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ENC2018-00003
1 June 26, 20191 Jeremy Ueno Norcal Management 2160 S. Bascom Ave. #1 Campbell CA 95008 SUBJECT: PERMIT NO. ENC 2018-00003 2160 S. Bascom Ave. #1, Campbell, CA FINAL INSPECTION AND ACCEPTANCE Dear Jeremy: The City of Campbell has made the final one year maintenance inspection of the subject Public Works improvements and finds that no remedial work is required. Your warranty requirements and any surety,therefore, are hereby released. AND The remaining 25% of your Faithful Performance Security deposit in the amount of $6,000.00 is enclosed. Sincerely, Syed Wahidi Public works Inspector Cc: Permit #ENC 2018-00003 Refundable Deposit Check Request To: Finance Director Check Payable To: Norcal Management i Address- Une 1: 2160 S. Bascom Ave. Line 2: City: Campbell State: CA Zip: 96008 Description: 2160 Bascom Ave. Account Number: 101.2203 Amount: $6,000.00 Account Number: 101.2203 Amount: Account Number: 101.540.7448 Amount: (Finance Dept only) Interest Earned (Finance Dept only) Total Payable: (Exact Amount) Purpose: 25% FPS Deposit;$r_6;ECet Permit#: ENC2018-00003 Receipt#: 274217 Date: 3/14/2018 Receipt#: Date: Requested by: Title: Inspector Date: Syed Wah' ' Approved by: Title: Sr. Engineer Date: Roger Sto Finance Dept Only: Verified by: Title: Accounting Clerk II Date: Approved by: Title: Accountant Date: Special Instructions For Handlinq Check Mall As Is: Mail in Attached Envelope: Interim (:heck: Needed By: Return To: JoAnna Thomason Public Works (Name) (Department) Encroachment Permit Final Sign Off Encroachment Permit# '2.1 cecG Address: 6o S Date of Final Inspection and Acceptance: �TIS I Inspected by: OK to release deposits: 100% V 75% Comments: 0 OD /6 (0) � O� - OF CA;/1 �Aa A� U A 9F D� •Hk CHAR9• - CITY OF CAMPBELL Public Works Department June 11, 2018 =` Jeremy Ueno . Norcal Management ` �f 2160 S. Bascom Ave. #1 Campbell, CA 95008 SUBJECT: PERMIT NO. ENC 2018-00003 2160 S. Bascom Ave. #1. Campbell, CA FINAL INSPECTION AND ACCEPTANCE Dear Jeremy The City of Campbell has made a final. inspection of subject Public Works improvements and finds the work to be acceptable and in conformance with City standards. Accordingly, the City Engineer accepts the improvements. The one year maintenance period stated in the permit begins as of May 10, 2018. Thee 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. 75% of your Faithful Security Performance Deposit in the amount of$18,000.00 and your Construction Cash Deposit for $960.00 is enclosed. The City will continue to hold 25% of your $24,000.00 Faithful Performance Surety cash deposit as your Maintenance Surety. If you have any questions,please call me at (408) 866-2165. Sincerely, Syed Wahidi Public Works Inspector Cc: Inspector/Suspense Files Permit File ENC2018-00003 70 North First Street • Campbell, California 95008-1436 TEL 408.866.2150 • FAX 408.376.0958 TDD 408.866.2790 CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR ONE YEAR MAINTENANCE ACCEPTANCE LETTER Encroachment Permit # ENC2016-00003 Property Address 2160 S. Bascom Ave. Date of Final Inspection: 5/15/19 On File: Bonds CD Cash Faithful Performance $6,000.00 Labor and Material $ Construction Cash Deposit to be released: $ , Other overdue deposits to be released (Description): Processed by: > Ad , inistr r l� Reviewed by: ctor Reviewed by: Insp Land Development Engineer JAJoAnnaT\Deposit refunds\CHECKLISTS\Bascom 2160 final.doc(Rev. 10/11) pF Cq4(A - •�RCHAR�• CITY OF CAMPBELL Public Works Department June 11, 2018 Jeremy Ueno Norcal Management 2160 S. Bascom Ave. #1 Campbell, CA 95008 SUBJECT: PERMIT NO. ENC 2018-00003 2160 S-. Bascom Ave.-#1.-Campbell, CA - FINAL INSPECTION AND ACCEPTANCE Dear Jeremy The City of Campbell has made a final inspection of subject Public Works improvements and finds the work to be acceptable and in conformance with City standards. Accordingly, the City Engineer accepts the improvements. The one year maintenance period stated in the permit begins as of May 10, 2018. 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. 75% of your Faithful Security Performance Deposit in the.amount of$18,000.00 and your Construction Cash Deposit for $960.00 is enclosed. The City will continue to hold 25% of your $24,000.00 Faithful Performance Surety cash deposit as your Maintenance Surety. If you have any questions, please call me at(408) 866-2165.. Sincerely, Syed Wahidi Public Works Inspector Cc: Inspector/Suspense Files Permit File ENC2018-00003 70 North First Street • Campbell, California 95008-1436 TEL 408.866.2150 • FAX 408.376.0958 TDD 408.866.2790 { ..... ._ ........... :, i .. S$ _._ _ -_ _-___.. - _________ ______. _-..._. .. _ -..___ _ _ CITY OF 'CAMPBELL VENDOR No. 10014948 CHECK NO. 268271 I - .;: - 101 2203 CRO5312:8 18,960.00 2,160 BASCOM AVE I c„ yam' I I C n- I I I , I 10014948 NORCAL MANAGEMENT I I ad mis l i I I _ - �, l 9 (' o SIT D CAIVIEBLL '! cHEcx DATE` CHECK,rro ' r WELtr6 HAR(d0 BANR N A 11 24 a �p 70 NORi H FIRST STREET 42a morrroor�xx sTTZE�x izia 06�1.1�18 268271 1 SAi3a FR7SNCISCO CA 94104 t - �U CANIPBELL CALIFORNIA 95008 3 �. I s I A Xlk VOID AFTER r90 DAYS Rr11nA� t D I F E -UNDRED SIXTY DOLLARS E m ! PAY THE SUM�OF EIGHTE N THOUSAND NIN ZEFO NT<C S 1F m To Tt1E NORCAL MANAGEMENT .ORDER -42160 S.,.BASCOM CAMPBELL CA 9 5 0 0 8 . y i8554zLSIl' .•: ., nZi_c..... ...�.�E.,, .M, :� .-,. ass.....:. ,...�.E;�. w. s �a, .a. y? r • • '• •• , 1 1 --,---- ,-'-,-•--- - '1 I I � . I I #S o Reverse.-Side Reverse.-Side For Easy Opening Instructions* CITY .OF CAMPBELL- •. 1 70 NORTH FIRST STREET CAMPBELL*, CALIFORNIA 95008 .E I I I_ I I I I NORCAL MANAGEMENT 2160 S BASCOM AVE. , #1 CAMPBELL CA 95008 I I I � I i _ I I CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR FINAL INSPECTION AND ACCEPTANCE LETTER S Encroachment Permit#: ENC 2018-00003 Name: Norcal Management Property Address: 2160 S. Bascom Ave. Date of Final Inspection: 5/10/18 On File: Bonds CD Cash Faithful Performance: $ 24,000.00 (75% _ $18,000.00) Labor and Material: $ Construction Cash Deposit to be released: $960.00 Other overdue deposits to be released (Description): Processed by: A mini rator Reviewed by: Inspector I Reviewed by: Land Development Engineer �l J:JoAnnanDeposit refunds\CHECKLISTS\Bascom 2160.doc(Rev. 10/11) Refundable Deposit Check Request To: Finance Director o: orca Management g 1 Check Payable T Nl M ement T. q - 1 Address- Line 1: 2160 S. Bascom Ave. \\� Line 2: City: Campbell State: CA Zip: 95008 Description: 2160 Bascom Ave. Account Number: 101.2203 Amount: $18,960.00 I Account Number: 101.2203 Amount: Account Number: 1,01.540.7448 Amount: (Finance Dept only) Interest Earned (Finance Dept only) Total Payable: (Exact Amount) k Purpose: 15% FPS Deposit& CCD return i Permit M ENC2018-00003 Receipt M 274217 Date: 3/14/201'8 Receipt M Date: i Requested'by: 512 �� Title: Inspector Date: 3 r(Q, Syed Wahidi Approved by: ��. Title: Sr. Engineer Date: Roger Storz Finance Dept Only: Verified by: Title: Accounting Clerk II Date: Approved by: Title: Accountant Date: Special Instructions For Handlinq Check man As IS: Mall to Attacned Envelope: Interim C:neCK: Needed By: Return To: JoAnna Thomason Public Works (Name) (Department) Other: Please return check to JoAnna Encroachment Permit Final Sign Off Encroachment Permit# l8— cx.,c,G3. Address: 2-1 S /���0�1 Ajl�- Date of Final Inspection and Acceptance: Inspected by: OK to release deposits: 100% 75% V Comments: C—\Maa l \� "A v\C { CITY OF CAMPBELL ENCROACHMENT PERMIT rermit rvo DEPT.OF PLIBLICWORKS (forworking within the public X-Ref. File 70 North First Street right- f-way) Application Date I labG Campbell,CA 95008 . 1 Applicati n Ex�iratio Date Ila Ph.(408)866-2150 Issued l APN Fx. (408)376-0958 'Go Permit Expiration Date APPLICATION-Application is hereby made fora Public Works Permit in accor ance with Campbell Municipal Code,Section 11.04. (Application expires in six (6) months if the permit is not issued. Application Fee is non-refundable.) y^� A. Work Address or Tract No.: Z160 Basom Ave -`�V S, ue__120" Poe- A--._..___._.___..._..._._.___.__.._____._.________..._._._.....-__--__ _. .........................-.____.__....----------_...__..._..._-_'; Utility Trench Location: (VGA B. Nature of Work: Remove and replace drive way approaches. C. Attach four(4)copies of an engineered plan showingthe location and extent of the work,and four(4)copies of the preliminary ngineers 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 work shall conform to the City of Campbell Standard Specifications and Details for Public Works 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 must be given to Public Works at least 24 hours before restarting any work. Name of Applicant: I COBE Construction Inc. Telephone: 408-371-3400 Address: 498 Salmar Ave Campbell, CA 95008 E-MailAddress: haun@cobelnc.com 24-HOUR EMERGENCY PHONE NUMBER: 408-391-6010 Is this work being done by the property owners at their own residence? ❑YES 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. The Applicant/Permittee hereby acknowledges that they have read and understand h the front and back of this permit, and they will inform their contractor(s) of the information. Applicant is advised that upon issuance of thi ermi property owner, or property owner's successors, shall be responsible for any and all damages arising out of�'mprovem ents completed' e p right-of-way. Z L2 Accepted: t. ` (ApIlicant Permittee) (sign) Date COBE Construction Shaun OI n 12-12-17 (Contractor) (Print Na e) Date SPECIAL PROVISIONS: ❑ 1. Street shall not be open cut for underground installations.Minimum cuts mavbe allowed for connections or exploration holes.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 before starting work. 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. 0 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 $ 442S 3 -7 j 12-c- le I PLAN CHECK DEPOSIT $ SECURITY FOR FAITHFUL PERFORMANCE/LABOR&MATERIALS or-6-M ( n CONSTRUCTION CASH DEPOSIT $ PLAN CHECK&INSPECTION FEE s ,ob ) EMERGENCY PERMIT FEE $ �,00 Lt i s , .�a a7Gli1 GI�ML TG111tl111 6.V IV YI IIVItl3 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. 5. 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 prior to 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.gov/water issues/programs/npdes/utilitvvaults.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. rc-o-G1 W� o (Z' L,I (�— Applicant Date: COBE Construction Shaun Olson 12-12-2017 Contractor (Print Name) Date: 1:\FORMS\Templates\Encroachment Permits\Encroachment Permit STATIC form2.pdf Rev.03/17 5/22/2018 � � Fees Associated With 11:45:14AM `A g CELJ'ir " Case#: ENC2018-00003 Fee ,.' Start Endrans ,Type` -Date ' '' Date Dept Descriptionz' " Code Account Number Created ° Amount Due' {{ YP l PCI1 7/1/2017 6/30/2018 Non-Util Plan Ck/Insp<S 101.740.4722 JT 1/8/2018 3,360.00 0.00 AF02 7/1/2017 6/30/2018 PrmtAppFee-Major-Eng E 101.730.4722 JT 1/8/2018 425.00 ' 0.00 CASH 7/1/2017 6/30/2018 Construction Cash Deposi 101.2203 JT 3/15/2018 100 M7 0.00 FPSD 7/1/2017 6/30/2018 Faithful Per£ Security/De 101.2203 JT 3/15/2018 : 4.400.ffi 0.00 Total Due: $0.00 Page 1 of 1 CaseFees..rpt PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1,2017 TO: Finance PUBLIC WORKS FILE NO. ENC2018-00003 PROPERTY ADDRESS 2160 S.Bascom Avenue Please collect&receipt for the following monies: ACCT. ITEM" ,.., AMOUNT' LAND=DEVELOPMENT 4722 Encroachment Permit Application-Fee IT L.0 CID f":+ 4 :iZ a trA o e . ia.i.._ . cri yt 47 i'� :{ .L.- L;.d Lt3 -.. L A.i ) t13 t [.1 iJr. C..:s LP.:. F...;+ lam- C..] -10% 47, 4722 En r. Est.<$250,000 14%of Engineer's Estimate 4722 En ir.Est.4250,000 000 and 5 500 000 $35,000.00+8%of Engineers Estimate 4722 En-qr.Est. > 500 000 $55,000.00+7%of Engineers Estimate 2203 Emergency Cash Deposit Refundable Deposit) 4%of En r.Est." $500 min/$10 000 Max $960.00 2203 Faithful Performance Security Refundable De osii 100%of ENGR:EST.* $24 000.00 2203 Labor and Materials Security 100%of EN R..EST." 4721 Storm Drainage Area Fee Per Acre R-1 $2,120.00 Multi-Res$2,385.00) All Other 2 650.00 4722 Parcel Ma 4 Lots or Less 4 200.00+ 90/lot 4722 Final Tract Ma 5 or More Lots 5 115.00+ 124/lot 2203 Monumentation Securi 100%of Ci 's Monumentation Estimate 4920 Parkland Dedication Fee 75%/25%Due Upon Cert.of Occu anc 4722 Lot Line Ad•ustment Includes Certificate of Compliance) 1 990.00 4722 Vacation of Public Streets&Easements $2,700.00 4722 Certificate of Compliance $1,970.00 4722 Certificate of Correction $590.00 4722 Document Recording Fees 15.00/first page 3 ea.Additional 4722 Private Improvement in Public ROW $100.00 4722 Approved Plan Revision Fee 100/sheet 4722 Ap6eal Filing Fee $200.00 730.4924 Notice of Improvement Obligation Payment 4722 Assessment Segregation or Reapportionment First Split $940.00 Each Additional Lot $295.00 511.7424 Postage MISCELLANEOUS",- Other Please S ecif *Engineer's Estimate shall be as approved) by the City Engineer and shall include all items of work. TOTAL $24 960.00 NAME OF APPLICANT I 1 1 I G`I �(��G v � NAME OF PAYOR F �i9b PHONE, {� ADDRESS ZIP LArld&l rA 9M �. FOR RECEIVED BY CITY CLERK ;Ra;, ONLY Date Recei "t'# 2A wn .. V. J:\Lard DeiAPIao Check Comments\t-Specific Projects Active Project In Progress\Bascom Ave S 2160\Fees\Fees.tl, - ' PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1,2017 TO: Finance PUBLIC WORKS FILE NO. ENC2018-00003 PROPERTY ADDRESS 2160 S. Bascom Avenue Please collect&receipt for the following monies: ACCT ITEM', LAND=DEVELOPMENT:,",'.'l-`'-. 4722 Encroachment-Permit Application Fee Non-Utility Encroachment Permit Major 2:$10,000 $425.00 $425.00 Minor Encroachment Permit<sioxo - $240.00 Initial R-1 Permit N/C Subsequent R-1 Permits within Two Year Period $240.00 Inspection Fee MinimumChar per Location $420.00 Street Tree Planting/Removal N/C 2203 0 per Tree Planting Deposit Required) $500.00/tree 22031 Plan Check Deposit 2%of Engineer's Estimate $500.00 min Utility and R-1 Permits no deposit required 4722 Gradinq&Drainage Plan Review Single Family Lot $295.00 Site< 10,000 s.f. $885.00 Site 10,000 s.f. <0.5 Acre $1,185.00 Site 0.5 Acre $1,772.00 4722 NPDES Review(C3 Requirements) For projects not required to submit numeric sizing $175.00 For projects required to submit numeric sizing Impervious Area 10,000 Sq. Ft to 1 Acre $740.00 Impervious Area 1 Acre or more $965.00 4722 For projects sent to Consultant for review Consultant Cost+20% 4722 Additional treatment facilities $315 ea Plan Check&Inspection Fee(Non-Utility) 4722 Engr.Est. <$250,000 14%of Engineer's Estimate $3,360.00 4722 Enqr. Est. �:$250,000 and:�$500,000 $35,000.00+8%of Engineers Estimate 4722 Enqr. Est. >$500,000 $55,000.00+7%of Engineers Estimate 2203 Emergency Cash Deposit(Refundable Deposit) 4%of Enqr. Est.*($500 minl$1 0,000 Max) 2203 Faithful Performance Security(Refundable Deposit) 100%of ENGR. EST.* - 2203 Labor and Materials Security 100%of ENGR. EST.* 4721 Storm Drainage Area Fee Per Acre R-1 $2,120.00 (Multi-Res$2,385.00) (All Other$2,650.00) 4722 Parcel Map(4 Lots or Less) $4,200.00+$90/lot 4722 Final Tract Map(5 or More Lots) $5,115.00+$124/lot 2203 Monumentation Security 100%of City's Monumentation Estimate 4920 Parkland Dedication Fee (75%/25% Due Upon Cert. of Occupancy) 4722 Lot Line Adjustment(includes Certificate of Compliance) $1,990.00 4722 Vacation of Public Streets& Easements $2,700.00 4722 Certificate of Compliance $1,970.00 4722 Certificate of Correction $590.00 4722 Document Recording Fees $16.00/first page$3 ea.Additional 4722 Private vate Improvement in Public ROW $100.00 4722 Approved Plan Revision Fee $100/sheet 4722 Appeal Filing Fee $200.00 730.4924 Notice of Improvement Obligation Payment 4722 Assessment Segregation or Reapportionment First Split $940.00 Each Additional Lot $295.00 511.7424, Postage 1--7-- —7— 7 MISCELLANEOUS' 7, I Other(Please Specify) *Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $3,785.00 NAME OF APPLICANT NAME OF PAYOR PHONE "1 ADDRESS ADDRESS zip 65r FOR RECEIVE BY-CITY CLERK 7' ONLY Date Rbe ipi-x 0 6 N: JAL.nd(D.,71an Check C..—IMI-Spedft P,.j.1.-Adw.N.pd in N.g—'B...n,Ave S 2160T—T--I 2a OF U+Rw . REM #; . 0100221255 S2UEOCE39 q+vS DATE. 6Ayg Ry#q +»; 01Z0 4e 2+= m;m +2q IA ' A 0 U 1114 mq B:ate ma+mq _ . . gm & mgD FILING . #3,m gm8mmDGRmF q. Cm . . TOTAL +a q,7&m IaR»e $31785.00 2q7: «m CHECK 7F kw 2095 . . COBEC-1 OP ID:JV DATE(MM/DD/YYYY) ACORO" CERTIFICATE OF LIABILITY INSURANCE 03/07/2018 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 CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must 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 CONTANAME: Lisa Malvido Bozuuto&Associates Insurance PHONE g00-989-8712 FAX No:408-429-8460 34 S.Second St A/c No Exf Campbell,CA 95008 E-MAIL-ADDRESS: Lisam@dbinsurance.com Linda Ellis INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Mt.Hawley Insurance Co. 37974 INSURED COBE Construction,Inc. INSURER B:Security National Insurance Cc 19879 498 Salmar Ave Campbell,CA 95008 INSURER C:Everest National Insurance Co. 10120 INSURER D:Ohio Security Insurance Co 24082 INSURER E:Underwriters at Lloyds London 15792 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 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUB LTR POLICY NUMBER MM/DD/YYYY MM/DD//YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE FXIOCCUR X MGL0186121 05/01/2017 05/01/2018 DAMAGE TO RENTED PREMISES Ea occurrence $ 60,000 X Owner/cont Prot. MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY�jE LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: I $ AUTOMOBILE LIABILITY CO cidentMBINED SINGLE LIMIT $ 1,000 00 Ea ac , B X ANY AUTO SPP133221102 05/01/2017 05/01/2018 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10,000,00 A X EXCESS LIAR CLAIMS-MADE MXL0425267 05/01/2017 05/01/2018 AGGREGATE $ 10,000,00 DIED I I RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER C ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N X 7600016366171 05/01/2017 05/01/2018 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 D Property Section BFS56408680 07/09/2017 07/09/2018 BPP/DED 21218/100 E Professional Liab AE172379 09/13/2017 09/13/2018 OCC/AGG 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: 2160 S Bascom Ave. Campbell CA 95008;Encroachment Permit #ENC2018-00003 City of Campbell, its officers, employees and volunteers are named as additional insured per the attached endorsements. The insurance coverage afforded to the Additional Insured is primary insurance per the attached endorsement. All work in the public right-of-way. r0�ba 3 CERTIFICATE HOLDER CANCELLATION CITYCAM 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 North First Street Campbell,CA 95008 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Policy Number: MGLO186121 Mt. Hawley Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations: All persons or organizations where required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to in- not be broader than that which you are required clude as an additional insured the person(s) or organi- by the contract or agreement to provide for such zation(s) shown in the Schedule, but only with respect additional insured. to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or B. With respect to the insurance afforded to these in part, by: additional insureds, the following additional exclusions apply: 1. Your acts or omissions; or This insurance does not apply to "bodily injury" or 2. The acts or omissions of those acting on your "property damage"occurring after: behalf; 1. All work, including materials, parts or equipment in the performance of your ongoing operations for the furnished in connection with such work, on the additional insured(s) at the location(s) designated project (other than service, maintenance or re- above. pairs)to be performed by or on behalf of the addi- tional insured(s) at the location of the covered However: operations has been completed; or 1. The insurance afforded to such additional insured 2. That portion of"your work" out of which the injury only applies to the extent permitted by law; and or damage arises has been put to its intended use by any person or organization other than another 2. If coverage provided to the additional insured is contractor or subcontractor engaged in performing required by a contract or agreement, the in- operations for a principal as a part of the same surance afforded to such additional insured will project. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 Insured C. With respect to the insurance afforded to these 2. Available under the applicable Limits of Insurance additional insureds, the following is added to Section shown in the Declarations; III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is required by a contract or agreement, the most we will This endorsement shall not increase the applicable pay on behalf of the additional insured is the amount Limits of Insurance shown in the Declarations. of insurance: 1. Required by the contract or agreement; or r CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2 Insured Policy Number: MGLO186121 Mt. Hawley Insurance Company 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 PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE I Name of Additional Insured Person(s) Location and Description of or Organization(s) , Completed Operations All persons or organizations where required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to Section organization(s) shown in the Schedule, but only with III—Limits Of Insurance: respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the If coverage provided to the additional insured is re- location designated and described in the Schedule of quired by a contract or agreement, the most we will this endorsement performed for that additional insured pay on behalf of the additional insured is the amount and included in the "products-completed operations of insurance: hazard". 1. Required by the contract or agreement; or However: 2. Available under the applicable Limits of Insurance 1. The insurance afforded to such additional insured shown in the Declarations; only applies to the extent permitted by law; and whichever is less. 2. If coverage provided to the additional insured is required by a contract or agreement, the insur- This endorsement shall not increase the applicable ance afforded to such additional insured will not Limits of Insurance shown in the Declarations. not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 1 Insured Policy Number: MGLO186121 Mt. Hawley Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under-the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition (2) You have agreed in writing in a contract or agree- and supersedes any provision to the contrary: ment that this insurance would be primary and would not seek contribution from any other in- Primary And Noncontributory Insurance surance available to the additional insured. This insurance is primary to and will not seek con- tribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 S Insured WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY, WC 04 03 06 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 under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION ANY PERSON OR ORGANIZATION FOR BLANKET WAIVER OF SUBROGATION WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER This endorsement changes.the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 05-01-17 Policy No. 7600016366171 Endorsement No. 001 Insured COBE CONSTRUCTION INC Premium $ INCL. Insurance Company EVEREST NATIONAL INSURANCE COMPANY Countersigned By -1998 by the workers'Compensation Insurance Rating Bureau of California. All rights reserved. From the WCIRB's California Workers'Compensation Insurance Forms Manual-1999. INSURED COPY INSURANCE REQUIREMENTS CHECKLIST Permit# '0D03 CIP Project# Consultant/Contractor: The following insurance is required of all consultants/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 Commercial 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 -jd_ $2,000,000 general aggregate limit. 9F - Policy expiration date SJ C II Automotive Liability: "Any Auto" checked on certificate )a, $1,000,000 per accident for bodily injury and property damage 4—Policy expiration date Jr Workers' Compensation and Employer's Liability Waiver of Subrogation clause 4— $1,000,000 per accident for bodily injury or disease ❑ Policy expiration date Course of Construction (if required in Special Provisions) o Completed value of the project ❑ Policy expiration date Required Endorsements to General Liability and Automobile Liability Policies Additional Insured Endorsement: The City, its officers, employees and volunteers are named as additional insured. D�(Reference Project Location/Permit Number) The insurance coverage afforded to the Additional Insured is primary insurance. Cancellation area should say: Should any of.the above described policies be cancelled before the expiration date thereof,notice will be delivered in accordance with the policy provisions. Workers' Compensation Insurance Sheet Submitted - For General Contractor ❑ For Developer or Owner J:\FORMS\Templates\Insurance Requirements\Insurance Requirements Cklist.doc (Rev Jan 2018) Page 1 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. a Name: NAIC# 3 Rating: Authorized in CA: V Name: NAIC# IWI Rating: Authorized in CA: Name: � � ,y'�l NAIC# 1012,0 Rating: Authorized in CA: l Name: NAIC# Rating: Authorized in CA: ❑ Campbell Business License# 4� C6 Expiration: 3c, �c Z z— ❑ Contractors License # ( Class: Expiration: Q Insurance Certificate Reviewed J 1 Initials Date ❑ Copy of Insurance Certificate placed in tickler file one month prior to expiration. ,9 J:\FORMS\Templates\Insurance Requi rem ents\Insurance Requirements Cklist.doc (Rev 08 14) Page 2 READY MIXED SAN JOSE PLANT GILROY PLANT 8CG04 . 1404 SOUTH 7TH STREET W5 AUTOMALL PARKWAY 0 0 SAN JOSE, CA 95112 GILROY,CA s502o WARNING ACCOUNTING: 408 848-1560 'IRRITATION TO THE SKIN AND EYES ( ) 408 947 0669 ) 'Contains Portland CeMent Wear Rubber Boots and Gloves.PROLONGED CONTACT MAY QUALITY CONCRETE FAX: (408.)t947-0434; MORGAN HILL PLANT CAUSE BUT;k noot-ContacPlush Tyes and Prolonged Contact-it MTth nki;.L sdtss Get ' DISPATCH:(408) 947-0159 " 199 MAST ST. Medical Atzantion KEEP CHILDREN AWAYi FAX: (408) 947-0193 MORGAN HILL,CA 95037 SOLD TO: (408)779 2520 '. t SHIP TO: t R TIME FORMULA LOAD SIZE YARDSORDERED USE DRIVERTfRUCK MAP COORDINATE PLANT TRANSACTION# 1•,.k'r-t _t c:i 3, d.r}�t -i al' y. xt DATE CHARGE' G.O:D. LOAD# YARDS DEL:' BATCH# WATER TRIM SLUMP ''" TICKET NUMBER 0#t. 1.9 l E) ❑ �:: �.�o .� I„ i''t xl. 9�—r-Ii PROPERTY DAMAGE RELEASE tl t+-� 4 (TO BE SIGNED IF DELIVERY TO.BE MADE INSIDE CURB LIN j WEIGHMASTIrR CETiT.IFICATE Excessive Water is Detrimental to Concrete Performance Dear Customer-The driver of this truck s presenting this RE SE to yoWorypursiAde,1me isof theopinion THIS IS TO CERTIFY that•the fpI aw•`described com- H 0 Added B Re xUe_s" Authorized B that the sire and weight of his truck may pectins y„galls da age to[he'premises and/or atljaceht properly A� .�... 2 y Q j y if he places the material o.this load where you desire t It is eucylish to help you in every way that we ca,IL„ modlty WB$WBlghed,R1eaSUred,fOf Bunted by a but in order tc do this the driver is requesting that you sign in 9 RELEASE.relieving his and his suggfrwfrom any responsibility from y„damage that may 8ccur to the premisces and/or adjacent property,hTlndings,. weighmaster,.whose signature is on this certificate,Who GAL sldewalks,.drive-ways, 5r s;etc.,by the delivery of this material,and that yeti aIse agree tp help; _ a- is a recognized authority of accura' as prescribed b remove mud from the wheVls of his vehicle so that he will not litter the puhlic street Further;as addiCio"daT 9 y - p y CONCRETE is a.PERISHABLE COMMODITY and BECOMES the PROPERTY of the PUR— consideration,the unde1olgded agrees to indemnity and Bold harmless the driver of this truck and this supplier Chapter (commencing with sectidn 12700)of Division CHASER WHEN TRUCK IS LOADED.ANY CHANGES or CANCELLATIONS of ORIGINAL for any and all damage to the'premises and/or,adjacent pmpefty which may be claimed by anyone tc have arisen out of delivery of this orderAurisdictipnand Venue.Socrand Buyeragreethat exclusive jurisdiction and 5 of California Business and ProfegsionsTCode;adminl5- INSTRUCTIONS MUST he TELEPHONED to,the OFFICE BEFORE LOADING STARTS. venueancing putniand related to the subject matter of this credit application and any sale of goods from Seller to teretl b the Division of Measurement Standards of the The undersigned promises to pay all costs,including reasonable attorneys'fees, Buyer shall Hein the Superior Ceud of the State of.California,County of Santa Clara y ingurre-d.in collecting any.sums owed:- SIGNED California Department of Food and Agriculture. All COD;s not paid at time of delivery will be itharged a$50.00 Service Charge and bear interest`at the rate of 10%per annum. • MASTER { Not responsible for Reactive Aggregate'or Color Quality.No Claims For Such Allowed Unless Made at Time Material is Delivered. rint'jan 1"mm, r. Collected on all Returned r A Checks. Service Charge and of Cash Discount will be LOAD RECEIVED BY: S ` Excess Delay Time Charged®$2.00/per minute X /, QUANTITY CODE DESCRIPTION _ UNIT PRICE-r- EXTENDED PRICE LS4i:. °siiSsi! i:;i!?3,. ('�':..',r. 'F iL,tiit47•ft;i`C. ! s.:l+ *THERE WAS NO CONCRETE OR CEMENTITIOUS MATERIAL LEFT'IN'STREET OR STORM DRAIN BY STAR CONCRETE X RETURNED TO PLANT LEFT JOB FINISH UNLOADING DELAY EXPLANATION/CYLINDERTEST TIMEALLOWED 1.JOB NOT READY 6.TRUCK BROKE DOWN 2.SLOW POUR OR PUMP 7.ACCIDENT 3.TRUCK AHEAD ON JOB 8.CITATION-" LEFT PLANT-, ARRIVEDJOB STARTUNLOADING 4.CONTRACTOR BROKE DOWN 9.ADDRESS TIME DUE 5.ADDED WATER 10.OTHER 7• ADDITIONAL CHARGE 7.' ERROR IN PRICE,EXTENS ION AND ADD ITION SU BJECTTO COB RE TION. TOTAL ROUND TRIP TOTALATJOB UNLOADTIME DELAY TIME ADDITIONAL CHARGE 2 �NifiVill MUM CUSTOMER COPY SUGGESTIONS FOR PLACING CONCRETE SLAB TO MINIMIZE RANDOM CRACKING WH.Xr YOU DO WHY YOU DO IT SUIT J. Level and compact sub grade, place 4" of STEP The sand provides a CLIshion for the concrete darnp sand and grade so concrete and good drainage. poured is a consistent depth. TEPI STEP 2. m" Separate your new concrete from all The felt separates your new concrete fro S existing concrete with. 1112" felt. Felt must eXiStiDg, so itinay shrink, expand, move tip match the depth of your new slab. or down without a detrimental affect. 3, P 3. Screen OITYOUr concrete. STE P Make sure there are no low spots. STEP-1. Roller bug your concrete. STEP 4. Once over the surface, it helps vibrate, con- soll.dale and Rive you a better finish. STEPS. Float concrete with wood bull float only. I STEPS. Wood keeps the surface open and allows the concrete to bleed preventing water entrapment and discoloration and/or plastic crackin'g. STEP 6. Cut control. oints perpendicular from.edge STEP6. These joints should allow the concrete to crack 1/4 the depth of the slab, using appropriate in the joint taking the path of least resistance. spacing. 4" slab would be 89xS'. STE'll 7 Allow all bleed water to evaporate from the STEI. If you do not wait for all bleed water to Sur-face, then you can. finish. the concrete evaporate, you end Lip troweling your bleed with metal trowels. water back into the surface, dramatically changing your water/cement ratio, on the surface, causli-ig a weaker surface. STEP 8. When surface is firiished,spray with a concrete S 17111 This protects the concrete froin wind, heat cure,if the concrete is colored you must use a and allows your_slab to cure on its own cure formulated for colored concrete. giving you a much better fliushed product. STIHIP 9. Never add water or dry cement to the STEP These two things also change water/cement surface of your slab.- ratio on the surface and can ruin your slab. , t CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT ENGINEERING DIVISION Revised 8/15 ENGINEERS ESTIMATE FOR LAND DEVELOPMENT PROJECTS Date: DecEmber 12,2017 For File No(s): Site Address: 2160 Bascom Avenue ENC. No. Estimated Cost of I m rovements $24,OW ITEM UNIT PRICES FOR PRO.ECT AMOUNT NO. DESCRIPTION OTY UNIT <$100K >$100K $AMOUNT I.DEMOLITION/CLEARING 1. CLEARING&GRUBBING 0 LS $2,750.00 $2,000.00 $ - 2. SAWCUT P.C.C./A.C.(UP TO 6") 122 LF $5.75 $4.25 $ 701.50 3. P.C.C.REMOVAL 621 SF $4.00 $3.00 $ 2,484.00 4. CURB AND GUTTER REMOVAL 76 LF $11.00 $7.00 $ 836.00 5. MEDIAN REMOVAL 0 SF $7.00 $5.50 $ - 6. DEMOLISH EXISTINGINLET/PLUGRCPS 0 EA $2,250.00 $1,750.00 $ II.STORM DRAINAGE 1. 12'R.C.P.(CLASSV) 0 LF $275.00 $225.00 $ - 2. 15'R.C.P.(CLASS III) 0 LF $300.00 $250.00 $ - 3. 18"R.C.P.(CLASS III) 0 LF $325.00 $275.00 $ - 4. 24"R.C.P.(CLASS III) 0 LF $350.00 $300.00 $ - 5. 30'R.C.P.(CLASS III) 0 LF $400.00 $350.00 $ 6. T.V.INSPECTION(12") 0 LF $1.60 $1.25 $ 7. STD.DRAINAGE INLET(C.C.DETAIL 5) 0 EA $3,600.00 $3.000.00 $ B. FLAT GRATE INLET(C.C.DETAIL 6) 0 EA $2,125.00 $1,700.00 $ 9. STD MANHOLE(C.SJ.DETAIL D-11) 0 EA $6,500.00 $5,250.00 $ 10. STD MANHOLE(C.S.J.DETAIL D-12) 0 EA $8,000.00 $6,500.00 $ - 11. BREAK AND ENTER M.H./D.I. 0 EA $1,300.00 $1,000.00 $ - Ill.CONCRETE IMPROVEMENTS 1. SIDEWALK 141 SF $10.00 $8.00 $ 1,410.00 2. DRIVEWAY APPROACH 492 SF $14.00 $10.00 $ 6,888.00 3. CURB AND GUTTER 76 LF $60.00 $47.00 $ 4,560.00 4. VALLEY GUTTER 0 SF $35.00 $30.00 $ - 5. CURB RAMP 0 EA $4,500.00 $3.500.00 $ - 6. TYPE B-1 CURB 0 LF $50.00 $40.00 $ - 7. TYPEA1-B3CURB 0 LF $25.00 $20.00 $ - 8. COBBLESTONE MEDIAN SURFACE 0 SF $25.00 $20.00 $ - 9 BUSSTRESSPAD 0 EA $12,000.00 $12,000.00 $ - WAACAD\ACAD 2017\1724-2160 BASCOM AVE\CITY COMMENTS\1724 SNCE 431.x1sx(Rev.03/08) Page 1 of 4 CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT ENGINEERING DIVISION Revised 8115 'ENGINEER'S,ESTIMATE FOR`" LANO'DEVELOPMENT PROJECTS Date: December 12„2017 For File No(s): Site Address 2160 Bascom Avenue ENC. No. Estimated Cost of Improvements $24,0W ITEM UNIT PRICES FOR PRCUECT AMOUNT NO. DESCRIPTION QTY UNIT <$100K >$100K $AMOUNT 10. STRIPING DETAIL39 0 LF $6.00 $5.00 $ 11. LIMITLINE 0 LF $7.50 $6.00 $ - 12. CROSSWALK,17 WHITE 0 LF $7.50 $6.00 $ - 13. PAVEMENT MARKINGS(PAINT) 0 SF $4.00 $3.25 $ - 14. PAVEMENT MARKINGS(THERMO) 0 SF $8.00 $6.60 $ - 15. PAVEMENT MARKER(NON-REFL.) 0 EA $6.50 $5.20 $ - 16. PAVEMENT MARKER(REFLECTIVE) 0 ' EA $8.25 $6.95 $ - 17. TYPE K MARKER 0 EA $125.00 $109.50 $ - 18. TYPE N MARKER 0 EA $125.00 $109.50 $ - 19. SALVAGE ROAD SIGN .0 EA $115.00 $99.00 $ - 20. RELOCATE ROAD SIGN(W81 ON NEW POST) 0;. EA $145.00 $115.75 $ - 21. INST.RD.SIGN ON EXIST.POLE 0. EA $265.00 $231.55 $ - 22. ROAD SIGN WITH POST 0 EA $400.00 $347.30 $ - 23. INSTALL 1226SSlGN WITH POST 0 EA $400.00 $350.00 $ - 24. STANDARD BARRICADE 0 LF $25.00 $19.50 $ - VI I.LANDSCAPING 1. STREET TREE 0 EA $650.00 $500.00 $ - 2. STREET TREE(36'BOX) 0 EA $900.00 $760.00 $ - 3. PRUNETREEROOTS 0 EA $200.00 $150.00 $ - 4. TREE REMOVAL - 0- EA $800.00 $650.00 $ - 5. PLANTINGS 0 LS $1.00 $1.00 $ - 6. IRRIGATION 0 LS $1.00 $1.00 $ - WAACAD\ACAD 2017\1724-2160 BASCOM AVE\CITY COMMENTS\1724 SNCE 431.x1sx(Rev.03/08) Page 3 of 4 CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT ENGINEERING DIVISION Revised 8/15 -ENGINEER'S"ESTIMATE FOR LAND DEVELOPMENT PROJECTS' Date: December 12,2017 For FileNo(s): SiteAddress: 2160 Bascom Avenue ENC. No. Estimated Cost of Improvements $24,0W ITEM UNIT PRICES FOR PROJECT AMOUNT NO. DESCRIPTION QTY UNIT <$100K >$100K $AMOUNT IV.PAVEMENT 1. ASPHALT DIGOUT AND REPLACE 78 CF $6.25 $5.25 $ 487.50 2. PAVEMENT WEDGE CUT(61 0 LF $5.50 $3.00 $ - 3. PAVEMENT GRINDING 72 SF $1.10 $0.75 $ 79.20 4. PAVEMENT FABRIC(PETROTECH) 0 SY $2.50 $2.25 $ - 5. ASPHALT CONCRETE(TYPE A) 2.7 T $226.00 $180.00 $ 607.50 6. AGGREGATE BASE(CLASS 2) 0 T $90.00 $50.00 $ - 7. SLURRY SEAL(TYPE II) 152 SF $0.30 $0.25 $ 45.60 8 AC REMOVAL/OFFHAUUDISPOSAL 30 CF $15.00 $13.50 $ 450.00 V.TRAFFIC SIGNALSILIGHTS 1. DETECTOR LOOP(V ROUND) 0 EA $650.00 $520.00 $ - 2. DETECTOR LOOP(6'x 30) 0 EA $950.00 $750.00 $ 3. DETECTOR LOOP(6'xW) 0 EA $1,300.00 $1,025.00 $ 4. ELECTROLIER 0 EA $10,000.00 $6,000.00 $ 5. 1 1/Z'RIGID CONDUIT 0 LF $1300 $10.00 $ 6. Z'RIGID TRAFFIC SIGNAL CONDUIT 0 LF $24.00 $20.00 $ 7. CONDUCTOR 0 LF $1.05 $0.85 $ 8. PULL BOX(NO.31/2) 0 EA $425.00 $350.00 $ 9. TRAFFIC SIGNAL PULL BOX(NO.5) 0 EA $580.00 $460.00 $ - 10. PULL ROPE 0 LF $0.60 $0.60 $ 11. NEWSIGNALIZED INTERSECTION 0 LS $380,000.00 $ VI.STRI PING AND SIGN$ 1. REMOVE PVMT.MARKINGS(PAINT) 0 SF $3.00 $2.65 $ 2. REMOVE PVMT.MARKINGS(THERMO) 0 SF $4.25 $3.70 $ 3. REMOVE PVMT STRIPING 0 LF $1.85 $1.50 $ 4. STRIPING DETAIL 0 LF $3.60 $3.00 $ 5. STRIPINGDETAIL22 0 LF $3.60 $3.00 $ 6. STRIPING DETAIL29 0 LF $4.75 $4.00 $ - 7. STRIPING DETAIL 32 0 LF $4.75 $4.00 $ - 8. STRIPING DETAIL 37(THERMO) 0 SF $6.00 $5.00 $ - 9. STRI PI NG D ETA]L 38(TH ERM 0) 0 SF $6.00 $5.00 $ - WAACAD\ACAD 201711724-2160 BASCOM AVE\CITY COMMENTS\1724 SNCE 431.)dsx(Rev.03/08) Page 2 of 4 CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT ENGINEERING DIVISION Revised 8115 ENGINEEIrS ESTIMATE FOR, LAND DEVELOPMENT PROJECTS - Date: becEmber 12,2017 For FileNo(S): SiteAddress: 2160 Bast m Avenue ENC. No. Estimated Cost of Improvements $24,OW ITEM UNIT PRICES FOR PROJECT AMOUNT NO. DESCRIPTION CITY UNIT c$100K >$100K $AMOUNT VI11.MISCELLANEOUS 1. PEDESTRIAN BARRIER 0 LF $86.85 $69.45 $ 2. CHAIN LINK FENCE(6) 0 LF $30.00 $25.00 $ 3. RAISE MISC.BOX TO GRADE 0 EA $600.00 $500.00 $ - 4. RAISE MANHOLE TO GRADE 0 EA $850.00 $700.00 $ - 5. INSTALL MONUMENT BOX 0 EA $3,000.00 $3,000.00 $ - 6. MEDIAN BACKFILL 0 CY $26.00 $22.00 $ - SUBTOTAL $ 18,549.30 PREPARED BY: Stew Nakaslima 10%MOBILIZATION,CONSTRUCTION $ 1,854.93 TRAFFIC CONTROL/PHASING, $ REVIEWED BY: CONSTRUCTION STAKING, $ CONSTRUCTION TESTING $ . APPROVED BY: 109/oCONTINGENCY $ 1,854.93 10%SECURITY ENFORCEMENT $1,854.93 TOTAL FAITHFUL PERFORMANCE SECURITY $ 24,114.09 USE THISAMOUNT FOR SECURITY W:\ACADWCAD 2017\1724-2160 BASCOM AVE\CITY COMMENTS\1724 SINCE 431.1dsx(Rev.03/08) Page 4 of 4 6 i ENGINEERING DIVISION 70 North First Street,Campbell,CA 95008 Ph. (408)866-2150;Fx.(408)376-0958 CHECKLIST FOR STREET IMPROVEMENT PLANS APPLICATION NON: ADDRESS: 12160 Bascom Avenue Instructions: This checklist provides advance notification to applicants of the City of Campbell's final street improvement plans and submittal requirements. Using this checklist will expedite your application through the City's review process. Prior to submitting a final street improvement plan list to the City Engineer,please place an"X"in the space to the right of each item below to indicate you have complied with,or place"N/A"to indicate that the particular item doesn not apply. Review applicable sections,which are referenced in parentheses,before checking off each item. SEAL AND SIGNATURE OF ENGINEER OF WORK I HEREBY DECLARE THAT I AM THE ENGINEER OF WORK FOR THIS PROJECT,THAT I HAVE EXERCISED RESPONSIBLE CHARGE OVER THE DESIGN OF THE PROJECT,AND COMPLETION OF THIS CHECKLIST,AS DEFINED IN SECTION 6703 OF THE BUSINESS AND PROFESSION CODE,AND THAT THE DESIGN IS CONSISTENT WITH CURRENT STANDARDS. Signature Date Printed Name: Stevan Nak ash ima RCE#: C26597 Expiration Date: 1.03/31/2018 (SEAL) ITEMS COMPLY NOT APPLY CITY COMMENTS I. GENERAL 1. City standard off'-site title sheet with applicable notes. rX7, OK 2. 24"X36"sheet size used,including City Standard {XI OK borders and Blueprint for a Clean Bay Plan Sheet. 3. Title Block/Scale/North Arrow Shown. FX— OK 4. Plans capable of microfilm reproductions-minimum OK 1/8 inch lettering. 5. Engineer's name,number,expiration date and r, OK signature included on all sheets. J 6. Vicinity Map shown(must be microfilmable). r OK 7. Sheet Index and key map included for 3 or more OK F— N/A sheets. 8. Limits of Public Works inspection clearly shown OK on plan,typical section,and bond estimate. 9. Street Light locations/legend/Electric Service f7 OK rX; N/A Connection Location shown. 10. Elevation tied to City benchmark. FX� OK Reference City benchmark. 11. Curb grade plans prepared by Public Works have -been incorporated into improvment plans and OK r N/A verified as adequate. 12. Curb grade plans prepared by Engineer for review by Public Works and cross-sections @ 50'max.intervals F- OK FX- N/A along road frontage and extending 150'min. beyond limits of work. Profile line,centerline,&EP 13. Signing and striping plan plus existing striping [7, OK rl N/A included in improvement plans. 14. Development No.(SUB,MS,LUP,DP)shown on each r7 OK FK7 N/A sheet. 15. Verification and land rights for off-tract work(title F7 OK N/A report,recorded easement,etc.) 16. Permits required from other agencies(Fish&Game OK [X N/A CalTrans,Army Corps of Engrs,Flood Control,etc.) 17. Right of entry submitted for review for all off-tract F- OK FX-; N/A work. 18. Landscaping within the public right-of-way OK JX N/A included in improvement plans. 19. Fence required along water district canals. r, OK r N/A 11. ROADS A. TYPICAL SECTIONS 1. Street cross-section shown at 50'intervals maximum(closer intervals may be necessary per r OK r N/A the City Engineer). Cross sections slopes shown. 2. Structural pavement design calculations submitted (per Caltrans Highway Design Manual)and [7, OK FX_ N/A correspond to plans. 3. Sidewalk,curb and gutter indicated with details r, OK F- N/A included on plans. 4. Right-of-Way and street width dimensions shown. (— OK 5. 2:1 max.cut/fill slopes shown beginning at R/W r OK r N/A lines-Soils Report verifying exceptions. -- 6. Crown Slope indicated. r- OK r N/A 7. Pedestrian or bike paths shown. r OK F>-( N/A 8. Pavement Design Chart shown with T.I. and R-values F, OK N/A for review. B. PLAN VIEWS ILUMMd rou I ArrLT ILI i Y 6.VMm11:611 i, 1. Radius of curvature shown on all curves. OK r, N/A 2. 20'curb return radii shown for major thoroughfares r OK r, N/A and industrial streets. 3. 24'min.curb opening for private road intersection. F7 OK N/A 4. Horizontal curves and sight distance designed per Highway Design Manual. (— OK N/A 5. Cul-de-sac radii(35'min.)shown. OK r N!A 6. Private road turnarounds shown. r OK r: N/A 7. R/W and street width dimension shown. r OK r N/A 8. Centerline stationing shown at 50'intervals. r7 OK rX7 OK 9. Curve info provided in table format(i.e.BC/EC station,offset,radius,and delta). OK FX- N/A 10. Lot/parcel lines and numbers letters indicated. r OK fX7 N/A 11. Valley gutters indicated. Flag flow line elevations at quarter points on curb returns and valley gutter r` OK F:K-, N/A centerline. 12. Stationing and offsets of all drainage structures r OK FX-, N/A shown. 13. TC/RIM elevations at all drain structures w/invert and F- OK r' N/A FL elevations shown. (Invert and FL elevations may be shown on profile if preferred. If profile is not on same sheet as plan view,TC/RIM,invert,and FL elevations must be shown on plan and profile.) 14. Drainage easements shown and dimensioned. r OK r N/A 15. Location of underground pipes and utilities shown for laterals and main lines(i.e.sanitary sewer,gas, r OK FX7 N/A water,etc.). 16. Street monuments shown. F7' OK r', N/A 17. Off-tract slope easement shown,with x-sections, r-. OK r, N/A topo and offer of dedication for slope easement submitted for review. 18. Pedestrian Paths shown. Basic grade shown. F7 OK r N/A 19. Wheelchair ramps shown at returns with details. [, OK FX N/A C. PROFILES 1. Vertical curves designed for proper speeds per f7 OK r N/A Highway Design Manual. 2. Minimum vertical curve lengths observed. f7 OK r, N/A 3. Curb returns and cul-de-sac profiles shown(high r- OK (X N/A and or low points indicated when vertical curve is used. 4. Vertical curve used for grade breaks greater than 2%. (3%on sag curves). r OK FX— N/A 5. 6%maximum gradient observed @ intersecting streets.I—. OK (X N/A 6. 6%maximum grade observed across intersections. (— OK FX N/A 7. 1%minimum grade observed on all streets. r OK [X N/A 8. Maximum street grades per ordinance. OK N/A 9. Underground pipes and utilities shown. (— OK r N/A 10. Existing ground at centerline shown. Where �, OK r N/A topography is steep,existing ground left and right of centerline has been shown. 11. Finish grade profile for centerline and for top of curb OK N/A shown(left&right)if special grades required. 12. Cul-de-sacs all have 1%to 4%cross slope between r' OK FX7 N/A gutter lip and high point. 13. Super elevation grades shown where required by F; OK FX_, N/A Highway Design Manual. 14. Back of curb flow diverters indicated on proposed county streets with grades over 5%when no sidewalk F OK FX' N/A installed. 15. Centerline profiles of intersecting streets shown to their point of intersection. (Showing curb return or 0K FX-i N/A other profiles in lieu of the centerline profile is not an adequate or correct representation.) 16. Off-tract profile to catch point shown where road is r—, OK !X N/A constructed to subdivision boundary. 17. Centerline stations and elevations shown @ 50' F' OK FX7 N/A minimum intervals and @ all BVC,EVC,PIVC,and grade breaks. 18. Profile slopes indicated. r, OK r, N/A 111. DRAINAGE A. HYDROLOGY-HYDRAULICS 1. Contours shown for 100 feet+beyond property. r; OK FX, N/A 2. 100 year water surface calculations completed when natural watercourse or drainage facility flows through r7 OK FX N/A or adjacent to subdivision or the property lies within flood hazards or flood prone area and water surface shown on plans. 3. EGL,HGL,F1,E1,Q,A,S,V,freeboard at structures, structure losses,tailwater assumptions,super or r OK N/A subcritical flow all indicated. 4. Adequacy of in-tract drainage system verified. J- OK F•. N/A 5. All starting water surface calculations adequately verified. (When computing beginning water surface in r OK N/A natural watercourse and no obvious point of control is available,beqin 500'downstream and work up to point B. EASEMENTS 1. Easements shown on map are shown on plans. OK N/A 2. Off-tract drainage improvements(plan and profile) F7 OK N/A and accompanying easements shown. Off-tract offers of dedication for drainage easement submitted for review. 3. Off-tract work to be done but no easement requirements. Right of entry submitted for review. OK N/A 4. Easement widths indicated for(a)closed conduits, r—: OK r, N/A (b)open channels. 5. Sufficient X-sections submitted to verify easement width and Development rights for open channels. F OK FK7 N/A 6. Access and ingress easements shown,graded to be �— OK [X—' N/A useable. -- - 7. Minimum 12'ingress easement to public way provided to all access easements. F7 OK �, N/A 8. Minimum 40'centerline radius for access easements j-- OK F)7�. N/A shown. 9. Structure setback line indicated and location verified with X-sections for unimproved channel. OK r N/A 10. Fences shown as required where street crosses F7, OK rX N/A watercourse or drainage structure. - 11. Fences shown as required at outside boundaries of r- OK F- N/A open lined channel easements and water district canals. C. STRUCTURES 1. Inlet detail shown for new inlet installation. F OK FX7, N/A 2. Inlet depths without manhole bases and max.dia. OK N/A Pipes through inlets observed. Type A 6' CC 3011 36"front 30"side Type B 12' CC3012 36"front 30"side Type C 4' CC3013 36"front 24"side Type D 6' CC3016 36"front 24"side Type E 4' CC3017 36"front 24"side 3. Max.diameter pipes through manholes observed. Type 24" CC 3020 �. OK r N/A Type II 42" CC 3021 Type III 60" CC 3022 4. 1.25"minimum freeboard in inlets and manholes. F— OK r N/A 5. HGL shown in all structure profiles. OK FX7 N/A 6. Structure type indicated on plan or on structure list r OK FX- N/A on same plan sheet. D. ,PIPES 1. Closed conduit minimum slope of 0.005 observed. r: OK ri N/A 2. Natural watercourses are placed in closed conduits for flows less than 80 cfs. j- OK r N/A 3. Storm drain calculations submitted and correspond F- OK FX7, N/A with plans. 4. Water directed into inlet does not reverse the direction of flow. OK N/A r: 5. Minimum centerline radii of pipe checked. Beveled RCP lengths specified(bevel one or both r. OK FX7 N/A ends)and stationing of EC and BC indicated. 6. Outlet protection for closed conduits or lined r, OK FX—, N/A channels provided. 7. 2'minimum cover over pipe observed(provided F OK FX-' N/A manufacturer specs does not require more)unless special design and calcs. 8. Design Q shown on pipe profile. OK r N/A 9. Minimum cleansing velocity of 2 FPS with half (- OK r" N/A design flow observed. r` OK FX— N/A 10. 18"minimum pipe size. E. CHANNELS 1. Maximum velocity in earth channel verified by soils report-minimum velocity 3 FPS. [ OK N/A 2. Improved earth channel side slopes shown to be 2:1 or less steep as specified by soils report. OK N/A 3. Lined channel side slopes as specified by soils OK r N/A report. 4. Areas noted to be cleared of structures,trees, r OK [X N/A brush,and debris within natural channel and watercourses. J:\FORMS\Templates\Land Development\Street Improvements\Checklist for Street Improvement Plans STATIC form2.pdf I I I A I ^ 0 0 0 0 C) 0 0 0 0 0 �0 w m c� M m I V �R- �5 p �5- cr :g CD (D -'- ,�; CD 0 4 C.- 0,0 )�. 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