ENC2017-00196 � 41
Pri-nit.Form
N.o
CITY OF CAMPBELL
ENCROACHMENT PERMIT
Permit �NC°.d�CDk ` ��Q��(D
DEPT.OFPUBLICWORKS (for working within the public X-Ref. File
70North First Street right-of-way) Application Date �� CA c/
Campbell, CA 95008 1 y—� 1 l `T Application Expiration Date a \�) D
Ph.(408)866-2150 Issued 1 11 / 1 APN \ L�OoL
Fx. (408)376-0958 s
Permit Expiration Date
APPLICATION-Application is hereby made fora Public Works Permit in accordance with Campbell Municipal Code,Section 11.04. (Application expires in six
(6) months if the permit is not issued. Application Fee is non-refundable.)
A. Work Address or Tract No.: L V" L�.s'� U y�,f Ll ,/
-_�_3 :--- -------- _ _-- - -- --- _
Utility Trench Location:
5 ---
B. Nature of Work:
C. Attach four(4)copies of an engineered plan showing the location and extentof the work,and four(4)copies ofttii re inary Engineer s T
Estimate of work. The plans shall show the relation of the proposed work to existing surface and underground improvements. When approved
by the City Engineer,said plan becomes a part of this permit.
D. All workshall conform tothe Cityof Campbell Standard Specifications and Detailsfor PublicWorks Construction;the General Permit Conditions
listed on the reverse side;and the Special Provisions for this permit,listed below. Failure to abide by these conditions and provisions may result
-in job shutdown and/or forfeiture of Faithful Performance Sureties and cash deposits.
E. The Contractor must have this permit and approved plans at the site and must notify the Public Works Department at least two days before
startingwork.Notice ustbe iventoPublicW rksatl st24ho rsbefore�e%tartin�apywork.
��� , mil" ` , ,
lJ
Name of Applicant: !"1 �- _ 1_ _ _� T _ r f. r Telephone:.
Address: �� 'I�fI_� rva vd -Ave_
I� _
E-MailAddress: . � 24-HOUR EMERGENCY PHONE NUMBER:
Is this work being done by the property own t their own residence. YES u NO
The Applicant/Permittee hereby agrees by affixing their signature to this permit to hold the City of Campbell, its officers,agents,and employees free,safe
and harmless from any claim or demand for damages resulting from the work covered by this permit.
MU The Applicant/Permittee hereby acknowledges that they have read and understand both the front and back of this permit, and they will inform their
contractor(s) of the information. Applicant is advised that.upon issuance of this permit, property owner, or property .owner's successors, shall be
V� responsible for any and all damages ar ing out of improve ents completed in the publi right-of-way. �, ! ( ^
Accepted:
v ..(Applicant Permittee) (sign) Date
r V6 r 11M-5d I:1.y 7/ , 7
(Contractor) (Print Name) Date
SPECIAL PROVISIONS:
❑ 1. Street shall not be open cutfor underground installations.Minimum cuts may be allowedforconnectionsorexplorationholes.Suchcutsmaybe
specifically approved by the Inspector prior to cutting;.
2. Pavement may be cut for underground installations and must be restored in accordance with the Standard Details Trench Restoration Method
"A",unless otherwise approved by the Engineer.
❑ 3. Work to be staked by a licensed Land Surveyor or Civil Engineer and two(2)copies of the cut sheets sent to the Public Works Department
n before starting work.
J - 4. Per Section 4216 of the Government Code this permit is not valid for excavations until Underground Service Alert(USA)has been notified and
the inquiry identification number has been entered hereon. USA Phone: 1-800-227-2600. USA TICKET NO.
❑ 5. Prior to any work,the property owner shall execute an Agreement for Private Improvements in the Public Right-of-Way,which shall be recorded.
❑ 6. Public Notification Requirements:
❑ 7.
SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT FEES
AMOUNT RECEIPT NO
PERMIT APPLICATION FEE
PLAN CHECK DEPOSIT $
SECURITY FOR FAITHFUL PERFORMANCE/LABOR&MATERIALS $
CONSTRUCTION CASH DEPOSIT $
PLAN CHECK&INSPECTION FEE $__ !!�v Z-0
EMERGENCY PERMIT FEE $
APPROVED FOR ISSUANCE 7
ForCity Engineer Date
1 ` Perm Expires 12 Months After Date of Issuance
GENERAL PERMIT CONDITIONS
1. The Permittee must provide evidence of insurance and Additional Insured Endorsements as required by the City.Insurance shall be maintained for the duration-of the
permit work.
2. A Construction Cash Deposit is required.Changes will be made against this deposit if there is an emergency call-out,overtime inspection or when City ordered
barricading is required.Any such costs in excess of the deposit will be billed to the Permittee.
3. Refund of the construction cash deposit balance and refund or cancellation of the Faithful Performance Surety will be initiated by the written acceptance of the work
by the City.
4. A one-year maintenance period and surety are required.Such period will begin on date of written acceptance by the City.Surety posted shall be equal to 25%of the
original Faithful Performance Security.
S. Submit project schedule 10(ten)days prior to proposed start of work.Additional lead time may be required for work within City facilities and downtown Campbell.
6. The Permittee must request in writing a final inspection and acceptance of the work upon completion.Acceptance by the City will be made in writing to the Permittee.
7. 'Maintain safe pedestrian and vehicular crossings and free access to private driveways,bus stops,fire hydrants,and water valves.
8.. A Construction Traffic Control Plan and a Construction Schedule are required for all lane closures,detours,and street closures.This plan must be reviewed and
approved prior to any lane closures.
9. A Construction Traffic Control Plan shall conform to the 2006 California Manual on Uniform Traffic Control Devices(MUTCD).
10. Replace,as directed by the City'Engineer,any damaged or removed improvements in accordance with City Standards and Specifications at the sole expense of the
Permittee as expeditiously as possible.
11. Sawcut for all PCC or AC removals.All PCC removals shall be to the nearest scoremark and new PCC shall be doweled to existing improvements.
12. Prior approval of inspector is required for any work proposed after normal working hours,on weekends or holidays and may require reimbursement of inspection
costs at the current overtime rate.
13. Work on arterials and collectors may require the use of changeable message boards.Adequate signing and barricading is required on the.job site.Failure to provide
such signing and barricading may result in the City's providing signing and barricades and charging the cost(including all labor and materials)against the construction
cash deposit.
14. Compaction testing of subgrade,base rock,and asphalt concrete by Permittee is required unless otherwise stated by the City Engineer.
15. The Contractor or Permittee will have a supervisory representative available for contact on the project at all times during construction.Contractor or Permittee shall
provide a phone number at which they can be contacted outside the hours of 8:00 a.m.to 4:00 p.m.and on weekends.
16. No storage of materials or equipment will be allowed near the edge of the pavement,the traveled way,or within the shoulderline which would create a hazardous
condition to the public. .
17. This permit shall not be construed as authorization for excavation and grading on private property adjacent to the work or any other work for which a separate permit
may be required,nor does it relieve the Permittee of any obligation to obtain any other permit required by law.
18. This permit does not release the Permittee from any liabilities contained in other agreements or contracts with the City and any other public agency.
19. This permit is not transferable.Work must be performed by the Permittee or his designated agent or contractor as specified thereon.
20. Call back(call out)due to emergencies regarding this permit shall be at the current overtime rate with a three(3)hour minimum charge per occurrence.
21. Pursuant to Chapter 14.02 of the Campbell Municipal Code,applicant shall not cause to be discharged any material into the municipal storm drain system other than
storm water.Applicant shall adhere to the BEST MANAGEMENT PRACTICES established by the Santa Clara Valley Urban Runoff Pollution Prevention Program.
22. If the public interest requires a modification of,or a departure from the permit,plans,special provisions and/or specifications,the City shall have the authority to
require or approve any modification or departure and to specify the manner in which the same is to be made.
23. Permittee must provide advance notification to all parties that may be affected by the permit activities.Notification shall be reviewed by the City priorto distribution
and include dates of work and a contact name and a phone number.
24. Applicant shall remove water from utility vaults in accordance with the requirements of State Water Resources Control Board Water Quality Order WQ 2014-0174-
DWQ. Said vault water shall not be discharged into the City of Campbell's storm drain
system. See http://www.waterboards.ca.Bov/water issues/programs/npdes/utilityvaults.shtml for more information.
Applicant is hereby responsible for ensuring that all those providing services under the applicant are aware of and abide by all of the above conditions.
Applicant Date:
Contractor (Print Name) Date:-
J:\FORMS\Templates\Encroachment Permits\Encroachment Permit STATIC form2.pdf
Rev.03/17
PUBLIC WORKS DEPARTMENT UTILITY ENCROACHMENT, TRAFFIC & MISCELLANEOUS RECEIPT
Effective July 1, 2017
TO: Finance -
PUBLIC WORKS FILE NO. C 0-e,1 7—C01 C7
PROPERTY ADDRESS l'f SO 1/VLSZ(vi�t� f�u
Please collect& recel t for the followln monles AMOUNT
ACTTr lTEPi
r
ENCROACHMENT.PERMIT...
4722 Utility Encroachment Permit Application Fee $455.00 S�
R-1 Encroachment Permit N/C
Emergency Permits $130.00
Plan Check& Inspection Fee
Minimum Charge Per Location $420.00 2-6-
Conduits/Pipelines up to 500 Feet $2.95/ft
Above 500 Linear Feet $1.75/ft
Manholes/Vaults/Etc. $190.00/ea
Pole Set/Removal $190.00/ea
4760 Storage Container Permit(valid up to 60 days only) $170.00
4760 Project Plans&Specifications Project No.
4760 Standard Specifications&Details $1/Pg$15.50/13k
4760 Engineering Maps&Plans
Aerial Plot 24"x 36" $65.00
Aerial Print 8 1/2"x 11" $32.00
Map Research (includes max of two 24"x36"copies) $32.00
Maps and Plans 24"x 36" $15.00
4722 Penalties: Failure to restore public improvements $100/Calendar Day(Muni Code Sec. 11.34.010)
4722 Penalties: Failure to correct unsafe conditions $100/Calendar Day
4722 Work Without Permits 4 Times Applicable Fee/Min $500
TRAFFIC h
4728 Traffic Flow Map(Daily Traffic Volumes) $35.00
4728 Signal Timing Information $73 per hour
4271 Truck Permits $16.00 pet trip
47281 No Parking Signs $1 each or$25/100
MISCELLANEOUS.
511.74241 Postage
Other(Please Speci ) --
TOTAL 875
NAME OF APPLICANT 'i
NAME OF PAYOR �` I Y "`C 1 1 PHONE
ADDRESS I J I DWIo ZIP rD / 0
FOR RECENEOilk
CITY CLERK
q
Rot ilpt
ONLY Date
t F=
J:IFORMS\Templates%Administratve\Receipt Form UGliry Encroachment&Misc 17-18.tds
INSURANCE REQUIREMENTS CHECKLIST `y eS�.M
Permit# IN DjCA- I-MkQ ` CIP Project#
The following insurance is required of all contractors working in the City of Campbell public
right-of-way. Insurance certificates must be accepted by City staff before work can begin.
These insurance requirements apply to work being performed under an Encroachment Permit
and work being performed under contract for Capital Improvement Projects.
Limits
C mmercial General Liability for bodily, personal injury and property damage:
$1,000,000 per occurrence, and
❑ $1,000,000 general aggregate limit applying separately to the project, or
,Z $2,000,000 general aggregate limit.
:a- Policy expiration date EJ 'D I
Automotive Liability:
"Any Auto" checked on certificate
p, $1,000,000 per accident for bodily injury and property damage
rp- Policy expiration date (.0 1, 17
Workers'Compensation and Employer's Liability
Waiver of Subrogation clause
0- $1,000,000 per accident for bodily injury or disease
Policy expiration date (o (g
Course of Construction(if required in Special Provisions)
❑ Completed value of the project
❑ Policy expiration date
Required Endorsements to General Liability and Automobile Liability Policies
Additional Insured Endorsement(Description of Operations Area)
y The City, its officers, employees and volunteers are named as additional insured.
(Reference Proiect Location & Permit Number)
The insurance coverage afforded to the Additional Insured is primary insurance.
Cancellation Area:
❑ Cancellation area of certificate edited to delete "endeavor to" and "but failure to
mail such notice shall impose no obligation or liability of any kind upon the
company, its agents or representatives".
OR Should Read
Should any of the above described policies be cancelled before the expiration date
thereof, notice will be delivered in accordance with the policy provisions.
\\Honouliuli.cityhall.ci.campbell.ca.us.local\Profile_Data$\ioannat\Desktop\All Insurance Requirements.doc(Rev
03/13) Page 1 of 1
❑ Workers' Compensation Insurance Sheet Submitted
❑ For General Contractor
❑ For Developer or Owner
Acceptability of Insurer(s)
❑ Insurer(s) has current A.M. Best Rating of A:VII and is authorized to transact business
in the State of California.
Name: NAIC# %sting: p` ��\ Authorized in CA: ✓
Name: \4se (a. NAIC# Authorized in CA:
Name: NAIC# �50l� Rating: N Authorized in CA: ✓
Name: NAIC# Rating: Authorized in CA:
i� Campbell Business License #
Insurance Certificate Reviewed _
Initials Date
❑ Copy of Insurance Certificate placed in tickler file one month prior to expiration.
C:\Documents and Settings\Ioannat\Desktop\Insurance Requirements 2 pgs.doc(Rev 03/13) Page 2 of 2
ACC)OR®®® CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDlYYYY)08102/2017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND .OR ALTER THE COVERAGE AFFORDED" BY THE "POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE E CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER NAMEACT Alex Eshraghi
Alex Arash Eshraghi alc°N o Ext• 408-840-4402 aAc No): 408 484-1074
Bayshield Insurance Services ADDRESS: alex@bayshieldins.com
1190 S.Bascom Ave.,Suite 140 INSURERS AFFORDING COVERAGE NAIC#
San Jose,CA 95128 INSURERA: Colony Insurance Company
INSURED INSURERB: Mapfre Insurance Company
INSURER C: Wesco Insurance Company
AMROCK CONSTRUCTION INC INSURERD:
1078 OAKTREE DRIVE INSURER E:
SAN JOSE,CA 95129 INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY.PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SLMJECT TO ALL THE TERMS,
EXCLUSIONS AND-CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDLSUBRTYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY POLICY EFF EXP
LTR MM DD/YYYY D MMDNYYY LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
DAMAGE TO CLAIMS-MADE OCCUR PREMISES(Ea occurrence)nce) S 100,000
MED EXP(Any one person) $ 5,000
A 101 GL0076422-01 05/30/2017 05/30/2018 PERSONAL&ADV INJURY S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
POLICY X PRO- ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000
JECT
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000
Ea accident
ANY AUTO BODILY INJURY(Per person) S
B OWNED SCHEDULED
AUTOS 8004010004001 06l11/2017 06/11/2018 BODILY INJURY(Per accident) $
ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE S
AUTOS ONLY AUTOS ONLY Per accident
UMBRELLA LIAR OCCUR EACH OCCURRENCE 5
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION$ 5
WORKERS COMPENSATION - PER OTH-
AND EMPLOYERS'LIABILITY STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000
C OFFICER/MEMBER EXCLUDED? ❑Y N/A VWJC3293584 0 //30/2017 06/30/2018
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000
If yes.describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
All Work in public right-of-way.City of Campbell,its officers,employees and volunteers are named as additional insured as respects liability per U156A-0313
Project Location:1430 Westmont Ave,Campbell CA 95008
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City Of Campbell ACCORDANCE WITH THE POLICY PROVISIONS.
70 N 1st Street
Campbell,CA 95008 AUTHORIZED REPRESENTATIVE
A.Eshraghi
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 0403.06
(Ed1: 4-84j
WAIVER:OF OUR RIGHT TO-RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA
We have the right to recover our payments from anyone liable for an injury covered_by this policy. We.Will not
enforce our right against the person or organization:named in the Schedule. (This'agreement applies only to the
extent that you perform work undera-Written contract that requires you to obtain this..agreement.from us)
You must maintain payroll.records accurately segregating:the remunerat on.of-your employees While engaged in
the work described in the Schedule:.
The additional premium for.this:endorsement shall be 2%0 of.the California Workers' oornpernsation premium
otherwise due on such remuneration.
Schedule
Any person or'organization.as requi red.bywritten.contract. $8,254.00
City Of Campbell
70 N 1ST
Campbell,CA 95008
This endorsement changes the pol cy'to which it is attached and is effective on;the date issued unless'otheWse stated:
Endorsement Effective 08/15/2017 Policy No. WWC3293584 Endorsement No, WC040306
Insured Amrock Construction Inc Premium$ 8,25400
Insurance:Company Wescolnsuiace:Company
Countersigned by
COMMERICAL.GENERAL LIABILITY
CG 20 37 07 04
Policy#: 101 GL 0076422-01
Insured Name: AMROCK
CONSTRUCTION
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES .OR CONTRACTORS -
COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Additional Insured Person(s)or Location and Description of Completed
Organization(s): Operations
City of Campbell,its officers,employees and volunteers 1430 Westmont Ave Campbell CA 95008 are named as additional insured
Informa.bon'required`to complete this Schedule, if not shown above, wilt be showii in the declarations
Section II-Who is an Insured is amended to include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only with respect to liability for"bodily injury"or"Property
damage"caused, in whole or in part, by"your work"at the location designated and described in the
schedule of this endorsement performed for that additional insured and included in the"products-
completed operations hazard''.
a
CG 20 37 07 04 Copyright Iso Properties, Inc.,2004 Page 1 of 1
Insured
•
BLANKET ADDITIONAL INSUREDS
OWNERS, LESSEES OR CONTRACTORS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE . . __ _ __ __ .
Policy Number,101 GL 0076422-01 i Endorsement Effective:08/02/2017 12:01 a.m.
Named Insured Countersigned By:
MASOUD E7_ATAGHA ;
AM ROCK CONSTRUCTIONle
S
SCHEDULE . .
-----�.
_Na.m_e o.-_f__Person o-r O--r ga-n-iza tion-. ------. ------ ----------------
—_....---
City �___.._.�_�_......<
of Campbell,its officers,employees and volunteers are named as additional insured �
-_--
1430 Westmont Ave Campbell CA 95008
(It no entry appears above, in orma ion required to complete this endorsement will e shown in e ec arations
as applicable to this endorsement.)
A. Section II—Who Is An Insured is amended to include as an insured the person or
organization shown in the Schedule, but only to the extent that the person or organization
shown in the Schedule is held liable for your acts or omissions arising out of your ongoing
operations performed for that insured.
B. With respect to the insurance afforded to these additional insured, the following exclusion is
added:
2. Exclusions
This insurance does not apply to'bodily injury"or"property damage"occurring after:
(1) All work, including materials, parts or equipment furnished in connection with such
work, on the project (other than service, maintenance or repairs) to be performed by
or on behalf of the additional insured(s)at the site of the covered operations has been
completed, or
(2) That portion of"your work" out of which the injury or damage arises has been put to
its intended use by any person or organization other than another contractor or
subcontractor engaged in performing operations for a principal as a part of the same
project.
C. The words "you" and"your" refer to the Named Insured shown in the Declarations. •
C. "Your work" means work or operations performed by you or on your behalf, and materials, parts
or equipment furnished in connection with such work or operations.
.Primary Wording
If required by written contract or agreement:Such insurance as is afforded by this policy shall be
primary insurance, and any insurance or self-insurance maintained by the above additional
insured(s)shall be excess of the insurance afforded to the named insured and shall.not contribute
to it.
Waiver of Subrogation
If required by written contract or agreement:We waive any right of recovery we may have against
an entity that is an additional insured per the terms of this endorsement because of payments we
make for injury or damage arising out of"your work" done under a contract with that person or
organization.
49-0108 0711 May Include Copyrighted Material of Insurance Services Offices, Inc. Page 1 of 1 ❑
Used with permission
,
s
CITY OF CAMPBELL
70 N FIRST ST
CAMPBELL,CA 95008
08/17/2017 16:48:39
CREDIT CARD
VISA SALE
Card# XXXXXXXXXXXX9909
4 Chip Card: Visa Credit
AID: A0000000031010.
ATC; 0081
TC: EDBD483C7C82C132
? SEQ#: 1
Batch#: 416
INVOICE 1
Approval Code: 817184 '
Entry Method: Chip Read
Mode: Issuer I
SALE AMOUNT $875,00
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5. APPLICANT IS RESPONSIBLE TO ENSURE TRENCHING AND SUBSTRUCTURE p Ix 1 r o Z
INSTALLATION MEET PG&E GREENBOOK STANDARDS. GREENBOOKS ARE AVAILABLE i JASMINE C T N ID Z AT YOUR LOCAL PG&E HEADQUARTERS OR CAN BE FOUND ON THE INTERNET 52 O WWW.PGE.COM/GREENBOOK > a^o ED z
6. FLAME RESISTANT(FR)CLOTHING IS REQUIRED WHEN WORKING ON OR AROUND ',� J I p N��d 1&
PG&E FACILITIES AND EQUIPMENT. SEE PG&E GREENBOOK FOR ADDITIONAL DETAILS I v>LI:��d p W
7. APPLICANT IS RESPONSIBLE TO COORDINATE WITH TELCO AND CATV _ 350A TPX-
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NOTES:
LEGEND: I.ALL ADVANCED WARNING SIGNS SHALL HE EQUIPPED
WITH 2 18-ORANGE FLAGS
2.NO PARKING SIGNS SMALL BE PLACED A MIN OF 72HRS
PRIOR TO START OF WORK.CONTRACTOR SHALL NOTIFY LOCALAUTHORITIES
ONCE SIGNS ARE POSTED.
3.ALL CONFLICTING SIGNS SHALL BE COVERED WHILE TEMPORARY
TRAFFIC FLOW SIGNS ARE IN PLACE PREPARED BY: ROBERT SCULLY
,LACCESS TO RESIDENTS AND LOCAL BUSINESSES SHALL BE MAINTAINED CAL-VET CONSTRUCTION SERVICES DVBE
4850 BANN CK CIRCLE
I—ER ATALLTIMES,ACCESS TO BE DETERMINED IN BASED 04 0
ACTUAL SAN.LOSE,CA.95130
TUAL EXISTING CONDITIONS 408-477-6850
S.CONTRACTOR SHALL MAINTAIN SAFE PEDESTRIAN ROUTES ATALL TIMES 408-379-1435 FAX
MERE CURRENT SIDEWALKS EXIST CONTRACTORS LIC.#894938
G.ALL TRAFFIC CONTROL PLANS AND DEVICES SHALL CONFORM TO THE C)VBE CERT.#1791297
CALIFORNIA MANUAL OF UNIFORM TRAFFIC CONTROL DEVICES
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From: SHANKAR NARAYAN <snarayan@sbcglobal.net>
Sent: Wednesday, November 01, 2017 8:30 AM
To: Syed Wahidi
Subject: Fw: Fwd: 1430 Westmont Redline
Attachments: 1430 Westmont Ave System map with original path to follow AT&T from pole..pdf
Will this do?
Shankar
Begin forwarded message:
From: "Ward, William" <william.ward(aD-cablecomllc.net>
Subject: 1430 Westmont Redline
Date: August 28, 2017 at 11:30:12 AM PDT
To: WBLENNAN(aD-gmail.com
Sir,-
Here is the Redline I was instructed to send you. If you have any questions feel free to
contact me or Gerardo Martinez. Thank You...
This email message, and any documents which may accompany it, contain information which is intended
for use only by the intended recipient(s), and may contain information that is privileged and/or
confidential. If you are not the intended recipient of this message you are hereby notified that any review,
disclosure, dissemination, distribution, copy or other use of this message or its attachments is strictly
prohibited. If you have received this message in error, please notify the sender by reply email, delete the
email from your computer and destroy all copies of the communication and any attachments.
1
DEVELOPER NOTES N -
r I n
I BEFORE BEGINNING SUBSTRUCTURE WORK, N N
PLEASE CALL THE UNDERGROUND
I! INSPECTOR AT LEAST 48 HOURS IN N o
I ;
ADVANCE AT 725-2202 OR FAX o tc3-
(408) 725-7773. (WORK NOT PROPERLY
INSPECTED MAY BE REJECTED) IF THERE w
1 ARE ANY CONFLICTS BETWEEN o c y
SUBSTRUCTURES INSTALLATIONS AND
j LANDSCAPING CONTACT THE INSPECTOR
PRIOR TO INSTALLATION. 45 m n cm� cc
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NOTES LU a
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1.APPLICANT TO TRENCH JOINT BATH ELEC, TELCO AND CATV Ana'
a
ELECTRIC APPLICANT IS TO PROVIDE ALL ElERIC SUBSTRUCTURES AS SHOWN P
1 APPLICANT IS TO PROVIDE MANDREL AND PERFORM MANDREL TEST
WITH PG&E INSPECTOR STANDBY
MINIMUM 3 FOOT SEPARATION
4. THE TOTAL NUMBER OF BENDS IN ANY SECONDARY DUCT RUN IN EXCESS OF 200 FEET BETWEEN WET FACILITES AND PG&E n n W
SHALL NOT EXCEED 3CO DECREES ANY SECONDARY DUCT RUN EQUAL TO OR LESS THAN FACILITIES. ALONG WITH 1 FOOT MINIMUM
200 FEET IN LENGTH MAY CONTAIN UP TO A TOTAL OF 315 DEGREES IN BENDS. OF UNDISTURBED EARTH }*• ` N
S.APPLICANT IS RESPONSIBLE TO ENSURE TRENCHING AND SUBSTRUCTURE I n
INSTALLATION MEET PG&E GREENBOOK STANDARDS.GREENBOOKS ARE AVAIABLE
AT YOUR LOCAL PG&E HEADQUARTERS OR CAN BE FOUND ON THE INTERNET I I Y h o
O WWW.PGE.COM/GREENBOOK o
N �Z 6.FLAME RESISTANT(FIR) JASMINE CT
GA j CLOTHING IS REQUIRED WHEN WORKING ON OR AROUND o
PE FACILITIES AND EQUIPMENT. SEE PG&E GREEN130OL FOR ADDITIONAL DETAILS w a^ _ -
7.APPLICANT IS RESPONSIBLE TO COORDINATE WITH TELOO AND CATV w in z o
FOR THEIR CONSTRUCTION REQUIREMENTS
z mZ—
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Syed Wahidi
From: PROCK, HOWARD E <hp5731@att.com>
Sent: Tuesday, October 31, 2017 11:21 AM
To: Syed Wahidi; 'snarayan@sbcglobal.net'
Cc: 'matezat@yahoo.com'
Subject: RE: CORRECTION - RE: Undergrounding of telephone wires
These are my official dwgs.
Howard Prock
Design Engineer ATT
Bay Construction and Engineering
870 N McCarthy Blvd.
Milpitas,CA 95035-5125
Email:.hp5731@att.com
Cell:408-635-8944
From:Syed Wahidi [mailto:SyedW@cityofcampbell.com]
Sent:Tuesday, October 31, 2017 10:07 AM
To: 'snarayan@sbcglobal.net'<snarayan@sbcglobal.net>
Cc: PROCK, HOWARD E<hp5731@att.com>; 'matezat@yahoo.com'<matezat@yahoo.com>
Subject: FW: CORRECTION - RE: Undergrounding of telephone wires
Hi Shankar,
Can you please provide the official approved plans for AT&T/Comcast services for this project?Thanks. Attached
sketches sent by Masoud are hand drawn and does not look like they are official sketches. Thanks.
ov•CAy Syed Wahidi
.4. A Public Works Inspector.
v r . City of Campbell I Public Works Department
0 o 70 N.First Street I Campbell,CA 95008
Asp 4' www.ciiyofcampbell.com l 408.866.2165
11RCHARO
From: Masoud ezat [mailto:matezat(ftahoo.com]
Sent: Wednesday, October 25, 2017 11:29 AM
To: Syed Wahidi
Subject: Fw: CORRECTION - RE: Undergrounding of telephone wires
Sent from Yahoo Mail on Android
----- Forwarded Message -----
From: "SHANKAR NARAYAN" <snarayan(a)-sbcalobal.net>
To: "matezat -Yahoo.com" <matezat , _yahoo.com>, "matzat _yahoo.com" <matzat _yahoo.com>
Cc:
1
Sent: Wed, Sep 20, 2017 at 10:40 AM
Subject: Fw: CORRECTION - RE: Undergrounding of telephone wires
Here is the markup from the telephone company.
Shankar
On Monday, August 28, 2017 7:42 AM, "PROCK, HOWARD E" <hp5731 att.com>wrote:
Please see marked redline
Thanks.
Howard Prock
Design Engineer ATT
Bay Construction and Engineering
870 N McCarthy Blvd.
Milpitas, CA 95035-5125
Email: hp5731@att.com
Cell: 408-635-8944
From: Shankar Narayan [mailto:snarayan(a)-sbcglobal.net]
Sent: Tuesday, August 22,.2017.10:38 PM
To: PROCK, HOWARD E <hp5731 CaD_att.com>
Cc: KEARNEY, PETER R <pk9132 „_att.com>; SCARLETT, LESLIE A <ls2187 _att.com>
Subject: Fw: CORRECTION - RE: Undergrounding of telephone wires
Hi Howard,
Can you please mark the construction drawing on the new PG&E drawing I have enclosed and send
it tome at the earliest. We are ready to do the trenching, but the City of Campbell Permit wants to see
one consolidated page.
Please note that the telephone wire would go from pole to only the side of the house (garage) like you
have shown in red line and the other line (marked "to second res") is not needed. Also, can you
suggest a smaller box than 24"x36"x36"?
Thanks.a lot for your understanding.
Cheers,
Shankar Narayan
From: SCARLETT;`1ESL-IE A "
'Sent:a,Monday,, July-03, 2017 7 20 AM
,To: Shankar Narayan
i ubject RE CORRECTION .a,RE„Undergroundrng ofIS
telephone wires „_..
Good morning Shankar,
Here is the re-marked construction drawing for you.
2
✓ Leslie
From: Shankar Narayan fmailto:snarayanCaD-sbcglobal.net]
Sent: Thursday, June 29, 2017 7:44 AM
To: KEARNEY, PETER R <pk9132CaD_att.com>; PROCK, HOWARD E <hp5731Q_att,com>
Cc: SCARLETT, LESLIE A <Is2187CcD_att.com>; Chris Bradley <c8ba pge.com>
Subject: Re: CORRECTION - RE: Undergrounding of telephone wires
Hi Howard,
This is regarding the undergrounding of Utilities to our property at 1430 Westmont Ave, Campbell
(please see the thread below for recollection).
-We had to change the location of electrical panel in the property and we have received a new
trenching plan from PG&E (please see: Old PG&E intent as well as New PG&E drawings).
-We would like to use the option you have suggested for undergrounding the telephone wires (See
Marked intent for ATT.pdf).
Can you please change the.location where it will be terminated at the residence (as shown in PG&E
drawing), make any final changes to your plan and send me the final drawing. We are ready to get
started.
I would like you to know that there will be a construction in the rear lot and we would need to provide
cable to that property also. Please take this to account in your suggestion and any cost effective plan
is appreciated.
Thanks for your help.
Regards,
Shankar Narayan
{From KEARNEY;'PETER R
'Sent Wednesday, March.,,01,,2017 11 38 AM ;
!To: PROCK, H6 kb E
Cc: SHANKAR'>NARAYAN , SCARLETT LESLIEA;'.Chris Bradley;
'Subject .RE CORRECTION �RE Undergroundmg;oftelephonewires v _____ ___ _ a_ _
Howard — I dropped the intent in your in-box.
Pete
From: PROCK, HOWARD E
Sent: Wednesday, March 01, 2017 11:32 AM
To: KEARNEY, PETER R <pk9132CaD_att.com>
Cc: SHANKAR NARAYAN <snarayana-sbcglobal.net>; SCARLETT, LESLIE A<Is2187CD_att.com>; Chris
Bradley <c8ba _pge.com>
Subject: Re: CORRECTION - RE: Undergrounding of telephone wires
Hi Mr Narayan, I am the engineer for this area. Can you please send me the PGE intent. I will mark,it
up for ATT and send it back to you.
3
Sent from my iPhone
On Mar 1, 2017, at 11:27 AM, KEARNEY, PETER R <pk9132CcD-att.com> wrote:
Actually this is in Dail Way area which is handle by Howard Prock hp5731.
From: SHANKAR NARAYAN [mailto:snarayanCcbsbcglobal.net]
Sent: Wednesday, March 01, 2017 11:25 AM
To: SCARLETT, LESLIE A <Is2187 -att.com>; KEARNEY, PETER R <pk9132 att.corn
Chris Bradley <c8baCaD-pge.com>
Subject: Re: Undergrounding of telephone wires
Adding Chris Bradley from PG&E.
Thanks Scarlett.
Shankar
On Wednesday, March 1, 2017 11:20 AM, "SCARLETT, LESLIE A" <Is2187 .att.com>wrote:
Shankar,
Pete Kearney will be your engineer on this. He will provide you with our specifications and let you know
how we would need things routed.
His email address is 1k9132 o,att.com,phone is 408-635-8827. We did receive the drawing from PG&E
and I have.given the drawing to him.
Leslie A. Scarlett,
Admin Mgr C&E
870 N.McCarthy Bl,Rm 100
Milpitas,CA 95035
408-635-8832
From: BIBAT,EDUARDO L
Sent: Wednesday,March 01, 2017 10:50 AM
To: SCARLETT, LESLIE A<ls2187@att.com>; snarayanna,sbcglobal.net; Bradley, Chris
<C8BA ,p eg�co_m>
Subject: FW: Undergrounding of telephone wires
Leslie,please have one of your engineers help Mr.Narayan with his project.
Chris, do you have the PG Intent for this project?
Thanks,
Eduardo Bibat
468-635-8816
AT&T California
South Bay Engineering
4
y:
From: SHANKAR NARAYAN[mailto:snarUan&sbcglobal.net]
Sent: Tuesday,February 28, 2017 9:05 PM
To: BIBAT,EDUARDO L<eb1243 a,att.com>
Subject: Fw: Undergrounding of telephone wires
Dear Mr. Babat,
Thank you very much for your offer to help me. I sent you an email earlier, but it bounced
because Iliad wrong email address (please see the thread below whihc gives soem
details). Please see the attached drawing of what PG&E has proposed. We want to know how
we can include under-grounding the telephone lines.
PGE project manager is Chris Bradley (c8ba@p eg com, tel: 408 725 2015 and cel: 408 439
5392).
My project number is 111827817 - Chris told me that there is no intent number and this is the
reference number.
I spoke to an ADE at PG&E by name R. Chiu(you probably know him). He has worked on
this project.
.I am grateful to you for your help.
Regards,
Shankar Narayan
On Thursday,February 16,2017 6:48 PM, SHANKAR NARAYAN<snaraYangsbcglobal.net>wrote:
Dear Mr..Bibat,
Greetings.To introduce myself, I am the owner of property at 1430 Westmont Ave,
Campbell. Currently we have overhead telephone connection to the property coming from a pole
across the street. The City of Campbell has asked us to underground the utilities as-a condition
of lot-split. We are planning to build another home in the back(since we had lot split). I am
working with PG&E to.underground the electrical connection. Please find enclosed the current
PG&E plan for trenching (across the street). The plan is to have a slice box at point marked 2
near the house from which we will take the utilities to the rear property in the future.
We would like to underground the telephone wires also during this process. How do we proceed
in this regard? The project manager at PG&E suggested that we contact you. I would like to meet
with you in person to discuss this. Please let me know a convenient time to meet. You can call
me at 408-857-4459.
Looking forward to hearing from you soon,
Best Regards,
Dr. Shankar Narayan
5