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95-277 cc~ ~r R_ OIYOF DEPI'. OF PVBuc WORltS '7U North PiDt St. ~ CA 950lII (0) 866-21SO .. .J. ~PI!RMD' (b.......... tba ,... -<<....> ...... ;;L)7)Cj~~ ,..... -12 .../?.::;J 'r a )tHo. .J6. - 277 x.Jw.1iIe. ,.. Compete uclI attadI WOJtas' a q~ --I...... Cr... llllr-Id. ~ taa.. GI 1 = o .... ., co u .... ..... .... ., = GI '0 l"4 · APPuCA1tON -....... -........ -.... '- _ _ 10 _.... no _.., . "'" CIloIo, -lUll. (JIwu h._ g ia 6 ..... if tbc permit II DOt iIIued). ~ A. W"'_.._# '~ S. ~ 1l.:ll'.....J ~. i l1ti&r--~\~I~~ iN", . ~40,' -de .~.!1>: O~ ~C~~:/~. ~ a -"'- ~ ~_B"'R.E- 7,.4 b iA.. -s~..,_ Ctsi,.J~""__L (/1"1 S1:>/o{H, a C "- '-(4) -"'.. -.. .....-...... ---"""'l . _ ",...-. 1100....__..._"'... I ~ __10-._..__--. ... --"'...a.,...., ._...._...."'...._ a D. ...-....-ID...a.,..-,<>-"1f...._a..........._.._ r J~__.'-_ t ,Q c............ ... '- - '"-'k_ ..... .. ... -....... ... Sp.w ,,", 1_..... _..... _ -'10_ '" E ~ - -"0"'" ....- __Iojob_ -..,......... _ "'_11..0& II _.._...... (Soo_ , .: -~1...2.) /I f ~ ~ Eo A -........... "" - _. ._......... f_ "/0 f1V" f W' r of' rfi ~ " t ~ -. "''-- '--- t/D J-I ~ LLf'!--- ~ 2..9,- 41 '10 ; ] -- 'Z-O '12-'7 Y ~ .<: ...",,,...l ::') (A den-""1 , _ Q. r <I- '15 [) j Y ~ ~ .. .... - ..... - '" tOe -.,.:.... It .... _ ....L....d Y.. X',.. ; ~ r I:: .. ~ ! ~.. 10. n.. J k OJ Ie., /p Aft" LJI. ..... _ 6 ... ~ '1>0 -~......_ "'-.-.........10 ...._ID-...a.,"'~ ...... _-,_"__-,,, IIIcI banDJca frcm aay daUa or dcmud (or cIlImapa .......lnlm die __ ClDIW:Nd by _ pemdt. ...... botIa tile ". ...1JICt 01_ permit, ... t!lerwill ..... dIeir '"" NOTEs: ALL WORK SHAU. CO DRAWINGS AND CONDmONS. ' er I ... ~ nm CONl'RAcroR NllSr HAVE 111IS I'IlRM1r AND A1'PR1lvt!D l'lANsATnm SI11lAND NllSrNOl1Pynm PV1IUCWOUS ~ DEPARTMENr AT I&srlWO DAYS BEFoRE Sl'AlmNG WOIUC. :l" 1 NOnQ! NllSr "" GlV1!N TO PllBUcwo_ AT U!Mr 2< BOIlRs BI!1'OJtB IlI!Sl"AItnNo ANY_ ~ : .sJ'EcrAJ. PROvrSlO~ Vi. - .......... BOt be - ........ ~~":::: __ - _be - ...- ..... .................. --.IIIIl be 1Dedfj,.,..... aDlhun:d bY the I . - _be........_ -.._... _be _10__.... "'1lliIII,~ II- ..... _ ~ W"'ID be ...... ",. - '-" s....,.... a.;, """'-.. '- (2) ..... "'...... _ -10'" ...... _ 0.,....... Won: ItUtiac 1IIUrt. -. :".N"ne.oL- .5c - Sv 8, f) ~ 0 Cu:>s u "'€..-'7. .REa r., I"'r N<<t ,.. I , , , I ~ c: ~ ~ '" c: e e-: ~ ~ ~ zi v: _4. .sI'ANnAIq} "2.Z~. C() PERMIT APPUCAnON FEE aJe:oo PLAN OlEa DEPOsIT Stnoo SlJRBIy FOR FAlI'HPUI. PERFoRMANCE (10QlJ5 OF ENG. ESI'.) CAsH DEPOsIT (of" OF stJREry, fSOO MIN) PlAN amac 4 INSPEcnON FEE (JIIRSr~4lJ(,; -~l....---~Diio-l AI'PRovEo PORISSUANa! ~~ ~ h:PW PERMrr/RcvA/94 (lee otbeF side) ITSA phone (800) 642-2444 TICKET NO. AMOlJllfI s Zl.l;. 00 ~c\ 2..2-1- S C:;f)o'~i &2- S z<:: 1";0'0.('0 :~~~: Jj$~ -7- J'/J. Date t:: '" '" ~ ~ '" , I I I I ... To: Accounts Receivable Cit:. of Campbell - Chec - : Re.q..uest Please Issue Check Payable to: Address - Line 1: Line 2: City: LDH, LLC c/o Deke Hunter 20725 Valley Green Drive Cupertino State: CA Zip: 95014 Description: REFUNDABLE DEPOSIT Amount Payable: $1,052.00 Account Number: 101.2203 bate and Receipt No: 2/5/96 #90753 Permit No: 95-277 Purpose: Refund Cash Deposit Finance Only..:. INTEREST EARNED 101.540.7448 Date: 10/10/96/ Date: 10/10/96/ Date:! I Title: Date: I Special Instructions For Handling Chec~ xx Mail in Attached Envelope: / Randy Westfall~ . .l4{~ Michelle Quinney Title: P. W. Inspector Requested by: Approved by: Title: City Engineer FINANCE ONLY: Verified by: Title: Approved by: Mail As Is: Return To: (NAME) (Department) Other: rev: 3/25/95 PUBLIC WORKS FILE NO. Ct.~_."2...., l\~ e. ~\H.\'L:\Q~' PROPERTY ADDRESS Please collect & receipt forthefollowing monies: ACl::T.>.........>..>..........>........ mM 435.535.49211 Proiect Revenue (sDecifv Droiect) ENCROACHMENT PERMIT 472" Application Fee Non-Utility Encroachment Permit ($225) R.1 First Permit (No Fee), SubseDuent Permit/Yr ($100) Utilitv Encroachment Permit Arterial/Collector Street Residential Street/Other Areas 220 Plan Check DeDosit 220 Faithful Performance Surety (FPS) 2203 Monumentation Surety 226~ Cash Deoosit 22m Labor and Material Surety. Plan Check & Inspection Fee (Non-Utility) 472~ Engr.Est. < $250,000 220 Enar.Est. > $250,000 472 Utilitv < $100000 Conduits/Pipelines up to 500 Feet ($1 . 60/ft.) Above 500 Feet ($1.10/ft.) Manholes/Vaults/Etc. ($105/ea) Pole Set/Removal ($105/ea) Minimum Charae Per Location ($120) Street Tree Plantina/Removal ($105/tree) Utilitv> $100,000 (Deposit 15% of ENGR. EST.)" ProTect Plans & SDecifications Proiect No. Standard SOecifications & Details ($1/Pa $12/Book) Co Dies of Enaineerino MaDs & Plans ($.50/sn.ft.) Penalties: Failure to restore Dublic imDrovements ($100/Calendar Dav) (Muni Code Section 11.34.010) 472 Penalties: Failure to correct unsafe conditions ($100/Calendar Dav) LAND DEVELOPMENT 4722 Lot Line Adiustment 472 Parcel Map (4 Lots or Less) 472 Final Tract MaD (5 or More Lots) 472 Certificate of Compliance 472 Certificate of Correction 472 Vacation of Public Streets & Easements 472 Assessment Segregation or Reapportionment First Split ($550) Each Additional Lot ($170) 472 Storm Drainaae Area Fee Per Acre (R-1, $2,000) J hii' P4~mi!d.J.---;"II~"1M1 (Multi-Res, $2,250) ~: :;..1 flY ....{,..,r5A-;...r_~-=- (All Other, $2,500) Parkland DediCation Fee (75%/25%Due UDon Cert. of Occupancy) Postaoe \ PUBLIC WORKS DEPARTMENT RECEIPT Effective July 1, 1995 TO: City Clerk ($325) ($225) ($500) (100% of ENGR.EST.) (100% of ENGR.EST.) (4% of FPS)($500 min.) (100% of ENGR. EST.) (12% of ENGR. EST.) (Deposit 15% of ENGR. EST.)" .. 220 476 476 476 472 ($500) ($1,060 + $25/Lot) ($1,380 + $25/Lotl ($400) ($300) ($550) 492C 496f TRAFFIC 472 472 472 472 472 427 472f Intersection Turn Counts (Two-Hour Count) ($60) Intersection Turn Counts (a.m. or o.m. oeaks) ($125) Traffic Flow Map (Daily Traffic Volumes) ($27) Camobell Traffic Model (Full ScoDe Assessment) ($2250) Campbell Traffic Model (Reduced Scope Assessni$740) Truck Permits ($35/trfD) No Parkino Sions ($1/each or $25/100) OTHER TOTAL NAME OF APPLICANT %L. ~rhr A _~___4 NAME OF PAYOR t{' ADDRESS :~/7 - -" J0&.vLJr d .. Actual Cost Plus 20% Overhead (Non-Interest bearint:positl ./ 7 , (/:: i #~? YfJ #~AM _. .601 M.. ~Jr :t. ~ \~ b.c.D i I I i I I i I I i 1 I I 1 I ~ .#~dP ' I I I I I I PHONE -"'<A:.-5/ / L?a -td~ ZIP ..-. - -' (,e ma CITY CLERK. ONLY '"'~ .. ~- .. -, ~C),~ . ~ ... . . I.ru. - . ----.. ----- .... u . __~, , 1- Finance. ,........ I. - ~ ,...,--/ Date/ Initials . h:\recfrm3.wk3(mp)rev.1/9/96 RECEIVED FEB 0 5 1996 CITY CLERK'S OFFICE . . , \' '''r'' ,:,;:~'i;{;i" , ;,{.,' \"~tt...-(,..-....."":' -;' ,~ .,.., CITY u~ C;:;~PHE___: F~E['!;D r';' ~ .jA~,:H ~~i:;~:: ':~~:;~: ;U: F~EGISTEf; DATE ~ l'. ..... : :~.:= /;-: ,- ....:-~ \......: :;~ DESCRIPTION REF DEPOSITS FUND 101 F-:MDUN'r TOTAL DUE~ ~. , CHECV PAID: 11 <~52aOG !. :-:.::~----. ..- LHt.Lr. NU; TENDERED~ CHANGE ~ ;-1 ' ':. 5: ~ 0(: '...!l (:1i}31 ,,' ,: 'l_"'.<~'~":'" \ ~ t:/;i'U~ ".:"~': ~- ;.. Q 1000090753 r= iI. '..'~:"'. ~ ' r- ~ ! ...,i' ~ _!~'~' ~ Vi;;" . TIME: G8:1:,~31 ~.~.-.o:'--- !": ;" ~ ~ : .... . r ~ Tir:::,-r:,7 c.,; r.. .. .. .-. $1 :,(;52: (H:I $1~(!52l:(:;(; f'U:-r- . $.:0(: ~ i-: ..' _ ~ ,_:. ','"'.~ ~.!",,:..:..., ! - . - - ~ - --- , ~r " l\.!i . ._ -. . . ~ - _. - ~. ... ~ i ' . -------------.-.-- T.' " l :" ~ To: Accounts Receivable Please Issue Check Payable to: Address - Line I: Line 2: City: Description: Amount Payable: Account Number. ate and Receipt No: Penn it No: Purpose: Requested by: Approved by: FINANCE ONLY: Verified by: Ci1} Jf Campbell - Chec' : Request Walsh Building Contractor 22 North Almaden Avenue San Jose State: CA Zip: 95110 REFUNDABLE DEPOSIT $500.00 101.2203 Finance Only':' INTEREST EARNED 101.540.7448 12/8/95 #89228 q r::.,-? 77 Rpfllnil Plrln C'hpC"k npp()~it- I Title: P. W. Inspector Date: 10/10/961 Title: City Enqineer Date:~ Title: Date: I Title: Date: I Special Instructions For Handling Chec~ Mail in Attached Envelope: Rrlnily Wp~t-frlll y1~ tiL~ Miche11e Qu' ney Approved by: Mail As Is: Xy Return To: (NAME) (Department) Other: I rev: 3/25/95 PUBLIC WORKS DEPARTMENT RECBPT Effectlw July 1, 1995 PUBUC WOfUCS FILE NO.ct ~ -~ -"7 .., \ ~ e-_ l-tJS,.. it-{ 1..L:1C;."-.} PROPERlY ADDRESS =:~;~:i~1~::::::!E!:~~::~~:i!f:~;j~:i':::0m~;.::::::::::::::::<:::;:;:;tt:ttit:;ttttttttttttt/::::ttt{{:::jj;jj;~ii'}{{{{{{ ENCROACHMENT PERMIT 472. ADDlication Fee Non-UtiIitV EncrollChment Permit (t2251 R-1 Ant P8rmit TNa feeT Sub.aunt PermitNr ,.,001 UtIlitvEncrollChment P1trmit ArteIt.uCollector Street ~.. Stnt..ilOthar Ant.. PI.n 0Mtck ~ F.ithful Perfo...__ Manwnentation sa;;;;;- Cllh Deaa.it Lebar end Metllriel s.- PI.n Check 6; ~ Fee (Nan-Util!tY1 472. Enar.Eat. < t250.000 112% of ENGR. EST.I 220 Ennr.EIt.>t250.000 IDaDO.it 15% of ENGR. EST.I" 472 UtIlitY < .'00.000 CondulhlPlDelin.. UD to 500 F.et 1t1.60/ft.1 Abaw 600 Feet; ,., . 1 O/ft. I M.nhaleeN.ulhlEtc. _ .'05/eel Pole ~Yeli '.,05/..1 ~ awa. P1tr Loc.tion _ .,201 StrMt TIM PI-lRamay.. /t1051hUl 220 UtlutV>.,OO 000 'Da..a.it 15% of ENGR. EST.I" 4~ Proilic:t P1en. 6; . ProI8etNa. 4~ St.nd.rd SDtICitIn~. 6; Detell. '.lIPan2/Bookl 47fl CoDle. of E M.... & Plan. ...60/aa.ft.1 472 P1tnattle.: F.... tD ntltORt "ublle lm..rovement. I. 1 OO/Celend.. Davl 'Munl Code SectIon 1'.34.01()I 472 Pltnaltle.: FlIiIunt to ~ unlit. condition. 1.,00/Calllnd.. Dawt LAND DEVELOPMENT 4722 Lot line Ad---... 472 PIIrcal MaD '4l.Dta or Le..1 472 Anal Tract MaD-,S or Mont Lotif 472 Certificate of 472 Certiflcna of ~ 472 VlICation of PublIri SIqete. Ea..ment. 472 A.~ s.a-.cIan or ReaDDOrtIonment Ant SIIIIt Eaoh Add!llonal Lot 472 Storm Drainaae A... Fee p., ACRt TO: CIty ClerK ~ -"1-CS;:. e (;/ 220 220 220 220 220 FPSI .3261 t2251 .6001 100% of ENGR.ESTJ 100% of ENGR.ESTJ 4% of FPSI'.600 minJ 100% of ENGR. EST.! ~a<:::i' .5001 ., 060 + U6/lfttI ., 380 + U61lDtl .4001 .3001 .5501 48m TRAFAC 472 472 472 472 472 427 472f Polt_ '.6601 '.,701 iR-1. U.OOOI lMultl-Re.. U.2601 iAI Other t2 6001 OTHER I~ Turn Cow1h ITwo-Hour Countl '.601 Interwection Turn ~ 'a.m. or ".m. Hakel T., 251 Traffic Raw M..,-'08iiVTraffIc Volumelf (t27l Camabell Traffic Madet 'Full Scone A.....mentl U 2501 CamDbeIl TRtfflc Madel/Reduced Scon. A.....;;; .7401 Truck Permitt .36/triDl No Park.... SInn. fiVellCh or * 25/1001 TOTAL .I'L-s, ~ CSC> NAME OF APPliCANT W i\L.s ~\ g V IL-O I 'N C:.. CDN\~ ~rr O\U' NAME OF PAYOR 5AM~ L 1-- N 1\ LH {4.\}f.. \~ Sh.~ doJ~ J '-{\ -........... . . . "., .. .. . .. ..... .. .. '.. ..... .' '.' .: . :::' . ".::::: . AVt--. . PHONE cro~. -112. S(,Q () ZIP ~S' 110 ADDRESS - an CLIU -'7 ~forP;liii1~lN1d~~t""'~wcic:lPYtC:l:~.'i:.. t~ACtU.tCo8t::PfI:it.::20"': ~.fbti.. ':if. .:::::,:: D8tilIriltf...:::::.,.. h:\ntCfrm3. wk3(mpIRlY.811 0/96 RECEIVED DEe 0 81995 CITY CLERK'S OFFICE ;00 :',~,'\J.,. " " .225,..<I:~c,,' · . .""~~~:~f"~:-,,~~:;: "r~.t""'j;''!i,:r'' 'ii' $225.06' .i;::: . ,~,~'". .& $.00 '. P "I' , " :- ,', '), .,:~;i;\;i'J:~;> , 4;;'~CjTY' of CAllPBal, CA ' · f,. .it, \'''',':~';'(.l.','''''' . . ~:ft....._".",:~" ,ci!!', '~~'HH' ,,:~~ .,01000089228 :t" . "" * <PAYOR: 'wALSH BUILDING CONT ,;,~.7.' TODAY'S DATE: 12108/95 '.~, 'REGISTER DATE: 12/08/95 TItfE: 13:57:;U ~ ~....~}:'\ ---' :;JJESCRIPTIOH AMOUNT I REF J(POSITS FUHD 101 $500.00 -------- e TOTAL DUE: $500.00 t1\'CHECK PAID: ,,' CHECK NO: 31263 ;ff'TEHDERED : . CHANGE : $500.00 $500.00 $.00 ,Cj , If) I. t;.....!. ," . I' " ~ BOND FOR FAJIHFUL PERFORMANCE Bond No. 1908048 Premium: $631.00 :;;'11/0~ ' We, Ihe UndetSJgn.. LOH, LLC , (horeinaft... "conlraclor") and jj.veloper, In,ur an'e company . a <0""","1ion OIlIanlzed uOder Ihe law. of the Slale of California , and authorized to -cl bu.lness in the Stal. of California. a. SU"'lY. a", obligated 10lhe City of c..mpbeU. (h....nall.r 'CllY1 a munlCipai corporation under the laws of the State of California. in the sum of TwentY-Six Thousand Three Hundred and NOi100'h,---______'nm",: Dol/an; IS 26 ,300 .OO--nnn,) lor lh. paym.nl of whid, sum we obUgate oU"'.Iv.s end our .ucces.ors and assigns, jointly and ....ra.y by th. following provisions: --,--:-.., ( L..C J " J I The cOndition of this obligation is: Docause Ihe obligated cantraotor hal. on 'F ~ f&, 1 _ ,1~ . entered into written contr~ct with the CIty for the ProjecUPermit # 95-277 ontitled E:ncroacInent Penni t 95-277 , a CDJ>lI of whidl '" allachod and """!....f.rt of Ihi. bond, for the construction of Project 01 Pern:m # Encroachnerit PeniU.t 9::> 'Lot , 715 E. Hamilton Avenue, San JOse, ~~ Now. Ih.",IO",. W th. contractor .haM faithfully perlnrm the work in -nee WIth the Plana, .p.ciflC.I.... and contract dOCument. during lho origlna/,""" and any o><tonsian. of the COIIIract whidl may be g","1ed by the CllY. With or Without notice 10 Iba auNly, and if It shall 0I8tlafy a. claim. and d.mand. in<:urred und"'lhe conlract. and .hall fully indemnify and .... he..._ the City from all cost. end damOlle. Whlch It may ",,"er by "'..on at tau"", 10 do "" and .halI ..1mb..... and reply Iha CllY ell outlay and """enee - the CIty may incur in m.l<lng any default then this Obligation shall be void; otherwise to remain in full force and effect. If any legal action be fJ1ed upon this bond. it shall be filed within one year aner flna' payment has been made under the canlract excluding Ih. walT3nly Ileriod. If ony, I>/OoNded lot in the contract. and venue shall/it! in the County of Santa Clara, State of California. and that Suroty. for va'ue r~ived stipulares and ag""'.lbot no chango. ellIenllon Of time, alteration or addition 10 the lom1. of the conlnlet or 10 Ihe wall< 10 be -ed under It or Ibe 5pocificallons OCO.ompanying rt Shalt in any way affect ils obligation on Ibis bond, and il does by thl. mean. waive notice Of any Change. ..ten.ion 01 lime. alteration or addllion 10 111. te"," of the conlnlct or 10 lhe wall< or 10 Ihe .pecjficaUon.. and thereby waives lhe provlaions at Section 2819 of the Civil Code of the State of California. In witness, contrador anCllurecy hlIvellltecuted Ihit agl'Hmltnt .. of January 24 . 18..,2L. :~ THIB tit . ~i.~__ (Surely) Developers Insurance Comr,'llY ay~~. Michelle Haase~ AttorneY-i~-fa~r Addr... 01 SLnlly: 17/80 Fitch IrvIne, LA ~Zi~.4 ----.. a:bOll(lUIJT1(contrlct doc. disk) Su'-*Y'a Bond NumtIet 1908048 (~ny tIl.. band wldl ACIclmey-in-faer~ authority from Surwty 10 execute the boncl. cerlifIIId 10 inaJde IfIe ChIt. of tn. bon(/., , STATE OF California }ss COUNTY OF Santa Clara On January 24, 1996 , before me, Matt Drumright PERSONALLY APPEARED Michelle Haase personally known to me (or 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 acknowl- edged to me that he/she/they executed the same in his/ her/their authorized capacity(ies), and that by his/her/ their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. i... ...................1 MATT DRUMRIGHT - COMM. .1071635 ... ~. NOTARYPUBlIC.CAlIFORNIA ~ .... '. SANTA CLARA COUNTY :i i ....... My Comm. fapir.. Oct. 17, 110 i ... ................... WIlNESS my hand and official seal. Signature ........;lwt ':)~ This area for Official Notarial Seal 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(S) Performance Bond No. 190804S TITLE OR TYPE OF DOCUMENT o PARTNER(S) o LIMITED o GENERAL 1 NUMBER OF PAGES lKJ ATTORNEY-IN-FACT o TRUSTEE(S) o GUARDIAN/CONSERVATOR o OTHER: January 24, 1996 DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) Developers Insurance Company SIGNER(S) OTHER THAN NAMED ABOVE 10-081 Rev. 6/94 ALL-PURPOSE ACKNOWLEDGEMENT POWER OF ATTORNEY OF I Ih lMNITY COMPANY OF CALIFO. ,A AND DEVELOPERS INSURANCE COMPANY P.O. BOX 19725, IRVINE, CA 92713 . (714) 263-3300 N~ 21 0 0 0 4 "~ 'C1",~-:r;te 31 Sf aay of ~,Iarch. 1996. '1.K.. :rle s:gnatures are 'n blue Ink J.na !nlS notice ,::; ((~(j ***SUSAN C. MONTEON, ALICE RODRIGUEZ, MICHELLE HAASE, E. URENO, MICHAEL J. HENSEL, JOINTLY OR SEVERALLY*** KNOW All MEN BY THESE PRESENTS, that. except as expressly limited. INDEMNITY COMPANY OF CALIFORNIA and DEVELOPERS INSURANCE COMPANY, do each severally. but not jointly. hereby make. constitute and appoint .: ~.nould rerl3Jrl.3 cerm2nenr part of tr.e Cbl:'.-;E-C '3: i'2Ccrc:;. the true and lawful Attorney(s)-In-Fact. to make. execute. deliver and acknowledge. for and on behalf of each of said corporations as sureties, bonds. undertakings and contracts of suretYShip in an amount not exceeding Two Million Five Hundred Thousand Dollars ($2.500.000) in any single undertaking; giving and granting unto said Attorney(s)-In-Fact full power and authority to do and to perform every act necessary. requisite or proper to be done in connection therewith as each of said corporations could do. but reserving to each of said corporations full power of substitution and revocation; and all of the acts of said Attorney(s)-In-Fact, pursuant to these presents. are hereby ratified and confirmed. The authority and powers conferred by this Power of Attorney do not extend to any of the following bonds, undertakings or contracts of suretyship; Bank depository bonds. mortgage deficiency bonds. mortgage guarantee bonds. guarantees of installment paper. note guarantee bonds. bonds on financial institutions. lease bonds. insurance company qualifying bonds. self-insurer's bonds. fidelity bonds or bail bonds. This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Boards of Directors of INDEMNITY COMPANY OF CALIFORNIA and DEVELOPERS INSURANCE COMPANY, effective as of September 24, 1986: RESOLVED. that the Chairman of the Board. the President and any Vice President of the corporation be. and that each of them hereby is. authorized to execute Powers of Attorney. qualifying the attorney(s) named in the Powers of Attorney to execute. on behalf of the corporation, bonds. undertakings and contracts of suretyship; and that the Secretary or any Assis- tant Secretary of the corporation be. and eaCh of them hereby is. authorized to attest the execution of any such Power of Attorney; RESOLVED. FURTHER. that the signatures of such officers 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 Shall be valid and binding upon the corporation 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. INDEMNITY COMPANY OF CALIFORNIA and DEVELOPERS INSURANCE COMPANY have severally caused these presents to be signed by their respec- tive Presidents and attested by their respective Secretaries this 1 st day of April. 1993. INDEMNITY COMPANY OF CALIFORNIA DEVELOPERS INSURANCE COMPANY N~~/ Walter Crowell Secretary By By ATTEST By N~~/ Walter Crowell Secretary ATTEST By STATE OF CALIFORNIA) ) SS. COUNTY OF ORANGE ) On April 1. 1993. before me. Tiresa Taafua, personally appeared Dante F. Vincenti. Jr. and Walter Crowell. personally known to me (or provided to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are SUbscribed to the within instrument and acknowledged to me that he/she/they executed the same in hiS/her/their authorized capacity(ies), and that by hiS/her/their signature(s) on the instrument the person(s). or the entity upon behalf of Which the person(s) acted. executed the instrument. WITNESS my hand and official seal. Signature ~~-~~ CERTIFICATE OFFICIAL SEAL TIRESA TAAFUA . NOTARY PUBLIC - CALIFORNIA .'..,. . PRINCIPAL OFFICE IN ! .' . ORANGE COUNTY i . . . My Comminion Exp. Aug. 4, 1985 .................................... The undersigned. as Senior Vice President of INDEMNITY COMPANY OF CALIFORNIA, and Senior Vice President of DEVELOPERS INSURANCE COMPAHY, COPS hereby certify that the foregoing and attaChed Power of Attorney remains in full force and has not been revoked; and furthermore, that the provisions of the resolutions of the rllsp9Ctive Boards of Directors of said corporations set forth in the Power of Attorney, are in force as of the date of this Certificate. . This Certificate is executed in the City of Irvine. California. this 24 th day of January , 199~ . INDEMNITY COMPANY OF CALIFORNIA By ~ cz: ~~ l.C. Fiebiger Senior Vice President DEVELOPERS INSURANCE COMPANY By ~ cz: ~~ l.C. Fiebiger Senior Vice President 10-310 REV. 4/93 \ Bond No. 1908048 Included in Performance Bond . F \..(;, -- {)l ,'~- -.. I ; \.0 We, Ihelll'lderllaned !.DR, LLe . ~.....~ _ Developer, In,uranee eO~ny a COIpDnIlfon argonilad ""der lha '- at Ill. - d califo~ii , lO1lI ~ to lnlnu.i b_.. lha SIote of c.a_, as SUI8Iy. .... oIlIlg- to lha CIly at Cam)lboI (1IoroInaIr8r "CIln. a Il1UnidpaJ CO/JIOIBtIcn Imder lha ,_ ot the Slato of Cali,.""... in the oum Of Twe",y,Six ThoU,.nd, Three HUnd ed and No 100 'h" ______ '_______ ,__ DoIIIIs ($ 26 ,300, go h -, - h -..J for lha JliIyInInt Of whlcll SUm ... obIga ClIJIll8JIg 0IId _ ........,. and 0SSigna, joinUy ond severally by the fonOwing provisions: The ctJ1d1lbn at lhlo obIig8lfan io -lha Pmo/poI ~ or 10 lIbouI to _, ilia. CllItlil_n contno:t With the City - F-oe"", " , 19 "i b . lO1lIlWlfIUed ~.. 95 _ 277 715 E . Hamilton Ave., San Jose, CA . . In1B and _ ""'" at1Olllcll1o P/ISantly onllle In tho - d the City C..... Of the CIty of CaIIpber, _ lIllfd lIgl1IBmen\ Is hllrobv -.... to .... ..... . JlIII\ """!<>I. v. . 1Ieca_ PrfllCipol,. IlItlUQd to furnIoh a band In -- ...... lha CllIlbot, ~ Ihal . PrInc/t>:II. or ally ~ 01 lis subcon-. shoJi faU 10 POY far IIIIy -.. or...... ..ppJioa. otfat anv _ or labor on tho __ -. of any kind, or far all10Unts due U_lha "'*"Ploymem ........"" lIl;\ with _ to IIIIy '""'" or labor on thl. JltllJOCf. tho SUIIlIy on thl. band WiJI pay for the dob1. in on lIIllOUl1\ not _ing tho ""'" _ in thlo bond. and also. in ca.. suit is brought upon the bond, a raUOn.ble attorney's fee fa 1M fixed by the COlIn. How, Ihoroto... ""', LnH, LLe .. Principal, AND ..l)evelo~e" In'uranee eomp,"y . .. Sumy, ""' obiItlotod to the CIty at c..ml>bel. in lha lIUlII at $..26. 19o po,- -- h -, --- __, ____ __ ________, Itwtul money Of lIIe UnIted S....... far the PtYmon\ at whlcll ..... wfI _ Iruly to be -. WIt the _ Principm and SUIIlIy bfnd ourselves, succesS018 and assigns, jofntly and IeYBI'8IIy. by 1hHe provisions. The condltJon oflhls obl/galfar, io - . Princ:Ipm, .. __ oraaigno. 01'11II ~, orsubeontractot., ""aU 1aiIto pay for lIIlY labor. ............ or other SlIIlIIIu. '-in the ""'*"'- of tho '""'" CllIIIr3ctad to be done. or for anounts due under the UII8JnpIoyIlIent .......... oct 1dh I1I8pIIl:l to lhtlI _ or labor. thalthe SuftIty on IhJa bond WiQ pay for them, in In arncx.tt nal ~ the a.... __ In lhtlIlxInd, _ in ..... ouit '" braIIght U/lOnIhJa bond will also pay a reaSonable attorney'. fee, to be fixed by th. CZUrt. I No pre- or ....., in flOY1nont and 110 chanoeo. lI1I\enoIana. lIIlIIlan or ......... of IIIIy _ of Qid conlract or In anv pions IIld SiIlIdlIcotIOa. ~ to '-. MId no rom...:. ... tno_ of Iht CIly shall _e to "lean the S"1'llIy ""'" Iiebiiity on IhJa llond, IIld - to...... ouch........,.". OIIl1otIIlurther _ to or """aont by the SUI'llly I. hllAlby !liven. IIIJ~ the SuI'llIy hBrBby ...... Ih8 JlIDVIIIions of S_ 2819 of tho CIvil COd. ot lha SllIle of Califomla. In Wftnau, rht PI- n.".1XItCurlId IhIa """-1iIodt .. 01 (SUAMy) Developers Insurance Company By, ~ ~~ M1chelle Haase, AttorneY-in-Fa~t Adchu otSIII'My; 17780 Fitch lrv1ne, LA '1m'" = - &ncy. Bond...... 190804S (~.. bandwtft~1 lIIIlorlty flail &nty to .... ... eonu, ~ to iIcIulM ..... d". boIwt.) --- rlbomUm(cantmc:t doc. diM) I STATE OF California COUNTY OF Santa Clara On January 24, 1996 , before me, PERSONALLY APPEARED Michelle Haase personally known to me (or 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 acknowl- edged 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. WI1NESS my hand and official seal. Signature ,/~,)~ OPTIONAL } 55, Matt Drumright i...tt....................t MA TT DRUMRIGHT ~. - COMM. .1071635 po l=$; . NOTARYPU81.IC.CAlIFORNIA g .. . . SANTA CLARA COUNTY :i ! ...... ~ Comm. EIpir.. Oct. 17. "" i .... ................... This area for Official Notarial Seal 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 TITLE(S) o PARTNER(S) o LIMITED o GENERAL [K] ATTORNEY-IN-FACT o TRUSTEE(S) o GUARDIANlCONSERV ATOR o OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) Developers Insurance Company 10-081 Rev. 6/94 DESCRIPTION OF ATTACHED DOCUMENT Labor and Material Bond No. 1908048 TITLE OR TYPE OF DOCUMENT 1 NUMBER OF PAGES January 24, 1996 DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE ALL-PURPOSE ACKNOWLEDGEMENT POWER OF ATTORNEY OF I .. .:MNITY COMPANY OF CALlFO. lA AND DEVELOPERS INSURANCE COMPANY P.O. BOX 19725. IRVINE. CA 92713 . (714) 263-3300 N~ 210 00 5 , - ~ ;! '~i)','"" KNOW ALL MEN BY THESE PRESENTS. that. except as expressly limited. INDEMNITY COMPANY OF CALIFORNIA and DEVELOPERS INSURANCE COMPANY, do each severally. but not jointly. hereby make. constitute and appoint ***SUSAN C. MONTEON, ALICE RODRIGUEZ, MICHELLE HAASE, E. URENO, MICHAEL J. HENSEL, JOINTLY OR SEVERALLY*** the true and lawful Attorney(s)-In-Fact. to make. execute. deliver and acknowledge. for and on behalf of each of said corporations as sureties. bonds. undertakings and contracts of suretyship in an amount not exceeding Two Million Five Hundred Thousand Dollars ($2.500.000) in any single undertaking; giving and granting unto said Attorney(s)-In-Fact full power and authority to do and to perform every act necessary. requisite or proper to be done in connection therewith as each of said corporations could do, but reserving to each of said corporations full power of substitution and revocation; and all of the acts of said Attorney(s)-In-Fact. pursuant to these presents. are hereby ratified and confirmed. The authority and powers conferred by this Power of Attorney do not extend to any of the following bonds. undertakings or contracts of suretyship: Bank depository bonds. mortgage deficiency bonds, mortgage guarantee bonds. guarantees of installment paper. note guarantee bonds, bonds on financial institutions, lease bonds. insurance company qualifying bonds. self-insurer's bonds. fidelity bonds or bail bonds. This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Boards of Directors of INDEMNITY COMPANY OF CALIFORNIA and DEVELOPERS INSURANCE COMPANY, effective as of September 24. 1986: RESOLVED. that the Chairman of the Board. the President and any Vice President of the corporalion be. and that each of them hereby is. authorized to execute Powers of Attorney, qualifying the attorney(s) named in the Powers of Attorney to execute. on behalf of the corporation, bonds. undertakings and contracts of suretyship; and that the Secretary or any Assis- tant Secretary of the corporation be. and each of them hereby is, authorized to attest the execution of any such Power of Attorney; RESOLVED. FURTHER. that the signatures of such officers 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 shall be valid and binding upon the corporation 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. INDEMNITY COMPANY OF CALIFORNIA and DEVELOPERS INSURANCE COMPANY have severally caused these presents to be signed by their respec- tive Presidents and attested by their respective Secretaries this 1 st day of April, 1993. INDEMNITY COMPANY OF CALIFORNIA By DEVELOPERS INSURANCE COMPANY By NdP ~/ Walter Crowell Secretary ATTEST ATTEST By NdPW Walter Crowell Secretary By STATE OF CALIFORNIA) ) SS. COUNTY OF ORANGE ) On Apri/1. 1993. before me. Tiresa Taafua. personally appeared Dante F. Vincenti. Jr. and Walter Crowell. personally known to me (or provided to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies). and that by his/her/their signature(s) on the instrument the person(s). or the entity upon behalf of which the person(s) acted. executed the instrument. WITNESS my hand and official seal. Signature ~*-~~ CERTIFICATE OFFICIAL SEAL TIRESA TAAFUA . NOTARY PUBLIC. CALIFORNIA PRINCIPAL OFFICE IN ORANGE COUNTY My ComtTis,ion Exp. Aug.... t995 The undersigned. as Senior Vice President of INDEMNITY COMPANY OF CALIFORNIA. and Senior Vice President of DEVELOPERS INSURANCE COMfANY, c.J<Jf)!; hereby certify that the foregoing and attached Power of Attorney remains in full force and has not been revoked; and furthermore. that the provisions of the resolutiOns of lile resp'?ctive Boards of Directors of said corporations set forth in the Power of Attorney, are in force as of the date of this Certificate. This Certificate is executed in the City of Irvine, California. this 24 th day of January . 199~. INDEMNITY COMPANY OF CALIFORNIA By ~ cz: ~~ L.C. Fiebiger Senior Vice President DEVELOPERS INSURANCE COMPANY By ~ cz: ~~ L.C. Fiebiger Senior Vice President ID-310 REV. 4/93 r=!!~I~,,__"Dlitl_''1 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 Rol I ins Hudig Hili of N. CII if 100 Plrk Center Pllzl, #506 Sin Jose, CA 95113 Wllsh Building Contrlctors 22 N. Almlden Avenue Sin JoS e CA 95110 COMPANY A Re ubi ic Indemnit CO!.PANY B FiCo. COMPANY C Generll COMPANY o :J~!'~~'iI~~~m:::::;:::?:?(:::=::::::::::::.::::::::::::::::::::::::::::.::::. ..: :W::: ,..::........:::.:.:. n .'.n ",:I::::",:,:,.:.:.::;;::,::::))::::::?):;:')::::::::: THISIS TOCERTIFY THA T THE POLICIES OF INSURANCE L1STEDBELOWHA VE BEENISSUED TO THEINSURED NAMEDABOVEFORTHE POLICY PERIOD INDICA TED, NO TWITHST ANDINGANYREOUIREMENT, TERM ORCONDITIONOF ANYCONTRACT OROTHERDOCUMENT WITHRESPECT TO WHICHTHIS CERTIFICA TE MAY BE ISSUED OR MAY PERT AIN, 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 TYPEOf INSURANCE POLICY NUMBER POLICY EffECTIVE POLICY EXPIRATIO L TR DATE CMM'DD'YY) DATE CMM'DO'YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ 2000000 B X COMMERCIAL GENERAL LIABILITY MXXB0630166 10/01/95 10/01/96 PROOUCTS.CO!.P/a> AGO $ 2000000 . . CLAIMS MADE [X] OCCUR PERSONAL Il. AnV I~Y $ 1000000 X OWNER'S Il. CONTRACTOR'S PROT EACH OCC~NCE $ 1000000 FIRE DAMAGE (Any one fire) $ 50000 MED EXP (Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT B X ANY AUTO MXXB0630166 10/01/95 10/01/96 1000000 ALL OWNED AUTOS BOOILY INJJlY SCHEDUlED AUTOS (Per person) X HIRED AUTOS BODIL Y I~Y X NON.OWNED AUTOS (Per accident) PRa>ERTY DAMAGE GARAGE LlAB IL ITY AUTO OM.. Y . EA ACCIDENT ANY AUTO OTHER THAN AUTO ON.. Y: EACH ACCIDENT AGGREGATE EXCESS LlABILlT Y EACH OCC~NCE UMBRELLA FORM AGGREGATE C X OTHER THAN UMBRELLA FORM UB60901 10/01/95 10/01/96 WORKERS COMPENSATION AND X STATUTORY LIMITS EMPLOYERS'LIABILITY A 03507606 3/05/95 3/05/96 EACH ACCIDENT 1000000 THE PROPRIETOR/ INCL DISEASE. POLICY LIMIT 1000000 PARTNERS/EXECUTIVE OFFICERS ARE: EXCL DISEASE. EACH EMPLOYEE 1000000 OTHER DESCRIPTION Of OP RATIONS LOCATIONS VEHICLE SPECIAL ITEMS RE: 715 E, Hlmilton Ave., City of Clmpbel I At t n : De pt. 0 f Pub I i c Wo r k s 70 N. First Street Clmpbel I, CA 95008 I AP~~~::(J~~J.l~~~~L)::::):(:::::::.::::::::\:::::::::: SHOULD ANY 01' THE ABOVE DESCRIBED POLICIES BE CANCELLED 1lEl'0AI! THE EXPIRATION DATE THEREOf, THE ISSUING COMPANY WILL ~AIL 30 DAYS WRITTEN NOTICE TO THE CERTI'ICATE HOLDER NAMED TO THE LEfT, ~W, . n_wn_.w . __... 00__ n_ AU HO I SENT A IV~~ 180640000 rr:r::::::::':rr:::r:::t:{:::::(I:;~tPJ.P':::qp:~~P'~;fiit!P:!jttl~': POLICY NUMBER: MXX80630166 Walsh Building Contractors COMMERCIAL 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 Attn: Dept. of Public Works 70 N. First St. Campbell, CA 95008, it's officers, employees and volunteers. RE: 715 E. Hamilton Ave., San Jose, CA All work in public right of way. (If no entry appears above, information required 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 of "your work" for that insured by or for you. Such insurance as is afforded by the General Liability policy is primary insurance and no other insurance of the additional insured will be called upon to contribute to a loss. CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 \ , ONl V 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 Cal ifornia PI az a >~:~\~~-- n I,'. \.... . ,\ \\,'>~' C'-:; \~ ..-" 1. tl \996 ~~~ COIA'ANY A Ro al Indemnit CO. COMPANY B Fireman' Fund Ins. CO. COMPANY C 95113 COMPANY o ?;g!~~!!i!:::'r:??mr::r:m'?:rm:':::::::'???:r.?:t.:,:.?::illlliW.Wf$}:??::?:::,:,}{,,::?::r:??:r:::::::::??)rt::::::::t'?:::,.,::::::.:.:...:.,.,.:.,.,.:.:.:.:.:::..:..... ... ..:,:.:,::::)::::')'t::t):),),tt::::):)'!:::::::: .... ....... .... ......::::::\,'((}\\\:t:\ ...... THISIS TOCERTlFY THA T THE POll SOFINSURANCE L1STEDBELOWHAVE BEEN ISSUED TO THEINSURED NAMEDABOVEFORTHE POLICY PERIOD INDICA TED.NOTWITHST ANDING ANY REQUIREMENT ,TERIv10RCONDITIONOF ANY CONTRACT ORO THERDOCWENT WITHRESPECT TO WHICH THIS CERTIFICA TE MAY BE ISSUED ORMAY PERT AIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERIv1S. EXCL.USIONS AND CONDITIONS OF SUCH POLICIES LMITS SHOWNMAY HAVE BEEN REDUCED BY PAID CLAMS. CO LTA TVPEOf INSURANCE POLlCV NUMBER POLICV EffECTIVE POLlCV EXPIRATIO DATE (MMlDDlVV) DATE (MMlDD'VV) LIMITS GENERAL L1ABILITV A X COMMERCiAl GENERAL LIABILITY PSV009979 .. . ClAIMS MADE [X] OCCUl OWNER'S II. CONTRACTOR'S PROT AUTOMOBLE L1ABILITV ANY AUTO AlL OWI\ED AUTOS SCH:DU.ED AUTOS HIRED AUTOS NON.OWNED AUTOS GARAGE LIABILITV ANY AUTO EXCESSLIABILITV B X UMBRELLA FORM XSC95445763 OTH:R THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOVERS'L1ABILITY PERSONAl II. AnV I fU)RY EACH OCClFRENCE GENERAl AGGREGATE $ PROOUCTS.COMP/OP AGG $ $ $ $ $ 2000000 2000000 1000000 1000000 50000 5000 11/15/95 11/15/96 FIRE DAMAGE (Anyone fire) MED EXP (Any one person) COMBINED SINGLE LIMIT BODILY IfU)RY (Per person) BODILY IfU)RY (Per accidenl) PROPERTY DAMAGE 11/15/95 11/15/96 AUTO OM..Y . EA ACCIDENT OTI-ER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EACH OCCURRENCE AGOREGA TE THE PROPRIETORI PARTt-,ERS/EXECUTlVE OFFICERS ARE OTHER INCL EXCL ST A TUTORY LI 1011 TS EACH ACCIDENT DISEASE. POliCY LIMIT DISEASE. EACH EMPLOYEE DESCRIPTION Of OPERATIONS LOCATIONS VEHICLES SPECIAL ITEMS RE: 715 E. Hamilton Ave., all work in public right of way. it's officers, employees and volunteers are additional er CG2010 attached. Ci ty of Campbell, insured/pr imary SHOULD ANV Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEfORE THE City of Campbell Attn: Dept. of Pub I ic Works 70 N. First St. Campbel I, CA 95009 I ...';;$~~P~~~$.t~'~~fi....::.',:)}':/"""" EXPIRATION DATE THEREOf. THE ISSUING COMPANY WILL MAIL 3 0 DAVS WRITTEN NOTICE TO THE CERTifiCATE HOLDER NAMED TO THE LEfT. -. -... fth_ -. -.. '''_ __.... nn" .._ __~..._ _n n_. ...c__..._...~~. ""'::::....:::.;;~~\mMg;~::;:: POLICY NUMBER: PSV009879 Hunter Properties, Inc. ";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, It's officers, employees and volunteers RE: 715 E. Hamilton Ave., all work in public right of way. (If no entry appears above, information required 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 of "your work" for that insured by or for you. Such insurance as is afforded by the General Liability policy is primary insurance and no other insurance of the additional insured will be called upon to contribute to a loss. CG 20 10 11 85 Copyright. Insurance Services Office, Inc., 1984 95~~ 17 ...... A4~4.111.. :::.:...:..:I:llel.IIIII.&:....::..:..:II..::......::...111'11'.'_ :':':P'R'dD06E~ ,.,.,.,.,.,.,.,.,.,.,.,.,.,.,./::".:,:,:"",., ,..... :./:,:.::::'.',:::::,:.'.',/:::.:.:\,:.:.:.'\'::::::'.:';:;::.:.:::::,:,:,:.:::\::::\\,:,:.:::},:,:::\\':::::,,-:,',:';:;::.:';:;::,:,:.:}::"".,.,:,.,.,:,.,."",:,:,,,,,,,,,":':'.'.,:,:,:"" .......... RHH of Northern Cal ifornia 100 Park Center Plaza Su i te #506 San Jose, CA 95113 409-297-7319 INSURED .. ..... ...... ...... ...................... ...................... . . . . . . . . . . . . . . . . . . . . . . ...................... . .. ""O'Alf(MMIDDivvj"" ONL Y 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 Re ub lie 'ndemn i t Walsh Building Contractors 22 N. Almaden Avenue San Jose, CA 95110 COMPANY B 0 fAme r i c a ~ 1!1''I19 COMPANY c PP~IMPI!:)'.::i}.i.n::?}:3n:::::..:i.r.:mm:/m.../m:.........:.:......trr..r.:::?\i?::/r::.:hdi::::::r:::r/:::.:.:::.::::::::::.:..:.::i:::::r:r:::t:rr:: THIS IS TO CERTIFY THA T THE POLICIES OF INSURANCE LIST ED BELOWHA VE BEEN ISSUED T'OT'HEiNSURED'NAME~riWi'i{jRTHEPOL'lcipERioD" INDICA TED.NOTWITHST ANDINGANYREOUIREMENT. TERMORCONDITIONOF ANYCONTRACT OROTHERDOCUMENr~t~.I;~eT\l;OWHICHTHIS CERTIFICA T E MA Y BE ISSUED OR MA Y PERT AIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJEl:'rf'q'4~~;jHE TERMS. EXCLU5!ONS AND CONDITiONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I\; -.--.---- CO TYPEDI"INSURANCE POLICY NUMBER POLICY EI"I"ECTIVE POLICY EXPIRATION L TR DATE (MM/DD/YY) DATE (MM/DD/YY) COMPANY o LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS.COMP/OP AGG $ CLAIMS MADE 0 OCCUR PERSONAL & ADV INJURY $ OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE (Anyone fire) $ MED EXP (Anyone person) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANV AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON.OWNED AUTOS (Per accident) PROPERTY DAMAGE GARAGE LIABILITY AUTO ONLY. EA ACCIDENT ANY AUTO OTHER THAN AUTO o Nt. y, EACH ACCIDENT AGGREGATE EXCESS LIABILITY EACH OCCURRENCE UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM - -."---. -'-- --~.-._._._~--_._,-~.,- -.-..___--..~m____ WORKERS COMPENSATION AND X STATUTORY LIMITS EMPLOYERS'L1ABILITY A NC3518925 3/05/96 3/05/97 EACH ACCIDENT $ 1000000 THE PROPRIETOR/ INCL DISEASE. POLICY LIMIT $ 1000000 PARTNERS/EXECUTIVE OFFICERS ARE: EXCL DISEASE. EACH EMPLOVEE $ 1000000 OTHER DESCRIPTION 01" OPERATIONS LOCATIONS VEHICLES SP CIAL ITEMS RE: 715 E. Hamilton Ave., San Jose, CA; All work in public right of way. City of Campbel I, it's officers, employees and volunteers are additional insured/ rimar er form CG2010 attached. $~ft]mI,9I:rg:ffl9~p~'r:,,:::.:ii.::ii....;.:::::::::.:.):9!~R~~!!:P8.~;::::::::i::::;::::::;::;:..::;::::';;::::::::::::::::::::::::,: City of Campbel I At t n : De pt. 0 f Pub I i c 70 N. First Street Campbel I, CA 95008 I ::A$~a~f'~8$.a~~~~rf" .. Works SHOULD ANY 01" THE ABOVE DESCRIBED POLICIES BE CANCELLED BEI"ORE THE EXPIRATION DATE THEREOI". THE ISSUING COMPANY WILL 0 MAIL 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. ................. .................. ................. .................. ................. .................. ................. .................. ................. .................. ............................................ ............................................. ............................................ ............................................. ............................................ ............................................. ............................................ ............................................. ............................................ ............................................. 190640000 ................................................................. .................................................................. ................................................................................................................................... ................................................................................................................................... ti>~~pm:.J.:::PA.le9..~AtlA:RJj") ...... ..... ................................................... .................................................................. ...~,,,,,.-.. . '10. .. ..... -~ ' ~... Of'C"'-it ~4.~. A~t'l'> ... r" U 1"" . . .. .. 1- '" ~'o ,,' "c H A" \J' CITY OF CAMPBELL Public Works Department September 4, 1997 Mr. Deke Hunter LDH,LCC c/o Hunter Properties 20725 Valley Green Drive Cupertino CA 95014 SUBJECT: PERMIT NO. 95-277 LOCATION: 715 E. Hamilton Ave. FINAL INSPECTION ANDACCEPTANCE Dear Mr. Hunter: The City of Campbell has made the fInal one year maintenance inspection of subject Public Works improvements and fInd that no remedial work is required. Your warranty requirements and any surety, therefore, are hereby released. Please fInd attached your original bonds for Labor & Material as well as for Faithful Performance which we are returning to you. Sincerely, t9~. Robert Phillips Project Inspector M<y Enclosures cc: Permit 95-277 Public Works/Maintenance Division Developers Insurance Company, 17780 Fitch, Irvine, CA 92714 H:\ WORD\PERMITS\95277 ACC(JD) 70 North First Street. Campbell, California 95008.1423 . TEL 408.866.2150 . FAX 408.376.0958 . TDD 408.866.2790 4..'Of'Ct'4A~ fo.,. ~ ... ~ U ~ . . .. ... 1- .. ~. ,,' O.l/CH~\lO' CITY OF CAMPBELL Public Works Department October 10, 1996 Mr. Deke Hunter LDH,LCC c/o Hunter Properties 20725 Valley Green Drive Cupertino, CA 95014 SUBJECT: PERMIT NO. 95-277 LOCATION: 715 E. Hamilton Avenue FINAL INSPECTION AND ACCEPTANCE Dear Mr. Hunter: 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. The one year maintenance period stated in the permit begins as of the date of this acceptance letter. The permittee is responsible for the repair and/or replacement of any defective work or failures that occur within one year. The City will inspect the improvements within one year and notify you, in writing, whether or not any repairs are required. If you so desire, the Faithful Performance Bond may be kept in force for the duration of the one year maintenance period; or may be replaced with a Maintenance Bond in the amount of $6,575. For your convenience, we have enclosed a copy of our required bond form. Additionally, your cash deposits totalling $1,552, plus any interest due, are now being processed and will be sent to you under separate cover. If you have any questions, please call me at (408) 866-2165. Sincerely, r2~!!!tafl Public Works Inspector cc: Doug Maher, Walsh Building Contractors, fax (408)998-5912 Suspense - 11 months Permit #95-277 ~15HAMFN.L TR(WP)(JD) 70 North First Street. Campbell, California 95008.14:23 . TEL 408.866.2150 . FAX 408.379.257:2 . TDD 408.866.2790 NEW PW FAX # 408.37ti.OQo;:n ~ITY OF CAMPBELL FIELD ENGINEER'S DAILY REPORT PROJECT NO. 9)-.177 71'S 6. (~w.,,) kv~. REPORT NO: CONTRACTOR: #t>t-_ ~f1/~S.. DATE: J. /<(w 9t:, WEATHER: A-t~ INSPECTOR: K. ~~S1fALL ITEM DES CRI Pl'ION ~ II? ),-ft. cc: PAGE: I OF I ~ITY OF CAMPBELL FIELD ENGINEER'S DAILY REPORT 7/r:; E-. I~/Ii~ ~ PROJECT NO. 9)'-.27 REPORT NO: CONTRACTOR: ftt5~ fJ\ r' fAe.-5 DATE: ~/ .7cO WEATHER: {;., ( INSPECTOR: K. ~G:-S1fA.LL ITEM DES CRI Pl'ION c..- t4 J~r~ ~~ cf J ec..sf ~ V-/1hftd cc: PAGE: I OF I CITY OF CAMPBELL FIELD ENGINEER I S DAILY REPORT -1 \'S 8-. ~~\L;{.\.L.\~ ITEM ~L""i:..'U \ CONTRACTOR: p.~~~ p\t>eLu..: DESCRIPTION PROJECT NO. q'S.-~L.~-1 REPORT NO: DATE ~- \"~ -C(. <0 Y8Ill""THER. ~~~ \~~, "~ · be;:; '" + ~ INSPECTOR: K. ~e:.5rrALL c... G:s ~)' =.. '2- p~~~~ \\->EL..l~~~ <:::..-<-~~ f.::.. rz-L.... 't---lO--...L ~ \~ L..'b. = \ \ ~.~O ::t:.... Lr---". '2:~ e.~~e- ~l~~r-.:-c cc: -.. t~~A.\;"2...I.~ PAGE: / OF I CITY OF CAMPBELL FIELD ENGINEER'S DAILY REPORT '7/~ t!,. 1~4~/t:T(J.J PROJECT NO. --J. 77 REPORT NO: - ITEM WM...~ I~ CONTRACTOR: PJ2C,STCl,J PJlf;~/~ ~J 'viiC-.. DESCRIPTION DATE: ~/ r 7'(, WEATHER: flt7l( INSPECTOR: K. ~~51fALL , ~, (a fJ1JC 3..~ c/~ CC: PAGE: / OF I CrrY OF CAMPBELL FIELD ENGINEER' S DAILY REPORT 7/'5' r;;. /J;/M/LforJ AWe. PROJECT NO. 97-",)7 REPORT NO: __ ITEM ~ o CC: wt1-6.J# CONTRACTOR: ~((,f;.,""a,.) fJ )! F/U~it.S DATE: j 7/9 ~ WEATHER: Cleo-{ lw~ INSPECTOR: K. .v~STfALL DESCRIPTION PAGE: OF I -. ..... ---- ~ ..... - pC' -.... ~..,-.... , ~~ ~ ./ CITY OF CAMPBELL FIELD ENGINEER I S DAILY REPORT 7/'1- 6-. I~l f1\Jr- _ PROJECT NO. 91- -17r REPORT NO: DATE : CONTRACTOR: IN J s ~ ) ~ WEATHER: {MfC INSPECTOR: R. .v~5TfALL ITEM DESCRIPTION cc: PAGE: I OF I Of'C,LIJ , . "fA ~' .. ~tt'> ... . t" U .. ~ .. 1- -!' ... .. ., f).q (' H A" '0 v CITY OF CAMPBELL Public Works Department March 6, 1996 Mr. Deke Hunter LDH,LLC clo Hunter Properties 20725 Valley Green Drive Cupertino, CA 95014 Subject: 715 E. Hamilton, Encroachment Permit 95-277 Dear Mr. Hunter: Enclosed is a revised copy of the plans as approved by the City Engineer for Revision 1 dated February 28, 1996. Please call if you have any questions or comments. Very truly yours, ~M Assistant Engineer CSG:jd Enclosure cc: Harold Housley Randy Westfall File: Permit 95-277 H:\715HAMHP.L TR(JD) .-- 70 North First Street. Campbell, California 95008.14'23 . TEL 408.866.'2150 . FAX 408.379.'257'2 . TDD 408.866.'2790 l\"F.W PW FAX # L!..fIO 4"j>""'r: o.n~.,.,. CITY OF SAN JOSE, CALIFORNIA DEVELOPMENT SERVICES DIVISION 801 NORTH FIRST STREET, ROOM 308 SAN JOSE, CALIFORNIA 95110 PHONE (408) 277-5161 FAJ<(408) 277-3879 March 1, 1996 RECEIVED MAR 4 10 ... f~96 DEPARTMENT OF PUBLIC WORKS RALPH A. QUALLS, JR., DIRECTOR Harold Housley City of Campbell 70 North First Street Campbell, CA 95008 .,. ".. ','p J.,uMINISTR A TlO'" Dear Mr. Housley: SUBJECT: Northeast corner of Bascom And Hamilton Avenues, Campbell Encroachment Permit 95-277 This letter is to serve as approval to the plan change dated February 28, 1996 which reduced the slope on the 12" PVC pipe to .0041. Please contact Kevin Smith of my staff at 277-5161 if you have any questions. Harry Freitas Project Engineer Development Services Civision HF:KS C: Randy Westfall, City of Campbell Mark Watson, Kier & Wright MRR-01-1996 09:19 'SJ PW DEV SVCS. RM 308 408 277 3879 P.02 CITY Of ~AN JOSE, CALIFORNIA OEVEL~PMeNT SERVICES DIVISION 801 NO~TH FIRST STREET. ROOM 308 SAN JOSE. CALIFORNIA 95110 I'HONE (G) 277-5161 FAX (408) 277..3117; hi€-. E- P-# 95 -l.77 OEP~OF~CWQRl($ RAI.PH A. CUAlLS. JR., DIRECTOR March 1, 1996 Harold Housley City of Campbell 70 North First Street Campbell, CA 95008 Dear Mr. Housley: SUBJECT: Northeast corner of Bascom And Hamilton Avenues, Campbell Encroachment Permit 95-277 This letter is to serve as approval to the plan change dated February 28, 1996 which reduced the slope on the 12# PVC pipe to .0041. Please contact Kevin Smith of my staff at 277-5161 if you have any questions. Harry Freitas Project Engineer Development Services Division HF: KS C: Randy Westfall, City of Campbell Mark Watson, Kier , Wright TOTRL P.02 WEST VALLEY SANITATION DISTRICT OF SANTA CLARA COUNTY SERVING RESIDENTS OF CITY OF CAMPBELL TOWN OF LOS GA TOS CITY OF MONTr SERENO CITY OF SARA TOGA UNINCORPORA lED AREA 100 East Sunnyoaks Avenue Campbell, California 95008 Telephone (408) 378-2407 February 29, 1996 ~EC~'''ED MAP 41996 Randy Westfall, Public Works Inspector City of Campbell Public Works Department 70 North First Street Campbell, CA 95008-1423 .\!:JNiINISTR \ ..4T10;\ Re: Bore for Storm Sewer, Bascom Ave. & Hamilton Ave Dear Randy: The District is aware that only five inches of clearance is available between the 10-inch sewer main and the proposed storm sewer in Hamilton Avenue. Proper placement of the specified bedding material (3/4" crushed rock) should provide sufficient protection for the V.C.P. main sewer. Very truly yours, Robert R. Reid District Manager and Engineer -'u~= ~~r by: DeVin~y Junior Civil Engineer (FORMERLY COUNTYSANITA TION DISTRICT NO.4) F -29-96 02:56P Preston Pipelines 408 262 1870 P.Ol Preston Pipelines Inc. UI4tf1"). CODfn.etors 151 BOTHELO AVEN'UE . MILPlTAS, CALIFORNIA 95035 COalractors L:ice1Se No. 367660 Thursday, February 29, 1996 From: 4:05 PM To: Name: Lynne Wilkins Name: Mr. Randy Westfall Company: Preston Pipelines, Inc. Company: City Of Campbell Phone: (408) 262-1418 (408) 262-1870 Phone: (408) 866-2165 Fax: Fax: (408) 866-8381 Total number of pages, including cover: 1. Message: Re: BASCOM AVElHAMIL TON AVE Bascom Square Dear Randy, Enclosed copy of memo, dated 2/27/96 to Don Armstrong at WVSD. _ FYI. Thanks, Lynne Feb-29-96 02:56P Preston P;pel;nes 408 262 1870 P.02 N7~. The Drawing Board' ~' - , 4iI-' I' po 80. i:i6N29' Dallas. Te.as 75266.Q.l29 . )) C::11 Toll Free' 1.800.527.9530 toMiMO-lETTER IV o AeGULAA 0 ...relUlFl"tCE '- REORDER ITEM # ML4N72 PRESTON PIPELINES, INC. 151 Bothelo Avenue. Milpitas. CA 95035. (408) 262-1418 Calif. Uc. 367660 MEMO ~ J-JE T 'r ER TO ~..l.~ ~~~~ , . ~ /.. J4..~ $11....: ht... 7 .1'.s tIe t.- DATE 02./.;2-=f- Ilq~~ SUBJECT<3A~ ff~ 0~~. - -k... t-k A.t44~}_ ?~ U-.U.Lfy il<;.~o a-.c ~11tu.. ~i.tL..Ah~O ~~. ~-~~t.-~ ~ "hr;5 cl~&, ~tL-.o(~ i!11 ~~. ~ ivd:o ~(.fJrn.. ~. / 8u.ik... p.;u...(~ ~..~. ..' 'f<<W. ,-k. S" ~,3k/ew4:lcf2-<..e&. b.t~~ i-e... -!o1i t1~~ 6f2.4;~7 ~ .~ {d cJtp oWl ~i.M.... Cf.: , ~ yt<M... ckkJs, u1. KJ~.. ~ ~ ~ ~~ '. 'tOAA.-. 'p:tu So ; I- ~ ~ 1I~ dL<-<.."";j e ~ adlv./7' { 1)/fL bWLat{ ".uQ ~ fM- C(~ a.' ~Wl .s~. ~ Q...k - {au.. i<r:...J~ Jp, . / _ {~ Cl+4 {S~ ~ M . S~ ~-IJtf6~ nem . Ml4N72 The Drawing Board. Dallas. T.x.s 75266-0429 Wheeler Group. Inc.. 1982 FOLD AT H TO FIT WING BOARD ENVELOPE. EW10P ..... ...." . \ .\ JI.. , . , i~ '. CITY OF CAMPBELL FIELD ENGINEER'S DAILY REPORT )f.:.rW\. ~('O\lrv -r: L....;~ . PROJECT NO. CJ';-.)" 7 REPORT NO: I 7/5 -, CONTRACTOR: VJfiWIV) hs1-^- PlJ/A.R~ WEATHER: fair INSPECTOR: K. .v~51fALL ITEM DESCRIPTION C{).AIJ " WvSO Mtl-;,.-. cc: PAGE: I OF I Feb-15-96 08:35A Preston Pipelines 408 262 1870 P.Ol Preston Pipelines Inc. U_rvn>UIl4 CODtrutors 151 BOrRELO AVENUE' MILPIrAS, CALIFORNIA 95035 CoDtractors l:ice:ase No. 367660 Thursday, February 15, 1996 From: 9:40 AM To: .. Name: Lynne Wilkins Name: Mr. Randy Westfall Company: Preston Pipelines, Inc. Company: City Of Campbell Phone: (408) 262-1418 Phone: (408) 866-2165 Fax: (408) 262-1870 Fax: (408) 866-8381 Total number of pages, including cover: 1 Message: Re: Bascom Square @ Bascom & Hamilton Avenue Traffic Plan Dear Mr. Westfall, I'm wondering about any changes I may need to make to this traffic plan. Have you had a chance to review it? We are still hoping to start the potholing on Tuesday, 20th. If I need to make changes and get the revisions on paper then, I would really like to hear from you today, so that I will have time to accomplish that. Thanks for your attention. Lynne Of'CA..tt "~~. . '. ""<1>t<'> .... . l"" u-. ....~?&. ~ . ~.- - ~~ ~ .... : ... '$0 "- ~ ., .0 L- II C H. "t>' CITY OF CAMPBELL Public Works Department February 8, 1996 Hunter Properties 20725 Green Valley Drive Cupertino, CA 95014 Subject: 715 E. Hamilton Avenue Permit 95-277 Gentlemen: Enclosed are receipts for fee paid, deposit made for the above permit for your files. Please call me if you have any questions or comments. Cruz S. Gomez Assistant Engineer CSG:jd Enclosures cc: File: Permit 95-277 H:\95277REC.LTR(JD) 70 North First Street. Campbell, California 95008.1423 . TEL 408.866.2150 . FAX 401L179 2572 ' TDD 4088662790 NEW PW r AX # " 408-376-0958 E-4 ~ :E: t.!'o:: Z~ ~l:. ll' ~s C;.. = OZ ~O ~ QE-4 ~< =U ~~ Q...:l t.!'E-401Q.. Z~~Q.. I-I:E:=< 0::0:: ~~ ~Q.. Z I-It.!' t:lZ ZI-f ~Q ...:l ~I-f 00 CQ C::I Uo:: ZO <r:.. Q tr.lo:: tr.l~ 1-fE-4 E-4 O::C::I O...:l ~ ~ CU ~l~ ta:I...:l o::u E-4 ~I-f U:E: zo:: <~ OQ.. t.~ tr.ltr.l I-I~ 0:: 0::0 03 C;.. U QI-f ~...:l == 1-10 QQ.. 01 ~r:.. 0::0 ~ mlC&I.L. ~ I.,"~ LTST City of C&_ .dl Oepart:ment of Public WarJcs ~ 1q:plicant sectian CDIplete' ~ A{::plicant signature and date L: Pemi.t A;plic:atian fee .00 paid P--ipt f1l!lllh:l.r JH:: ~~~.OOpajd ~Five sets of ~ plans sullllittal ~ Pemi.t No. 5?~~::,? ...../II! SUrety for fait:htUJ. perfatmnce, lOOt of City Enqineer's estiJIate, lied or paid Am:lunt $ ~~ Farm ~ I.D. .. .$~ -IIIi! Cash lle!pcsit: 4\ of no sumty, $500 lIliniDum P"~id . /1/ 1JI!Am:lunt $ /~ . ~ipt No. ~ . d?'et Plan 01eck & Inspection fee of~of F.P. surety,,~ $3 0, 1 fI 30 0 , , Yd /1/1 ~d Worker's CXlIpenSatian infcn:maticn ~~t JCi fer AJ;:p1icant~OJ!, (see Infonation Sheet for ~ Pemi.ts) ~Ie All other PUblic Worlcs requirements listed in the ~~f ~ of the cleve1~. P--ipt No. ,.;!IllrWorker,s CXlIpenSatian ~ o:ntract:or's Infatmatial t....ed for Ccntractcr'!(see Information Sheet for Eh::roachment Pemi.ts) ~ Certific:at:~ ~with AdditialaJ. Insured's ~ -- received fran o:ntract:or (see General SUmmary of Insurance - 2 . for Eh::rcadmEnt pemi.ts) / / 'lhree sets of off-site plans, si"~ APmovEo (Tract or '/I Jj ,J ~lt an:! FIJbllc Wct:l<s Pemit "'mtler an:! ptq>erty aah:ess $I/!C Pemit signed for City Eh;!ineer ~ /~_ WHEN AIL OF 'IHE ABJVE l'lDS ARE CI:MP!Em, P.ERMIT MAY BE ISSUE:o Issuer: Initial am date ard file with pemi.t tmE ISSUANCE, lNITIAT.E am:K ~ FOR PIAN CiECK IEUSIT REruNo f:pmtck1st Revised 8/92 CITY OF CAMPBEIL Fe t No. 96=~;:7 mFtR4ATIm ::itI1':ti:'1' FtR ~ PERMl'rS mRKERS' aJ.tPENSATION INSURANCE INFORMATION Name of Contractor/Applicant 5r':~~ ~ / h k one of the followirg must be on file with the Public Works 0epartJnent: - A Certificate of O:msent~-~S,CZl1ed by the Director of Iniustrial Relations: QB - - ~ Certificate of Worxers, O:Irpensation Insurance Insurance Co. Policy No. Expiration Date : OR See iF/' 5?::?;;:1~ h~ - 'lhi.s certi.fica~ !ran the Workers' Compensation laws printed below cate must be signed) . f7i ~CATE OF EXEMPI'ION ~//- e. ~ ~~ I cert:ify~ In the pertOI:1lla1>Oe of the wm:lc fer this pemit, I shall not enploy aIT:l person in aIT:l manner so as to ~ subject to the Workers' COmpensation raws of califomia. Signeq #r Date NOI'ICE 'lO CDNmACIOR/APPLICANT: If, after sign.in;J this Certificate of Exenption, you should ~ subject to the Workers' CCm;;lensation provision of the tabor Code, you DIJSt forthwith cc:mply with such provisions or this pemi.t shall be n~ revoked. OONmAcroRS INFORMATION Note that all contractors an:! sub-co11tractors must have current City of ~ti~~~' state~Cont:ract:o~ Workers' Nane of cmtractori~ ~ ~-j1$-$pe1 Address ,#'{~ ddz__ __~A~-e. -~ ~te eor.rt:r-actor License No. ~~ ~ City Busll'leSS License No. ___ Expiration Date 4/# Will do the followin1 types of work: V Un:iergrcund _P.C. Ccncrete other (specify) A.C.Pavm; Electrical f:penninfo Revised 8/92 4h/f4 01/30/1997 15:25 4089958301 STORM LAND CO PAGE 02 DENISE A. LEADBETTER, ESQ_ REAL ESTATe CONSULTING PRIVATE OlnCJ;;;; 4104 24ul 5TRI;J;;T, #401 SAN l"RI\NClSCO, CA 94114 TZUl'KONE (415) 821.-0347 FAC5JM11X (415) 821-4111 AT HUNTER PROl'eRTlJ;:5, INC. 20725 V ALJ.EY ell-ttN DRIVE, SUITE 100 ClJPJ;I<TtNO, CA 95014 TELePHoNE (408) 2.55-4100 l'ACSIMIU!. (408) 996-8425 January 3, 1997 Mr. Randy Westfall, r.E. Public Works Inspector City of Campbell 70 North First Street Campbell, CA 95008-1423 Rc: Permit No. 95-277 Your letter of October 10. 1996 to Mr. Deke Hunter Dear Mr. Westfall: Please contact me re: the above-referenced, a copy of which is attached for your convenience I am not clear on Hunter Properties' obligation with respect to maintaining the Bond which you reference In the third paragraph of your letter. Thank you for your cooperation enclosure FEE 29 '96 07:36~M SJWC ENGR/OPER P.1/1 _. =~:s. . ... Company 374 West Santa Oara SI. San Jose, CA 95196 .408 279-7808 Fax 40S 279-7934 FACSIMILE TRANSMITTAL ~ DATE: 29 rt€5 . 'f~ PROM: e-b ~e 4L-o PHONE NO: 279- 78 f7 TIME: 7:~S JOB NO.: ~32L. SJWC ENGDmERDlG/OPERATIONS FAX NO.: (408) PLEASE DELIVER THE FOLLOWING PAGES TO: 292-5812 NAME: R~Y COMPANY: 'C / .7Y WP.5TFALL ~.r- ~8-/??r' fi'fi'"LL FAX NO.: 379- 2572 NO. OF PAGES 'rBANSHITTED (INCLUDING THIS PAGE): / SUB~CT: 7/S $~r #~ 'V7/L /C)/V #l ve REMARKS: ?~"",,/r:# 7.5>- 2"77 5 A "-J. ~ s €- (..A.J A-7E Ii!... Co "-'1. jt/)~ Y ~A$ NO O~~c-nc)^-L s: r-o nl-E '1 ~/Jc Co CL.€.RJ<!.If~E:. 8~"-l..UE=-.AJ nhE. tuA-7&./.C /V'JP}IM h7\..I.. ~ ~ <",~I'~~ ~,e ~- .?7,Z)R/V7 L //V€. ~ tUILL 8e: ~T ~ .:::JO &. .s~/7EE. ~ C'O"y.;c;~ /.s L'LE/heA;u.c~. ~ ~ ~~- -_.~~e;,. ~~?"-?7(~'/ 0..~h~