96-138
CITY OF CAMPBELL ENCROACHMENT PERMIT
DEPT. OF PUBUC WORKS (for working within the
70 North First St. public right-of-way)
Campbell, CA 95008
(408) 866-2150 Issued bJ/~/~ Application Date 3-/2 -~"
Fax (408) 37~58 Pennit expires' 12 lJK)~ Application expires in 6 mos.
APPUCATION _ Application is hereby made for a Public Works Pennit in acamtance with Campbell Municipal Code, Section 11.04.
expires in 6 months if the pennit is not issued Application Fee is non-refundable).
'lOt) U/ !-lam; l'ton /l--I/C
?t:nnit No. q ~ - 13S
'~-p'j'. FUe--:er...-,o-<" UP. 7'-1-0j
(Application
A. Work address or tract #
Utility trench location
B. NatUre of work S\TI'-e.e T / c:; ,)Jot=' J./:l (?:.- /7.?--d,f,.~~
C. Attach four (4) copies of engineered plans showing the location and extent of the work, and four (4) copies of the preliminary Engineer's
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 plans become a pan of this pennit.
D. All work shall confonn to the City of Campbell Standard Specifications and Details for Public Works Construetion; the General Pennit Conditions
listed on the reverse side; and the Special Provisions for this pennit, listed below. Failure to abide by these conditions and provisions may result in
job shut-down and/or forfeiture of Faithful Performance Sureties and cash deposits. (See General Pennit Conditions 1 and 2.)
E. THE CONTRACTOR MUST HA VB TIllS PERMIT AND APPROVED PLANS AT THE SITE AND MUST NOTIFY THE PUBUC WORKS
DEPARTMENT AT LEAST TWO DAYS BEFORE STARTING WORK.. NOTICE MUST BE GIVEN TO PUBUC WORKS AT LEAST 24 HOURS
BEFORE RESTARTING ANY WORK..
Name of Applicant/Pennittee .::::; c- c> 11 Cc 0 Ie y
Address 10 {) CI/. I:f [/ t/i/!; iT 0/1 fl // e-
Is this work being done by the property owner at their own residence?
Telephone ~ 70 - / '7 C) ()
Yes
'y:: No
The ApplicantlPennittee hereby agrees by affixing their signature to this pennit 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 pennit.
The Applicant/Permittee hereby acknowledges that they have read and understand both the front and back of this pennit, and they will infonn their
contractor(s) of the information:
~
~-'1'-90
Robert Phillips ~~~
L
~Michelle Quinney
To: Accounts Receivable
Please Issue Check
Payable to:
Address - Line 1:
Line 2:
City:
Description:
Amount Payable:
Account Number:
Date and Receipt No:
Permit No:
Purpose:
Requested by:
Approved by:
FINANCE ONLY:
Verified by:
Approved by:
Mail As Is:
Return To:
Other:
Cit) of Campbell - Chect( Request
. i,;~
Scott Cooley
700 w. H~ilton Avenue
Campbell
State: CA Zip: 95008
REFUNDABLE DEPOSIT
Finance Only:
INTEREST EARNED
$ 9,500.00
101.2203
101.540.7448
5/10/96 #93182 $9,500.00
96-138
End of maintenance period.
Title:
PW Inspector
Date: 7/7/97
Date: 7/7/97 I
Date:1
I
Title:
City Engineer
Title:
Title:
Date:
Special Instructions For Handling Check
x
Mail in Attached Envelope:
(NAME)
(Department)
rev: 3/25/95
Cit af CampbeII- Chel__ Request
To: Accounts Receivable
Please Issue Check
Payable to:
Address - Line 1:
Line 2:
City:
Description:
Amount Payable:
Account Number:
ate and Receipt No:
Permit No:
Purpose:
Requested by:
Scott Cooley
Contour Software
700 W. Hamilton Avenue
Campbell
CA
State: Zip:
95008
REFUNDABLE DEPOSIT
Finance Only:
INTEREST 'EARNED
$ 29,926.81
Refund 75% of $38,000 FPS ($28,500), refund $1,520 construction
cash deposit less backcharge of $93.19 tor 1nsp~~~UL OT.
Randy Westfall
Title: PW Inspector
D 9/17/96
ate:
Approved by: Michelle Quinney ~_
Title:
city Engineer
Date: 9/17/96 I
Due:1
I
FINANCE ONLY:
Verified by:
Approved by:
Mail As Is: x
Return To:
Other:
'ev: 3/25/95
Title:
Title:
Date:
Special Instructions For Handling Check
Mail in Attached Envelope:
(NAME)
(Department)
PUBLIC WORKS DEPARTMENT RECEIPT I
Effective July 1, 1995 \
PUBLIC WORKS FILE NO. c:!l( b - \~~ I
...., c:>c:::> "'-"J. ~ ~'-1l \...~
I
I TO: City Clerk
PROPERTY ADDRESS
Please collect & receipt for the following monies:
l'r5.535.49211 rreM AMOlJ>lT
Proiect Revenue (specifv proiect)
ENCROACHMENT PERMIT
4722 Application Fee
Non-Utility Encroachment Permit ($2251
R-1 First Permit (No Feel, Subseouent Permit/Vr ($100)
Utilitv Encroachment Permit
Arterial/Collector Street ($325)
Residential Street/Other Areas ($225)
220 Plan Check Deoosit ($500)
220 Faithful Performance Surety (FPSI (100% of ENGR.EST.) ~-. -~_. ~
220 Monumentation Surety (100% of ENGR.EST.)
220 Cash Deposit (4% of FPS)($500 min.) ~
220 Labor and Material Surety (100% of ENGR. EST.)
Plan Check & Inspection Fee (Non-Utility) 4 ~ t.-C> .OC::>
472 Engr.Est. < $250,000 (12% of ENGR. EST.)
.. 220 Erlor.Est. > $250,000 (Deoosit 15% of ENGR. EST.) **
472 Utilitv < $100.000
ConduitslPipelines up to 500 Feet ($1.60/ft.) (MIN. $105)
Above 500 Feet ($1.10/ft.)
Manholes/Vaults/Etc. ($105/ea)
Pole Set/Removal ($105/ea)
Minimum Charge Per Location ($1201
Street Tree Plantino/Removal ($105/tree)
.. 220 Utilitv > $100,000 (Denosit 15% of ENGR. EST.)**
476 Proiect Plans & Soecifications Proiect No.
476 Standard Specifications & Details ($l/Po $l21Bookl
476 Co Dies of Enoineering MaDs & Plans ($.50/so.ft.1
472 Penalties: Failure to restore oublic imnrovements ($1 OOICalendar Dav) I
(Muni Code Section 11.34.010) ,
472 Penalties: Failure to correct unsafe conditions ($100ICalendar Dav) I i
LAND DEVELOPMENT
4722 Lot Line Adjustment ($500) I i
472 Parcel MaD (4 Lots or Less) ($1.060 + $25/Lot) I
472 Final Tract MaD (5 or More Lots) ($1 380 + $ 25/Lotl I
472 Certificate of Comoliance ($400) I
472 Certificate of Correction ($3001 I I
472 Vacation of Public Streets & Easements ($550) ,
472 Assessment Segregation or Reapportionment
First Split ($550)
Each Additional Lot ($170)
472 Storm Drainage Area Fee Per Acre (R-1, $2,000)
(Multi-Res, $2,250)
(All Other $2,500)
4920 Parkland Dedication Fee (75%/25% Due Uoon Cert. of Occuoancv)
496 Postaoe
TRAFFIC
472 Intersection Turn Counts (Two-Hour Count) ($60) I
472 Intersection Turn Counts (a.m. or n.m. neaks) ($125)
472 Traffic Flow MaD (Dailv Traffic Volumes) ($27)
472 Camnbell Traffic Model (Full Scone Assessment) ($2250)
472 Camobell Traffic Model (Reduced Scooe Assessm$740)
427 Truck Permits ( $35/trio)
472 No Parkino Sfo-ns ($1/each or $25/1001
OTHER
TOTAL $ 44-. C:Ji!::;O.- b
NAME OF APPLICANT ~ ~~\T ".-? -~ - '--fii':-1'
NAME OF PAYOR \., <.e::> 4- ~'D-\ Dn.. PHONE -:2,1.6 -- 9-'C.....4<..
ADDRESS .~~. ~. c:> ZIP ""l~~!Y...Y:_
.. Actual Cost Plus 20% Overhead (Non-Interest bearino deposit) R E: C E~
.oa
CITYCLEH
ONLY
IVED
MAY 1 0 1996
Cf5\ F 1- CITY CLERK'S OFFICE
o
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CITY OF CAI1PBB.L, CA
RECVD BY: LISAB 01000093183
PAYOR: SCOTT COOLEY
TODAY'S DATE: 05/10/96
REGISTER DATE: 05110/96 TIME: 14:12 :39
j DESCRIPTION AMOUNT
" REF DEPOSITS FUND 101 $1,520.00
'. ------
TOTAL DUE: $1 , 5.."0 .00
CHECK PAID:
CHECK NO: 1500
TENDERED:
CHANtI :
$1,520.00
$1,520.00
$.00
Lt
. I
i .,',.11"....' ,. .,.,. ~"i I' ',...... ....... ~. .. .... ..... '..., .
"" ...'-\I......-.T..-,..."'... .0.'"
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CITY OF CAltPBB.L, CA
REM BY: LISAB 01000093184
PAYOR: SCOTT COOLEY
rODAY'S DATE: 05/10/96
REGISTER DATE: 05/10/96 TIME: 14:13:25
( .
DESCRIPTION A"OUNT
EHGR & SUBDIV FILING F $4,560,00
--------
TOTAL DUE:
$4,560 .00
\ '
CHECK PAID:
CHECK NO: 1500
TENDERED:
CHANGE :
$47560.0()
$47560.00
$.00
To: Accounts Receivable
Please Issue Check
Payable to:
Address - Line 1:
Line 2:
City:
Description:
Amount Payable:
Account Number:
ate and Receipt No:
Permit No:
Purpose:
i
i Requested by:
,Approved by:
FINANCE ONLY:
Verified by:
Cit: Jf Campbell - Chec~_ Request
CONTOUR SOFTWARE
700 W. Hamilton Avenue
Campbell
State: CA
Zip:
95008
REFUNDABLE DEPOSIT
Finance OntYl
INTEREST EARNED
$500.00
101.2203 101.540.7448
3/12/96 #91541
96-138
Refund plan Check Deposit
-. . )
Randy Westfall~~
Michelle QUinney~
P.W. Inspector
Title:
D 9/17/96
ate:
Title:
City Engineer
Date: 9/17/96 I
Dae:~
Date: I
Title:
Approved by:
Title:
Mail As Is:
x
Return To:
Special Instructions For HandIing Check
Mail in Attached Envelope:
(NAME)
(Department)
Other:
~v: 3/25/95
PUBLIC WORKS DEPARTMENT RECEIPT
Effective July 1, 1995 ql,-/3J(
TO: City Clerk PUBLIC WORKS FILE NO.
PROPERTY ADDRESS
..< PleasecoUect.& receiptforthefoU~wing monies: ...... .. ...
~. 535.4921 ~i~ct Revenue (sDe~i~v Droiectl .
ENCROACHMENT PERMIT
472:.2 Application Fee !):J5 -
Non-Utility Encroachment Permit ($225)
R-l First Permit (No Fee I Subsel'luent PermitlVr ($100)
Utilitv Encroachment Permit
ArteriallCoUector Street ($325)
Residential Street/Other Areas ($225)
2203 Plan Check DeDosit ($500) -'" fJC-
2203 Faithful Performance Surety (FPS) 1100% of ENGR.EST.)
2203 Monumentation Surety (100% of ENGR.EST.)
2203 Cash DeDosit (4% of FPS)($500 min.)
2203 Labor and Material Surety 1100% of ENGR. EST.)
472J Plan Check & Inspection Fee (Non-Utility)
Engr.Est. < $250.000 (12% of ENGR. EST.)
.. 2203 Enor.Est. > $250,000 (DeDosit 15% of ENGR. EST.)"
4722 Utilitv < $100.000
ConduitslPipelines UP to 500 Feet ($1.601ft.)
Above 500 Feet ($1.10Ift.)
ManholeslVaultslEtc. ($105Ieal
Pole SetlRemoval ($105Ieal
Minimum Charge Per Location 1$120)
Street Tree PlantinalRemoval 1$1051treel
.. 2203 Utilitv > $100 000 'DeDosit 15% of ENGR. EST.)"
4760 Proiect Plans & Snecifications Proiect No.
4760 Standard SDecifications & Details l$lIPa $l21Book)
4760 Coeies of EnDineerinl'l MaDS & Plans 1$.60Isa.ft.)
472:11 Penalties: Failure to restore Dublic imorovements ($1ooICalendar Davl
I IMuni Code Section 11.34.010)
4722 Penalties: Feilure to correct unsafe conditions 1$100lCalendar Dav}
LAND DEVELOPMENT
4722 Lot Une Adiustment ($5oo)
4722 Percel MaD (4 Lots or Less) 1$1.060 + $25/Lotl
4722 Final Tract MaD (5 or More Lotsl ($1.380 + $25/Lotl
472:11 Certificate of Comeliance 1$400)
4722 Certificate of Correction '$300)
472~ Vacation of Public Streets & Easements ($550)
472. Assessment Segregation or Reapportionment
First Split 1$550)
Each Additional Lot ($170)
472 Storm Drainaae Area Fee Per Acre (R.l, $2.000)
(Multi-Res. $2,250)
(AU Other $2 5001
4920 Parkland Dedication Fee 115%/25% Due UDon Cert. of OccuDancv)
4965 Postal'le
TRAFRe
4728 Intersection Tum Counts (Two-Hour Countl ($601
4728 Intersection Tum Counts (a.m. or p.m. Deaks) ($125)
4728 Traffic Flow MaD (Dailv Traffic Volumes) ($27)
4728 CamDbeU Traffic ModellFuU Scope Assessmentl 1$2250)
4728 CamnbeU Traffic Model (Reduced ScoDe Assessm$740)
4271 Truck Permits ($35/tripl
4728 No Parkina Slans ($lIeach or $25/1oo)
OTHER I
TOTAL $ 7~5" ..-
NAME OF APPLICANT S~ (I () b Je1A
NAMEOFPAYORt1~~-~~~) J
A./UI~, ' ~ 1. // PHONE
ADDRESS ~/) 11). It/~ ~.JI. ;';~.A :3-v{ UAJ ZIP 9~oo g
. ,.....
~/.} .IU 6\ ~ AA~
.. Actual Cost Plus 20% Overhead (Non-Interest bearina denosit) 7
.ForPlanClleck. an~Clish Deposits, send. Yello.,.,capy to Finance..
R~CEIVED
MAR 1 2 1996
CiTY CLERWS OFFICE
-
ern CLDIt
ONLY
h:\recfrm3.wk3Implrl'v.l/9/96
I
I TO: City Clerk
I
PUBLIC WORKS DEPARTMENT RECEIPT
Effective July 1, 1995
PUBLIC WORKS FILE NO.
PROPERTY ADDRESS
I Please collect &. receipt for the following monies:
-=r. nDI
,435.535.4921' Project Revenue (specify project)
ENCROACHMENT PERMIT
4722 Application Fee
i Non-Utility Encroachment Permit ($225)
i R-l First Permit (No Fee), Subsequent Permit/Yr ($100)
I Utility Encroachment Permit
Arterial/Collector Street
Residential Street/Other Areas
Plan Check DeDosit
Faithful Performance Suretv (FPS)
Monumentation Suretv
Cash Deposit
Labor and Material Sure
Plan Check &. Inspection Fee (Non-Utility)
Engr.Est. < $250,000
En r.Est. > $250000
Utility < $100,000
Conduits/Pipelines up to 500 Feet
Above 500 Feet
ManholeslVaults/Etc.
Pole Set/Removal
Minimum Charge Per Location
Street Tree Plantin /Removal
220 Utilit > $100000
4760 Pro'ect Plans &. S ecifications
4760 Standard S ecifications &. Details
4760 Co ies of En ineerin Ma s &. Plans {$.50/s .ft.1
4722 Penalties: Failure to restore ublic im rovements ($l00/Calendar Da
(Muni Code Section 11.34.010)
4722 Penalties: Failure to correct unsafe conditions
LAND DEVELOPMENT
4722 Lot Line Ad'ustment
4722 Parcel Ma (4 Lots or Less)
4722 Final Tract Ma (5 or More Lots)
4722 Certificate of Com liance
472 Certificate of Correction
4722 Vacation of Public Streets &. Easements
4721 Assessment Segregation or Reapportionment
First Split
Each Additional Lot
472 Storm Drainage Area Fee Per Acre
2203
2203
2203
2203
2203
I
4722
2203
4722
($3251
($225)
{$5001
(100% of ENGR.EST.)
(100% of ENGR.EST.)
(4% of FPS)($5oo min.)
l1oo% of ENGR. EST.)
(12% of ENGR. EST.)
(De osit 15% of ENGR. EST.)"
($500)
{$1 060 + $25/Lotl
($1 380 + $25/Lot)
($400)
($300)
($550)
4920
4965
TRAFFIC
4728
4728
4728
4728
4728
4271
4728
($550)
{$170l
(R-l, $2,0001
(Multl.Res, $2,2501
(All Ot.,er, $2,500)
on Cert. of Occu anc )
Parkland Dedication Fee (75%/25% Due U
Posta e
($60)
($125)
TOTAL
CSj~
ADDRESS
j..)-
_ C'
.. Actual Cost Plus 20% Overhead (Non-Interest bearin de osit)
ma
CITY CLElUt
ONLY
Iliitl
.-,..
....q3q.~~
'"
":ForPlan. c:~eckandCashDeposits, send yellow copy to Finance.
Date/Initials
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RECEIVED
JUN 1 11996
CITY CLERK'S OFFICE
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04/38/1997 17:10
4082958857
KENNEDY INS AGENCY
POBOX 9747
SAN JOSE CA 95157
CQlnNf'f
A
EMPLOYERS FIRE INS. co.
CONTOUR SOFTWARE INC. AND
SCOTI' M. COOLEY, AN INDIVIDUAL
700 W. HAMILTON AVE.
CAMPBELL CA 95008
ctJJIW'N4Y
II
COMMERCIAL UNION
.-uRG
CONI'N4Y
C
GOLDEN EAGLE INS. CO
CD
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THIS IS TO CERTlFY TMAT THE POUClES OF INSURANCE ~ BELOW HAVE BEEN ISSueD 'TO 114E INSURED NAMED ABav5 FOR THE POUCY P9UOD
INDICATED, NOTWm48TANClHG ANt REOUIAeMEHf. TEfM OR CONOITlON OF Nl'f CONT'AACf OR OllER COCUMENT WITH RESPECT TO WHI64 THIS
CEFlT1J'lCATE MAY 8E ISSUED OR MAY PERTAIN, n4IINSUAANCe AFFORDED BY 114E POUCIE5 DESC"IBEO HeREIN IS SUBJECT TO ALL. nE TaWS.
EXCUJSlON8 AND CONDmON& OF SUCH POLICIES. UMITS SHOWN MAY HAve BEEN REDUCED BY PAlO Cl..'1MS.
"J"tft 01" _1IIANCe ~'f NII1IIIIDI l'OIJC'f ~ POUCT DP'IIlA11OIII1
DAT& fIIIMlDI'l\') DAft ~
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PRODUCTS. COMp/ofI AGGI $
PERSONAL I HlV IW'lV I 1 0 0 0 00
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FIRE O,\MAGE IAny _ 11191 $
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NWC323144-01
9 ~2 96
COMII1NID PIGLE UMIT l, 1,000 00
I
IlODIL Y lNJUAY I
(P'W _I
BOO&. y JIllJ\jAY ,
~-.o
~"eRTY DAMAGE ,
Al/T'O ONLY. liA ACClDl!NT ,
arnEI' _ AUTO ONLY;
rAQ4 ACCmEItT
/lGGAEGAl1l
I!.104 OCCURREJIlCi
"GliReGA~
X In'A'I''IJ1''O''Y I.JMITlI
eACH ACClOI!NT I ~ 000
olS&ASE . I'OLlCY UMrf I 1,000
0lSEASli . EI\Q4 I!M I 1,000
~ .J; .~ :~ i V E D
nil,' v n
1Ylt"',1 -
1m.
~ucae UM&m'
X UM8AaU~'"
\ cnlOI 'T)WI ~ IIOIlIlI
~ ..o1ll..1",,,1lIOII MID
..umI!Ilr ~
CADZ66953
'n1t! ,.,.,_lil'OW
PAJml~
c~ M2:.
~
tNCL
Xl!llD.
~ C# ClIIeM'nQIlM.OCA~ nuM
RE: PERMIT #96-138 700 W. HAMILTON AVE., CAMPBELL. ALL WORK IN pUBLIC RIGHT
PF WAY, CITY OF CAMPBELL, ITS OFFICERS, EMPLOYEES & VOLUNTEERS ARE NAMED ADD-
ITIONAL INSUREDS AS PER ATTACHED POLICY FORM CG20091185. PRIMARY COVERAGE.
~~n:l~~~"~:''',"i:;..:r.:~......~~t~~~1..~"F''''>'-~~ . ,,~- ~",,..~~~"H"''':~~''''':'''';'' ~....::.~ ~--.:.~:.
. ,'.. ,~,,,.H,"..~~M.t..~,..~....i!!~*.lcl:,,,(,,,....l..~A~::oI~'*.._,<:~.~~,," ?:~..,." "'A'...... ^,<<..+ _ "...~..,'^ .~M,'!:':'~.~ ~~_~Ao~V,T.....I:e; "'.~"""". ~lf:'
CITY OF CAMPBELL ATTN: DEPT.
OF PUBLIC WORKS CHUCK GOMEZ
70 NORTH FIRST STREET
CAMPBELL CA 95008
IHOUUI ,.., 01' 'Ml A80~ lIIIlalIIED PQUC:IU . ~ I ftI ~ nc
IllPIlATlOM DAft ncMOI". T1C II8VItQ COW...,. WIU. Dm&AVOfIl TO 11M.
:l..L DAft WRmOlIlO'nCll TO nc C2InW'lCAft nouM!R - TO 1M! Lm'T.
AII.UR& TO 11M. tua'J ItOTlCS SItAU. ~ JIG 0IUQA11OII 011 ~
01' ,.., U_ TIE COllI' AaaInS OR ATJYU.
.I.i............o'lOOo.O
"" ....',..,... ....._.... ' r'.-.'" ......
04/38/1997 17:1~
48:32958857
KENNEDY IN5URANC~
PAI.:;E 02
l:'I1.~-E'Jl'''' CG 2009 1185
ADDITIONAL INSURED--OWNERS, LESSI!ES OR CONTRACTORS (Form A)
Cl245
(11-85)
This endorsement modifies in:juranCe provided under the following:
COMMERCIAL GENERAL UABlllTY COVERAGE PART
SCHEDULE
Name of Person or Organization (Additional Insured):
Location of Covered Operations
CITY OF CAMPBELL
AS PER ENDl. 103
80dily InjUry and
Property Damage liability
Premium Basis
Cost
Rates (Per $1000 of cost)
Advance Premium
$1,000,000
1
$0
Total Advance Premium
'0
(If no entr; appears above, information required to complete this endorsement will be shown in the Declarations as applicable
to this endorsement.)
1. WHO IS AN INSURED (Section II) is amended to include
as an insured the person or organization (called 'addi.
tional insured') shown in the Schedule but only with
respect to liability arising out of:
A. 'Your work" for the additional insured(s) at the
location designated above, or
B. Acts or omissions of the additional insured(s) in
connection with their general supervision of "your
work" at the location shown in the Schedule.
2. With respect to the insurance afforded these additional
insureds, the following additional provisions apply:
A. None of the exclusions under Coverage A, except
exclusions (a). (d), (e), (f), (h2), (i) and (mJ. apply
to this insurance.
B. Additional Exclusions. This insurance does not apply
to:
(1) 'Sodily injury" or "property damage" for which
the additional insured(s) are obligated to pay
damages by reason ofthe assumption of liability
in II contract or agreement. This exclusion does
not apply to liability for damages that the addi-
tional insured(s) would have in the absence of
the contract or agreement.
(2) 'Bodily injury' or "property damage' occurring
after:
(a) All 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
(b) That portion of "your work' out of which the
injury or damage arises has been put to its
intended use by any person or organi~ation
other than another contractor or subcon-
tractor engaged in performing operations
for a principal as a part of the same
project.
(3) 'Bodily injury" or "property damage" arising out
of any act or omission of the additional in-
sured(s) or any of their employees, other than
the general supervision of work performed for
the ~ddition81 insured(s) by you.
(4) 'Property damage" to;
(a) Property owned, used or occupied by or
rented to the additional insured(s);
(b) Property in the care, custody or control of
the additional insured(s) or over Which the
additional insured(s) are for any purpose
exercismg physical control; or
(c) "Your work" for the additional insured(s).
POlICY NUM6ER F ALK143Z0
9
A6EHT COpy
04/30!1997 17:10
408295:3857
KENNEDY INSURANCE
PAGE 03
t:'.'~E"""
1. _ EMPLOYERS FIRE INSURANCE COMPANY
A Stock Company. Boston, .\1a5w,chusetU 02108-3100
COMMON POLICY DECLARATIONS
~
.... :..:.... ": '\.' . '. . ,'" .. ..... .,:~'" '" 1, _. '. . ' '" . :.'. " " ..' . . .?
The following Special Provisions apply to the Policy:
01 ADDITIONAL INSURED-MANAGERS DR LESSORS OF PREMISES
SCHEDULE
1. DESIGNATION OF PREMISeSCPART LEASED TO YOU):
700 HAMILTON AVE., CAMPBELL,CA
Z. NAME OF PERSON OR ORGAHIZATIDNCADDITIONAl INSURED):
HOME SAVINGS OF AMERICA, FSI, !NS.DEPT.,P.O. lOX 7075, PASADEHA,CA
CRE:LOANI01680191)
3. ADDITIONAL PREMIUM: . INCLUDED.
02 ADDITIONAL INSURED-LESSOR OF LEASED EQUIPMENT.CG2DZ8
SCHEDULE
NAME OF PERSON OR ORGANIZATION:
REGINA B. WILLE
SIEMENS CREDIT CORPORATION
5300 BROKEN SOUND BLVD., N.W.
BOCA RATON, FL 33487
RE: LEASED CONTRACT 106200518-900 C620-0000205-000)
03 ADDITIONAL INSURED -- OWNERS, lESSEES OR CONTRACTORS CFORM A)
NAME OF PERSON OR ORGANIZATION (ADDITIONAL INSURED) \
CITY OF CAMPBELL
ATTN: DEPT. OF PUBLIC WORKS
70 NORTH FIRST STREET
CAMPIELL, CA 95008
LOCATION OF COVERED PREMISES:
ALL PREMISES
RE: ALL WORK IN PUBLIC RIGHT Of WAY, THE CITY OF CAMPBELL, ITS OFFICERS,
EMPLOYEES AND VOLUNTEERS ARE HAMED ADDITIONAL INSURED AS RESPECTS LIABIL!TY
G28211 (11.93)
ASEHT COpy
Page 03 at 03
llffll:t. 6l.EJID4LE
Y1LE HUM8El': Cn""l IWSLA55
INSURANCE REQUIREMENTS CHECKLIST
Permit # c; 1.0 - /38 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
CO!JlIll. ercial General Liability for bodily, personal injury and property damage:
ff / $1,000,000 per occurrence, and
~ $1,000,000 general aggregate limit applying separately to the project, and
~/ $2,000,000 general aggregate l~t:
\.EJ Policy expiration date ilI3 I 9 7
.A!!tOmotive Liability - "any auto" ~ /lA<?~a 61C-1o Cicc..t~ c..<) ~
~ $1,000,000 per accident for bodily injury and property damage
it:] Policy expiration date 3/..5/ /07
y
Wo!ker's Compensation and Employer's Liability
~ /' $1,000,000 per accident fi;bod,/njury or disease
b:J Policy expiration date 9. ~ t (p
/ '
Course of Construction (if required in Special Provisions)
o Completed value of the project
o Policy expiration date
Required Endorsement to General Liabilitv and Automobile Liability Policies
Additional Insured Endorsement
~ The City, its officers, employees and volunteers are named as additional
insured.
~ The insurance coverage afforded to the Additional Insured is - prim~ry ...~/
insurance. ~ .f2/L~.-/1. /- ~~~I-( CL 4/-2,.S'/7 (0
o Workers' Compensation Insurance Sheet Submitted
o For General Contractor
o SUbrogati~ Clause
!=ranee CcnificaIC Rcvic c;;{)ff /\< ~ J f>n, . ~ 6) {p /1 Ip
~ Date
~ Copy of Insurance Certificate placed in tickler file o~e month prior to eXPira:ion.
j:\forms\inscklst 4/96
~~.~~~':~""~~.'J
PRODUCER THIS CERnFlCATE IS ISSUED AS A MATTER OF INFORMAll0N
ONLY AND CONFERS NO RIGHTS UPON THE CERllF1CATE
HOLDER. THIS CER11F1CATE DOES NOT AMEND, EXTEND OR
KENNEDY INS AGENCY ALTER THE COVERAGE AFFORDED BY THE POUCES BELOW.
P 0 BOX 9 74 7 COMPANIES AFFORDING COVERAGE
SAN JOSE CA 9 5 1 5 7 COMPANY
A EMPLOYERS FIRE INS . CO
ItIIURED SCOTI' M. COOLEY , AN INDIVIDUAL & COMPANY
CONTOUR SOFTWARE INC . B COMMERCIAL UNION
ATr'N. :THERESA HOWARD COMPANY
7 0 0 W HAMILTON AVENUE C GOLDEN EAGLE INS . CO
CAMPBELL CA 9 5 0 0 8 COMPANY
I D
M9"..l.Il:tt:rllrit:::i:i:::::::lmmli:::rrrr:ttt:::r:::::::::t:::::l:::t::::t:::::::::::::i:::ll:::m::i:i:li:::::ri:rri:i:l::it:::ri:i:i:i:r::::lli:i:i:i:lit;t:itttt:li:i:til:t:l:::t:mt:i:i:::::r:::::::ttllrrl11riirlrrritfllfrllrit:itlit:tfi:rrifitttWri::tt:
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICATED, NOlWlTHSTANDING ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCWSIONS AND CONDmONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF IN8URAIICI! POLICY NUllBER POLICY 1EFPl!CtM! POLICY EllPIRA110N LIIIn1I
1..1R DATE (IIII/DDIYY) DATI! (IIIIIDDIYY)
~ QENERAL IJA8UTY FALH74 3 2 0 3 / 3 1 / 9 6 3 / 3 1 / 9 7 GENERAL AGGREGATE $ 2 , 0 0 0 , 0 OC
-
X COMMERCIAl.. GENERAL UABIUTY PRODUCTS . COMPIOP AGG $
) I CLAIMS MADE [K] OCCUR PERSONAL & ADV INJURY $ 1, 0 0 0, 0 0
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ l, 0 0 0 0 0
-
FIRE DAMAGE (Any one h) $ 1 0 0, 0 0
r-- 5, 0
MED EXP (Anr one peNM) $ 0
~ AUTOIIOBLE IJA8UTY FALH74 3 2 0 3/3 1/9 6 3/3 1/9 7
r-- COMBINED SINGLE LlMrr . OC
f- ANY AUTO 1, 0 0 0, 0
r-- Au. OWNED AUTOS BOOLY INJURY
.
SCHEDULED AUTOS (Per peNM)
~ HIRED AUTOS ~ ~ (" I: "' " ~ ~ " BODLY INJURY
ex " $
NON.QWNED AUTOS ~i-r (Per 8ClCidenI)
~
f- MftR 2 g 199F PROPERTY DAMAGE .
~ IJA8UTY AUTO ONI.. Y . EA ACCIDENT ~
ANY AUTO OlMER THAN AUTO ONI. Y:
r--
f- " EACH ACCIDENT .
AGGREGATE .
l3 EXCE88 IJA8UTY CADZ3 6 94 3 3/3 1/9 6 3/3 1/9 7 EACH OCCURRENCE . 2, 0 0 0, 0 0
~ ,UMBRELLA FORM AGGREGATE . 2, 0 0 0, 0 0
OlliER lliAN UMBRELLA FORM ~
~ WORICEIl8 C0I0IPD8A11ON AND NWC3 2 3 144 - 0 0 9 / 2 2/9 5 9 / 2 2/9 6 XI STATUTORY LIMITS
1!MPLOYER8' IJA8UTY $ 1, 0 0 0, 0 0
EACH ACCIDENT
lliE PROPRIETOR! ~INCL DISEASE . POUCY LIMIT . 1, 0 0 0., 0 0
PAR11IIERSlEXECUllVE X EXCL 1 0 0 0, 0 0
OFFICERS ARE: DISEASE . EACH EMPlOYEE . ,
01'HM
DE8CRF11ON 01' 0PERA1ION8ILOCA1IONINEHICLE8I8PECIAL IT!II8
RE : PERMIT # 9 6 - 13 8 7 0 0 W . HAMILTON AVE . , CAMPBELL . ALL WORK IN PUBLIC RIGHT
OF WAY CITY OF CAMPBELL ITS OFFICERS , EMPLOYEES & VOLUNTEERS ARE . NAMED ADD-
, ,
ITIONAL INSUREDS AS PER ATTACHED POLl CY FORM CG 2 0 0 9 . PRIMARY INSURANCE .
::91mfl!!1!irH9.r:t:li:mt:::ri:::::rit::tt:r:::tli:rit::t:::rrit:::::rrrMri::t:::Jrit:ri:Jr::JrrrlrIIg!!m:t:I.D9!Htt:ilit:i::::;:li:t:::::::rlt:ri:it:i:i:ri:::i:::tt:l::M:mWlWtJliflilt;lr:l:Jllll:lr::::
SHOULD AllY 01' THI! ABOVE DDCRIBI!D POLIClE8 - ~I I ~ft IID'ORa THI!
EllPIRA110N DATI! 11EREOI', THI! I88UIIIQ COIIPAIIY WLL ~IIAL
CITY OF CAMPBELL ATTN : DEPT J..Q..... DAYS WIUT'IEN NOTICE TO THI! CERTIPlCATI! HOLDER NAMED TO THI! LEPI',
OF PUBLIC WORKS CHUCK GOMEZ
7 0 NORTH FIRST STREET
CAMPBELL CA 95008 AU1HOR~ R.EPRE8QTA.....~~I-.""~~:i
:ii.QjQt:ftJ,$~Itiijjir:ttt:::::::Imt~:~I:r:~:~:~:~::r::~::::m:::IIIImr:I:::r:~:~~::::::I:~:rmI:~:::rr:::~:I::::II::I::I::::::m:::I:t:m::::::mm0:;:~i::W:f::]::f::;~:::~:::~~~:~:~mi:::t~~&:::::~I:::::ill.ij'~I~MiQR::::~'.:
~'II'~E''''''
THE EMPLOYERS FIRE INSURANCE COMPANY
A Stock Company, Boston, Massachusetts 02108-3100
COMMON POLICY DECLARATIONS
The following Special Provisions apply to the Policy:
01 ADDITIONAL INSURED-MANAGERS OR LESSORS OF PREMISES
SCHEDULE
1. DESIGNATION OF PREMISESCPART LEASED TO YOU):
700 HAMILTON AVE., CAMPBELL,CA
2. NAME OF PERSON OR ORGANIZATIONCADDITIONAL INSURED):
HOME SAVINGS OF AMERICA, FSB, INS.DEPT.,P.O. BOX 7075, PASADENA,CA
(RE:LOAN#01680191)
3. ADDITIONAL PREMIUM: $ INCLUDED.
02 ADDITIONAL INSURED-LESSOR OF LEASED EQUIPMENT-CG2028
SCHEDULE
NAME OF PERSON OR ORGANIZATION:
REGINA B. WILLE
SIEMENS CREDIT CORPORATION
5300 BROKEN SOUND BLVD., N.W.
BOCA RATON, FL 33487
RE: LEASED CONTRACT #06200518-900 C620-0000205-000>
03 ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS CFORM A)
NAME OF PERSON OR ORGANIZATION (ADDITIONAL INSURED):
CITY OF CAMPBELL
ATTN: DEPT. OF PUBLIC WORKS
70 NORTH FIRST STREET
CAMPBELL, CA 95008
LOCATION OF COVERED PREMISES:
ALL PREMISES
RE: ALL WORK IN PUBLIC RIGHT OF WAY, THE CITY OF CAMPBELL, ITS OFFICERS,
EMPLOYEES AND VOLUNTEERS ARE NAMED ADDITIONAL INSURED AS RESPECTS LIABILITY
G28211 (11.93)
AGENT COPY
Page 03 of 03
OFFICE: GLENDALE
FILE NUMBER: C60781l8 IWSLA35
J: ...N]l;E.....,
ADDITIONAL INSURED--OWNERS, LESSEES OR CONTRACTORS (Form A)
CG 20 09
11 85
CL 245
01-85)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization (Additional Insured):
Location of Covered Operations
CITY OF CAMPBELL
AS PER ENDT. #03
Bodily Injury and
Property Damage Liability
Premium Basis
Cost
Rates (Per $1000 of cost)
Advance Premium
$1, 000,000
1
$0
Total Advance Premium
$0
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable
to this endorsement.)
1. WHO IS AN INSURED (Section II) is amended to include
as an insured the person or organization (called "addi-
tional insured") shown in the Schedule but only with
respect to liability arising out of:
A. "Your work" for the additional insured(s) at the
location designated above, or
B. Acts or omissions of the additional insured(s) in
connection with their general supervision of "your
work" at the location shown in the Schedule.
(a) All 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
completedj or
2. With respect to the insurance afforded these additional
insureds, the following additional provisions apply:
A. None of the exclusions under Coverage A, except
exclusions (a), (d), (e), (1), (h2), (i) and (m), apply
to this insurance.
B. Additional Exclusions. This insurance does not apply
to:
(1) "Bodily injury" or "property damage" for which
the additional insured(s) are obligated to pay
damages by reason of the assumption of liability
in a contract or agreement. This exclusion does
not apply to liability for damages that the addi-
tional insured(s) would have in the absence of
the contract or agreement.
(2) "Bodily injury" or "property damage" occurring
after:
(b) 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 subcon-
tractor engaged in performing operations
for a principal as a part of the same
project.
(3) "Bodily injury" or "property damage" arising out
of any act or omission of the additional in-
sured(s) or any of their employees, other than
the general supervision of work performed for
the additional insured(s) by you.
(4) "Property damage" to:
(a) Property owned, used or occupied by or
rented to the additional insured(s)j
(b) Property in the care, custody or control of
the additional insured(s) or over which the
additional insured(s) are for any purpose
exercising physical control; or
(e) "Your work" for the additional insured(s).
POLICY NUMBER, FALH74320
9
AGENT COPY
~~"AN~~'"'r::::":';;111I1111~:::':";I!III:111111111.11:::::::::':':':':':'. ;::;~::~:~;::::;::::::.:.:.:.,.."............ 3 15 '96 !~
Pl'ODUCIII THIS CERTIFICATE IS ISSUED AS A MAlTER OF INFORMA'nON
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AIIEND. l!XTEND OR
AL TEA THE COVERAGE AfFORDED BY THE POLlCES BELOW.
COMPANIES AFFORDING COVERAGE
KENNEDY INS AGENCY
POBOX 9747
SAN JOSE
CA 95157
COMPANY
.A
EMPLOYERS FIRE INS. CO.
.......
SCO'IT M. COOLg., AN INDIVIDUAL &
CONTOUR SOF".l"wARE
INC.
700W. HAMILTON AVENUE
CAMPBELL CA 95008
COMPANY
B
COMMERCIAL UNION
COMPANY
C
GOLDEN EAGLE INS. CO
COMPANY
D
!l9L;~.~~~.:~.~;.:.;<-;M.wMMg:illilmiM1JMntltWjWjt{iMMMiMMMlWiig\til@UlmMjHi&Y1f_it}tMlj$!J.MMiWUlai.tMt.tJ..it1tli"'1W.~
THIS IS TO CEFmFV THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICATED, NOTWJTHSTANDING ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTlACATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO AU. THE TERMS,
EXCWSIONS AND CONDmONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
co
LTR
T'II'I! OP _AIICIl
POLICY ......
POLICY EI'PI!c:TMl POLICY \!XPlRA1IOII
DAn! (MMIDDfYY) DAn! (IIIIIDDIYY)
~("E.VII!~
~ ^" II... r,:; ~,ii
.......
GENERAL AGGREGATl! I 2 000 00
PAODUCTS . COMPIOP AGG I
Pl!A8ONAL . MN NJURY I 1 000 00
EACH OCCURRENCE I 1 000 00
FIRe DAMAGI! (Anr - "'1 I 100 00
MIlD ElCP (/lint _ ~ I 5 00
COMBI'tED SIG.E LIMIT I 1 000 00
BClDlL y INJUR'f I
(Pw .--.l
BClDlL y INJURY I
(Pw 8lIllIdInO
PAOPBITY DAMAGII! I
FALH74320
AII1'OIIIMLB L.IUUfY
ANY AUTO
MA. OWNI!D AUTOS
8CHI!DUI.ID AUTO.
X HlAI!D AUTO.
X NQN.OWNID AUTOS
FALH74320
.,
AUTO ONLY . EA AOCIDINf I
OTHER 'THAN AUTO ONLY:
EACH ACClD!NT
AGGRl!GATI!
9 6 EACH OCCURR!NCl!
AGGReGATI!
OTHER 'THAN UMBRB.1.A FOAM
..---- COIINIIIA11OII Ale
.-..ovmw I..IMUIY
NWC323144-00
STATUTORY I.IMI'TS
EACH AOCIDINf
Dl8EA8I! . POLICY LIMIT
Dl8I!A8E - EACH EMPLO
2,000,000
2,000,000
CIAIUlGIIlIJM&IfY
ANY AUTO
\?,'~) J L! (.
l.DhA!t,QS':"R ,::c:,~,
CADZ36943
1HI! I'ROPRIETOAI
PAR1'NER8/l!lCSC
OPl"lCER8 ARe: .
011tIIl
INCl.
Xexa.
IIUCIlIP110tI OP OI'l!IIATlOIIIoU)CA11ONI/V1MCLES/lINCIAL I1BIlI RE: PERMIT :#: 96-138, LOCA-
TION700 W. HAMILTON AVENUE, CAMPBELL. ALL WORK IN PUBLIC RIGHT OF WAY, CITY
OF CAMPBELL, ITS OFFICERS, EMPLOYEES AND VOLUNTEERS ARE NAMED ADDITIONAL IN-
SUREDS AS RESPECTS LIABILITY PER ATTACHED FORM CG 2009. PRIMARY INSURANCE.
ATI'N: CHUCK GOMEZ
Ll@!aCAlii@9!1JJ!fffilmiMMnilmi%t.%filwnmmtM@MiMMMB1SR!'!lt._tMW.iitilMJ.fEIDJ1JMtf~t@4%tilt..
AU1HOIIIDD Rl!PRl!8Dl'A1M! I (" f--K. : . Pfl (\ C{ I:
Patricia L. Ke ne C ~-~~ ". k' . '--
jj~i_t":":::':':::""'::::~mmmm~jW:j;;j::~f!r:j:lrriJif@lfWN:jWrrm:j;rmrfttlrtlrllntWMtilt@lHr:HW~Mmrlw;r~WWlnrmilWHMWf.iJlbb.ijP.t~'ij-,.
CITY OF CAMPBELL
ATTN: DEPT. OF PUBLIC WORKS
70 NORTH FIRST STREET
CAMPBELL CA 95008
\!XPlRA1IOII DA'" ntmIEOI', n.- IUUIIIG COWAIIY WILI.~JIAL
J.!L DAYS WIlIT1DI N011Cl! TO n.- CI!R11I'ICATE tIOLDD ....... TO n.- UPI',
-~~.~~
~
11
~.I1'f'!1,!E.P.l' CG 20 09 11 85
ADDlnONAL INSURED-OWNERS, LESSEES OR CONTRACTORS (Form A)
CL 245
(11-85)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL UABIUTY COVERAGE PART
SCHEDULE
Name of Person or Organization (Additional Insured);
CITY OF CAMPBELL
ATIN: DE:?!'. OF PUBLIC WORKS
70 NORTH FIRST STREET, CAMPBELL, CA 95008
Bodily Injury and Premium Basis
Property Damage Liability Cost
Location of Covered Operations RE: PERMIT #96-138
AND ALL WORK IN PUBLIC RIGHT OF WAY. CITY OF
CAMPBELL, ITS OFFICERS, EMPLOYEES AND VOI1JNTEERS ARI
NAMED ADDITIONAL INSUREDS.. AS RESPEcrS LIABILITY
PER CG 2009 (11/85)
Rates (Per $1000 of cost) Advance Premium
$1,000,000
1
$0
Total Advance Premium
$0
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable
to this endorsement.)
1. WHO IS AN INSURED (Section II) is amended to include
as an Insured the person or organization (called "addi-
tional insured") shown in the Schedule but only with
respect to liability arising out of:
. A.'Your worK" for the additional insured(s) at the
. location designated above, or
B. Acts or omissions of the additional insured(s) in
connection with their general supervision of "your
work" at the location shown in the Schedule.
Z. With respect to the insurance afforded these additional
insureds, the following additional provisions apply:
A. None of the exclusions under Coverage A, except
exclusions (a), (d), (e), (f), (h2), (i) and (m), apply
to this insurance.
B. Additional Exclusions. This insurance does not apply
to:
(1) "Bodily injury" or "property damage" for which
the additional insured(s) are obligated to pay
damages by reason of the assumption of liability
in a contract or agreement. This exclusion does
not apply to liability for damages that the addi-
tional insured(s) would have in the absence 'of
the contract or agreement.
(2) "Bodily injury" or "property damage" occurring
after:
(a) All 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
(b) 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 subcon-
tractor engaged in performing operations
for a principal as a part of the same
project.
(3) "Bodily injury" or 'property damage" arising out
of any act or omission of the additional in-
sured(s) or any of their employees, other than
the general supervision of work performed for
the additional insured(s) by you.
(4) "Property damage" to:
(a) Property owned, used or occupied by or
rented to the additional insured(s);
(b) Property in the care, custody or control of
the additional insured(s) or over which the
additional insured(s) are for any purpose
exercising physical control; or
(c) "Your work" for the additional insured(s).
* ?OUCY NUMBER:
FAIlf74320
Insured Name
SCOT!' M. COOLEY, AN INDIVIDUAL, & CONTOUR SOFTWARE INC.
Policy :# FALH74320
PRIMARY WC~C1NG:
SUBJECT TO All. 01H~ ilRMS AND ~C'.nStCN8 OFiHIIPC1.:CY. Sl.JCA IN8UMNC2AS
Pf1CVICEO BY "M-iIS eNCORSeAENT SHAU. BE OEEM!!J ~, auT' QM:f WITH
RES?1!CTTC WORK ?5;FCAMEO BY OR Fe::' THE NAME INSUAEC IN CONMLil\.iN WITH
ilie ABave cesCntaeo CONTIiACT.
PRODUCER THIS CERnRCATE IS ISSUED AS A MATTER OF INFORMAnON
ONLY AND CONFERS NO RIGHTS UPON THE CERTIRCATE
HOLDER. THIS CERTIRCATE DOES NOT AMEND, EXTEND OR
KENNEDY INS AGENCY ALTER THE COVERAGE AFFORDED BY THE POUCES BELOW.
P 0 BOX 9 74 7 COMPANIES AFFORDING COVERAGE
SAN JOSE CA 95157 COMPANY
A EMPLOYERS FIRE INS . CO .
....MD SCOTT M. COOLEY, AN INDIVIDUAL & COMPANY
CONTOUR SOFTWARE B COMMERCIAL UNION
INC . COMPANY
70 0 W . HAMILTON AVENUE C GOLDEN EAGLE INS . CO
CAMPBELL CA 95 0 08 COMPANY
I D
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICATED, NOlWlTHSTANDING ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTlRCATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDmONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OIl INSURANCE POLICY NUMIIER POLICY EPRC11VE POLICY EXPIRATION LIIIn'8
LTR DATE (MMlDDlYY) DA'M (MMIDDIYY)
~ GENERAL LIA8LIJY FALH743 2 0 3/3 1/95 3 /3 1/96 GENERAL AGGREGATE . 2,0 0 0,0 0
XI COMMERCIAL GENERAL UABIUTY PRODUCTS . COMPIOP AGG .
IiI I ClAlM8 MADE 00 OCCUR PERSONAL & NJV INJURY . 1,0 0 0,0 0
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE . 1.0 0 0,00
f--
FIRE DAMAGE (My - IN) . 10 0,00
f--
MED EXP (My - ~) . 5,00
~ AII1'OIIo.IU! LIAIIUT\' FALH743 2 0 3/3 1/ 95 3/3 1/9 6
~ COMBINED SINGLE
LIMIT . 1. 0 0 0, ooe
~ ANY AUTO
~ AU. OWNED AUTOS V E D BODLY INJURY
C E , .
SCHEDULED AUTOS R i (Pw ~I
f--
~ HIRED AUTOS BODLY INJURY
~ ~ED AUTOS 13 199b (Pw ..xlIdInI) .
MAF
Vj{ \, PROPERTY DAMAGE .
, . .~, ~(. Ii" .......
~ LIAIIUT\' .ADMIN\STRAl IUI'i AUTO ONLY . EA ACCIDENT
f-- ANY AUTO OTHER THAN AUTO ONLY:
f-- EACH ACCIDENT .
AGGREGATE .
B UCI!II LIAIIUT\' CADZ3 6 943 3/3 1/95 3/3 1/96 EACH OCCURRENCE! . 2 , 000 ,000
~,UMlREUA FORM AGGREGATE . 2 ,000 ,000
OTHER THAN UMBRELLA FORM .
C WClRUM COIIPBIaATION AM) NWC3 23 144 - 0 0 9/ 22/95 9/22/96 I STATUTORY LMT8
IIMPLOftRr LIAIIUT\' 1 0 0 0 0 0
~ EACH ACCI)ENT .
THE PROPRIETORI INCL DISEASE . POLICY LlMrr . 1.0 0 0,00
PARTNERSIEXECUTJVE EMPLOYEE 1,00 0,0 0
OFFICERS ARE: EXCL DISEASE . EACH .
OTHI!R
.
DUCRPnON OIl OPERATIONM.0CA11ON8IVEHICLE8I8PECIAL Il1!II8
RE : 70 0 W . HAMILTON AVENUE , CAMPBELL . ALL WORK IN PUBLIC RIGHT OF WAY , CITY
OF CAMPBELL , ITS OFFICERS , EMPLOYEES AND VOLUNTEERS ARE NAMED ADDITIONAL IN-
SUREDS AS RESPECTS LIABILITY PER ATTACHED FORM CG 2 0 0 9 . PRIMARY INSURANCE .
:P'!fmfjMlII~M9_t:I~:::~t:mt:::::I::::::~t:~t~~!~~~ttt:~:II~:I:tt:III~:IIIIlltttttttt:~:IIImII:::}JMlel!t:!>>9'tm:::I:l~:II1:MIllllllll::1:I@1111::::m~:111II:lllmlItlWmlMM1:IMt
ATI'N: I HAROLD HOUSLEY SHOULD MY 01' THE AIIOVI! IlUCMIED POLIClE8 IIIl ~I." IIIlFORE TIE
.
EXPIRATION DA'M THEREOP, TIE IS8UNI COMPANY wu...-.Q8KRI.MAL
CITY OF CAMPBELL .3JL DAYS WRIT1EII NOnCE TO TIE CEIlTIFICA'M HOLDER NAIID TO TIE LEFI',
ATTN : DEPT OF PUBLIC WORKS ~~ - ~~~r
7 0 NORTH FIRST STREET
CAMPBELL CA 95008 ~ R~.TNI!~hJ:t~;,: C;.,~_ ~'V-9I' 0...roJ.\
~~Miitil.jtliiijf:":::mr~?((:::::::::::::~~:~?:::::~:::~::l=-::'(:~:::::::~:f::?~/~:~::~::~~f:M:~~:~r:~::~~:r::r:tr~~~:::t:::~::t~:Jr::t{t::l)~t~~t~i~;~~i~~t~~?::t:~f~~Brr~~~:~:;:~:I::::0:j~:\:=:ijrt:t~::$~~fm::@iJ.~ikl.r~iO.M.dliiii
~
E.I1"'!J'!E.Il.7 CG 20 09 11 85
ADDITIONAL INSURED--OWNERS, LESSEES OR CONTRACTORS (Form A)
CL 245
(11-85)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization (Additional Insured):
CITY OF CAMPBELL
ATIN: DEFT. OF PUBLIC WORKS
70 NORTH FIRST STREET, CAMPBELL, CA 95008
Bodily Injury and Premium Basis
Property Damage Liability Cost
Location of Covered Operations
RE: ALL WORK IN PUBLIC RIGHT OF WAY. CITY OF
CAMPBELL, ITS OFFICERS, EMPLOYEES AND VOLUNTEERS ARE
NAMED ADDITIONAL INSUREDS.:\AS RESPECTS LIABILITY
PER CG 2009 (11/85)
Rates (Per $1000 of cost) Advance Premium
$L 000,000
1
$0
Total Advance Premium
$0
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable
to this endorsement.)
1. WHO IS AN INSURED (Section II) is amended to include
as an insured the person or organization (called "addi-
tional insured") shown in the Schedule but only with
respect to liability arising out of:
- A.'Your work" for the additional insured(s) at the
location designated above, or
B. Acts or omissions of the additional insured(s) in
connection with their general supervision of "your
work" at the location shown in the Schedule.
(a) All 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. With respect to the insurance afforded these additional
insureds, the following additional provisions apply:
A. None of the exclusions under Coverage A, except
exclusions (a), (d), (e), (f), (h2), (i) and (m), apply
to this insurance.
B. Additional Exclusions. This insurance does not apply
to:
(1) "Bodily injury" or "property damage" for which
the additional insured(s) are obligated to pay
damages by reason of the assumption of liability
in a contract or agreement. This exclusion does
not apply to liability for damages that the addi-
tional insured(s) would have in the absence of
the contract or agreement.
(2) "Bodily injury" or "property damage" occurring
after:
(b) 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 subcon-
tractor engaged in performing operations
for a principal as a part of the same
project. .
(3) "Bodily injury" or "property damage" arising out
of any act or omission of the additional in-
sured(s) or any of their employees, other than
the general supervision of work performed for
the additional insured(s) by you.
(4) "Property damage" to:
(a) Property owned, used or occupied by or
rented to the additional insured(s);
(b) Property in the care, custody or control of
the additional insured(s) or over which the
additional insured(s) are for any purpose
exercising physical control; or
(e) "Your work" for the additional insured(s).
?OUCY NUMBER:
FALH74320
.... .........,.~"l?,....
'.... -'-u...--~}MAs:~L _'"".._
Of' c'4<if
~4.'~ A~~
... t"'
U , r"
. ' .
.... ...
-$0 ..
~. ..'
ol/c H A Ill)'
CITY OF CAMPBELL
Public Works Department
July 7, 1997
Scott Cooley
700 West Hamilton Avenue
Campbell, CA 95008
Subject:
Permit No. 96-138
Location: 700 W. Hamilton Avenue
ONE YEAR MAINTENANCE INSPECTION - ACCEPTANCE
Dear Mr. Cooley:
Please be advised that the fInal warranty period inspection of the Public Works improvements
at the above location has been completed and your warranty requirements and any surety,
therefore, are hereby released.
Your remaining warranty deposit of $9,500.00, plus any interest due, will be sent directly to
you from our Finance Department.
Sincerely,
/C~-
"Robert Phillips
Public Works Inspector
MQ....r
cc: Permit 96-138
Public Works/Maintenance Division
h: \word\permits\96138mtc{np)
70 North First Street. Campbell, California 95008.1423 . TEL 408.866.2150 . FAX 408.376.0958 . TOD 408.866.2790
'^~
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/1.
3.
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?iZYI&
PERMIT 96-138
GOLD'S GYM - 700 W. HAMILTON
PRELIMINARY INSPECTION REPORT
Remove form boards from interior of catch basin at the back of the Hamilton Avenue
driveway, then grout interior of catch basin.
2.
Remove sod from above the root ball of the new trees, also uncover watering tubes.
--- '
~.J" wr..........
Replace dead sod. J 1"
IQ~ Jrt"j 'r-rr. -~/(..
Adjust sprinklers to provide proper coverage. Conduct irrigation test in the presence of
the inspector.
Prune sucker growth from new trees, especially from rootball.
6.
Submit as-built drawings, on mylar, stamped by the Engineer of Record.
-(4;",'1' f, f<-I/ G./7 IL' ..t;r;-
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'O~CHA\lQ'
CITY OF CAMPBELL
September 17, 1996
Public Works Department
Mr. Scott Cooley
Contour Software
700 W. Hamilton Avenue
Campbell, CA 95008
Subject:
Permit No. 96-138
Location: 700 W. Hamilton Avenue
Preliminary Inspection Report - Deficiencies
Dear Scott:
This letter is in response to your request for a fmal inspection on subject Public Works
improvements. There are deficiencies in the work which are indicated on the enclosed
preliminary inspection report. These deficiencies must be corrected in accordance with City
standards before we can make a final inspection or accept the work. Please contact me at
(408)866-2165 to coordinate the correction and inspection of these deficiencies, or if you have
any questions.
Upon completion of the corrective work, please submit a written request for a final inspection
and acceptance. Seventy-five percent (75 %) of your Faithful Performance Security (FPS) cash
deposit of $38,000, plus any interest due, is now being processed and will be sent to you under
separate cover. Additionally, your $500 plan check deposit and $1,520 construction cash deposit
will be refunded after deducting $93.19 for 1 1/2 hours of inspector overtime on June 10, 1996
when demolition work had begun prior to issuance of the permit.
If you have any questions, please call me at (408) 866-2165.
SincereIY'jjtf#
e:~-
Public Works Inspector
MQv.&..
,
Attachment: Preliminary Inspection Report
cc:
Building Division
Permit 96-138
h: \landdev\ 700whamilton
70 North First Street. Campbell, California 95008.1423 . TEL 408.866.2150 . FAX 408.379.2572 . TOO 408.866,2790
NEW PW FAX #
408-376-0958
PERMIT 96-138
GOLD'S GYM - 700 W. HAMILTON
PRELIMINARY INSPECTION REPORT
1. Remove fonn boards from interior of catch basin at the back of the Hamilton Avenue
driveway, then grout interior of catch basin.
2. Remove sod from above the root ball of the new trees, also uncover watering tubes.
3. Replace dead sod.
4. Adjust sprinklers to provide proper coverage. Conduct irrigation test in the presence of
the inspector.
5. Prune sucker growth from new trees, especially from rootball.
6. Submit as-built drawings, on mylar, stamped by the Engineer of Record.
.Of'CJ\.-ttA
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1-o{t> c- ,'"
.rJ"CH,\\lO
CITY OF CAMPBELL
Community Development Department. Current Planning
August 15, 1996
Scott Cooley
Contour Software
700 W. Hamilton
Campbell, CA 95008
Subject: Punchlist of items observed remaining to be accomplished to "retire bond"
I visited 700 W. Hamilton this afternoon, as you requested in order to provide you with
a list of the items remaining to be accomplished. Most of these appear to be in Tim's
domain, except for the canopy.
CANOPY
Regarding your most recent decision to return to canvas canopy: I would suggest that
no posts be used if they cannot be of substantial proportions. The standard posts used
by canopy companies are relatively small diameter metal pipes. These would be out of
proportion with the architecture of the building.
I noticed that you had reused the free-standing sign which had been in front in order to
direct people to the side entry. This cannot be approved as only one freestanding sign
is permitted per parcel. Types of signs which are exempt from the requirement for a
sign permit are: 1) identification signs, maximum 1.5 square feet, with the name of the
business or address only, no advertising, and 2) directional signing, which are sign
which say such things as "employee parking" with an arrow. Any other signing in your
parking lot must be approved by the Planning Commission even though it may not be
visible from off site. I believe they would approve signing which is limited to directing
people to the correct door, but we cannot approve it at a staff level. Any signing you
want for the canopies or elsewhere should be applied for immediately, due to the
expiration date on your bond.
LANDSCAPING
Irriaation
The irrigation system both within the public right-of-way and on your property is not
properly working. The sod in front is dying in several places and there are three areas
in the rear where plants are dead or dying. The plants will need to be replaced and the
irrigation system shown to be working correctly. The system was not working well
before. It may be that the old system has been overextended, and cannot support the
70 North First Street. Campbell. California 95008.1423 . TEL 408,866.2140 . FAX 408.379.2572 . TOD 408.866.2790
additional area and heads without being upgraded or added to. If the system is not
working well when the time comes to sign off, the City may need to require an 18 month
plant and irrigation bond.
PlantinQ
The approved landscape plan specified sod, not seed for all the grass areas. Also,
Condition 6A of the Planning Commission approval required the Streetscape to be sod
for 10' on either side of the sidewalk. The majority of the area behind the sidewalk used
seed. It is not coming in well, being sparse, uneven, and with weeds.
As I mentioned to you and Tim before, the variety of ceanothus which was substituted
for one of the varieties of juniper grows to a width three times that of the width of the
islands they are planted in. I told Tim that they could be moved to the back area where
there is space for them, and the correct variety of plant, as indicated on the approved
plan be planted. It appears this has still' not been done. As there are a large number of
plants now in the back area which have died due to the poor irrigation coverage, which
will need to be replaced, you may wish to use them there
TRASH ENCLOSURE
The trash enclosure has not been constructed. Please be sure not to use standard
concrete block, but decorative block. During the preparation of the landscape plans it
was decided that instead of using plant material to screen the enclosure, decorative
instead of standard block would be used. Please have the person who is to construct
the enclosure submit a sample of the block to us for approval before beginning the
work.
BICYCLE RACKS
No racks have been installed. They were a condition of the permit and their location
indicated on the landscape plan.
I will be on vacation next week (Aug 18-23), and wanted to get this list to you before
then so that you will have adequate time to address the items. If you have any
questions while I am away, please contact Darryl Jones at 866-2141, or Randy Westfall
for items in the public right-of-way at 866-2165.
Sincerely,
%~ l?~--
Barbara Ryan
Planner I
cc. Darryl Jones, Senior Planner
Randy Westfall, Public Works Inspector
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City of CaD!. U
Department 01. pun1 it: Wc:IrJcs
Pemit No. q w -['g-'O
IC q,s-" o;L
UP 9L/-o/
~
t.,-
Applicant section cazpl.ete'
Applicant signature ani date
1I72f'
PeJ:mi.t ~licaticn fee~OO paid
~ipt I1l1mher '1 I s-&J i)
~ Plan check r1~it, $500.00 paid
P~ipt I1l1rnher f'1 Si /
~ Five sets of imprcveDEnt plans $I'""ittai
Lr-
~
V-'
SUrety for faithful perfomarx:e, loot of City Erqineer's
estimate, supplied or paid t2xU!ijJJ- /..>> ..
Anr:Junt $ :'36 ,DOO Fom ~ ~ f. '1 3/ t3 2-
,
Cash Deposit: 4t of FP surety, $500 minimJm paid
Anr:Junt $ J S-:U> ,oD' a=v-ipt No. q 3 Ie :3
Plan Oleck & Inspection fee of 14t of F.P. surety for cmcunts of
$0 - $30,000: lot for 30,000 - $80,000: 7t for $80,000 ani above:
$200 min:imJm paid .
Amamt $ LJ5/P/),oO ~jpt No. 93/13'1
~ Worker's canpensatien infor.maticn received for ~licant
(see Infonnatien Sheet for Encrcachment Pemits)
V'
~
All ather PUblic Works requirements listed in the Ccrdi.ticns of
Apprcva1 of the devel~..lJttka~ ~ CAhJzu1cU;'
'II 9; ono d,u_ iI/kYl.. ~{J.;ndcT
............ Worker's CYl~ticn arxi a~ul..L4ctcr's Infozmation received for
Ccrrt:ractcr (see Infor.matien Sheet for En:rcachment Pemi.ts)
V-- certificate of Insurance with Additional Insured's Erxicrsement
received frail 0:Irt:ractar (see General SUmmaJ:y of Insurance -
Requirements for Erx:roadmlent pemi.ts)
'three sets of off-site plans, st"~ APFRJVED (Tract or
Devel~ am PUblic Wol:Xs Pemi.t 1"11mher an:i property address
en plans)
.,.--
Pemi.t signed fer City En;ineer
WHEN AIL OF 'mE ABJVE I'IDS ARE CDtPIEm, PERMIT MAY BE ISSUED
Issuer: Initial an:i date ani file with permit
""
UFtN ISSUANCE, INITIATE cm::cK ~ FOR PIAN aim{ IJE:R:\SIT
REFUND
f: pmtcklst
Revised 8/92
CITY OF CAMPBELL
PUBLIC WORKS DEPARTMENT
CITY ENGINEER'S CONSTRUCTION SURETY COST ESTIMATE
ITEM
NO. DESCRIPTION $30 K 10 $150 K > $150 K $ AMOUNT
3. URB AND GUTI'ER $18.00 $15.00
I
4. ALLEY GUTI'ER sri $12.50 $10.00 $8.25
I
S. ANDICAP RAMP EA\ -.$1,200.00 $800.00 $700.00
6. YPE B-1 CURB LFI $12.00 $9.50 $7.50
I
I $15.00\
7. YPE Al-B3 CURB LFI $12.00 510.00
!
8. OBBLESTONE MEDIAN SURFACE SF $'12.001 $8.00 $5.001
1 I i
i i
9. .C.C. DRIVEWAY CONFORM SFI 57.001 $5.501 $4.501
' '
I I $3.001
10. .C. DRIVEWAY CONFORM zt;; SF $4.501 $3.75 t l~. <,0
V.
I. CF $5.00 $3.50 $2.50
2. A VEMENI" WEDGE CUT (6') LF $5.00 $2.50 $1.501
I
3. AVEMENI" GRINDING SFI so.801 SO.50 SO.35\
I I
I
I
4. AVEMENT FABRIC (PETRO-MAT) SY 1 $1.001 $1.851 $1.50
I
5. T $80.00 $50.00 $35.00
6. GGREGATE BASE (CLASS 2) -3--3- T $40.00 $20.00 $12.00 ~
7. SO.07[ SO.06 SO.05
I
8. SO. 11 SO.09 SO.07
VI.
1. $450.00 $300.00 $250.00
I
I
2. EA 5650.00 $540.00 S440.oo
3. EAt $900.00 $750.00 $640.001
\..-~ :~L~10O- \~\~-
4. EA I, $2.~.00 \ $2.200.00 $1.800.00
~ ""'... -!:l. \.sz::.c. ~ ~;;;<:a6-
5. LF $9.001 $7.00\ $5.00
6. LFI Sl7. 00 I $13.00 I $10.00
06-Feb-96
Page 2 of 4
ITEM UNIT PRICES FOR iCT AMOUNT
NO. DESCRIPTION OUANTITIES < S30 K S30 K TO SI50 K > SI50 K S AMOUNT
7. rONDUCTOR LF SO.70 SO.55 SO.45
8. ULL BOX (NO.3 In) EA S3OO.00 S240.00 SI85.00
I
9. ULL BOX (NO.5) EA $400.00 I S350.00 S3OO.00
I
VII. !ITRII'Il'lGANDSIGNS ....... i
REMOVE PVMT. MARKINGS (PAINT) i I !
I. SF S2.501 $ 1.50 SI.OO
REMOVE PVMT. MARKINGS (THERMO) I I
2. SF S3.001 S2.00 SI.40
i
I I
3. ~EMOVE PVMT STRIPING LF SI.401 SO. 80 $0.40
I
~RIPING DETAIL 9 . S 1.351
4. LF SO.85 $0.35
." I
STRIPING DETAIL 29 I
5. LF S2.25 1 SI.65 SI.20
I
STRIPING DETAIL 32 I
6. LF S2.4OI S 1.75 SI.25
I
I
7. STRIPING DETAIL 37 (THERMO) LF SI.851 SI.50 SI.OO
8. STRIPING DETAIL 38 (THERMO) LF ' $2.501 $1.85 $1.15
STRIPING DETAIL 39
9. LF $1.501 SO.85 SO.45
I
STRIPING DETAIL 40 . $2.201
10. LF S 1.70 $1.00
I
11. IMIT LINE LF SI.351 $1.05 $0.90
,
12. rROSSWALK I LF S 1.35 i $1.05 $0.901
i i
i
13. PAVEMENT MARKINGS (PAINT) SF $2.501 SI.90 SI.W\
PAVEMENT MARKINGS (THERMO) I
14. SF $5.501 S3.80 $2.W
I
IS. AVEMENT MARKER (NON-REFL.) EA $4.50 I S3.00 $2.20
I
I
16. A VEMENT MARKER (REFLECTIVE) I EA $6.001 $4.15 $3.15
I
I
17. YPE K MARKER EA $95.00 I $80.00 $70.00
I
18. YPE N MARKER EA $,95.00 I S80.00 $70.00
I
19. AL V AGE ROAD SIGN I;A S85.00 I $75.00 S65.00
!
20. RELOCATE ROAD SIGN EA $100.001 S85.00 S75.00
I
i
21. NST. RD. SIGN ON EXIST. POLE EA $200.00 I $145.00 $110.00
1
! $195.00\
22. ~OAD SIGN WITH POST EA $300.00 I $240.00 I
I
I
06-Feb-96
Page 3 of 4
ITEM UNIT PRICES FOR PROJECT AMOUNT
NO. UANTITlES < $30K 30K TO S150 K SI50K S AMOUNT
VIII.
1. RRIGATION. PLANTING WORK LS 2.100.
2. RUNE TREE ROOTS EA SI25.00 $100.00 $85.00
3. REE REMOVAL -,~ EA $650.00 $500.00 $400.00 \.q.ec ..
I
4. OOT BARRIER (12"> LF S20.00 S 10.00 $6.001
i I
5. OOT BARRIER (18') LFI $25.00 $15.00 $10.00
I $250.00 ~\.~-so-I
6. ~ EA $450.00 $325.00
7. EA S700.00 $550.00 $400.00
8. t7 CY \ co. 4--70(l
IX.
1. LF '$75.00 $60.00 S50.00
2. LF SI5.00 SI1.50 $9.25
. 3. EA S300.00 S200.00 $175.00
4. EA $400.00 $275.00 $200.00
5. EA $450.00 $350.00 $300.00
6. CY SI9.00 $17.00 $15.501
SUBTOTAL )...cj 2..i I
PREPARED BY: J EJ2Je.'I C!.lY-tU/S CONTINGENCIES 10% ;2, if / ?
,
TOTAL CONSTRUCTION ESTIMATE 2-& 700
REVIEWED BY: PRELIMINARY ENGINEERING %
I
CONSTRUCTION ENGINEERING I
APPROVED BY: TOTAL ESTIMATE U,700
FAITHFUL PERFORMANCE SURETY
H:\CECOSTEST. WK3(MP)7120/95REV 1/18196
06-Feb-96
Page 4 of 4