95-273
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(for workin9 withill tile
public r19b~-of.....y)
($3,500 _v~,.... value of work)
IallUed /:::?-- / - ~-L:r- . )
, /11 cL-- Appl1c:aUon ap1ru ill 3 _.
A.PPLICATION - A.pplicaUon ia hereby ..de for e Public worD Perai~ ill eccordanoe with CUipbe11
Municipal COde, SecUon 11.04. (Application ap1ru in 6 -=t.ba if tbe pen1~ 18 DOt l8wed)
A. .ork addre.. /~7S" a/leelY' at~~ CA'/#'f"~L 75008
B. .a~ure of work: t1~ ~.oew.Q~. ~/:'> AceeA
C. A~tach ~e (3) copies of a drawin9 Dovin9 the locaUon, ex1:8nt and .u...n.lona of tbe work.
'the drawing Dall cow the relation of the propoHCS work m exlllt1"9 1IIprovaenu. 1Iben
approved by th. City Engin.er, _id draw1nl;r bac-oae. a part of thi. puai~.
ern op ClHPBILL
DZPl'. OF PUBLIC IfOJUtS
'0 North Firat S~.
ca.pbell, CA '5008
(408) 866-2150
k
9)~ ~73
to 10.
X"'f. fUe
ApplicaUon Dau
/ol4/'1 S
D. All work ahall confor. to th. CitY'a General COD4i~iona, S1:andard conR.rw::t:ion Provialona and
Standard conatruction Detail. for Public Worb conatrucUon, 'lbe General Jlenli~ COIlClltiona
li.ted on the rever.e aide, and Special Provl.iona for t:h1a pen1t:, lillted belovo Failure m
abide by th... condit.iona and proviaiona ..y nault in job uut.-dovn aad/or fortelan of
Faithful Perforunca Surety.
._ of _'..... rAU&X c:-,~ .ZlI<!..
Addr... loto R'lLlM!. - ~ ~
'l'alepboDel ~/-~t77 /
'76//0
CClIIplet.e and attach Morken' Coapenaation and conuacmr %D.f~t1on f..-.
'!'he Applicant/Permittee hereby agr... by afflxinCJ their .iqnature m t:h1a pemit m hold the city of
Campbell, ita officen, agenta and ..ploy... free, _fe and hu'al... fzaII any c1aia or daaDd for
damage. re.ulting frem the work covered by thi. pen1t.
'!'he Applicant./Permittee hereby acknowledge. ~t. have read and undentand both tbe fftmt and
back of t.hi. permit., and that t:hey will info co (.) f tbe inforution.
ACCEP'l'ED '/l fL /~-/-9~
Applicant (Permit.ue1 Dau
ROTES: ALL WORlt SHALL COHPORM VI'1'B THE A'1"1'ACIIED, Al'PJORD PUlIS UD ALL APPLICUIoI CAIIPBILL
STANDARD DETAILS AND CONDITIONS.
THE CONTRACTOR MOST HAVE THIS PERMIT AND A.PPROVED PUNS UD MOST AJDWrGE '1'0 IIDT wrm 'f'BE ....
INSPECTOR AT THE SIn AT LEAST TWO DAYS BEI'ORE STARTIRG 1IORlt.
NOTICE MOST BE GIVEN TO PUBLIC WORKS AT IoDST 24 BOUJtS BBPORE RESDllTIIfG &1ft .oJtJt.
SPEC~~L ~o;::~ _
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SURETY lOR PAI'1'BJ'UL
APPROVED lOR ISSUANCE
S'l'1lmUD
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...J.O(JO. \} 0 ~"'IJ*SA/tJ./4--17f"
>>;);/;r
Date
(100' OF -=. a'l'.)
f: R1 PERKIT
bViHd 6/12
(lID 0'1'BD BUlB)
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20 RUFF DRIVE
'N JOSE, CA 95110
DUReE "tJ
TOME~ P. :f 1IJ,t.J
IooRESS /3/ S
~
onerete, I:~e.
(408) 287.8091 · FAX (408) 287.8095
-JGm I'LE
&/ /JEE.AI }VA I
HM. PHQM; J 1 tf- S .:!J S ,
~eJL ZIP '?5oo~
DIAGRAM
TRACTOR AND TRUCK is NO
JACKHAMMER ES NO
DISPOSAL LOAD ES NO
CONCRETE SAWING S NO
FACE OF STEPS EXPOSED YES NO
EXPANSION JOINT @) NO
TYPE DEEP
REDWOOD YES
TYPE/SIZE ~
ANISH lis ~IOWII_ YES NO
ROCK YES NO
TYPE / SIZE
~M~
~~
YES NO
LAMP BLACK YES
NO. PINTS PER YARD
WIRE MESH @ NO
OTHER INSTRUCTIONS:
CROSS STREETS
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M/I1I~ELL .1\
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tu/lceN
. . NOT RESPONSIBLE FOR NN
IN.GROUND UTIUTIES/lRRlGATION UNES
DATE TO START (WEATHER PERMITTING)
APPROVAL
STATE LlC. #603078
IN BUSINESS SINCE 1978
INVOICE
DATe -
/b -2-9~
uJ&~KO~E~- : "J)1!/!ewI9/' ~ /)~I}LK. + lieK.saJ~
t!/LZ- ~tU!..eJlF" A.8 JlltJiU#
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73LDa lJur :!. MJEA5 ro~. "-n!cEEL~v p) 6J'x..:)'J
FOR JOB SCHEDUUNG OR
NN OTHER QUESTIONS
CAll 287- 6091
EXTRA CHARGE FOR CONCRETE REMOVAL
THICKER THAN 4" OR STEEL REINFORCED
~
2,ttJO 80tJD
TOTAL BALANCE
DOWN PAYMENTS 400
.COD BALANCE -4 Z b 9
.4,2..61
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(I
DAY OF POUR
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CITY OF CAMPBELL
Public Works Department
October 9, 1997
Mike Stonehouse
Valley Concrete Inc.
1020 Ruff Drive
San Jose, CA 95110
SUBJECT: PERMIT NO. 95-273
LOCATION: 1375 Colleen Way
ONE YEAR MAINTENANCE INSPECTION - ACCEPTANCE
Dear Mike:
The City of Campbell has made the fInal one year maintenance inspection of subject Public
Works improvements and fmd that no remedial work is required.
Your warranty requirements and any surety, therefore, are hereby released.
Please fmd attached your original Faithful Performance Bond which we are returning to you.
iBs~df
Public Works Inspector
MQ
Enclosure
cc: Permit 97-273
Public Wodes/Maintenance Division
Star Insurance Company, 100 Century Center Court, Suite #302, San Jose, CA 95112
H:\ WORD\PERMITS\97273ACC(JD)
70 North First Street. Campbell, California 95008.1423 . TEL 408.866.2150 . FAX 408.376.0958 . TOD 408.866.2790
PermitjProject # qf"';;73
BOND NO.: SA1414178
BOND FOR FAITHFUL PERFORMANCE
We, the undersigned V ALLEY CONCRETE & REDWOOD, INC. . (hereinafter "contractor") and
STAR INSURANCE COMPANY . a corporation organized under the laws of the State of
MICHIGAN , and authorized to transact business in the State of Califomia, as Surety, are obligated
to the CIty of Campbell, (hereinafter "ClYJ a muni~ co~ratlon under the laws of the State of ~ifomia, in the sum of
TWO THOUSAND AND NO /l 00 ***** ** Dollars ($ * 2 ,000 . 00 ) for the payment of which
sum we obligate ourselves and our successors and assigns, jointly and aeverally by the following provisions:
The condition of this obligation Is:
Because the obligated contractor has, on
with the CIty for the Project/Permit # CJ'i- 2.7 ~ entitled
copy of which is attached and made a part of this bond, for the construction of Project or Permit 1/
AND PARKS TRIP - 1375 COLLEEN WAY, CAMPBELL
~c.
. 19~ entered into written contract
.a
DRIVEWAY, SIDEWALK
Now, therefore, if the contractor shall faithfully perform the work in accordance with the plans, specifications and contract
documents during the original term, and any extensions of the contract which may be granted by the City, with or without notice
to the surety, and if it shall satisfy all claims and demands incurred under the contract, and shall fully indemnify and save harmless
the CIty from all costs and damages which it may suffer by resson of failure to do so, and shall reimburse and repay the CIty all
outlay and expense which the City may incur in making any default, then this obligation shall be void; otherwise to remain in full
force and effect.
If any legal action be filed upon this bond, it shall be filed within one year after final payment has been made under the
contract excluding the warranty period, If any, provided for in the contract, and venue shall lie in the County of Santa Clara, State
of Califomia, and that surety, for value received stipulates and agrees that no change, extension of time, alteration or addition to
the terms of the contract or to the work to be performed under it or the specifications accompanying it shall in any way affect its
obligation on this bond, and it does by this means waive notice of any change, extension of time, alteration or addition to the terms
of the contract or to the work or to the specifications, and thereby waives the provisions of Section 2819 of the Civil Code of the State
of Califomia.
In witness, contractor and surety have executed this agreement as of
NOVEMBER 15
.19~.
(Surety)
FACT
Attest:
Secretary
Approved for the City of Campbell
By
Title
h:contract.doc(mp)page 9
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of
CALIFORNIA
County of SANTA CLARA
On 11/15/95 before me,
DATE
LINDA K. LA MARR, NOTARY PUBLIC
NAME, TITLE OR OFACER. E.G. "JANE DOE, NOTARY PUBUC.
personally appeared
G.F. GERBING, JR.
NAMEISI OF StGNERISl
!Xl personally known to me - OR -0 proved to me on the basis of satisfactory evidence to be
the person(15) whose name(sO istsm subscribed to the
within instrument and acknowledged to me that
he/~ executed the same in his~
authorized capacity(tn), and that by his/~
signature(~ on the instrument the personOs), or the
entity upon behalf of which the person(l) acted,
executed the instrument.
lIHllA K. LA MAg ~
Comm. . 971389
NOTARV PImUC . CAUFalNIA
Slnll Clh ClMIlIy
... ("......... Exlir.. AilS. 13. I t96 ...
WITNESS my hand and official seal.
5j WuU\ / ~J)JU
SIGNATURE OF NOTARY
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and
could prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER
o INDIVIDUAL
o CORPORATE OFFICER
DESCRIPTION OF ATTACHED DOCUMENT
TITLE QR TY~E OF DOCUMENT
TlTLEIs)
o PARTNER(S) 0 LIMITED
o GENERAL
~ ATTORNEY-IN-FACT
o TRUSTEE(S)
o GUARDIAN/CONSERVATOR
o OTHER
NUMBER OF PAGES
DATE OF DOCUMENT
SIGNER IS REPRESENTING:
NAME OF PERSON(SI OR ENTlTY(IES)
STAR INSURANCE COMPANY
SIGNER(S) OTHER THAN NAMED ABOVE
AWXlOO32 Rev, 5194
STAR INSURANCE COMPANY
GENERAL POWER OF ATTORNEY
NO.:
SA 1414178
(Void unless numbered in red.)
KNOW ALL MEN BY THESE PRESENTS, that Star Insurance Company has made, constituted and appointed, and by these presents does
make, constitute and appoint
G. F. GERBING JR. OF SAN JOSE, CALIFORNIA
its true and lawful attorney-in-fact, for it and in its name, place, and stead to execute on behalf of the said Company, as surety, bonds,
undertakings and contracts or suretyship. to be Jiven to
Appticable to All Obligees
provided that no bond or undertaking or contract of suretyship executed under this authroity shall exceed in amount the sum of
two million five hundred thousand ($2,500,000.00) dollars.
This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution
adopted by the Board of Directors of the Company on the 7th day ofJanuary, 1993.
"RESOLVED, that the Chairman of the Board, the Vice Chairman of the Board, the President, an Executive Vice President or a Senior
Vice President or a Vice President of the Company be, and that each or any of them is, authorized to execute Powers of Attorney qualifying the
attorney-in-fact named in the given Power of Attorney to execute in behalf of the Company bonds, undertakings and all contracts of suretyship;
and that an Assistant Vice President, a Secretary or an Assistant Secretary be, and that each or any of them hereby is, authorized to attest the
execution of any such Power of Attorney, and to attach thereto the seal of the Company.
FURTHER RESOLVED, that the signatures of such officers and the seal of the Company may be affixed to any such Power of
Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or
facsimile seal shall be valid and binding upon the Company when so affixed and in the future with respect to any bond, undertaking or contract of
suretyship to which it is attached."
IN WITNESS WHEREOF, STAR INSURANCE COMPANY has caused its official seal to be hereunto affixed, and these presents to
be signed by one of its Senior Vice Presidents and attested by one of its Assistant Vice Presidents this 13th day of March, 1995.
Attest:
STATE OF MICHIGAN
STAR INSURANCE COMPANY
~~
Willner, Senior Vice President
sS.:
COUNTY OF OAKLAND
On this 13th day of March, 1995, before me personally came Marc S. Willner, to me known, who being by me duly sworn, did depose
and say that he is a Senior Vice President of STAR INSURANCE COMPANY, the corporation described in and which executed the above
instrument; that he knows the seal of the said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed
by order of the Board of Directors of said corporation and that he signed his name thereto by I ike order.
COlLEEN KElTZ
CERTIFICATE Notary Pldc, Oakland CaunIy, MI
My Commission Expires A(Y. 30, 1999
I, the undersigned, of STAR INSURANCE COMPANY, a Michigan corporation, DO HEREBY CERTIFY that the foregoing and
attached Power of Attorney remains in full force and has not been revoked; and furthermore that the Resolution of the Board of Directors, set
forth in the said Power of Attorney, is now in force.
Signed and sealed at the city of South field in the State of Michigan. Dated the1STHday of NOVEMBER , 199_~
:~~A~
6030-Mar.95
Page 1 of 1
ST J 1 INSURANCE C( MPANY
100 Century Center Court Suite #302
San Jose, CA 95112
REINSTATEMENT NOTICE
obligee;
11/04/96
CITY OF CAMPBELL
70 N. FIRST STREET
19q!
CAMPBELL
CA 95008
Re: BOND# SA1414178
HIGHWAY/STREET ENCROACHMENT PERMIT
Principal: VALLEY CONCRETE & REDWOOD, INC.
1020 RUFF DRIVE
SAN JOSE CA 95110
GENTLEMEN:
On 10/17/96 NOTICE OF CANCELLATION on the captioned bond was mailed.
Said bond is hereby reinstated and remains in full force and effect.
is::::Y''' · : \" ". I -\," ~ \ ~ \ '"
By: ~"'A_l\J-.' j.,.. ,"-"".,..,>....... ,-.,..'
MONICA L. FOLKERS
Attorney-in-fact
*** OBLIGEE COPY ***
Of' C-iAt
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CITY OF CAMPBELL
R-l PERMIT
Public Works Department
December 15, 1995
Mike Stonehouse
Valley Concrete Inc.
1020 Ruff Drive
San Jose, CA 95110
RE: PERMIT NO. 95-273
LOCATION: 1375 COLLEEN WAY
FINAL INSPECTION AND ACCEPTANCE
Dear Mike:
The City of Campbell has made a fInal inspection of subject Public Works improvements and
finds the work to be acceptable and in conformance with City standards. Accordingly, the City
Engineer accepts the improvements.
The one year maintenance period stated in the permit begins as of the date of this acceptance
letter. The permittee is responsible for repair and/or replacement of any defective work or
failures that occur within one year. The City will inspect the improvements within one year and
notify you, in writing, whether or not any repairs are required.
At your request, the Faithful Performance Bond will be kept in force for the duration of the one
year maintenance period.
If you have any questions, please call Randy Westfall, Public Works Inspector, at (408) 866-
2165.
Sincerely,
7l1utdk ({Ju~
Michelle Quinney
Acting City Engineer
Attachment
~
RRW
h:95-273(mw)6.0
/,0
t Street. Camp ell, California 95008.1423 . TEL 408.866.2150 . FAX 408.379.2572 . TOO 408.866.2790
NEW PW FAX If
4IlfL'!l'~.c .0.0.,-....
CITY OF CAMPBELL
"'-'\ ~
,~.(~-(
FIELD ENGINEER'S DAILY REPORT
PROJECT NO.
~~1n
REPORT NO:
DATE: \l /r7 tts-
WEATHER:
CONTRACTOR:' U~) t1w:-
INSPECTOR:
0,
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