1 _ ._._.....
. . . . " a I ~ t . ," ..", . .;1
. ,I ~
111. rill property In 1h8 City of e, ty Q' Cempbe 1 t
Countv of $." ta e 1 a re
Y~AO~I~^ WINKLER,
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rlbld II .
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All of that ,ortlon of th.t~~rt.ln. parGet of land
conveyed to Roy 8. Stol'ler ~d Ver"V"'Ga Stober. husband
and wlfo; .. Jol~t tenant5t,by Grent o.odlJolnt T.~I"CY
fl1~d for record June 30, lt~', t,n Bgok 9~l,of affle,'.'
Recerds at pages ", and l~lt _f" the offf~ of the
County Recorder ~~ the County of Slntl CI.ra, State of
Cel.forn", l~~ated wtthtn1~~ 'e~t. m,llur,ed .~ . rlsht
enlle. easterly of the cenltrllne of unton Avenue Ii -
..ld centerlIne 1$ deswtl~d In $i'd Gr.nt geed. '
I.
! . .
pursuant t.o C1t)' of C~1.'i' Land oe.,,-elop1ant. Q~cu.ria:no.,
an lnevo)ca))le', cCIIIllit.Jle!1' :.by the C1t.)' th,~ p-rovic!es for
!:he eonst.ruot,lOft:.a1: Cit~ "~n8. l!lI~ at.l'e.~ .iJlWroWllients
In 1eole:ted are.. When no ~;velQPD8nt is 1ri"01,,a5 ~~c:n
the ilhut\;el! p~oe1 of . lei ':
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MAY-10-93 MON 9:14
LITLE / NEAL REALTORS
FAX NO, 4083796992
p, 03
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Ref. No.
TELEPHONE CALL RECORD
DATE
sltlh3
)i PLACED CALL
C RECEIVED CALL
TIME
<g ~ tnJ
PROJECT 1 Z -/ /~
MI1F
NAME
OF C of'C SPOKE WITH
IIJtflrllcl4A1 L41/f1C/2477r
COMPANY
NAME
OF
~ CJl{ -() 3S?
TELEPHONE NO.
ITEM DISCUSSEDI A.CTION REQUIRED ".I It; $ Ul:> ~ t-JlheJ2 ~ JO A/'D
f..I-~ wolfI'7}gt!' / nJ 1/ A/T7 ~ 7J-I /~ ~/l/1!hh1/ · :z ex /) L JIJ/ NEZ>
7ZJ T)-It5 Pt!rl<;ON 'm 77M pM;JtJ~ 7}.IGT I WtEt5h ut!'/.{/c(.c
IIl!S'UJlJ.J4A1ce INFC1I2/UA77/JA/ ~t!/ 77-I1!f'V CAIlJ ~ ~
o/'.P5/7Z Wa/2IL ,,~ J./~C./~AlD~WAI /bill. 5H~ SA/I>
LJtH?IlJ! 1AJ01.A 7> 6K-r ~JqCJr:: 721 J4~.
DISTRIBUTION:
r/ t..t .
CONTINUED:
eYES
JJ' NO
A.~..III.~
CERTIFlCA"\ ~ OF INSURANCf:
-
ISSUE DATE (MMIDD/YY)
t}Z-Hq
I
THIS CERTIFicATE IS ISSUED AS A MATTER OF INFORMATlON'O'NL.Y AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
PRODUCER
c' c J< c:. t"
-Ln":::.u. "I
l::tn c:
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COMPANIES AFFORDING COVERAGE
:":.l)n
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-...1 e) ';::- (.::., y
~~T~~NY A
':'." J .i. '::) ::;. .;'x r~i J (.:.:, n n en--,
INSURED
~~T~~NY B
RECEIVED
MAY 11 1993
.J F.; nr i"..l..., i I . ;;. t.. r- u C 'J:., :i. c: n c:: i,J f' P ;,.
~~T~~NY C
Public Works/Engineering
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~~T~~~NY D
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i.... t'j
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~~T~~~NY E
COVERAGES
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.
CO
LTR
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MMIDDIYY) DATE (MMIDDIYY)
TYPE OF INSURANCE
POLICY NUMBER
LIMITS
r' GENERAL LIABILITY
....,i..,...
.)..;",;.
GENERAL AGGREGATE
PRODUCTS-COMP/OP AGG.
PERSONAL & ADV_ INJURY
EACH OCCURRENCE
E.; Ii: "f'li"\ j
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE
OCCUR.
OWNER.S & CONTRACTOR'S PROTo
FIRE DAMAGE (Anyone fire) $
MED_ EXPENSE (Anyone person) $
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
COMBINED SINGLE $
LIMIT
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
EACH OCCURRENCE $
AGGREGATE $
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
STATUTORY LIMITS
EACH ACCIDENT
AND
EMPLOYERS' LIABILITY
DISEASE-POLICY LIMIT $
DISEASE-EACH EMPLOYEE $
OTHER
$
$
$
$
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,o.,ES~~::T,IOi~ 0: OPERATIO~~/LO~A:IONhHCi~S~fCI~ll am its offiCErS, ~ am arplojee3 are rarID as crl:ticn:U iIBrErlsl
' "fi:t:inladf~ ah}tC1airrs, less licbility, a::st cr exp:nse arisirg o.Jt. of cr in ~ a:1I~ with tha
a::nst.ru:ticn of tha p:o~. 'Ihis ~ .:hall re p:irrary am CClj ~ carried bj an crl:litiaal i.rarerl shill
CE CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL .:. '-.> DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
'j "( L_.('~; :'n' .l::;j::. ,...
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c.: (:j ;--'-'1 I:: r:; L L. L.~. ::::: (~I ":'. i' "j i"... .::)
AUTHORIZED REPRESENTATI
w..J./
ACORD 2108 (7/10)
.i. C'
ACORD CORPORATION 1990
I '.
JanUarY!4, 1993 (0N/lp~ Q-1"'?3j
JRT Con~tt~ctjun "
18t91 S~reto9a-LoS Gatos Rd.
HoIILe S~reno, CA 95030
,... "~..
. Itife ~/R~-"".\
(i#~f (kltfl/~ ..
:319-11'-12 /
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-;.Jt[Em~[E~ (Cm~mnnrncroDm~ cem~[pm~~
,. :/" 565 MeliU..eey In., Cempbell .CR. 95008
.. . (401) )11-1049
: '..
Re: Al e~tl11owntlouses (Rev1 sed city street improvemeni.12-9-92)
540 ~acienda Avenue
campDell, CA
,
Dear' Mr.i ray 'I or',
i
I _
Here h pur proposa 1 for the add 1 t i onal work reQue s~ed 'by the Cay of Campbell
i n accor~ance with thei r drawi ng dated 12-9-92. Pl ease note th,at the ment 1 oned
plan is not marked with an approved engineer's stamp~or does it .appear to be
accepted; by the City engineer. An approved City plan'mu$tbe. made available to
us befor~ .work 1s to proceed. If you should have any Questions, please contact
me at yo~r convenience. ., .
\
INClUSIO~~S. 1. Provide demolition of additional asphalt street surface at the
~ I~ ~;., intersection of Hacienda and WalnutAvehues,approx. 3, 160 SF.
1; 0 '()v. '''If__ - rj ,
: ,Exc~vate to proposed subgaae elevati6ns, approx. 3,160 SF.
/1~~1---3. Subgraae & compact to 95%, additional street surface, 3,160 SF.
'~ Provide & place new street section, H~cif3ndaapprox. 2.060 SF.
~ Its'"~.,... -. 411 AC over 12" CL-2 Base or 9"'AC Dee'pUft. .
, 5. l>r'ov1 ae & pl ace new street sect 1 on, Walnut approx. 1,100 SF.
3i" AC over Gin CL..2 Base or 6" ACOeep,l.-1ft.
i
~~,a;'r- 6. Deep L1 ft Opti on: Prov1 de tack at edge.s on,l y; sea 1 at edges onl y.
.) AC over Base Option: Provide tack at edges, prime oil, seal
: edges only. . ,
~(lt?pt) ! - "F Prov 1 de s tak 1 n9 & cutsheets.
I
EXCLUSI0N~: 1. Compaction testing,
! . 2. Permits, ~onds, fees.
l. Utility adjustment or removal
4. Stripes, markers.
~ -
I
. Add to OrJg1nal tontract: $15,300.00
' ,
i
Respectfully submitted,
PE.'rEfCSfN tO~STRUCIION COMPANY
I
Jerry S. Petersen
I
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CA. LIC. -i7838B
1
MAKING THE GRADE I
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CITY OF CNAlELL, CITY ENGINEER'S n~ ESTI~TE
Ad:ress s-Lf t{ 1I J1 Cf 6/il1 0/7
&.rface Cal;tru:tim
PERMIT NJ. C} Z - fie!
I7f /jfrt,{L ~
CleeriFll & G/Ui)irg
Slw:ut Calcrete
Calcrete R8ID\f8l
Q.rb & OoJtter R8ID\f8l
Inlet Orein with Pipe
Q.rb & QJtter
Sidelelk
OrivaIIY AI:P"C*h
lIln:Ii cap Rarp
Extn.ded Q.rb
Bard c:ade
Street Excavatim
K:.PMII81t
Adj ust MIrilole to Grade
Adjust Hrdlole to Grade
Mcn.m!nt Bolt w/MCnIII!nt
Street Tree (15.gallm)
Pavlm!nt Stripirg (S100nin)
Pavlm!nt LeglI'ds (S100ni n)
Stq:l, Street NIIre other Sil1l
PBv8rEnt Marker
PBv8rEnt Key QJt
Lulp ~ EstiDllte
S-O LF a '11$4.50
SF iI *$3.50
LF iI "SS.50
EA a S6lXl.00
Lf iI S16.OO
SF a $4.50
SF a 16.00
EA iI $475.00
EA iI 10.00
LF a S60.OO
SF x (SO.12) x (
SF x (0.35) x
EA iI S425.oo
EA &I S325. 00
EAil S7OO.OO
"7~
/917_
II 7?
I r" 1-
EA a S550.OO
LF iI S.75
EA a sso.oo
EA &I S1~.00
EA &I S17.OO
LF a s10.oo
arface &btotal ''5''
Adjust for size: ''5'' > S1oo,CXXl,Slbtract 1~
Street Li!t1tirg
Elec:trolier
Cal:tJi t
Ca'd.ctor, FXlir
Pull Bolt
EA&I S22lXl.00
LF iI S10.OO
LF iI 12.00
EAa S2IXI.oo
Stonn Drairege
12- or 15" RCP
18" or 21" RCP
Street Inlet
MIrilole
Break & Enter MIrilole
LF iI S70.oo
Lfa $11).00
EAiI S1750.OO
EAa S25lXl.00
EAa S750.oo
TOTAL ESTI~TE S
lEE RR IlCN) S
(.
C)
6
~J
date t-!ff / c; ~
")
I')
-S
-S
-S
-S
-s
-S
.s
-s
-S
.S
.s
.s
.s
-S
-S
.S
-s
.s
.S
-s
.S
-s
-S
22 S- - CI 0
2 I CJ I? < / 2
(, ~ '} 6 < b 0
- s "
_ S f II) {; J Lf~ 72
-S
-S
.s
.s
.s
-s
-s
.s
-s
-s
.s
.s
revi se::l 8192
F :ca'lCOSt
fJ;q C f If fIJ br:; :::; 1/1 /'2 tjJ (s t, J) c! CP L-IFT\
wlllLw (J T ~ I, 178 0 (t; J/ J?cH L-/~T)
CITY a: C'.NAIELl, CITY er;1N:ER1~ ,~SnU:T1CJ4 ESTIMATE PEIlMIT tIl. <7 Z -I ;cl
1di'ess s-cf'6 H ACIlIVD/9 bf /Z41 Ct f cBte Z/t ( hJ
9.rface Calstn.ctia'1
CLeerire & Gn.tbire Lurp &.In Estimrte =$
Saw::ut: On:rete ~O LF Q "SIt.50 =$ 225. cro
Calcrete RBltMIL SFQ *$5.50 =$
Qrb & OJtter RBltMIL LFliI ~.50 =$
Inlot Drain with Pipe EAQ $600.00 =$
llrb & CUter LF Q $16.00 =$
SidewElLk SFiI SIt.50 =$
DrivaIIY ~ SFQ $6.00 .$
H81:Ii~ RaJp EAlil Slt75.oo =$
Extn.ded QJ"b EAiI 10.00 =$
Barri c:a:le LF lil $60.00 =$
,'I7g 10 ~/O '3 '-I, b 1
Street Excavatia'1 l'i' Z SFx (SO.12) x ( /6 ") =$
K;P8\/8lBlt "6070 SFx (0.35) x ( 1 II) .$ "1 (.3 -Z t~oo
Adjl.St MlrhoLe to Grade EAiiI S425 .00 =$
Adjl.St IIIn::hole to Grade EA lil 5325.00 =$
McrurB'lt Box wIMcnment EAlil S7OO.oo =$
Street Tree (15-gaLLa'1) EAQ S350.oo =$
P8wnEnt Stripire (S100nin) LF Q $ .75 .$
P8wnEnt Legen:ls (S100nin) EAiI '50.00 =$
Step, Street N&re other SilJl EAlil $140.00 =$
P8wnEnt MEIrIcer EAiI $17.00 =$
P8wnEnt Key !lit LF iiI $10.00 .$
=$
=$
9.rface !UJtotaL 1'5" =$
Adjl.St for size: liS" > $1oo,00>,Slbtract 1~ =$
Street Lic:htil'A
ELectrel ier
CcrdJi t
Ccn::iJctor, plIir
PuLL Box
EA Q S22lXl.00
LF iil $10.00
LF iil $2.00
EA iI S2lXl.00
=$
=$
=$
=$
=$
Storm Draire!ll!
12- or 15" R(p
18" or 21" RCP
LF iI $70.00
LF iI 8.00
EAiil $1750.00
EAiil S25OO.oo
EAiil S750.oo
TOTAL ESTIMATE $
USE f(R OCN) $
=$
Street InLet
Mlrhole
BreeIt & Enter MlrhoLe
=$
=$
=$
=$
=$
revised am.
F:c:accst
I-r,f}e.'/[/V 0/9
hJ,ALW uT "Z
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1,1 7~cjJ (C;f( neON 6 '11-115)
STATE
COMPIENSATION
INS'-'~ANCE
I=UNC
P,O. BOX 420807, SAN FRANCISCO, CA 94142-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
APRIL 13, 1993
POLICY NUMBER:
CERTIFICATE EXPIRES;
1124806-92
6-1-93
r-
CITY OF CAMPBELL
ATTN: BUILDING DEPT.
75 N. CENTRAL
CAMPBELL, CA 95008
L
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California
Insurance Commissioner to the employer named below for the pOlicy period indicated,
This policy is not subject to cancellation by the Fund excePt upon ten days' advance wrinen notice to the employe,_
We will also give you TEN days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the
policies listed herein. Notwithstanding ilny requirement. term, or condition of any contract or other document with
respect to which this certificate of insurance 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.
~~
PRESIOENT
EMPLOYER
r
J.R.T. CONSTRUCTION CORP
1~191 SARATOGA-LOS GATOS
btONTE !':'Rn_nNC>. CA 95030
CITY OF Cf\MPBEIl
70 NORTH FIRST STREET
CAMPBELL. CALIFORNIA 95008
(408) 866-2100
FAX # (408) 379-2572
Department:
Public Works
March 31, 1993
Mr. Russ Aleshi
510 Beth Drive
San Jose, California
95111
Subject: Permit Number 92-114, 548 Hacienda Avenue
Dear Mr. Aleshi:
The City sent a letter to you on February 12, 1993 outlining the
ci ty 's concerns regarding your proj ect on Hacienda Avenue. To
date, the following concerns have not been met:
1) A new proposal has not yet been submitted by Petersen
Construction which outlines unit prices and quantities for
each item of work. The new proposal must also show the
corrected section of 4" AC on 6" of base, as is shown on the
current plan.
2) The insurance certificate submitted by your contractor has
expired. A new insurance certificate which meets the City's
requirements must be submitted immediately. Enclosed is a
copy of the City's insurance requirements.
3) According to West Valley Sanitation District, the defective
building sewer on Hacienda has not been repaired. This must
be done prior to paving to avoid cutting the new pavement.
The City has estimated the additional work associated with this
project, and found that the proposal submitted to your contractor
is in excess of what we feel is a fair price. We beHe've that the
work should cost no more than $12,000. This is the maximum
contribution which the City will make towards this work.
The City will begin to process funding for the extra work as soon
as the first two conditions outlined above are met. If you have
any questions, please do not hesitate to call.
Very t~~y ~l'~~s,
~::lA, ~
M1chae A. Fuller
Assistant Engineer
~rA
( h:\aleshi1
'12.,/19
Ref. No.
TELEPHONE CALL RECORD
DATE.7~ /5:3
.
TIME / ~ t/7)
PROJECT ~ 2 -11<(
~ PLA~ED CALL
~ RECEIVED CALL
M/.Jr
NAME
OF C of'C SPOKE WITH
\77' F F 77'/ V LCI'U...
NAME I
OF
COMPANY
TELEPHONE NO.
ITEM DISCUSSED/~CTION REQUIRED .J7J:'J: CI4LLcD ~t'.s JIJ.J.1. '('
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DISTRIBUTION: Flc.e
CONTINUED :
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Mon~. ~.r.no, california '15030
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Place and Qom~act ,It, A.C:'.
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March 3. 1993
JRT CCNSTRUCTlcrl- Hacienda & Wa1nUt Proj€Ct . ;':-:.'f.
':"-.\~f;
Pavirg Bid. Plan data:112-9-92 ::~t
, -:.. \-' ~.,'
1. Farnve edsting strEet surface to allcw' f(r.:.:,...
- :' :_:\~:.
2. Grade & furnish installa::.l new asphalt ~i
. , '.:,:~i.~,
3. FC9 seal surface at paving carp1etiCtl.' -:. ;.:::,1":-
'i :'1
We will not furnish perrnits, lines, ~s/:
'<<:Jrk w111 be carpleted after ywr origfnal s ". l.
are installed by YCJ..Jr Cun-ent pavif)J CCtltractor~',
. ~;'.':;:~
Bid: $19,700.00 D.ie up::il COlpleticn. '..'.'~:):;t
::'{::,,;~;
lhank YQj. - "". :l;
/ ~F' ,'~":::;;0~
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L~ H. Evans .:,))~t
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HACIENDA WALNUT - STATUS REPORT
Mr. Aleshi's contract is with JRT Construction. JRT has Peterson
Paving as a sub-contractor. Peterson bid on plans that were not
approved ( again) . His bid to JRT was for a smaller roadway
section.
On Wednesday, Dec 9th, Chuck, Hank, and I met with Mr. Aleshi, Jeff
Taylor (JRT) and Mr. Peterson. I provided Mr. Aleshi and Mr.
Peterson with the proposed grades for Walnut and Hacienda and asked
Mr. Aleshi if he had any objections to us working directly with Mr.
Peterson and requesting a price to have the additional work beyond
centerline on Walnut and Hacienda done for the City. I explained
that if Mr. Peterson's price was in line with our estimate, that we
would be interested in preparing a purchas~ order to Peterson to
have that additional work accomplished at the same time as Mr.
Aleshi 's work is done. We also asked for a copy of Aleshi' s
contract with Peterson - through JRT- so that we can make sure that
we are not paying for anything associated with Mr. Aleshi 's
developement - especially since Peterson bid on unapproved plans
that had a reduced pavement section.
Mr. Peterson was to get back to us with a price for doing the
additional work. We should follow up on this - JRT was anxious to
get the project complete, and the situation needs to be resolved
quickly.
All of the information on this is in the encroachment permit file
for this development.
MQ:730STAT02
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Ref. No.
DATE
TELEPHONE
~ff lei 3
( ',01)
7 z -;1''1
CALL
RECORD
TIME
~ PLACED CALL
C RECEIVED CALL
PROJECT
/-IFJC1t5I1JD/I -f WI1L/JtJT
fl/l Ii r
NAME
OF C of'C SPOKE WITH
Russ nt. 6'5/11
NAME
OF
s-q ~ 1-1 A Cle'lV D/l
COMPANY
TELEPHONE NO.
ITEM DISCUSSED/A.CTION REQUIRED CRl CE.D fZOSS 110 L.C5 1-11 TO
,
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DISTRIBUTION:
CONTINUED:
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.pmm[l]~[I~ (hqo~~rncmo CD~ a;m[X][Pm~~ '
:.65 MClillniceg Ln., tllmpbell CR. 9:J008 ~~{~\.
: (408) S77-7D49 -"
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iJanuClT'Y ~. 1993
I
JRl conStruction
18191 Sa atogB-lOS Gatos Rd.
Monte Se eno, CA 95030
!
, --
Alesb1 lownllouses (Revl::sed city street improvement, lc::-~,.9")
548 Haci~nda Avenue
Clllrlrpe 11, CA
Dear Mr.; Taylor,
Re;
'.' .....
HtH'e b iJur pr'oIJosa'l for ttle add1 ti onal work reques'tea oy Ule VI ty Of Campoe"ll
in accor~ance with the1r drawing dated 12-9-92. Pleaie note that the ment1oneo
pl~(1 is hot m~T'k~d with an approved engineer's stamp nor does It appear io be
acceptediby the City eng1neer. An approved City plan must be made available to
us beror. work is to proceed. If you should have any questions, please contact
me at )'o~r cOIlVt:lnience.
I
INClUSIO~S: 1. provlae aemol1tl0n Of aaalt10nal aspnalt street surface at trle
'1IlLt:H'st!(;\;1oll uf Hacienaa and walnut Avenues, approx. ::S,160 Sf.
2. txcdvate to propused ~ubyad~ elevations, approx. 3,16U Sf.
3. Subgrc:1ue & ~OllljJ(lCL t.o 95%, additional street surface, 3, 'lbO SF.
. ~, ,"
4. Proviae & place new street section, Hac1enaa approx. ~,UbU Sf.
4" AC over 12" CL-2 Base or 9" At !Jeep un.
"',';
5. Provide & place new st.reet section, walnut approx. 1,100 Sf.
3i" AC over 6t" CL-2 Base or 6" AC Deep Lift.
6. Deep Lift Option: Prov1ae tack at eages only, seal at eages only.
AC over Base Option: Provide tack at edges, prime oil. seal
edQcs only.
I
EXCLUSIO~S: 1.
2.
6. Proviae staking & cutsheets.
. -'/'
Compaction testing.
Permits, bondS, fees.
~. Utility adjustment or
4. Stripes, markers.
:'1"
rernuva'l
Add to Ot1g1nal Contract: $15,300.00
I
,
Respectf~ll y 5ubmi tted,
!
PETERSEN CONSTRUCTION COMPANY
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CA. LIC. ~478388
i
MAKING THE. GHAUE I
WEST VALLEY SANITATION DISTRICT
OF SANTA CLARA COUNTY
SERVING RESIDENTS OF
CITY OF CAMPBELL
TOWN OF LOS GA ros
CITY OF MONTE SERENO
CITY OF SARA TOGA
UNINCORPORA TED AREA
100 East Sunnyoaks Avenue
Campbell, California 95008
Telephone (408) 378-2407
January 15, 1993
Mr. Rassoul Aleshi
510 Beth Drive
San Jose, CA 95111
RE 3-Lot Sub-Division
Hacienda Avenue, Campbell
Dear Mr. Aleshi:
The district's TV-inspection revealed a dislocated joint in a 4-
inch building sewer. Although your contractor was informed of the
situation several months ago, no work has been done to correct the
situation. In addition, there are settlements over the trenches.
Your immediate attention to these problems are needed. Please
notify our inspector, Bob Moehle, of your schedule to complete the
repairs.
Very truly yours,
Robert R. Reid
::s~~~eer
~~istant civil Engineer
cc Bob Moehle, WVSD
~ike Fuller, Campbell
Billy Vick, Vicks Pipeline
RECEIV~~
JAN 19 1992
Public W arks! EnginGorin:)
(FORMERLY COUNTY SANITATION DISTRICT NO.4)
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(Applicable Item marker 0) NOTI,CE OF ,,,ANCELLATION OR NONRENEWAL '- CALIFORNIA
.
I
CANCEL-
LA TION
NON- 0
RENEWAL
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r
Named
INSURED
L;,iH'i'l-.
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You are hereby notified in accordance with the terms and conditions of the policy mentioned below ,that your insurance will cease
at and from the hour and date mentioned below_
If the premium has been paid, premium adjustment will be made as soon as practicable after cancellation becomes eIIc&C
If the premium has not been paid, a bill for the premium earned to the time of cancellation will be forwarded in due course_
D 'You are hereby advised that California law provides that upon request in writing made by you to this CompanAlAVI
request to be mailed or delivered not less than 15days prior to the effective date of cancellation, you are entitled to be in~e~
by this Company in writing of the reason(s) for the cancellation_
O 'The reason for cancellation is Paragraph(s) _____of California Insurance Code Section 676 (see reverse ....
written request of the named insured_ the insurer will furnish the facts on which the cancellation is based_
'Not applicable to Commercial Lines_ These boxes will not be checked unless a California law is applicable
You,are hereby notified in accordance with the terms and C01ditionS"~f the policy mention.td below that your insurance will cease
at and from the hour and date mentioned below due to nonl'l.a\m1!!nt of ~'I1ium_ _
A bill for the premium earned to the time of cancellation will'be 10Twarded'-\h'clue course_
You are hereby notified in accordance with the terms and conditions 0 tl')e policy'mentioned e w that the policy will expire
effective at and from the hour and date mentioned below and the' polic~ will NOTbe rene ed_
You are hereby advised that California law provides that upon request in writing made by you to this Company_ such request to
be mailed or delivered not later than one month following the effective date of :the nonrenewal_ the Company will notify you in
writing of the reason(s) for such nonrenewal within 20 days of receipt of your r~quest. ~> ,.,
You are hereby notified in accordance with the terms and conditions of the policy rtl6ntio d belolN that the policy will expire
effective at and from the hour and date mentioned below and the policy will NOT be renewed
s/EnGineor1nQ
IV~ ;.,
o 1992
o
CCP-l 177 80
,- REASON FOR CANCELLATION
10 0 Rewritten by
JFFF TAYLUl'(
Dr~A:
1 S i. S~.t
J ~T CONSTRUCnV';
'H\HATOGr\ -- :_.AS (AT/i;:
SELENO, GA 950JIi
20 o Agents Request (23) t:l Non-pay Agent
30 o Non payment of $ on policy
-1 3'3 o Non payment Finance Company
40 o Non Report of Payroll/ Auditable values to
on policy
R nit...)
60 0 Insured's Request
70 0 Company Election
80 0 Policy not accepted
90 0 Policy issued in error
KIND OF POLICY
,) );::~ERCIAL
r- POLICY NUMBER ---,
(;1.;;-> t 7 77 gU
I
Policy
Issued
th rough
(Agent)
L
I' ",
Mortgagee
or Loss
Payable
L
EFFECTIVE DATE OF CANCELLATION OR TERMINATION
~ at 12:01 A_M 0 at Noon
o
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Standard Time 0
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A.R.
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GOLDEN EAGLE INSURANCE COMPANY
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SAN DIEGO_ CALIFORNIA
By
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'MPORTANT INFORMATION ON REVERSE SIDE
~
E:-
" (Z-84)
White-INSURED Green-AGENT Canarv-ADMINISTRATION Pink-ADMINISTRATION Goldenrod-HOME OFFICE
-
riLe
1
I
I
70 NORTH FIRST STREET
C AMP BEL L, C A L I FOR N I A 9 5 0 0 8
(408) 866-2100
FAX # (408) 379-2572
Department:
Public Works
September 17, 1992
Mr. Rassoul Aleshi
510 Beth Drive
San Jose, CA 95111
Subject:
548, 550 Hacienda Avenue, Street Improvements, Permit 92-114
Dear Mr. Aleshi:
Our inspection of the construction of the public improvements associated with your
development at 548 & 550 Hacienda Avenue (Permit 92-114) has raised the following
major concerns which must be addressed and resolved immediately before any further
work will be allowed under encroachment permit #92-114.
1) We have noticed that the curb and gutter constructed by your development on the
west side of Walnut Avenue appears to have been constructed much lower than
the existing curb and gutter on the east side of Walnut. This would be in conflict
with the plans submitted for your development.
2) The curb and gutter on Hacienda Avenue also appears to be much lower than the
street center line. The City's standard cross-slope is 2%. It appears that your
development is proposing construction of cross-slopes of 4%. This is
unacceptable and must be resolved immediately.
3) There's also a great difference in elevation between the top of curb at Sta. t+32.5
and the cone;rete driveway at Sta. 1 + 50 on Walnut which must be resolved.
Please have your engineer and surveyor collect the information necessary and prepare
full street cross-sections for Walnut and Hacienda Avenues at 25 foot intervals and
centerline profiles for both streets. Your engineer will need to show us how these
improvements can be constructed to meet City standards. The cross-sections on
Hacienda are to include the intersection of Walnut Avenue. We are very co.1cerned about
the cross-slopes on both streets, and in particular, the cross~slope of Hacienda through
the intersection. If you would like, we will meet with you and your engineer to field review
our concerns.
CITY OF CA. ~PBEIl
Aleshi/548 & 550 Hacienda Avenue
September 17, 1992
Page Two
We are also very concerned that your excavation may be flooded during the rainy season
and cause damage to public improvements. We therefore urge you to expedite this work
to prevent further complications.
These concerns have been discussed with JRT, your contractor. We have also informed
him that we will not allow any further roadway excavation until the power pole jtelephone
pole is relocated.
Please call us at (408) 866-2150 if you have any questions. We expect to hear from you
within the week so that these concerns can be resolved quickly and your development
can proceed.
Very truly yours,
~ih
Assistant Engineer
L~
"MO:jd
cc: JRT
Joan M. Bollier
f: 92-114(JDjWP)
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CITY OF CAMPBEll
70 NORTH FIRST STREET
C AMP 8 ELL. C A L I FOR N I A 9 5 0 0 8
(408) 866-2100
FAX # (408) 379-2572
Department:
Public Works
September 30, 1992
Mr. Rassoul Aleshi
510 Beth Drive
San Jose, CA 95111
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SUBJECT: 548, 550 HACIENDA AVENUE, STREET IMPROVEMENTS, PERMIT 92-114
Dear Mr, Aleshi:
It is imperative that you have your surveyor and engineer provide the cross-sections and
profiles that the City has requested in our September 17, 1992 letter to you. Please have
your engineer provide the required information to the City for review this week. You may
call us at (408) 866-2155 if you have any questions.
Very truly yours,
bt~lJtY7~
Cruz S. 8o~ez
Assistant Engineer
I~:djr
cc: JRT
Joan M. Bollier
f:92-114
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CITY OF CAMPBEll
70 NORTH FIRST STREET
CAMPBELL. CALIFORNIA 95008
(408) 866-2100
FAX # (408) 379-2572
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Department:
Public Works
September 30, 1992
Mr. Rassoul Aleshi
510 Beth Drive
San Jose, CA 95111
SUBJECT: 548, 550 HACIENDA AVENUE, STREET IMPROVEMENTS, PERMIT 92-114
CONSTRUCTION TRAFFIC CONTROL AND SAFETY
Dear Mr. Aleshi:
This letter is a follow-up to our telephone conversation on September 29, 1992,
concerning construction traffic control and safety. Please instruct your contractor to
place, monitor and maintain lighted barricades at 30 maximum foot spacings on Hacienda
and Walnut Avenue and to also place on C-27, "Open Trench" sign panel on each first
barricade facing approaching traffic.
These construction traffic control devices are to be monitored and maintained daily,
including Saturdays, Sundays and legal holidays. The contractor has barricades at the
site but they are not being properly utilized. Please install the barricades and signs as
outlined above by not later than 2:00 p.m. September 30, 1992. If they are not installed
by the above time and date the City will order them placed, monitored and maintained
and deduct the amounts from your cash deposit.
Please call us at (408) 866-2155 if you have any questions.
Very truly yours,
(ft,~jl~
Cruz S~~~~ez V
Assistant Engineer
~:djr
cc: JRT
Joan M. Bollier, City Engineer
Gary Kruger, Traffic Engineer
File (92-114)
f:92-114
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CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL. CALIFORNIA 95008
(408) 866-2100
FAX # (408) 379-2572
Department:
Public Works
CERTIFIED MAIL
October 14, 1992
Mr. Rassoul Aleshi
510 Beth Drive
San Jose, CA 95111
SUBJECT: 548,500 HACIENDA AVENUE, STREET IMPROVEMENTS, PERMIT 92-114
Dear Mr. Aleshi:
This is to remind you that it is imperative that you have your surveyor and engineer
provide the cross-sections and profiles that the City requested in our September 17,1992
letter to you. Please have your engineer provide the required information to the City for
review without any further delay. You may call us at (408) 866-2155 if you have any
questions.
Very truly yours,
~;t,b~A~
Cruz S." ";~~; . -0
Assistant Engineer
~Q:djr
cc: JRT
Joan M.Bollier, City Engineer
File (Permit #92-114)
f:92-114oc
(
CITY OF CAMPBEll
70 NORTH FIRST STREET
CAMPBELL, CALIFORNIA 95008
(408) 866-2100
FAX # (408) 379-2572
Public Works
Department:
October 16, 1992
Rassoul Aleshi
Javad Aleshi
Djalil Aleshi
510 Beth Drive
San Jose, CA 95111-2204
RE: 548-550 HACIENDA AVENUE, CAMPBELL
Gentlemen:
This letter is a notice to you that your proj ect at the above
referenced site has some serious problems that must be resolved as
soon as possible.
The inspection record for both units has not received an approval
for the exterior lath which was inspected on September 9, 1992, by
one of my inspectors. You must within 10 days, no later than
October 27, 1992, contact Mr. Mark Nadvorik at 866-2130 concerning
the exterior lath problem.
The second major problem, the street cross slope design concern of
the Public Works Department, Design and Construction Division, have
not been responded to. You have been alerted to their issues by
written letters and you have failed to resolve their issues.
This letter places you on notice that the Building Division will
not final, nor can these units be occupied until the street cross
slope problem has been resolved, approved and constructed.
Your immediate attention is required and you must contact Michelle
Quinney at 866-2162 to finalize the street problem.
yea truly.-,Yours, ~
;??,~-C~~~~'
Frank B. Cauthorn, P. E.
Building Official
7'
cc: Public Works Director
Michelle Quinney
City Attorney
First Assurance & Casualty Company
16901 N. Dallas Parkway,suite 210, Dallas, Texas 75248
JRT
Engineering Division Permit File #92-114
AUG 10 '92 14:50 JRT C0~STRUCTION
P.1/2
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F^CSIMILE TnANSMITTAL SHEET
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18191 SARAT'JGA LOS CATOS RD.
MONTE SERENO, CA 95030
OFFICE (408) 354.1980 "
FACSIry1JLE (408) 354.617G
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1303
MEMORANDUM
TO: tv{ C?-
CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL, CA 95008
(408) 866-2100
P~V--1.. \.~ q""2..-\ \4-
SUBJECT: ~ ~ \~c...Le::b.,.) ~'"
FROM:
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SIGNED.
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CITY OF CAMPBELL
70 NORTH FIRST STREET
C AMP BEL L, C A L I FOR N I A 9 5 0 0 8
(408) 866-2100
FAX # (408) 379-2572
Department:
Public Works
November 9, 1992
Mr. Russ Aleshi
510 Beth Drive
San Jose, CA 95111
SUBJECT: ENCROACHMENT PERMIT # 92-114
Dear Mr. Aleshi:
Thank you for providing the survey data requested for the street
improvements proposed with your development at the intersection
of Hacienda Avenue and Walnut Drive. From this data, it appears
that the curb and gutter, as constructed, have been located in
the correct place per the plans. However, we have reviewed the
survey data further and have found a major discrepency between
what your engineer has represented on the plans and what is to be
built in the field.
The street cross slopes proposed on the encroachment permit plans
are not as represented in the typical sections shown on the same
plans. According to our calculations, cross slopes proposed for
Hacienda vary from 0.32% to 3.79%, not between 2.2% and 3.7% as
shown on the typical section. Cross slopes proposed for Walnut
apprear to vary from 2.72% to 5.5%, not from 2% to 2.8% as shown
on the typical section. The City's standard for street cross
slopes is 2.0%. We realize that deviations from this standard
may be necessary to conform to existing conditions, however,
cross slopes of 3% and larger are discouraged. In no case should
a cross slope exceeding 3.5% be built. Another concern is the
rate at which these cross slopes are changing through this
intersection.
Since it is the engineer's responsibility to provide a design in
accordance with City standards, please have your engineer provide
us with a plan that will eliminate the need for the excessive
cross slopes. Until such a design has been received, reviewed,
and an addendum issued to your encroachment permit, street work
will not be allowed under your existing permit.
We would be willing to meet with you and your engineer if you
have any questions or would like to review any potential
CITY OF CAMPBEll
2
solutions. Please feel free to contact me at 866-2162.
Sincerely:
/; ~:1.{ l ck! 1.( C(J (.,<-~
Michelle Quinne)f
Senior Civil Engineer
cc: Hank Imokawa, Public Works Inspector
File (Encroachment permit # 92-114)
gel ~ Iht/J~
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MQ:EP92114A
THE AMERICAN INSTITUTE OF ARCHITECTS
AlA Document A312
BOND NO FA 190845
Payment Bond
Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable_
CONTRACTOR (Name and Address):
JRT Construction Company
18191 Los Gatos Saratoga Rd.
Monte Sereno, Ca. 95030
SURETY (Name and Principal Place of Business):
First Assurance & Casualty Company
16901 N. Dallas Parkway Suite 210
Dallas, Tx. 75248
OWNER (Name and Address):
Ci ty of Campbell
70 North First st.
Campbell, CA. 95008
CONSTRUCTION CONTRACT
Date: December 13, 1991
Amount: Seventy Thousand Three Hundred & 00/100 ($70,300.00)
Description (Name and Location)Offsite Improvements at 548 Hacienda Ave., Campbell, Ca.
(---
BOND
Date (Not earlier than Construction Contract Date):
Amount: Seventy Thousand Three Hundred &
Modifications to this Bond:
May 11, 1992
00/100 ($70,300.00)
IX] None
o See Page 6
CONTRACTOR AS PRINCIPAL
Company:
JRT Constr.uct'
/!
( po rate Seal)
SURETY
Company: (Corporate Seal)
First Assurance & Casualty Company
VI '';~
Signature:. I );1~~ (, ,I -if.{)
Name and Totle, Attorney-in-p;;;'
(Any additio al signatures appear on page 6)
(FOR INFORMATION ONL V-Name, Address and Telephone)
AGENT or BROKER: OWNER'S REPRESENTATIVE (Architect, Engineer or
other party):
AlA DOCUMENT A312 . PERFORMANCE BOND AND PAYMENT BOND' DECEMBER 1984 ED_ . AlA @
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006
THIRD PRINTING. MARCH 1987
WARNING: Unlicensed photocopying violates U,S, trademark laws and is subject to legal prosecution.
A312-1984 4
1 The Contractor and the Surety, jointly and severally,
bind themselves, their heirs, executors, administrators,
successors and assigns to the Owner to pay for labor,
materials and equipment furnished for use in the perfor-
mance of the Construction Contract, which is incorpo-
rated herein by reference.
2 With respect to the Owner, this obi igation shall be
null and void if the Contractor:
2,1 Promptly makes payment, directly or indirectly,
for all sums due Claimants, and
2,2 Defends, indemnifies and holds harmless the
Owner from claims, demands, liens or suits by any
person or entity whose claim, demand, lien or suit is
for the payment for labor, materials or equipment fur-
nished for use in the performance of the Construction
Contract, provided the Owner has promptly notified
the Contractor and the Surety (at the address
described in Paragraph 12) of any claims, demands,
I iens or suits and tendered defense of such claims,
demands, liens or suits to the Contractor and the
Surety, and provided there is no Owner Default.
3 With respect to Claimants, this obligation shall be
null and void if the Contractor promptly makes pay-
ment, directly or indirectly, for all sums due_
4 The Surety shall have no obligation to Claimants
under this Bond until:
4,1 CI"imants who are employed by or have a direct
contract with the Contractor have given notice to the
Surety (at the address described in Paragraph 12) and
sent a copy, or notice thereof. to the Owner, stating
that a claim is being made under this Bond and, with
substantial accuracy, the amount of the claim,
4.2 Claimants who do not have a direct contract
with the Contractor:
.1 Have furnished written notice to the Con-
tractor and sent a copy, or notice thereof, to
the Owner, within 90 days after having last
performed labor or last furnished materials or
equipment included in the claim stating, with
substantial accuracy, the amount of the claim
and the name of the party to whom the
materials were furnished or supplied or for
whom the labor was done or performed; and
.2 Have either received a rejection in whole or
in part from the Contractor, or not received
within 30 days of furnishing the above no-
tice any communication from the Contractor
by which the Contractor has indicated the
claim will be paid directly or indirectly; and
.3 Not having been paid within the above 30
days, have sent a written notice to the Surety
(at the address described in Paragraph 12) and
sent a copy, or notice thereof, to the Owner,
stating that a claim is being made under this
Bond and enclosing a copy of the previous
written notice furnished to the Contractor.
5 If a notice required by Paragraph 4 is given by the
Owner to the Contractor or to the Surety, that is suffi-
cient compliance.
6 When the Claimant has satisfied the conditions of
Paragraph 4, the Surety shall promptly and at the
Surety's expense take the following actions:
6.1 Send an answer to the Claimant. with a copy to
the Owner, within 45 days after receipt of the claim,
stating the amounts that are undisputed and the basis
for challenging any amounts that are disputed,
6.2 Payor arrange for payment of any undisputed
amounts,
7 The Surety's total obligation shall not exceed the
amount of this Bond, and the amount of this Bond shall be
credited for any payments made in good faith by the Surety.
8 Amounts owed by the Owner to the Contractor under
the Construction Contract shall be used for the perfor-
mance of the Construction Contract and to satisfy claims,
if any, under any Construction Performance Bond. By
the Contractor furnishing and the Owner accepting this
Bond, they agree that all funds earned by the Contractor
in the performance of the Construction Contract are
dedicated to satisfy obligations of the Contractor and
the Surety under this Bond, subject to the Owner's prior-
ity to use the funds for the completion of the work_
9 The Surety shall not be liable to the Owner, Claimants
or others for obligations of the Contractor that are unrelat-
ed to the Construction Contract. The Owner shall not be
liable for payment of any costs or expenses of any Claim-
ant under this Bond, and shall have under this Bond no obli-
gations to make payments to, give notices on behalf of, or
otherwise have obligations to Claimants under this Bond_
10 The Surety hereby waives notice of any change,
including changes of time, to the Construction Contract
or to related subcontracts, purchase orders and other
obligations_
11 No suit or action shall be commenced by a Claimant
under this Bond other than in a court of competent juris-
diction in the location in which the work or part of the
work is located or after the expiration of one year from the
date (1) on which the Claimant gave the notice required by
Subparagraph 4.1 or Clause 4.2.3, or (2) on which the last
labor or service was performed by anyone or the last mate-
rials or equipment were furnished by anyone under the Con-
struction Contract, whichever of (1) or (2) first occurs, If the
provisions of this Paragraph are void or prohibited by law,
the minimum period of limitation available to sureties as a
defense in the jurisdiction of the suit shall be applicable_
12 Notice to the Surety, the Owner or the Contractor
shall be mailed or delivered to the address shown on the
signature page_ Actual receipt of notice by Surety, the
Owner or the Contractor, however accomplished, shall
be sufficient compliance as of the date received at the
address shown on the signature page.
13 When this Bond has been furnished to comply with a
statutory or other legal requirement in the location where
the construction was to be performed, any provision in this
Bond conflicting with said statutory or legal requirement
shall be deemed deleted herefrom and provisions con-
forming to such statutory or other legal requirement shall
be deemed incorporated herein_ The intent is that this
AlA DOCUMENT A312' PERFORMANCE BOND AND PAYMENT BOND' DECEMBER 1984 ED.' AIA@
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE. NW, WASHINGTON, DC 20006
THIRD PRINTING' MARCH 1987
WARNING: Unlicensed photocopying violates U.S. trademark laws and is subject to legal prosecution,
A312-1984 5
Bond shall be construed as a statutory bond and not as a
common law bond.
14 Upon request by any person or entity appearing to be a
potential beneficiary of this Bond, the Contractor shall
promptly furnish a copy of this Bond or shall permit a copy
to be made.
15 DEFINITIONS
15,1 Claimant: An individual or entity having a direct
contract with the Contractor or with a subcontractor of
the Contractor to furnish labor, materials or equip-
ment for use in the performance of the Contract. The
intent of this Bond shall be to include without limita-
tion in the terms "labor, materials or equipment" that
part of water, gas, power, light, heat, oil, gasoline,
telephone service or rental equipment used in the
MODIFICATIONS TO THIS BOND ARE AS FOLLOWS:
Construction Contract, architectural and engineering
services required for performance of the work of the
Contractor and the Contractor's subcontractors, and
all other items for which a mechanic's lien may be
asserted in the jurisdiction where the labor, materials
or equipment were furnished.
15,2 Construction Contract: The agreement between
the Owner and the Contractor identified on the sig-
nature page, including all Contract Documents and
changes thereto.
15.3 Owner Default: Failure of the Owner, which has
neither been remedied nor waived, to pay the Con-
tractor as required by the Construction Contract or to
perform and complete or comply with the other terms
thereof.
(Space is provided below for additional signatures of added parties, other than those appearing on the cover page.)
CONTRACTOR AS PRINCIPAL
Company:
(Corporate Seal)
Signature:
Name and Title:
Address:
SURETY
Company:
(Corporate Seal)
Signatu re:
Name and Title:
Address:
AlA DOCUMENT A312 . PERFORMANCE BOND AND PAYMENT BOND. DECEMBER 1984 ED. ' AlA @
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., NW., WASHINGTON, D.C. 20006
THIRD PRINTING. MARCH 1987
WARNING: Unlicensed photocopying violates U.S. trademark laws and Is subject to legal prosecution.
A312-1984 6
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" ".it (,m'th, 21 dalN TfESDTlMObNY WHEREOF,I have hereunto subscribed my name and affixed Ute Corporate Seal of the said Company .~,r,;,";;,',-,',',:,'",',":'" ',:,,'~,','~~':_'~_'~":""_'..'.:_'.',';'_:,'..~:,:,:':",,:,"'.':.'~'~,~,.,/
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,/":' ~,""';,t:H~;ft '",.;~~')-~;}~,,;:,
:;, f'J' fi;--Sf1t\~, Yr:it;~
':""' :,:, ',j'.'}' ';;flJ ~ ' r:c/ ,.,-' " ',., ""I
r >" ,\;~
~\ \~~.,
~,'.~,
l,"", '.
/
.......
I
.- COT SHeET
~ CORPOllAXION Project : "'t R\ c~w~~
LAN/) SllRJ/"EYJ.N"G LOC<1 f/on : ---\-\ "Q \ t2W -0 t\. 4JrF
Date: -, - 2. B . ql.- Surv~YIJd. iJy: Q. \-\ u u.J i\~~
125 E. Sunnyoal<s Av.. 1/1 cOZ ~<t..
C8mpbel/, C.. 95008 (.": - :' 4-.
(408) ..:379-5450 "./ '-"""""' Sh~ef -L of \
Oescription Stafion Slope Offset Elevation Crr<ilde CU)';
% E/ew/tion Ft'/I
'TOP
of Lv\2-3
t\.\E€\" I:~ ,-:., '",c... I+bS:!: ~ @ ~ 23ro.cn CONf'Ol2.~
C.v a ~ I \oJ <:.,
~ 24-1 WIDi:: 1+ 2A ~ ~ -----
::i)e,vc, .,1:>., ·
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, + \If . 'I
~ 2 3G..<'::l \ 2 3(.., .' ) F-D.2.0
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C~TC~ "BP6I~ ----- ~ 2 -=3'-. I ~ 2~b.zCo F-D.IO
o I-l etv~ '-'
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----
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)+O~ ~ 2-3~.2-3 2 ?G:..C}'l- F -0. (Ocr
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cf-Yl'~' W\O~ 1+'8 ~ ---- ---
R \VGll1AV -----
,
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END J+3v, ty
Cv~13 IN~ ::2-?&.. D7 2"17.03 r:O.q~
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~ 1'----......... ---- '----- .,...---' /'-, l~ :.-~ ~ v
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7-
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.6
"3
-Ati.t"u.~-' CERTiFICAT:OF'INSURANCE
- ......a
ISSUE DATE (MM/DD/YY)
I
6/3/92
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Barlocker Insurance
1299 Del Mar.Avenue
San Jose, CA 95128
Services
COMPANIES AFFORDING COVERAGE
<-('-6<"6- G.'l..~'~
~~T~~~NY A
Golden Eagle Insurance
CODE
SUB-CODE
INSURED
~~T~~~NY B
JRT Construction
Jeff Taylor,dba:
18191 Saratoga-Los Gatos Rd.
Monte Sereno, CA 95030
~~T~~NY C
~~T~~NY D
~~T~~~NY E
COVERAGES
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.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MMIDD/YY) DATE (MM/DD/YY)
ALL LIMITS IN THOUSANDS
GENERAL LIABILITY
A X COMMERCIAL GENERAL LIABILITY CCPl77780
CLAIMS MADE X OCCUR.
OWNER'S & CONTRACTOR'S PROTo
3/23/92
3/23/93
GENERAL AGGREGATE $ 1,000,
PRODUCTS.COMP/OPS AGGREGATE $ 1,000,
PERSONAL & ADVERTISING INJURY $ 1,000,
EACH OCCURRENCE $ I, 000,
FIRE DAMAGE (Anyone fire) $ 50,
MEDICAL EXPENSE (Anyone person) $ 5,
COMBINED
SINGLE $
LIMIT
BODILY
INJURY $
(Per person)
BODILY
INJURY $
(Per accident)
PROPERTY $
DAMAGE
EACH AGGREGATE
OCCURRENCE
$ $
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON.OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
AND
STATUTORY
EMPLOYERS' LIABILITY
$
$
$
(EACH ACCIDENT)
(DISEASE-POLICY LIMIT)
(DISEASE-EACH EMPLOYEE)
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
City of Campbell is named as Additional Insured per:the attached endorsement.
CERTIFICATE HOLDER
CANCELLATION
Ci ty of Campbell
Dept. of Public Works
70 N. First Street
Campbell, CA 95008
Attn: DonKing
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL -1Q. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATiON OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
ACORD 25-5 (3/88)
1~t
@ACORD CORPORATION 1988
AUTHORIZED REPRESENTATIVE
GOLT T EAGLE INSURANCE COMPANY
POLICY NUMBER: CCPl77780
EFFECTIVE DATE: 3/23/92
ISSUED TO
City of Campbell/Dept. of Public Works
70 N. First Street, Campbell, CA 95008
COMPREHENSIVE GENERAL LIABILITY INSURANCE
MANUFACTURERS AND CONTRACTORS LIABILITY INSURANCE
PRIMARY INSURANCE ENDORSEMENT
IT IS AGREED THAT SUCH INSURANCE AS IS AFFORDED BY THIS POLICY FOR THE BENEFIT OF
Ci ty of Campbell
AND ,l'R'T' ~()n~rrll("t;Ol1
SHALL BE PRIMARY INSURANCE AS RESPECTS ANY CLAIM, LOSS OR LIABILITY ARISING OUT OF
JRT Construction
OPERATIONS, OR BY ITS INDEPENDENT
CONTRACTORS FOR WHICH JRT Construction
IS FOUND
TO BE LIABLE AND WHICH LIABILITY APPLIES TO THE SPECIAL CONTRACT UNDER WHICH
JRT Construction
HAS AGREED TO PERFORM SPECIFIC OPERATIONS,
AND ANY OTHER INSURANCE MAINTAINED BY
Ci ty of Campbell
SHALL BE EXCESS AND NON-CONTRIBUTORY WITH THE INSURANCE PROVIDED HEREUNDER.
GE-GL018 (09-87)
POLICY NUMBER:
CCPl7. JO
OMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS. (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
Name of Person or Organization:
City of Campbell
Dept. of Public Works
70 N. First Street
Campbell, CA 95008
(If no entry appears above, information reqrilred to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
WHO IS AN INSURED (Section II) 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 work" for that insured by or for you.
CG 20 10 11 85
Copyright. Insurance ~ervices Office, Inc., 1984
c
- J IJUN 03 '92 10: 01 JRT CONSTRUCTI ON
rp. 2/3
.
.
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C%2'Y" or CAHlJILL,
r.=~.. 10.
~1tOR ~ 1m m~~~..~
T;oqns' eoMP~.A.'l'ION I!l91l1r6nCE tm'OltHA.'t'ImI
,~u. of co,.trac~o.r/A''Pl1G_e . :J1!-f~' e,.O~V;!/ c. u ~
One 'of c1\. followi.na INle 1>>. ora fila wid'!, the Publla'Vol:'ka DepaJ:t:IItA.;
. . .
_ A Cal'clflc.Ct of Con'aAc co, Self-i.nl\lZ" i...lIed bjth. !)~~'AIO~'oi'
!nclult2:tal atl&Clcma.; g& , , .
. " . ,. .
: LL. ACer~1ttc.t. Df.V.rke~.' Cozapl"aac1on JMU%anOI , "
. ,lftlUZ',&ftG& Co. '5~7f> FV-vD '. 6 / 't7
,'oli.o)' No. /12'1 ~C)6 -qL. 'bpt~&Cl0ft D.e. - ~ ?...J : a ,
r
I _ tb~~ t;6~cS.f1aat. of SUIIlpc101'l from ch. WCIIl"ura' COIlp.ft.a~1on
I law., pti.nce4 ~.lov (cert1f1o.lce, mWI1~ \I. .lSt\t4).. '
I
I '"u'l't~Qr IXtMUlQI
,
f % &erc1fy' ~hAt in the pt:fo~.nl' of t~. vCllrk for thi. plt.a1c.
1 .hall not .mploy any per,oft in any ..nner ao .. co ~'Go", .
1 il.lDjelSeeo d\. llork.~.' Comp.nlat1on Law. of ,.1if.lft!a. '
!h...."'.&:(.1'M.... 4€' ~DA:. D~ 7",~,:
I. '
l' NOT%CI 'lO CON11.AC'tOI/APPLt.OANT:'.' tf, atter Ii.pin, I:h1.
I' ' Cere1!~c.~e ~f Ix..pcion, you .h~14 ~.oo=. .ubJ'Of~o C~.. .
~o~kera' Co.p.n,.:1o~ p~ov!'1on of ~. tabor Cod., you m~c
I forthw1~h comply w1:h.uaft provi.ion. 'or :hi. p.~lt thall ~.'
, Id...c1 revokld.
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eON'l'IAeTOR! lIIPRMAT!OH
l:ote eh&t all con~r&ccor. and .ub-conCI'&otor. ID\&I. hav. C\U:'~.Qt C1t7"of .
C..pb.l1 .~.1na..: Lic'nll, 'cac. Con~r.ctor'. Lil.ftI. &ft4 .vQ~kar.1
Comp'Nlation%n.~t.nG'. .
NISI of,. C:G~.C~ ~P"CP '1'.lo,bJ.. r-yS<j-I/~
A..r..., /t:{/~ '~- N5' ~"Z?J '/W., h~ ~6~ CA ~"tt:J
.'t&~. C:ontJ'&ttol' Licon.. No. 3'1IJ6S.3
Cl,ty I~.in... L1c.n.. No. .. . bp1zo&tion f).C.
.
I
" , V.ll1 d.o ~h".' followi"l eyp., of work:..
Und.l'lrouncl' . j
Other C.p.~1fy)
P.C. Conerec.
.J.. C. 'Avina
118o~~i.o.l:
-
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10/91
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JUN 03 ' 92 10: 01 JRT CONSTRUCT! ON ..--.--..-
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STATE
C:OM".NSATION
.NaU"ANC.
I=UND
P.O. BOX 807, SAN FRANCISCO. CA 94101.0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
JUNE 3 a 1992
POLICY NUMI.f1t
ceRTIFICATE EXPIRES:
1124S06-f2
6-1-93
!
r
CITY OF CAMPBELL
ATTN.: PUBLIC WORKS
70 N. FIRST ST.
CAMPBELL. CA 9~008
L
Thi, is 10 certify that WI nll\/8 .uued a valid Workers' Compe"Sltion jnsut.nee pOlicy in a form approved bV rhe Cil\for"ia
I "surlnee Commissioner to tPl. employer named btlow for the policy period indicated. I
i
This policy is not s~bj'~l to cancellat;on by the Fund except u"on ltn diYS' advanc:e wrine" norice to the .mpIOyer.!
I
We will alSo give Y04,/ TeN days' .d\lanee notice should this pOliQY be cancelled prior to its normal txpiration. I
I
This certiflcatt of inSutinCe is not an insurance poliCy and doC$ nOf amend, extend or altef the COII.roIISI' afford.d ~y the
~olicjes li'ted h.,tin. Notwithstanding any requirement, term, or eondition of any contract Of other doeu",enl with
respect to which this etrtificato of insurance may bf: issued or may pertain, tne insurance afforded by the Slplici"
".."ille" he..in is subject to all tho !I,ms. ..elu.ion. and eonditi... of such polid... ~ ~
PR~SIDENT I
I
&MP~OyeR
r
J.R.T. CONSTlUC~ION CORP
18191 SARATOCA-LOS GATOS
MONTE SERENO, CA 95030
L
CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL, CALIFORNIA 95008
(408) 866-2100
FAX # (408) 379-2572
Department:
Public Works
May 6, 1992
Mr. Russ Aleshi
510 Beth Drive
San Jose, CA 95111
SUBJECT: 548 W. Hacienda Avenue
Dear Mr. Aleshi:
As you requested, below are the outstanding requirements that you
will need to fulfill prior to the Engineering Division's release
for the building permit and the issuance of the encroachment
permit:
o Return two signed and notarized copies of the street
improvement agreement that was sent to you on March 4,
1991. I have enclosed two more copies in case you have
misplaced the previous agreements.
o Post a surety for faithful performance in the amount of
$70,300 (contractors normally post a bond for this
surety) .
o Pay the balance of the cash deposit in the amount of
$800.00 required for the encroachment permit.
o Pay the balance of the plan check and inspection fee in
the amount of $3,509.00 required for the encroachment
permit.
o Provide current workers compensation and insurance
information required for the encroachment permit.
o Provide a grading and drainage plan for review by the
City Engineer.
/
.jelTY OF CAMP~ELL
,;' When the above requirements have been completed the encroachment
permit will be issued and the Engineering Division will release
clearance to the Building Division for your building permit. The
Building Division may have other requirements that you would need
to fulfill prior to the issuance of your building permit. You
need to check with that Division for other requirements.
I hope this letter has been helpful to you. Please call Don King
or me at 866-2150 if you have any questions.
Sincerely,
11f~ ~ -
Michelle QU~
Senior Civil Engineer
cc: Frank Cauthorn, Building
Tim Haley, Planning
MQ:DEVLPMNT/R9103D
_~-._..,....j~.:;-;""~cw.~......__,v,."__...~,,_~E~~,,...,~\~~~~.~r{lo":""rr.r..',;~,,,.,,;:,..
" ,,_ _. _ _. ,,_..~ :.~_ ..~. _" ' H:.~ (,.-.,O:Cl'<'''- ~._ ~", ~'-, .... _,' . ..,~~_r......-'" J ,.- ...'.'
TO:
City Clerk
PUBLIC WORKS FILE NO. Perr'(.-.t ~ 92.-1\4
Please collect & receipt
for the following monies:
35-3396
ACCT. ITEM AMOUNT RECEIPT NO.
3372
3521
3521
Project Revenue (specify project)
Public Works Encroachment Permit Fees:
Application Fee
Plan Check Deposit
Faithful Performance (Cash) Deposit
($105)
($500)
(100% of)
(ENGR. EST)
(4%of FPB)
($500 min.)
Other Cash Deposit (specify)
Plan Check & Inspection Fee ($0 - $100,00010%;
$100,000 - $500,0009%; $500,000 and above 7%; $100 min.)
3373 Project Plans & Specifications
3373 General Conditions, Standard Provisions & Details ($10 or $1/page)
3373 "No Parking" signs ($1/ea. or $25/100)
3373 Copies of Engineering Maps & Plans ($.50/sq.ft.)
3372 Final Parcel Map Filing Fee ($475 + $21/ per lot)
3372 Final Tract Map Filing Fee ($525 + $21/ per lot)
3372 Lot Line Adjustment Fee/Certificate of Compliance ($420)
3372 Vacation of Public Streets and Easements ($500)
3372 Assessment Segregation or Reapportionment
First Split ($500)
Each Additional Lot ($150)
3370 Storm Drainage Area Fee per Acre (R-1, $1,875;
Multi-Res" $2,060; all other, $2,250)
3380 Public Works Special Projects
3395 Park Dedication In-lieu Fee
3510 Postage
$
COOO l!C. ',~413
3 SCF) 00 3413
NAME OF APPLICANT --.M (- A I es k
51 0 B e-+iA 4), \'v-e ) Sau .Jost_
RECEIVED BY ~
DATE ~
ADDRESS
FOR
CITY CLERK
ONLY
D~
$-130j-
PHONE 4OB- 2-2.4 - 4777
ZIP qSIJ I
TOTAL
b/11 ,,2,-
I
-JUN.04 '92,10:00 JRT CONC'~~UCTION
Ar'L ~I:; "::lC: lCl: 1::> I'(H:'~LJUL
F~ "_2/2
WEST VALLEY SANITATION' DISTRICT
OF 3ANT A CLARA COUNTY
SE"VING ,,"'OENTS Oir
CITY OF CAMPBELL
, TOWN OF LOS,OA TOS,
CITY OF MONTE $fRiNO
Clryop SARA TOGA
IJ,.,NC ORPORA TEa 'A REA
100 Ia,t SunnYOIK. A~n.ue
Campbell.Cali,o,nla Q800e
Tlltprlone (401) S7.2~7
April 28, lig:2
C1ty of Campb.l1
gep~. ot.Publ1c Work.
70 M. J1rat .tr..~
C.mpbel~, CA 16008
RBi Lande'cf :Al.sh1 .- 3 Townhouses an, Hac1enc1a
p~,^,...q ~ 9'z..~- \ \4-
Gentlepez-lIofts,
!h1. 1., th1a d1.,tr1ctlt nolear,-nee letterllfor the
r.car4a~ion ot th1a development.'
All' of thed.1str1ct requirement., tor tract ,recordation hav.'
~..n ..t.
Verytru1-y,youra,
William ,A. Gissler
t)'1etI'1.ct Manag.r lIng in..r
~4nR'11.cL~
by P~../o~r.;1ChOl.
Sen.1or C.ivil Engineer
,
,
, '
(FORMIRL.V COUNTY SANITATION DISTRICT NO, 4)
TO:
City Clerk
PUBLIC WORKS FILE NO.
9' - // '-I
Please collect & receipt
for the following monies:
ACCT. ITEM AMOUNT RECEIPT NO.
3372
3521
3521
Project Revenue (specify project)
Public Works Encroachment Permit Fees:
Application Fee
Plan Check Deposit
Faithful Performance (Cash) Deposit
($105)
($500)
(100% of)
(ENGR. EST)
(4%of FPB)
($500 min.)
$
( .'.' ""1-11
/C;.) ;::.. '3
"+-'
35-3396
3521
Other Cash Deposit (specify)
3372 Plan Check & Inspection Fee ($0 - $100,000 10%;
$100,000 - $500,0009%; $500,000 and above 7%; $100 min.)
3373 Project Plans & Specifications
3373 General Conditions, Standard Provisions & Details ($10 or $1 /page)
3373 "No Parking" signs ($1/ea. or $25/100)
3373 Copies of Engineering Maps & Plans ($.50/sq.ft.)
3372 Final Parcel Map Filing Fee ($475 + $21/ per lot)
3372 Final Tract Map Filing Fee ($525 + $21/ per lot)
3372 Lot Line Adjustment Fee/Certificate of Compliance ($420)
3372 Vacation of Public Streets and Easements ($500)
3372 Assessment Segregation or Reapportionment
First Split ($500)
Each Additional Lot ($150)
3370 Storm Drainage Area Fee per Acre (R-1. $1,875;
Multi-Res., $2,060; all other, $2,250)
3380 Public Works Special Projects
3395 Park Dedication In-lieu Fee
3510 Postage
TOTAL
$
/05
C;;JC'
NAME OF APPLICANT
ADDRESS
FOR
CITY CLERK
ONLY
PHONE
RECEIVED BY ~c...s '''1 q .
DATE . ~/~u
ZIP
CITY a= CNAIEU.. CITY ENGIIEER'S axmu:rICM ESTIMATE PERMIT 1<<). I ,
:;:: I/O /11") C/(' /' ,~. 7 r ~ /. /- .' . /
Ad:Fess '('~_.i /.. bt --..-' # d:Jte /
9rfac:e Ca'lstru:tiCrl
Cleeriru & Gn.t:biru lU1p ~ EstiRBte =$ ""'"/" ('-',
/
Sawcutt Calcrete LF Q '*$4.50 =$
Cal::rete R8lD\I8l SF lil *$3.50 =$
Qri) & G.Jt:te!" ~8lD\I8l LF a *$5.50 =$
Inlot Drain with Pipe EAlil S6OO.oo =$
Qri) & G.Jt:ter :2.13 LF a $16.00 =$
SicBlllk 'lIe- SFQ $4.50 =$
~, I'~ .:.
DrivewiIY ~ ~./ SFa $6.00 =$ "'-.-,..
Hrdicap RaIp I EAGl $475.00 =$ ~/~/
Extru:lecl D.J'b EAiil 10.00 =$
Barricade LF iil S60.oo =$
,}j.' ~ /'} '5 / r- " .)
Street ExcaIIatiCrl / C,/ SF x ($0.12) x ") =$
I ( ~ ",) /
- I
N:. PIIV8IB1t SF x (0.35) x ( ") =$
AdjlBt Mlrhole to Grade EAGl S425 .00 =$
AdjlBt IIlrd10le to Grade ....- EAGl S325.oo =$
Mc:n..IJEnt Box w/MCn..nEnt EAal $700.00 =$
Street Tree (1S-gallCrl) EAlil S3S0.00 =$
PIIV8IB1t Stripiru ($100mn) LF lil $ .75 =$
PIIV8IB1t Legen:ls ($100mn) EAGl $50.00 =$
Step, Street Nane other Si!Jl EAlil $140.00 =$
PIIV8IB1t Marker .. EAGl $17.00 =$
'.
P8'v'SIEI1t Key QJt LF iil $10.00 =$
. - '. =$
=$
9rfac:e 9.bt:otal =$ ";-" 7 r-'
liS"
I
AdjlBt for size: liS" < S30,00J,ad::l ~, liS" > $1oo,00J,Slbtract 10X (+ or -) =$ -
Street L i!tltilll
Electrol ier EAlil S22OO.oo =$
CadJi t LF a $10.00 =$
CCrdJ:tor, pair LF Gl $2.00 =$
Pull Box EAGl S2lXl.00 =$
=$
Storm Drairege
12- or 1S" R(l) LF Gl $70.00 =$
18" or 21" R(l) LF Q SlIl.oo =$
Street Inlet EAlil $1750.00 =$
Mlrhole I EAlil S25lXl.00 =$
Break & Enter Mlrhole EAGl $750.00 =$
=$
TOrAl. ESTIMATE $
revi sed 6191 USE FeR Il:H) $ .. /
F:ccrcost
..:
CITY CJ' CNIIIIELl., CITY BliItHR'S aJlSl1U:nCII __. tM\TE
Adhss 1>Lft3 /-I/lCI(?AI04
9rfac:e Ca'8tru::ticn
PERMIT to.
I7i ..!), (~.
Clerirg & Gn.tbirv LuIp Qa Estillllte
SaIcutt Ca1crete Lflil ..50
Caaete R8n:Mtl Sf a *$5.50
().ri) & ~ REIlIMIl - LF a *Si5.5O
Inlot Drain with Pipe - EA lil $600.00
().ri) & ~ 2/3 LF a $16.00
SidElelk 7/(- Sf a 14.50
OriYlllillY Af:p"a8ch S7~ Sfa $6.00
Hanfic:ap RaIp I fA a 1475.00
Extn.ded om EAlil 10.00
BIlrTi c:ade LF a 160.00
Street ExaMlticn qib 9 9 Sfx (SO.12) x ( /3 II)
/l; P8'IIEIIEnt .7:..).....b 9 Sfx (0.35) x ( q II)
Adjl.&t MIrhole to Grade I fAa $425.00
Adjl.&t IIlI'd1ole to Grade "2- EAlil S2i.00
Ib'Unent 8aK wItb'u1Ent I 9a S7OO.oo
Street Tree (15-gallcn) R EA a S550.oo
P8'IIEIIEnt stripirv ($100nin) ~C.o LF a $ .75
P8'IIEIIEnt Legrds ($100ni n) EA a &1.00
5tq:), Street N8Ine other SflJ'l fA lil S14O.00
P8'IIEIIEnt MlIrIcer .20 fA lil $17.00
P8'IIEIIEnt Key Q.It: LF lil $10.00
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~O
ENCROACHMENT PERMIT ISSUANCE .ECK LIST
City of Campbell
Department of Public Yorks
~Applicant section complete
Encroachment Permit No, 92 - 114
v Applicant signature and date
~Permit Application fee $105.00 paid
Receipt number 37714
~Plan check deposit.
Receipt number A\
~Five sets of improvement plans submitted
---------------------------------------------------------------------------
~urety for faithful performance, 100% of City Engineer's
estimate, supplied or paid FA
Amount $ 70,300 Form~ I.D. #,jjOB45
~Cash Deposit: 4% of FP surety, $500 min, paid
Amount $ 2 BI2. ,0 () Receipt No. 1'201.:r'- Z (PI')
&\a.wudre:i~ ~(e;pt-l()l' "3-173 ~/13
~lan Check & Inspection fee of 10% of F.P, surety for
amounts of $0 - $100,000; 9% for $100,000 - $500,000;
7% for $500,000 and above; $100 min, paid )
Amount $ 76 ~o ,00 Receipt No. [If 35'21..- 2~o
Ytl\~ do~ :''3,S042S' ~..cf'l/"t ~c 3113 t;/r}
_____Workers' compensation information received for Applicant
(see Information Sheet for Encroachment Permits)
_____All other Public Yorks requirements listed in the
Conditions of Approval of the development.
---------------------------------------------------------------------------
~Yorkers' comp and Contractor's Information received for
Contractor (see Information Sheet for Encroachment Permits)
i./
_____Certificate of Insurance with_~dditional Insured's
Endorsement received from Contractor (see General Summary of
Insurance Requirements for Encroachment Permits)
~Three sets of off-site plans, stamped APPROVED (Tract or
Development and Public Yorks Permit number and property
address on plans)
~Permit signed for City Engineer
WHEN ALL OF THE ABOVE ITEMS ARE COMPLETE, PERMIT MAY BE ISSUED
Issuer: Initial and date and file with permit
UPON ISSUANCE, INITIATE CHECK REQUEST FOR PLAN CHECK DEPOSIT REFUND
f:pmtcklst
Revised 10/91
TO:
City Clerk
PUBLIC WORKS FILE NO,
9;2 -I/V'
Please collect & receipt
for the following monies:
ACCT. ITEM AMOUNT RECEIPT NO.
35-3396
3372
3521
3521
Project Revenue (specify project)
Public Works Encroachment Permit Fees:
Application Fee
Plan Check Deposit
Faithful Performance (Cash) Deposit
$
3521
Other Cash Deposit (specify)
($105)
($500)
(100% of)
(ENGR. EST)
(4%of FPB)
($500 min,)
2 .~Z ,to
3372 Plan Check & Inspection Fee ($0 - $100,000 10%;
$100,000 - $500,0009%; $500,000 and above 7%; $100 min.)
3373 Project Plans & Specifications
3373 General Conditions, Standard Provisions & Details ($10 or $1/page)
3373 "No Parking" signs ($1/ea, or $25/100)
3373 Copies of Engineering Maps & Plans ($.50/sq,ft.)
3372 Final Parcel Map Filing Fee ($475 + $21/ per lot)
3372 Final Tract Map Filing Fee ($525 + $21/ per lot)
3372 Lot Line Adjustment Fee/Certificate of Compliance ($420)
3372 Vacation of Public Streets and Easements ($500)
3372 Assessment Segregation or Reapportionment
First Split ($500)
Each Additional Lot ($150)
3370 Storm Drainage Area Fee per Acre (R-1, $1,875;
Multi-Res., $2,060; all other, $2,250)
3380 Public Works Special Projects
3395 Park Dedication In-lieu Fee
35 1 0 Postage
TOTAL
$ 9 7J t/;'7. vO
I
NAME OF APPLICANT
ADDRESS
FOR
CITY CLERK
ONLY
PHONE
ZIP
RECEIVED BY
DATE
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12109048
TO :JE REC()m.,,,,'.:II}:()Ui' rE:
SECn0(', 6wa (.:.(Y1l!:i\''"WJ' '" (,'r,
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AT REQUESl Of
CITY OF CAMPBELL
,.. I '.~J" 1~'r An '93
,iU 'G
. '1 FDS
SAN I' ",r~;, l~ :J HTY
L {, v l, i [ ~'.:. '., f
REC;jRLit ii
SEP 1 6 1993
Above space for recorder
NOTICE OF COMPLETION
NOTICE is hereby given that CITY OF CAMPBELL as OWNER, and Michelle
Quinney, the undersigned, as City Engineer caused
street
improvements to be constructed upon the property described.
That the work on said street
improvements was
actually accepted on the day of
, 1993
That the name of the contractor
for said owner
is Petersen Construction
That the nature of title of said city to said
street improvements
is that of owner in
fee simple, and the names and addresses of all owners of said
property are:
NAME
ADDRESS
City of Campbell
70 N. First Street
Campbell, CA 95008
That the property herein referred to and on which said
street improvements
are located is situated in the
City of Campbell, County of Santa Clara, State of California and
described as follows:
IN AND NEAR THE INTERSECTION OF HACIENDA
AVENUE A1~D WALNUT AVENUE
1 of 2
'"
N 0 0 g fA r ~ '11
and having the following address:
548 HACIENDA AVENUE. CAMPBELL
Dated
/Iv~ lIP ,19 93 .
'1Ui
Michelle Quinne , P.E.
Acting city Englneer
STATE OF CALIFORNIA
ss
COUNTY OF SANTA CLARA
I, Michelle Quinney, being duly sworn, says: That I am the Acting
city Engineer for said city of Campbell, The owner of the property
described in the foregoing notice; that I have read the foregoing
notice, and know the contents thereof; and the facts therein stated
are true of my own knowledge.
Subscribed and sworn to before me this
day of
, 19
Notary Public in and for said County
of Santa Clara, State of California
H: \NOTICE (DR)
2 of 2
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