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PUBLIC WORKS INSPECTION REPORT
Permit or Project No.
'28-2-47
Address
~() . 3" //;~-u-t:Y ~~.
Type of work: Street ..........- Storm
Other (de~cribe)
SAnitAry
ElectricAl
(JPRELIMINARY INSPECTION WITH DEFICIENCY LIST (AttAched)
[JFINAL INSPECTION WITH DEFICIENCY LIST (attAched)
o FINAL INSPECTION - ACCEPTANCE
Signed plAns"? Y N (If signed, Council ACceptAnce.)
ChArge& AgAinst depo&it? y
Overtime: hrs. @ $
DAte {. re,,&on:
N
/hr.
-
$
BArricAde rentAl (AttAch invoice)?
DAte {. reAson:
y
N
$
Other?
$
$
TotAl chArgea deducted from deposit:
(CA&h Depo~it $ less chArges $
.~ YEAR MAINTENANCE WITH DEFICIENCY LIST (AttAChed)
$
- Refund $
ck. req.)
[JaNE YEAR MAINTENANCE - ACCEPTANCE
(ReleASe'mAintenAnce bond. Check Request if CAsh.)
En9ineer
In~
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
April 25, 1989
Kip's Kustoms
907 North Ninth Street
San Jose, CA 95112
RE: FINAL INSPECTION AND ACCEPTANCE
PERMIT 88-247 FOR 60 SHELLEY AVENUE
MAINTENANCE BOND AMOUNT: $5,625.00
IRREVOCABLE LETTER OF CREDIT: $22,500.00
Gentlemen:
We have made a final inspection of subject Public Works construction
and find it acceptable and in conformance with City standards.
Accordingly, we will recommend the acceptance of the work to the City
Council. We will send a copy of their resolution accepting the work
upon their approval of same.
You are responsible for the maintenance, repair and/or replacement of
all work done should any failures occur within one (1) year of this
date. We have received your maintenance bond and hereby release your
letter of credit dated Nov. 9, 1988 from the California Security
Bank.
We will inspect the work in one (1) year and advise you whether or
not maintenance is needed.
Please feel free to call me if you have any questions.
Sincerely,
~~
Car~s M. Jocson
Associate Civil Engineer
CMJ/p
cc: G. Eaton, P. W. Inspector
Council Agenda
C. Case, Adm. Aide
Suspense - 1 yr
California Security Bank
88-247CJ
CITY OF CAMPBEll
70 NORTH FIRST STREET
CAMPBELL, CALIFORNIA 95008
(408) 866.2100
FAX # (408) 379-2572
Department:
April 21, 1989
Public Works
Kip's Kustoms
907 North Ninth Street
San Jose, CA 95112
RE: Final Inspection and Acceptance
Permit No.: 88-247
Location: 60 Shelly Avenue
Maintenance Bond Amount: $5,625.00
Gentlemen:
We have made a final inspection of subject Public Works construction
and find it acceptable and in conformance with City standards.
Accordingly, we will recommend the acceptance of the work to the City
Council. We will send a copy of their resolution accepting the work
upon their approval of same.
You are responsible for the maintenance, repair and/or replacement of
all work done should any failures occur within one (1) year of this
date. To guarantee this, you must either post a maintenance bond in
the amount indicated above, or maintain your existing faithful
performance bond. If you post a separate maintenance bond, your
current bond will be released by separate action.
We will inspect the work in one (1) year and advise you whether or
not maintenance is needed.
Please feel free to call me if you have any questions.
Sincerely,
,.
~~
Carlo M. Jocson
iate Civil Engineer
CMJ:p
cc: G. Eaton, Public Works Inspector
Council Agenda
C. Case, Administrative Aide
Bond Company:
Suspense - 1 year
f/acc-ltr
TO: City Clerk
PUBLIC WORKS FILE NO. '??9 -2V7
,
$ .;J.J-/73. f7
;;9ff-075i!7
ZIP ~~j 2-
Please collect & receipt
for the following monies:
ACCT.
35-) 6
3372
3521
3521
(specify project)
Pvr.m-U: eM:
R-l :
($"35)
($200)
t VL:
($ 50)
'( 500
(4% of FPB)
($500 m in. )
(n of FPB)
($35min.)
(Cash) Depos i t
3372
3521
Plan Check & Inspection Fee
Other Cash Deposit (specify)
J373
3373 &
3372 Tentative Parcel Map Fil ing Fee ($350)
3372 Final Parcel Ha Filin Fee ($300)
3372 Tentative Tract Map Fil ing Fee $ 00
}372 Final Tract Map Fil in Fee ($350)
3372 Lot Line Ad.ustment Fee/Certificate of Com I iance
3372 Vacation of Publ ic Streets and Easements
3372 Assessment Segregation or Reapportionment
First Spl it ($500)
Each Additional Lot ($150)
3372 Environmental Assessment:'
Categorical Exemption
Ne ative Declaration
3370 Storm Drainage Area Fee per Acre Multi-Res.,
$2,060; all other, $2,250)
J395 Park Dedication In.lieu Fee per Unit ($1,132)
3380
3510
()~
(~~ a. D~ L.. TO r TOTAL
~ t(r~5 IZV::;~
ADDRESS f#/ ~ AJ//lJ1H ~__~
Publ ic Works Special Projects
Pos tage
PHONE
FOR
C I TV CLERK
ClliLY
RECEIPT NO..
~ PAID
1390
;J.. 4-73. g 7
~
/ / -/7- g &'"
RECE J VED BY
DATE'
AMOUNT
$
j ~tJO,6U
1;>7~ 8'7
July, 1987
Iransamenca
nsurance Services
Transamerica Premier Insurance Company
Ac.lmIIIlM'all't~ ullll.:~ If\llru~. C.slilOH\lit
TRANSAMERICA PREMIER INSURANCE COMPANY
c/o Commercial Surety Bonding Agency
o Southern California
630 The City Dr., Suite 1 20,
Orange, CA 92668
(7141 971-CSBA (2722)
o Northern California
1265 S. Bascom Ave., Suite 1 DB.
San Jose, CA 95128
140BI 298-CSBA l2722)
SUBDIVISION STATUS INQUIRY
r City of Campbell -, ~Ff~~~./. ~~i::d47
70 North Firstr/T, ~0 .
L Campbell, CA 95008 -.J
BOND NUMBER
TPI 1893433
TRACT NUMBER
SUBDIVIDER
TRACT NAME
R. K. and Maria DuPuis
Sanitary Sewer improvements
60 Shelley Avenue
IMPROVEMENTS
PLEASE ANSWER THE QUESTIONS BELOW AND RETURN THIS FORM.
1. Has this work been fully completed and accepted? l;if Yes 0 No
2. If accepted, on what date?~S-") ) q '69
3. If not accepted, is work progressing satisfactorily? 0 Yes 0 No
If no,. explain
,.,-"
4. Percentage completeq?
".-
R EMAR KS
cOn;r-r- ~J;ond- .iJ.~ ,
JIY1' ~
"
Above information furnished by: (signature) Title
DATE
TO: City Clerk
PUBLI C WORKS FI LE NO. 8"'Y- 2,'7' 7
Please collect & receipt
for the following monies:
ACCT.
35-3 96
3372
3521
3521
pro 'ect)
PeJw1d e.M :
R-l :
($'35)
($200)
;t eJt:
($50)
'( 500)
(4% of FPB)
($500 min.)
(710 of FPB)
($ 35 min.)
(Cash) Depos it
3372
3521
Plan Check & Inspection Fee
Other Cash Deposit (specify)
2373
3373
Project
Gene ra 1
&
3372 Tentative Parcel Map Filing Fee ($350)
3372 Final Parcel Map Fil ing Fee ($300)
3372 Tentative Tract Map Fil ing Fee ($400)
3372 Final Tract Ma Fil in Fee ($350)
3372 Lot Line Ad'ustment Fee/Certificate of Compl iance
3372 Vacation of Publ ic Streets and Easements
3372 Assessment Segregation or Reapportionment
First Spl it ($500)
Each Additional Lot ($150)
3372 Environmental Assessment:
Categorical Exemption
Ne ative Declaration
3370 Storm Drainage Area Fee per Acre Multi-Res.,
$2,060; all other, $2,250)
2395 Park Dedication In-l ieu Fee per Unit ($1,132)
3380 Public Works Special Projects
3510 Postage
TOTAL
NAME
\~
PHONE
AMOUNT
$
SO#uo
~ SOD. ....0
-~L fk
tk~I" ..
$
S-S-O. cr (J
ADDRESS
. I
^'.; .
/'{
/' ..j-' .......
ZIP
FOR
C I TV CLERK
~LY
RECEIPT NO.
~ PAID
RECE J VED BY
DATE"
July, 1987
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
May 25, 1989
Kip's Kustom
907 North Ninth Street
San Jose, CA 95112
RE: RESOLUTION ACCEPTING WORK
PERMIT 88-247 FOR 60 SHELLEY AVENUE
Gentlemen:
Per our letter of April 25, 1989, enclosed please find your copy of
Resolution 7738 accepting street improvements in 60 Shelley Avenue,
Campbell, California.
Sin,cere1y,
~.~
?ar~s M. Jocson
Associate Civil Engineer
It
88-247.4
,r ~~~r~n~~~~!:fa
T ransamerica Premier Insurance Company
Mman66u.'a.. aUI~.: 11...IOtI. Call'gln.&
TRANSAMERICA PREMIER INSURANCE COMPANY
P. O. Box 25310
SANTA ANA, CA 92799
MAINTENANCE BOND
TP 11893432
Premium-$169.00
KNOW ALL MEN BY THESE PRESENTS:
That we R.K. Dupuis and Maria R. Dupuis
hereinafter called the Principal. and TRANSAMERICA PREMIER INSURANCE COMPANY,
a California Corporation, with principal offices at Santa Ana, CA. hereinafter
called the Surety, are firmly bound unto City of Campbell
in the full and just sum of
Five Thousand Six Hundred Twenty Five Dollars------------ ($5,625.00
lawful money of the United States of America, to be paid to the said
City of Campbell for which
payment well and truly to be made, we bind ourselves, our heirs, executors,
administrators, successors and assigns, jointly and severally, firmly by
these presents.
WHEREAS, the above bounded Principal entered into an agreement with the
City of Campbell dated for
Public Street Improvements
NOW, THEREFORE, the condition of this obligation is such that if the above
bounded Principal shall remedy without cost to the said City of Campbell
any defects which may develop during a period of One
year(~~ from the date of completion and acceptance of the work performed
under said contract provided such defects are caused by defective or in-
ferior materials or workmanship, then this obligation shall be void; other-
wise it shall be and remain in full force and effect.
IN WITNESS WHEREOF, the said Principal and Surety have duly executed this
bond under seal the 25th day of April , 19~.
IiK~UiS afita R..~p T.RA
~ dC.k.v, P-
~ '
Principal
COMPANY
T I~~r~~~~~!!~a
N~ 3010
GPA___________
Power of Attorney valid only if numbered in red.
Transamerica Premier Insurance Company
Administrative Office Irvine, CalifornIa
General Power of Attorney
Know All Men by These Presents, That Transamerica Premier Insurance Company, a corporation duly organized and existing under the laws of the
State of California, and having its administrative office in Irvine, Orange County, California, does by these presents make, constitute and
appoint ____~______ ---~----------------- --------
CHARLES GRISWOLD
of San Jose and State oL__1.:aliiorn1.a...___ its true
and lawful Attorney(s)-in-Fact. with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver
--=~ cd'NflrACT~ONDS 'TS.B.A. Guarantee Agreement - MAXIMUM PENALTY l~J2(f:Ooo-:QQ_=-=-~=~=~-~:=
OTHER CONTRACT BONDS - MAXIMUM PENALTY 100,000.00
_=~n__.t\.~~___9THEJrBONDS - MAXIMUM PENALTY $25,000.00
IITHIS POWER OF ATTORNEY SHALL TERMINATE AND BE
OF NO FURTHER EFFECT AFTER DECEMBER 31, 198'9"---"------------------
and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the President. sealed with the corporate seal of the
Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in the premises. Said
appointment is made under and by authority of the following resolution adopted by the Board of Directors of the Transamerica Premier Insurance
Company, at a meeting held on the 12th day of June, 1984.
"Be It Resolved, that the President. any Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and
authority to appoint anyone or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the
following provisions:
"Section 1. Attorney-in-Fact. Attorney-in-Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute,
acknowledge and deliver, any and all bonds, recognizances, contracts, agreements of indemnity, consents of surety and other conditional or
obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments
so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and attested by the Corporate
Secretary. "
County of Orange
} ss
Pres i dent.,_,___
16th day of
In Witness Whereof, Transamerica Premier Insurance Company has caused these presents to be signed by its
and its corporate seal to be hereto affixed this
__ October __, A.D., 19
By __
State of California
On this__ 16th
CALtFOR"\~
_day of ~
Joan M. l~ynn
Jack M. Trapp
President
October
, in the year 1987. before me
. a notary public, personally appeared
, personally known to me to be the person who
, on behalf of the corporation therein named and
executed the within instrument as
acknowl~~ tbal ~r:.~P!lti1W~~ it.
11 ~"'~ OF!'-'I~'A'L SEAL I'"
1 /f.,.?""'\";Y::-;"::<,..., "..., f\~: IV~I" ...,.. I (
,,1, . .1..-:..... .J,-,,,..J ".,; "1' 1~!Nl .
. ;.;:. 'Sr....-.:'(" \,"\, " .1 ll. ". I".
: t..,,,,"'.... ..',' 1.1"'['''' f....." ....,.'.,.,...~ It
11 \~\o.J.~':.,~;.~';;R;;:;;~ i:,~~\>~);:'!~;'(:~I\~~~' !
'I;'j ,'~~:r:,_.I:-" Oi,'_t;;'!'3L CU:Ji~TY I"
~J~;'lh~~~12!,gEi~~i FG.h.;?-,,!.$'11 ,~
..-.-yIW-..r............~~'~
I. the undersigned Secretary of Transamerica Premier Insurance Company hereby certify that the above and foregoing is a full, true and correct copy of
the Original Power of Attorney issued by said Company, and do hereby further certify that the said Power of Attorney is still in force and effect.
('
~ A~_LL)~- ____
Notary Public
And I do hereby further certify that the Certification of this Power of Attorney is signed and sealed by facsimile under and by the authority of the
following resolution adopted by the Board of Directors of the Transamerica Premier Insurance Company at a meeting duly called and held on the 12th
of June. 1984, and that said resolution has not been amended or repealed:
"Resolved, that the signature of the Secretary or any Assistant Secretary of this Corporation, and the seal of Corporation, may be affixed or printed by
facsimile to any certificate to a Power of Attorney of this Corporation, and that such printed facsimile signature and seal shall be valid and binding
upon this Corporation."
Apri 1
day of _______,___,__________~,_________
GIVEN under my hand and the seal of said Company, this
25th
89
19_________
THIS POWER OF ATTORNEY EFFECTIVE ONLY IF
ATTACHED TO BOND NO. TPI 1893432
(Ju/JcL-
Secretary
30024A
10-85
KIP'S KUSTOMS
General Contractor
License # 451958
It~c
~/.,
I/P/i J ? t IJ
PUBI 798'9
f}/ 1..IC IAI
IrGIIV~ 'YORI(. .
("RIIVG J
April 14, 1989
City of Campbell
70 North First Street
Campbell Ca. 95008
Department
Public Works
Att: Greg
Dear Greg:
In reference to 60 Shelley Ave., Campbell Ca.
Please be advised that all Public Work Improvements
have been. completed and I, Hereby request Final
Inspection.
Thank you,
Kip DuPuis
KD/md
907 North Ninth Street. San Jose. CA 95112. (408) 998-0987
ENGEOTECH, INC.
Soil and Geological Engineers
473 Sapena Court, Unit 15 0 Santa Clara, CA 95054 0 (408) 988-8225
Kip's Kustoms
907 N. Ninth Street
San Jose, California 95112
lI'e
""
/JPR 1 7 · b
PUBliC 1989
fNGINE~/fOR/(S
RING
March 28, 1989
Attention: Mr. Kip Du Puis
Subject:
Proposed Residential Development
Shelly Avenue
Campbell, California
TESTING AND INSPECTION DURING GRADING OF STREET
Gentlemen:
Per your request, our firm performed testing and inspection
services during grading operations in the street adjoining the
Residential Development on Shelly Avenue in Campbell, California.
The existing street section was dug out and the material was
hauled away. The subgrade was moisture conditioned and compacted
with a roller. The wet area was subexcavated and plugged with
A.C. The street area was filled with A.C. in lifts and compacted
to 98.1 to 98.6% relative compaction.
If you have any questions, please give us a call.
Yours truly,
ENGEOTECH, INC.
J~~~
Muhammad Hussain, G.E.
~..IY\ ,'-r-
CITY OF CAMPBELL
70 NORTH FIRST
CAMPBELL, CALIFORNIA
(408) 866-2100
STREET
95008
Public Works
Department:
February 14, 1989
Kip Dupuis
907 No, Ninth
San Jose, Ca. 95112
RE: CLEANLINESS OF CONSTRUCTION AREA AND SHELLEY AVENUE
Dear Mr. Dupuis:
The City has received numerous complaints regarding dirt and debris stock
piled and spread out in front of your job site and in front of adjacent
areas. Granted there is other construction going on on Shelley Avenue and
those owners are being notified as well.
By City Ordinance and by the City Standard Specifications you are required
to continuously maintain your frontage as well as adjacent areas in a
clean manner. ~he present condition of Shelley Ave. is unacceptable. I
therefore have ordered a sweeping firm to sweep Shelley Avenue and will
continue to do so until the maintenance performed by you is adequate.
If you have any questions or require additional information please contact
me at 866-2150.
Sincerely,
A~1'1~_7Mv
Gregg Eaton
Public Works Inspector
UI.JUUU,
TO BE r:r:tCICi.::> '::,,":)UT 1-'"::
SECllON 6103 GOVE:~.':f.E"'n CODE
AT THE REQUEST OF CITY OF CAMPBEll
NO FEE
fna; FuR RiiOQtU)
A" ~'ltul'T OF
CITY OF CAMP8!::LL / ",' '4 ,.f r ,..,..Q b~ I'
70 N. FIHST STREET NOTICE OF COMPLETION G t- I ur ~ IJ
CAMPBELL, CA 95008 Jill Zt 8 01 ~M '89
NOTICE is hereby given that City of Campbell as Owner and Donald ~~ I'l. .
Wimberly the undersigned, as City Engineer caused street improvements Qfif'.f6~~ RECORD!r-"
constructed upon the property hereinafter described. SA.NTJ.. C1-...HA COlairY
LJ.URIE .Kt,}; ~
That the work on said street improvements was actually accepte~ on t~~F~~~RER
day of May, 1989. K 994 PAGE 14 75
That the name of the Subdivider for said Owner is R. K. and Maria R.~.
Dupris.
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:
City of Campbell
70 North 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:
Improvements installed in Tract No. 8202, Shelley Avenue and having the
following address: 60 Shelley Avenue, Campbell, CA 95008.
Dated: June 9, 1989
"
Donald C. Wimberly,
City Engineer
STATE OF CALIFORNIA
ss.
COUNTY OF SANTA CLARA
I, Donald C. Wimberly, being duly sworn, says: That I am the 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('\wn know~ge. .
~l!)~Vvv--~\/
Donald C. Wimberly,
City Engineer
Subscribed and sworn to before me
this ~ day of June, 1989
88-247.1
OFFICIAL SEAL
CHARLENE M. CASE
Notary Public-Callforn1a
SANTA CLARA COUNTY
My Ccmm. Exp Oct 12, 1991 ~
~..--..~ ..!__~~---:JIIIIIIC'..-..:,l.I"'::;'.
(?Iz~~ m. ~~-
Notary Public in and for said County
of Santa Clara, State of California
RESOLUTION NO. 7739
BEING A RESOLUTION ACCEPTING STREET IMPROVEMENTS
IN 274 EVERETT AVENUE, CAMPBELL, CALIFORNIA
WHEREAS, the City Council has been advised by the City Engineer that
public improvements in 274 Everett Avenue, have been completed in
accordance with City standards; and
WHEREAS, the City Engineer recommends acceptance of the improvements;
NOW, THEREFORE, BE IT RESOLVED by the City Council that public
improvements be, and the same are hereby accepted, and that the City
Engineer is hereby ordered to record a Notice of Completion of said
improvements.
PASSED AND ADOPTED this 16th day of
following vote:
MAY
, 1989, by the
AYES: Councilmembers:
KOTOWSKI, ASHWORTH, BURR,
CONANT, WA TSON
NONE
NOES: Councilmembers:
ABSENT: Counci1members:
NONE
APPROVED:
~~~
NETTE WATSON, Mayor
TH~ FOREGOING 'NSTRUt.AENT 18 A T1'I~
AND CORRECT COP V OF THE ORIGINAl
ON FILE IN THIS OFFICE.
ATTEST: BARBARA 01 S"SKV. CITV CLERK,
CITY CAMPBELL, CALIFORNI
01
8'
DATED
. 87-199.3
RESOLUTION NO. 7738
BEING A RESOLUTION ACCEPTING STREET IMPROVEMENTS
IN 60 SHELLY AVENUE, CAMPBELL, CALIFORNIA
WHEREAS, the City Council has been advised by the City Engineer
that public improvements in 60 Shelly Avenue, have been completed
in accordance with City standards; and
WHEREAS, the City Engineer recommends acceptance of the
improvements;
NOW, THEREFORE, BE IT RESOLVED by the City Council that public
improvements be, and the same are hereby accepted, and that the
City Engineer is hereby ordered to record a Notice of Completion of
said improvements.
PASSED AND ADOPTED this 16th day of
following vote:
MAY
, 1989, by the
AYES:
Councilmembers:
KOTOWSKI, ASHWORTH, BURR,
CONANT, WA TSON
NONE
NOES:
Councilmembers:
ABSENT:
Councilmembers:
NONE
APPROVED:
Mayor
THE FORE'OOINO INSTRUME'NT 18 A TAU!'
AND CORRECT COPy OF THE ORIOINAL
ON FilE IN THIS OFFICE.
ATTEST: BARBARA OtS..SKY, CITY CLERK,
elTY eAMPBEll, CALI FORNI
IV
DATED
88-247
.--
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_____ 2 J-j 8.14'
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THIS IS TO CERTIFY THAT 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 WrrH RESPECT TO WHICH THiS CERTIFICATE MAY
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREiN is SUBJECT T(1 !l,LL THE TERMS, EXCLUSIONS, AND CONDI,
TIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
r--
I
GENERAL LIABILITY t------,------~-
X COMMERCIAL GENERAL LIABILITY i
~IAOE [K] C:CCcRR[',C: I GSP 003188
:J'vV~J~RS & cor'iTRACORS tJf:\OTEC\.':
!
TYPE OF INSURANCE
~CiLIC'l i\Ju(\,'~[3E-~~;'"
"!~~~ IN THOUSANDS
11/19/8811/19/89
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
X SCHEDULED AUTOS
$ 1,000,
HIRED AUTOS
'~ON OWNED AUTOS
GARAGE LIABILITY
I GSP 003188
I
I
+n_
11/19/8811/19/89
s
A(:;C;REGATF.
$
OTHER THAN UMBRELLA fORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
C993552
11/4/88
11/4/89
s
OTHER
RENTED EQUIPMENT
$50,000
$500 DEDUCTIBLE
DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES! RESTRICTIONS SPE'>:,~
ALL CALIFORNIA OPERATIONS OF THE NAMED INSURED
CITY OF CAMPBELL
PUBLIC WORKS
70 N. 1ST STREET
CAMPBELL, CA 95008
P;RA riCH', D;CTF '"!EREU~ 1-( "~:!,:JiM; C~OMPANY WILL ENDEAVOR TO
M41L 10 DI>YS WRiTTEN NO';:i:. "; ':;,PTiF:CATE HOLDER NAMED TO THE
l.EFT BUT FI'ILURE TO MAIL SUCH r<r:'CE SfiAU, IMPOSE NO OBLIGATION OR
liABiLITY OF ANY KI~m UPON THE COMPM,' :TS AGENTS OR REPRESENTATIVES,
A::"-'~-;o '1 ;zc~~0'="R-E's[:~-,;:-,~;r.---DSI IE irE REtf-'w. ST A RK AND CO.
'rn~J (~r,Li--{P/~,
~ . .. ......
~
rrr PRODOCER THIS CERTIFICATE IS ISSUED AS A MATT F INFORMATIO ONLY:.",::.
/:?{ 0 AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
@:?m CERTIFICA TE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE . .
rrM! Cu r tis Day & Camp a ny AFFORDED BY THE POLICIES BELOW.
trr 50 F reman t St., Sui t e # 300 COMPANIES AFFORDING COVERAGES
II ~~~_~~;~~~~go,CA 94105 ~~~:r~m A Republ ic Indemnl ty
I ~"~':'s Pipeline Constluction ~::::
jjj:jj::::::: 16250 Bur ton Roa d LETTER
trr: Los Ga t os COMPAm D
:?i:i/: CA 95030 LETTER
I ~E ....
::ii:r:::C.~!t~Mo.l*Mlf,f.:il::K::Mm:m:!t!:r:!:!:!:!:tttt::::!:mt:!:!:!:!t:!:!:!:::t::ttttttt:!,!:!:::::::::::::::!:!=!:::t::ttt:t:::!:mt:l:mt::!:::tt::::m::::::::ttl!tt:!:m::@::!::tt:t:ttt:t:::::::::!:!:!:::!:!:!:::!:tt::::!:tttt:@:l:t:t!lt:::!:ttt:tttt:::!:::t:ttt:!:::::!:::::,:::!!!::::::\:
:mnm THISISTO CERTIFY THAT POLICIES OF I NS.U.RA t'.j"CE.LISTE'D BELOW HAVE BEEN ISSUED TO THE NSUREDNAMED ABOVE. FOR THE =:::=::::r
ttt POLICY PERIOD INDICATED, NOTWITHSTANDING ANV REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER :t!:::t
ttt: DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE :/"!':;:
m:t:f POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH POLICIES. ....
iffm co TYPE OF INSURAN:E POLICY NUMBER POLICY EFFEClIYE POLICY EXPIRAlION ALL LIMITS IN THOUSANDS
::::::::::::: L TR DA IE (M,1/DDIVYI DA TE (M,1/DDIVYI
I E~::::::::~~,~;;:"","" ~~~~~~ ~:~ y ~OR~ ~s O~~~~E~ V~~~ES
Ill:ll!::::: OWNER'S & CON1RACTORS PROTEClIYE ~~~~~U~~Y F~~~~E~ ~ CERTlFI TE
iii!:!:::!:.1 AUTOMOBILE LIABILITY
11* Am AUTO
:::::::::=::: All OWNED AUTOS
::::::::::::: SCHEDULED AUTOS
l~~l;~~
.:.:.:.:.:.:. HIRED AUTOS
:::::::;:;:;:
~::l:::::: ~~~~~~~~BI~I~:OS
~i:!i\i!::
~::::,:,:,:= EXCESS LIABILITY
IIIII1111111
.:-:.:.:.:.;.
:::::::::::::
I
;.:.:.:.:.:.;
1]."1..11~
~::::::::::
:~:::::~:::
it::@i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I RESTRICTIONS I SPECIAL ITEMS
]@ RE: ALL CALIFORNIA OPERATIONS
1:::::::: ~~Kx~~tmxt~~J3"~~kxx~KIQx~Si~oc)( .. .
1IIIIIIIIIIIIG~~t~fl<l~llt::.: ::. :.. ::o.~~t:l:!lr:::ff::ft::!:!:t!rtt::::ttt:::::::::::::!:::::::::::!:::!:!::::;:::!!:!::mf::::::::::;:::::::!::!r:::::::~^l'9~l;~ilAlIPtt!r:t:t::t:::::::::::f:n:::!:!:::!::::::::::t:ttIff!:!:!:!:::!:t:l:t:::::::t:t:::t:rmt:tti:!;m:::!::t:::::ttllt:t:::::::;:; ::1il1:.::.:.
tit::" SHOULD ANY OF THE ABOVE DESCRI.BED.P.OLICIES.BE. CA.NCELl~ED :}}}
:::::::f!: .. BEFORE THE EXPIRA TION DA TE THEREOF, THE ISSUING COMPANY'.::.:.::.:
lttt Ci t y Of Campbe II WILL ~MAIL 30 DAYS WRITTEN NOTICE TO THE .....
!m:/? 75 No r t h Ce n t r a I A v e n u e CERTIFICA TE HOLDER, NAMED TO THE LEFT, .>>:m:lXK.Xl)1!JUiVM~
:;mtt .. SREH..mmcalll~~~~'X
I:::::::::::: Campbe II, CA 95008 ::::AUTHORIZED REP~JmKJlJllJ;Nm~~ ........
::::::i::::!: .. f> 1 78000000 :::::::::::::
.:.:.:.;.:.:.
..
.....
.....
:i::ii::i:i::':bbijd\ii@i:mIUiJJF:!:!:::\::::::::::!::::::::,:m:mm:!:!m:mm:::!:!::::!rrmmm::::j:mm:::::::::::!::::!:::::::::::::::j::!:::::!:j::!;::!!!!jj!:!:::::!::::::::::::'::::::!:::jjjj!::::r!/irrr\..:::::rmfi:::::;::lff!:!:m::::~nijj~:b6Rijr:b6R~Qij~har4r:iijii:::j:::.::!.::
.:1.::::.1.::
GENERAL AGGREGA IE
PRODUC1S-CClMP/OPS AGGREGA If
PERSONAL & AOI/fRlIS1NG INJURY
EACH OCCURRENCE $
FIRE DAMAGE (ANY ONE FIRE) $
MEDICAL EXPENSE (ANY ONE PERSON! $
1'111111\111
:::::::::::~
...................................
................ .......
CSl
$
$
$
PROPER TV
DAMAGE
$
OCCURRENCE
AGGREGA IE
WORKERS'
COMPENSA TION
AND
EMPLOYERS' LIABILITY
12/31/89 12/31/90
II!!!!!!!!!!!!I!!!.II!!!I!II!!! $
ST ATUTORY
$
$
$
$
OTHER THAN UMBRELLA FORM
C993762
~~~~~~tt~tm~ttrrttttr~ff~\f ~triji~
1000lEACH ACCIDENll :!m!m\
1000(OISEASE-POllCY lIMlll rt:::::
1 000 (DISEASHACH EMPLOYEE) ::::::1:1111:
:::::::::::::
:::~:::::::~:
THER
ENCROACHMENT PERMIT ISSUANCE CHECK LIST
City of Campbell Encroachment Permit No.'?{"~ -"2 '11
Depa~ent of Public Works
Applicant section complete
e..
1-1
Cl~
%c.:l
I-I~
~a:
_0
a:f>..
0%
f>..0
o E:: . / paid.
~15 1/
~I-I~ Five sets of improvement plans submitted
~
~~
~----------------------------------------------_._--------------.------
t/ Applicant signature and dat~
1/
Permit Application fee $50.00 ($35.00 for R-l Homeowner),
paid. Receipt number
~ Plan check deposit, $500.00 (waived for R-l Homeowner),
Receipt number
o
%
1-1
a:
c.:l
~
1-1
Cl
%
c.:l
r..
o
1./ Bond for faithful performance, 100' of City Engineer's
estimate, (waived for R-I Homeowner), supplied or paid.
Amount $ Form I.D. #
~ Cash Deposit: 4' of FP bond, $500 min. ($200 for R-I
Homeowner), paid.
Amount $ Receipt No.
~Plan Check & Inspection fee of 7' of FP bond, $35.00 min.,
(waived for R-I Homeowner) paid.
Amount $ Receipt No.
v/ Worker's compensation information received for Applicant
(see Information Sheet for Encroachment Permits)
All other Public Works requirements listed in the
Conditions of Approval of the development.
~,
---------------------------------------------------------------------------
E-o
j 1-1
~!
::> ~
f)
~~
~ 0
)~
..
U
;)1-1
~ ~
-40
::>~
)l
2~
~vorker's comp and Contractor's Information received for
Contractor (see Information Sheet for Encroachment Permits)
$"
Certificate of Insurance with Additional Insured's
Endorsment received from Contractor (see General Summary of
Insurance Requirements for Encroachment Permits)
1/
Three sets of off-site plans, stamped APPROVED (Tract or
Development and Public Work~ Permit number and property
address on plans)
...
Permit signed for City Engineer
WHEN ALL OF THE ABO~ I!TEMS ARE COMPLETE, PERMIT MAY BE ISSUED .
Issuer: Initial ~~ and date 1- Z.~-xi and fUe with permit
UPON ISSUANCE, INITIATE CHECK REQUEST FOR PLAN CHECK DEPOSIT REFUND
8/88
permchklst
CITY OF CAMPBELL
Permit No.
Applicant
INFORMATION SHEET FOR ENCROACHMENT PERMITS
A separate form must be completed for the applicant and each contractor
that will work under this permit.
YORKERS' COMPENSATION INSURANCE INFORMATION
Name of Contractor/Applicant
One of the following must be on file with the Public Yorks Department:
A Certificate of Consent to Self-insure issued by
the Director of Industrial Relations; QR
A Certificate of Yorkers' Compensation Insurance
Insurance Co.
Policy No. Expiration date
;QB
.... .......................................................................
This Certificate of Exemption from the Yorkers' Compensation
laws printed below (certificate must be signed).
CERTIFICATE OF EXEMPTION
I certify that in the performance of the work for this permit, I
shall n~:r~.m loy any pers.on in any manner so as to become subject
to the '~J:7~ OfZ;f7~ .
Signed- ?> ate / ;,$-16
,
NOTICE TO CONTRACTOR/APPLICANT: If, after signing this Certificate
of Exemption, you should become subject to the Yorkers' Compensation
provision of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
. .
................................. ..........................................
CONTRACTORS INFORMATION
Note that all contractors must have current City of Campbell Business
License, State Contractor's License and Yorkers' Compensation Insurance.
Name of Contractor
Address
Telephone
State Contractor License No.
City Business License No.
Expiration Date
Vi11 do the following types of work:
underground
P.C. concrete _____A.C. paving
electrical
other (specify)
f:PERMINFO
REV. 8/88
Tafoya Johnston Insurance
3880 S. Bascom Ave. Ste 117
San Jose, CA 95124
INSURED
Kip's Kustoms
907 No. 9th Street
San Jose, CA 95112
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.
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
Scottsdale Insurance Co./Hull Co. #040035
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HA VE 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 CONDI-
TIONS OF SUCH POLICIES,
TYPE OF INSURANCE
POLICY NUMBER
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISES/OPERATIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTS/COMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CDr-;TRACTDRS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
GLS 211782
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV PASS)
ALL OWNED AUTOS (OTHER THAN)
PRIV. PASS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
eTHER
DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/SPECIAL ITEMS
Exclusions: Asbestos, Pollution, Subsidence
The City of Campbell and its respective
employees are named as additional insure
and against any claims, loss liability,
or expense arising out of or in any way
connected with the construciton of the p
This coverage shall be primary and any c
POLICY EffECTIVE
OA TE (MMIDDiYYI
POLICY EXPIRA nON
DA TE (MMIDOiYYI
LIABILITY LIMITS IN THOUSANDS
OCC5~~~NCE AGGREGATE
BODILY
INJURY
11-15-88
1-15-89
PROPERTY
DAMAGE
BI & PD
COMBINED
$
$
$
$
$1,000, $1,000,
PERSONAL INJURY $
BODilY
INJURY $
(PER ptRSONI
BODilY
INJURY $
(ptR ACCIDENTI
PROPERTY
DAMAGE $
BI & PD
COMBINED $
~~t~~ED $
STATUTORY
$
$
$
$
(EACH ACCIDENT)
(DISEASE-POLICY LIMIT)
(DISEASE-EACH EMPLOYEE)
xpense
/
TENTATIVE SUBDIVISION MAP
CONDITIONS OF APPROVAL
t.-->'
~'P~
t.ANDS OF
SITE ADDRESS:
APN t
CONDLIBR
CODE .
~
E)
.~
e
r;;::~
(ED
(f;J
,c41
8
8
rev
~
(!!J
f: CONDLIDR
USERl
v.
Installation of a sanitary sewerage system to serve all lots
within the subdivision in conformance with the proposed plans of
the County of Santa Clara Sanitation Distrct No.4. Sanitary
sewerage service to be prOVided by said District NO.4.
Installation of a water distribution system to serve all lots
within the subdivision in conformance l/lith the plans of the San
Jose Water Works. Water service to be provided by said water
company. Fire hydrants and appurtenances shall be provided and
installed at the locations specified by the Fire Chief, Fire
D'epartment" City of Campbell. Fire hydrant maintenance fees shall
be paid to City at the rate of $195 per fire hydrant.
SUbdiVider shall create or provide any pUblic service easement and
any other pUblic utility and/or pUblic service easements as may be
necessary for the installation of any and all public utilities
and/or facilities.
Compliance with the proviSions of Title 20, SUbdivisions of the
Campbell Municipal Code~
SUbdivider to pay Storln Drainage Area Fee.o('4&f,&<D.
SUbdivider to furnish copy of Preliminary Title Report.
Subdivider shall install street improvements and post surety to
guaranty the work.
Subdivider shall execute an agreement and post surety to install
street improve~ent8 in the future and agree to jOin a Local
Improvem.nt District.
Dedicate additional right-of-way to widen
to "3-0 feet from centerline.
sh.4fl(v A\Jcn,-,~
,
CC'R's to be approved by City Engineer to insure provisions for
maintenance of buildings and common area.
PrOVide a grading and drainage plan for the review and approval of
'the City Engineer.
Obtain an excavation permit and pay fees and depOSit for all work
in the public right-of-way.
Pay a fee of $ ~ in lieu of dedication 0; land for
,Jt~6~o~
parks. ~
,~y
\(6 I I ( 3/ fC,V
CITY OF CAMPBELL, CITY ENGINEER'S CONSTRUCTION COST ESTIMATE
Address &'6 SHbZLG: rj
,/
- $
- $
- $
- $
- $
$
- $
- $
- $
Surface Subtotal "5" - $ 1Z.1';;Y~ f:,o
Adjust for size: .5"<$30,000 add 20', .S">$lOO,OOO subtract 10' (+ or -) $ ;).')/7. 3 :z,.
,
Surface Construction
Clearing & Grubbing
Sawcut Concrete
Concrete Removal
Curb & Gutter Removal
Inlot Drain with Pipe
Curb 6 Gutter
Sidewalk
Driveway Approach
Handicap RIIIIp
Extruded Curb
Barricade
Street Excavation
AC Pavement
Adjust Kanhole to Grade
Adjust Handbole to Grade
Konument Box w/MoIlUlllent
Street Tree (IS-gallon)
Pavement Striping ($100 min)
Pavement Legends ($100 min)
Stop, Street Name or Other Sign
Pavement Karkers
Pavement Key Cut
Street Li"htin"
Electrol1er
Conduit
Conductor, pair
Pull Box
Storm Draina2e
12- or IS" RCP
IS" or 21. RCP
Street Inlet
Kanhole
Break 6 Enter Kanhole
CC~j4"/ Oc/r'
. .' If"
'1VJJn.d '/.. -
reviaed 6/St/'-t' -
f/eon-eost-es/V ?~ -:;.
EA@ 1,600.00 $
/ EA@ 2,400.00 - $ 2, ((00, au
EA@ 650.00 $
/ ~Ae ;Q:udb - $ 500.6-V
Lump Sum Estimate
LF@ $ 4.00
SF @ 3.00
LF@ 5.00
EA@ 600.00
~? LF@ 14.00
,;2yS SF @ 4.00
~J"O SF @ 5.50
....-- EA@ 400.00
LF@ S.50
- LF@
50.00
~/PIO SF)X($O.lO)x(~")
(~SF)X($0.30)x(~")
;L EA@ 375.00
-
EA@ 275.00
EA@ 600.00
~ EA@ 300.00
LF@ 0.65
EA@ 40.00
EA@ 120.00
EA@ 15.00
LF@ 10.00
! EA@ 2,000.00
SO LF@ 10.00
50 LF@ 2.00
I Ea @ 200.00
dlk
60.00
LF@
LF@
70.00
Permit No. ?J?-Z~7
bY_dste~f/-:r1/ F;:
- $ 50l?.. <TV
- $
- $
- $
- $
- $ ~ Z I J1. &0
,
- $ 950. CTO
- $ J.., 6> (10. ,'3'0
- $
- $
- $
- $ ,:./ t:, 10, d tJ
- $ ~ z. lfJ' . 6 C)
- $ 7 :; o. c> ~)
- $
6 ~O. (> t}
--
_ $,,) CX::XJ, c'" I;)
_ $ ')60. "0
/ ~~ ~d
'1"0- 0"0
- $
- $
- $
_ $ I ~ '80.6' J
,
- $
TOTAL ESTIMATE
}~ '/Y5e9 z.
I
$
$ '22_ S-o 0 _ 0' I)
-- ,
t) USE FOR BOND
1 RO ,0 !)
1,5Y3. 'd7
PURCHASE ORDER
/ DEPARTMENT
PLEASE NOTE:
City 0/ Campbell
70 N. FIRST STREET CAMPBELL, CALIFORNIA 95008
(408) 866.2100
THIS NUMBER MUST APPEAR or< ALL l/.~OICES PAC_AGES
SHIPPING PAPERS AND COR~ESPO~DE~CE PtHl AiNIN" TO
THIS OADER.
PURCHASEORDEA' ,"
No. 9-914
Shl To Add,.... Checked
To .
W1VBRSAL SWBEP'~G...t!~~.. .................,............... ................,......,... ~..,....._.. .......
P.O. BOX 5993
SAN JOSE, CA 95150
"." .'"
CITY OF CAMPBELL
70 H. FIRST ST.
CAMPllEu, CALIf. ll600I
...... .....".... .."'.........
....... .,..'.... ........... -..-..................,.
.....
DUAIlTIIEHT .
IlIQUUTlDIY
VENDOR PHONE tI (
IIIPARTIlEHT
DATE
AC:COUln' NO.
?6S: 4~~Z-
PtJBLIC womcs
. - ~~!.~!.L.i ...j;...,L "'.__ __,....f.O:!~~'!L...:..":.. ;.....::.i. .
2/14/89
. TEIlMI
.. \ '. OIlDIIlIlATE _.,
~~
2-17-89
..:,....
rEII
~. ,,' ; , ,.'t. . ,'" ~._ , D.lefl'PTION
............"._~ ......... .,- '-,.,_.,~"""""""".........: _.........:.....,;::;.."..;.;...,J.., ....,<.........k____-................""""', J.
UNIT l'IIICE
~.'
1
L.S.
.,
L.S.
~
YA
B
3O~. 09.
..
.."
CHARGB TOa
PElUCI'1' NO.
(1.50.00)
PlmHIT 110.
(~.lSO.OO)
88-229-
Bclr
.-
.~ ..,.~..,...._.",
lCu8toIIl' .
...
88-247- n
_.
. .............""'-i~.
.. .
AL
ALL INVOICES ARE TO BE ADDRESSED TO
CITY OF CAMPBELL, FINANCE DEPARTMENT
70 N. FIRST ST., CAMPBELL, CA 95008
lis Order is Sub'actto The Terms And Conditions Stated Below:
TERMS AND CONDITIONS
::CIFICATIONS . Ally apec:ification. and/or drawings referred to and/or
died hereto are expre"'y made a part of thl. purchue order.
ww:.s . No changes or varlalions of any kind are authorized without the
ten consent of the Purchasing Agent.
.BlEfri.. Plaaae notify the City promptly if delivery cannot be made on or before
elat. lP8Cified. The City reserves the right to cancel any or all item. not 10
vered.
DER IDENTIFICATION. Show this order number (and blanke' number if
CIted) on IIlI Ihlpping label.. packing lisll. Invoice.. and communication.. If
jallhlpment illUthoriZed. 10 indIcat. on IIlI documents. Complete packing Ii..
Tax
Total
PACKAGING. No boxing, packing or cartage charge will be allowed unless authorized on order.
:uJL- This purchase order is exempt of Feelar" Tax (Certifica.e furnished upon request) but ia
subject to aaJeslax if applicable.
--.~~- ~ -_.- .-
City of Campbell
li\;llliilllll~.~IIII_1
FROM ~r;Y~11t-
75 NORTH CENTRAL AVENUE
CAMPBELL, CALIFORNIA 95008
PHONE 378-8141
MESSAGE
~Vf c..w
DATE
SUBJECT
..
,~
..&- I4.4A.
. ~ \0 lr-..) ::;~L\"-'
~-
~. ~"r!
If'ECEIVED
FER 2:) 19Gtl
c ( ,
,I . l
...r~ '~.""t'.1: . ...... -" ....~..... ~
IRREVOCABLE LETTER OF CREDIT
This is an irrevocable letter of credit issued by California
Security Bank (issuer) which is intended to secure the
performance of an agreement dated _~~~~_2_~~8~_______between
Kips Kustoms (developer) and The City of Campbell for the
construction of certain improvements on 60 Shelley Avenue and
to secure payment to contractors, subcontractors, and to
persons furnishing labor, materials or equipment on said
project.
This letter of credit is in the amount of TWENTY TWO THOUSAND
FIVE HUNDRED DOLLARS ($22,500.00). Upon presentation of written
statement signed by the City of Campbell that the developer has
failed to satisfactorily complete and pay for the aforesaid
improvements or that a claim has been filed and is payable
pursuant to the provisions of Title 15 (commencing with Section
3082) of Part 4 of division 3 of the California Civil Code, or
that the Developer has failed to satisfy the guarantee of work
performed, Issuer shall pay to City of Campbell an amount not
to exceed $22,500.00.
This letter of credit shall remain in full force and effect
throughout the term of the agreement between Developer and City
of Campbell; provided, that upon completion of the improvements
and acceptance by the City of Campbell the terms of the letter
for payment of any claims filed pursuant to Title 15 of Part 4
of Division 3 of the California Civil Code within ninety (90)
days of completion and acceptance of the improvements by the
City of Campbell.
Issuer hereby stipulates and agrees that no change, extension
of time, alteration or additional to the terms of the agreement
between Developer and City of Campbell or the specifications
accompanying the same shall in any manner affect Issuers
obligation hereunder, And ISSUER hereby waives notice of any
such change, extension, alteration or addition.
"" cont'd.
1694 Tully Rd, San Jose, CA 95122/PO Box 21388, San Jose, CA 95151-1388/1408) 270-1500
Irrevocable Letter of Credit - page 2
City of Campbell hereby indemnifies and hold harmless ISSUER
from and against any claim or liability arising out of ISSUERS
disbursement of funds to City of Campbell hereunder.
B NK /
/L ~
BD a Cl ine ;;lr.
Vice President & Senior
Loan Officer
CITY OF CAMl)HEII
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
WIMBERLY
HElMS
ANDUNG ~~r-;
+-....
RETURN TO I ;
,.--_1_..,
,DiSCAHD J:
..
..i ::i,,~~; DI~
; 1"~'I'" -'}
~1::,:':~:,::",_,
-. --
Fqri~"',;;'),
_."'.. .,l
,
Department:
Public Works
April 25, 1989
Kip's Kustoms
907 North Ninth Street
San Jose, CA 95112
RE: FINAL INSPECTION AND ACCEPTANCE
PERMIT 88-247 FOR 60 SHELLEY AVENUE
MAINTENANCE BOND AMOUNT: $5,625.00
IRREVOCABLE LETTER OF CREDIT: $22,500.00
Gentlemen:
We have made a final inspection of subject Public Works construction
and find it acceptable and in conformance with City standards.
Accordingly, we will recommend the acceptance of the work to the City
Council. We will send a copy of their resolution accepting the work
upon their approval of same.
You are responsible for the maintenance, repair and/or replacement of
all work done should any failures occur within one (1) year of this
date. We have received your maintenance bond and hereby release your
letter of credit dated Nov. 9, 1988 from the California Security
Bank.
We will inspect the work in one (1) year and advise you whether or
not maintenance is needed.
Please feel free to call me if you have any ,Questions.
Sincerely,
Carlos M. Jocson
Associate Civil Engineer
CMJ/p
cc: G. Eaton, P. W. Inspector
Council Agenda
C. Case, Adm. Aide
Suspense - 1 yr
California Security Bank
88-247CJ
REFUNDABLE DEPOSIT
CHECK REQUEST
TO: FINANCE DIRECTOR
CITY OF CAMPBELL
Please issue check payable to:
KIP'S CUSTOMS
Address:
Line 1:
907 NORTH NINTH STREET
(30 spaces)
(30 spaces)
(30 spaces)
Line 2:
City :
SAN JOSE
(20 spaces)
State: CA Zip:
(2)
95112
(10 spaces)
Description:
CASH DEPOSIT REFUND-60 SHELLEY AVE(24 spaces)
Exact Amount Payable:
$350.00
Account Number:
001.00.905.0000.4662
PURPOSE: RELEASE OF CASH DEPOSIT FOR EXCAVATION PERMIT 88-247. SEE RECEIPT
NO. 779 OF 10/19/88 FOR $500.00 LESS $150.00 FOR UNIVERSAL SWEEPING P. o. 9-914 OF
2/14/89.
Requested by: GREGG EATON
Title: P. w. INSP
Date: 4/19/89
Approved by: DON WIMBERLY
Verified by:
Title: DIR. OF PUB. WKS. Date:
Accounts Receivable
Date:
SPECIAL INSTRUCTIONS FOR HANDLING CHECK:
Mail as is
X
Mail in attached envelope
Return to:
(N ame)
(Department)
Other:
08/24/88
REFUNDABLE DEPOSIT
CHECK REQUEST
TO: FINANCE DIRECTOR
CITY OF CAMPBELL
Please issue check payable to:
:eA Rl\lPC: ~ flT1PTTT c: . T Tn (30 spaces)
907 SOUTH NINTH STREET (30 spaces)
(30 spaces)
SAN JOSE State: CA Zip: 95112
(20 spaces) (2) (10 spaces)
Address:
Line 1:
Line 2:
City :
Description: 60 SHELLEY AVE FP DEPOSIT REFUND
(24 spaces)
Exact Amount Payable: $900.00
Account Number: 001.00.905.0000.4662
PURPOSE:
RELEASE OF FAITHFUL PERFORMANCE CASH DEPOST FOR EXCAVATION PERMIT 88-247.
SEE RECEIPT NO. 2490 OF 11/16/88 FOR $900.00
Req uested by: GREGG EATON
Title: P. W. INSP.
Date: 4/19/89
Approved by: DONALD WIMBERLY
Title: DIR. OF P.W.
Date:
Verified by:
Accounts Receivable
Date:
SPECIAL INSTRUCTIONS FOR HANDLING CHECK:
Mail as is
x
Mail in attached envelope
Return to:
(Department)
(Name)
Other:
08/24/88
PUBLIC WORKS INSPECTION REPORT
Date f~. Pexmit or Project No.
Address (,f'J S~
BR~.?47.
Type of work: Street~rm
Other (describe)
Sanitary
Electrical
o PRELIMINARY INSPECTION WITH DEFICIENCY LIST (attached)
[]FINAL INSPECTION WITH DEFICIENCY LIST (attached)
~INAL INSPE~TION -~CEPTANCE
Signed plan&? , V H (If signed,
Charges against depo&it? Y H
Overtime: brIO. @ $ /hr.
Date 5 reason:
Council acceptance.)
-
$
Barricade rental (attach invoice)? Y
Date 5 reason:
N
$
$ /Sb.GO *'
$
Other? UAA~-%5AL ..swee;iJ,~b {,o..o. q -'1/40
Total charges deducted from deposit: lJ $ ..kP.CJO
(Cash Deposit $ ~Ot9(/ le&& charges $ /.5lJ" - Refund $ .:3S{:Pb ck. req.)
-Jl '719 I~ /9//</
o ONE YEAR MAINTENANCE WITH DEFICIENCY LIST (attached) f::/,P (S I:: t/ S~
o ONE YEAR MAINTENANCE - ACCEPTANCE
(Release'maintenance bond. Check Request if cash.)
~~
. gineer
~
~ Mttj f-/fwG ~':J ~ ~
~ il. CA:5r! i>ef>05' I.
~~
~fJro ~D2;n,4t!L
iCa ~{Jb~ r