91-020 Wong, Tony 91-020 WONG, TONY
C*4 of Cuperti"o
10300 Torre Avenue P.O. Box 580
Cupertino. Ciiiiorn i 95014 Cupertino,California 95015
Telephone: 1408} !5_'-i505
DEPARTMENT OF THE CITY CLERk
July 8, 1991
Tony Wong
19028 Stevens Creek Boulevard
##D
Cupertino, CA 95014
Mar Mr. Wong.
We are enclosing to you for Your files one (1) COPYthe
and between the City of Cupertino and Tony Wang and Cathy Teang, which has
been fully executed by city officials, along with one (1) copy of
Resolution No. 8406, which was enacted by the City Council of the City of
CuF,,:rtino, at their regular meeting of Monday, June 17, 1991.
Sincerely,
DOROTHY oDRNELIUS
CITY CLERK
CITY of CUPERTINO
DC/so
encl.
cc: Departnent of Public Works
RE ICK NO. 8406
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CUPERTINO
APPI WrWG FINAL PLAN Fit THE n1PROVE ENT OF FMnWZ WCATED
22561 POPPY DRIVE, DEVUDM, TCKY WONG AND akMY TSANG,
AUTHORIZING THE CITY ENGINEER. M SIGN T[M FINAL PLAN; AND
AU hMMZING E MICN OF AGREEMU IN CONNECTICN THEREWITH
WE REAS, there has been presented to the City Council for approval
of the final plan for the it rovenent of street frontage located at 22561
Poppy Drive by Tony Wong and Cathy Tsang; and
NM:CF wS, there has been presented to the City Council a proposed
agreement for the construction of streets, curbs, gutters, sidewalks, and
for other improve mts, and good and sufficient bonds, fees, and deposits
as set forth in Exhibit "A", having been presented fcr the faithful
performance of said ageement; and said plan, agreement, and lands having
been approved by the City Attorney;
NOW, THEREPME, BE IT RESOLVED that said final plan for the
improvwmt of street frontage at 22561 Poppy Drive be and the same is,
hereby, approved; and the City Engineer is hereby authorized to sign said
final plan; and the Mayor and City Clerk are hereby authorized to execute
the agreement herein referred to in behalf of the City of Cupertino.
PASSED AND ADOPTED at a regular meeting of the City Council of the
City of Cupertino this _ 17th day of .Tune 1991, by the
following vote:
Vote Members of the City Council
AYES: Goldman, Rogers, Sorensen, Szabo
NOES: None
ABSENT: Koppel
ABSTAIN: None
APPROVED:
/s/ Nick Szabo
Mayor, City of Cupertino
Pro Tempore
ATTE���:
LJ Dorothy Cornelius
City Clerk
t
AGREEMENT
22561 POPPY DRIVE
APN N 342--12-006
This AGRE04DM made and entered into this day
of , 19-�&_, by and between the CITY OF
CU7PEFUM10, a municipal corporation of the State of California, hereinafter
designated as CITY, and TONY WONG and CATHY TSANG
heretinafter designated as DEVELOPER.
WITNESSETH
WHEREAS, the DEVELOPER has made application to the CITY for a
BUILDING PERMIT
to construct and maintain a SINGLE FAMILY DWELLING
hereinafter referred to as "Project."
WHEREAS, CITY hereby approves theiq=vvemmt plans and specifications
prepared for the Project by JOHN OU & ASSOCIATES ;
a true copy of which iaprovemexit plans and specifications are on file in
the office of tha City Engineer of Oupertino; and
WEB, the same are incorporated herein by reference, the same as
thouc#i set out in full;
NOW, TREREFC11E, said iut=ovement plans arrd specifications shall be
hereinafter called the "Plans," and the work to be done =der the Plans
shall be called the "Wank."
File: 51,934
1
WI AS, putsuannt _to the provisions Of this ACTT, the CrrY h2rebY
established the amwnts of Bands, Fees, and Deposits as set forth in the
follawirg schedule:
SC ELUIE OF BONDS, FEFS AND DEPOSIT'S
Street Inprove nt Category:
PART A. Faithful Performance Bond:
TEN THOUSAND EIGHT HUNDRED SEVENTY FIVE AND NO/100 $10,875.00
PART B. Labor and Material Bond:
TEN THOU."'9ND EIGHT HUNDRED SEVENTY FIVE AND NO/100 $10,875.00
PART C. Checking and Inspection Fee:
FIVE HUNDRED FORTY FOUR DOLLARS AND N0/100 $ 544.00
PART D. Indirect City EXpenses:
EIGHTY TWO DOLLARS AND NO/100 $ 82.00
PART E. Developwnt Mab*Ananoe Deposit:
FIVE HUNDRED DOLLARS AND NO/100 $ 500.00
PART F. Storm Drainage Fee:
TWO HUNDRED EIGHTY FOUR DOLLARS AND N0/100 $ 284.00
PART G. One Year PbWer Cost:
THIRTY SIX DOLLARS AND NO/100 $ 36.00
PART H. Street Tree-: BY Dsveloper
PART I. Map checking Fee:
PART J. Park Fee:
PART K. Water Main EXtensiOn Deposit:
ONE THOUSAND ONE HUNDRED SEVENTY DOLLARS AND N01100 $ 1,170.00
PART L. Maps and/or improvement Plans:
AS SPECIFIED IN ITEM #23
2
NOW, rj�nRE, IT IS FAY MtTILAI U AGREED by and between the
parties hereto as follows, TO WIT*.
1. DEDICATION
A. The DEVELOPER offers to dedicate the real property shown on
Exhibit "A", which is attached hereto and made a part hereof by reference.
Said dedicated property shall be free and clear of all liens or
encumbrances except those which the CITY shall waive in writing. the
DEVELOPER agrees not to revoke said offer of dedication, and to keep said
offer open until the CITY accepts offer by resolution.
B. Upon execut on of this AGREEMERr the DEVFM eER agrees to
deliver a properly executed cant deed to the CITY of the real property
described in Exhibit "A", and such other executed sa.---rveyances, or
instr ments necessary to convey clear title as herein required. Tone
DEVELOPER shall provide, at the LEVELDPER'S sole cost and expense, to the
City:
(1) A preliminary title report issued by a title insurance
many relating to the property offered for dedication.
(2) A standard policy of title insurance issued by a title
insurance company and insuring the CITY in the sum of: N/A, and
which shall show said property fry and clear of all liens or
encumbrances exempt those as the CITY shall expressly waive in '
writing; said policy shall be furnished at the time of acceptance
of dedication and recordation of Bleed.
C. Upon the condition precedent that the DEVELOPER shall
perform aach, and every covenant and condition Of this ANTI', the CITY
agrees 4.o accept said real property offered for dedication.
2. LNSTALSA.TICN OF WOW
It is further agreed that:
A. The DEVMOP1ER shall install and complete the Work within one (1)
year from the date of execution of this AGIMIMM, or such longer period
as may be WA ifically authorized in writing by the City Engineer. In the
event the Ly VEMPER fails or reftses to owplete the Work within the
spe::ified period of time, the CITY, at its sole option, shall be
authorized to ccuplete the Work in whatever manner the MY shall decide.
In the event the CITY completes the Work, the CITY may recover any and all
costs incurred thereby from the DEVELOPER .or the DEVELOPER'S surety or
both.
B. The MVEIDPER shall install and c>cuplete the Work in a good and
workmanlike manner in a--ordance with the plans as approved by the City
Engineer of Cupertino. Me Work shall be done in aocordanoe with existing
ordinances and resolutions of the CITY and in acoordance with all plans,
specifications, standards, sizes, lines, and grades approved by the City
Engineer. The Work shall be done in acoozrlance with all State and County
Statutes applicable her-ca. The decica of the City Engineer shall be
final as to whether arty material or workmanship meets the standards,
specifications, plans, sizes, lines and grades as set forth.
3
C. It is ft:ther agreed that the Wort: shall be done in acoordaaxr:
with the most ant Standard Specifications of the De;partment of Public
Works, California Department of Transportation, State of California, and
in accordance with the specifications of the 04pertino Sanitary District
where applicable.
Wherever the words "State" or "California Division of Hi4iwrays" are
mentioned in the State Specifications, it shall be considered as
referring to the CITY of 04=tino; also wherever the "Director" or
"Director of Public Works" is mentioned, it shall be considered as
referring to the City Engineer.
In case of conflict between the State Specifications bnnd the
specifications of the CITY and/or the Cupertino Sanitary District, the
specifications of the CITY and/or the CL4ertino Sanitary District shall
take precedence over and be used in lieu of such conflicting portions.
3. EXCAVATION FER IIT
It is further agreed that the DEVELOPER shall easily with Section
Three of Ordinance No. 130 of the CITY by obtaining an excavation permit
from the. City Engineer before the " "nowncement of any excavation in, on,
or under the surface of any existing public street, lane, alley, sidewalk,
or other public place. It is further agreed that the DEVEMPER shall
notify the City Engineer of the exact date and time when the proms
excavation is to commence.
4. gJrl=AIK ICED
It is further agreed that the DEVEXOPE R, when requested by the CITY,
shall quitclaim all his rights and interests in, and shrill grant to CITY
authorization to extract water from the underground strata lying beneath
said project and DEVELOPER agrees to execute a "Quitclaim Deed and
AuthorizatioWl in favor of CITY, when pied to him for signature.
5. HCNDS AND OTHER SECURITY
A. Upon the exert iun of this AMMMM, the DEVEMPE R shall file
with the CITY a faithful performance bond to assure his full and faithful
perfarnoarce of this 11T. The penal, sum of said faithful performance
bond shall be the full cost of any payment to be made under this
AGREEMENT, the value of any land agreed to be dedicated, and any
improvements to be made under this AGRE 2MM. In the event that
hgnvvementts are to be made under this AMEEMMM, the DEVE FER shall, in
addition to said faithful pexforaenoe, file with the CITY a labor anadJ--
matAwials bond in a penal sum adequate to assure full payment of all labor
and materials required to construct said iazv®aents. The amount of said
bands shall be as designated by the City Engineer. Said bonds shall be
executed by a surety any a*J=ized to transact a surety business in
the State of C aliforania and must be approved by the City Attorney as to
form and by the City Engineer as to sufficiency. In the event that the
DEVELOPER shall fail faithfully to perform the covets and oon3iticns of
this AGREE MM, or to make any payment, or any dedication of land, or any
improvements herein required, the cm shall call on the surety to perform
this AGREEMENT or otherwise indemnify the CM for the CEVELOPE RIS failure
to so do.
4
B. In lieu of a surety bond, the DEVELOPER may elect to secure this
AGMMW by depositing with the CITY:
1. Cash; or,
2. A cashiers check, or a certified check payable to
the order of the City of Cq)extino; or,
3. A certificate of deposit, or instrument of credit meeting
the requirements of Government Code Sew son 66499 (b) or
(c) .
C. The amount of said cash, checks, certificate of deposit, or
instrument of credit shall be as designated by the City Engineer, and
shall be the equivalent to that which would have been required had the
DEVELOPER furnished the CITY with a surety bond. In the event that the
DEVELOPER shall fail faithfully to perform the covenants and conditions of
this ACTT, or to make any payment, or any dedication of land, or any
improvements herein required, the CITY may apply the proceeds of said
security thereto.
D. No release of surety bond, cash deposit, check, or certificate of
deposit, shall be made exoept upon approval of the City Council.
E. No interest shall be paid on any security deposited with the
CITY.
6. CHECKI IG AND INSPECTICK FEE
It is farther agreed that DEVELOPER shall pay any and all necessary
direct expenses for inspection, checking, etc., incurred by CITY in
connection with said Project, and that DEVELOPER shall have deposited with
CITY, prior to eoscution of this AGFMMM. the amount as set forth herein
at Page 2 (Part C) . Should construction cost vary materially from the
estimate from which said sum is calculated, the City Engineer shall notify
DEVELOPER of any additional sum due and owing as a result thereof.
7. INDIRECT EXPENSES
It is further agreed that DEVELOPER shall pay to STY, prior to
execution of this AGMMMU, indirect expense allocable to processing
these I -- -gem- I , the amount as set forth herein at Page 2 (Part D) .
8. MAP CHECKIM FEE
It is farther agreed that the DEVELOPER shall deposit with CITY, prior
to execution of this ACTT, for office checking of final map and
field Checking of street MMUMents, in coWlianos with Section 4:1 of
Ordinance No. 47 (Revised 12/04/61) of CTTY, the amount as set forth
herein at Page 2 (Part I) .
9. DEVELOPMFN, MAINTENANCE DEPOSIT
It is further agreed that the DVIELOPER shall pay to thr. CITY, prior
to ex(-cution of this ACREEI4FIU, the arwAint set forth herein at Page 2
(Part E) as a development maim deposit to insure proper dust
control and cleaning during the construction period. The development
maintenance deposit may be utilized for repairs of defects and
imperfections arising out of or due to faulty workmanship and/or materials
appearing in said work during the period until release of the improvement
bonds by the CITY. Should the DEVELOPER complete the required repairs to
the entire satisfaction of the CITY, the unused balance will be returned
after the release of the improvement bond.
10. SPORM DRAINAGE FEE
It is further agreed that the DEVELOPER shall deposit with the CITY,
prior to execution of this AGREEMENT, z: storm drainage charge in
connection with the said Project in accordance with the requirements
established in Resolution 4422, March 21, 1977, in the amount as set forth
herein at Page 2 (Part F) .
11. WATER MAIN EXTENSION DEPOSIT
The DEVELOPER further agrees to deposit with the C'I'I'y those monies
required to coaply with "Policy on Water Main Extelsions Work and
Deposits" dated 9/30/77. She deposit shall be held by the CITY until said
monies are needed to implement improvements outlined by the Director of
Public Works or improvements outlined within the adopted Water Master
Plan.
The amount shown herein at Part K, Page 2, shall be the full amount
due.
12. ONE YEAR POWER COST
It is further agreed that the DEVELOPER shall pay to CITY prior to
execution of this AGREEMENT, the amount as set forth herein at Page 2
(Part G) , which amount represents the power cost for street lights for one
year.
13. THE INSTALLATION OF SIREET TREES
It is further agreed that the DEVELOPER shall, at such time as deemed
appropriate by the city Engineer, plant street trees in conformance with
the standards of the city of Cupertino, Variety of tree shall be selected
from the city approved list.
14. PARK FEES
It is further agreed that the DEVELOPER shall pay such fees and/or
dedicate such land to the CITY, prior to execution, as is required within
Section 18-1.602 Park Land Dedication, Cupertino Municipal Code, and which
is further stipulated under Part J, Page 2 herein.
6
14-A. PARX _ AD.IL 'E*i'T P K� Ir?75
Me value of the land used in e_--tablishing the "Park Fee"
herein on Page Z, Part J, requires formal ccnfi-.=ticn. Zee CITY
shall employ a qualified local appraiser to provide a market value of the
land. The City will ca.lc..►zldte the "Park Fde" based on the appraisal.. The
Davrelcper agrees to pay for arty deficiercr within thirty (3 0) days and tre
City agrees to refund overage within thirty (30) days. Adjustments shall
be made prior to acceptance of the subdivision improvements.
15. ;�A 7I'=`Ie�PIC OF WORK
It is furs"_er agreed that the DE=PER shall maintain the work until
a�, deficiencies in the Work are corseted to conform to the Plans and "e
City stair's and specificatieru for the Work. The C ELOPE.R shall, upon
-writ--en notice thereof, immediately repair or replace, withcut c^st or
obligation tp the. City of CL'..*ertino, and to the entire satisfaction of
said C'_*'I'Y, all defects and imiu erfectzcns arising cut of or a?e to faulty
,.rcrkmanship and/or materials appearing in said Work.
15. SANZ'= 01=CI'
It is fu ther agreed that the DEVELOPER shall file with L"''IY, =cn
execution of this ACC"4=, a let`s fran the CLape tino Sanitary Dist`isr
stating that the DEVELOPER has e_^.tered into a separate Ate== with t':e
said Dis-i ct to install sanitary sF4ers to sere all lots within said
P=vjec` and stating that a bond to insure fall and faithful performance of
the cony,-.uc`-ion of the said sanitary supers and to insure mainterance of
said sanitary sewer in conformance with. .tl-a provasions as set forth in
Paragraph 1.5 above has been filed.
17. GOVE—EraZ= CODE
It is fart.`e_r agreed that DEVELOPER shall file with CI:'Y, anon
execution of this AGE, substantial evidence that all provisions of
Section 66493, Article 8, Chapter 4 of the Government Cale, pertaining to
special assessments or bonds, have been complied with.
18. C2 UI L = 01=CT
It is further agreed that the Ds:=PER shall file with the CITY, upon
execution of this A `. , a letter fr m the Central Fire Protection
Distr ct of Santa Clara Ccunty, stating that the Ig.'V=PE R has entered
into an AGE with said District to install fire hydrants to sere
said Project and stating that all necessary fees have been deposited with
said District to insure installation and five (5) year rental fee of said
hydrants.
19. PACIFIC CAS AND E ECMIC/pAIC M
i
It is further agreed that the L EV=PER shall pay to Pacific Gas and '
Electric many and/or to PACMC MML C 9any any and all foes required
for installation of overhead and,/or Undergrennd wiring ci=U:Lts to all
elect=liers within said prcperty and any and all fees req1ired for
uniergrcunding as provided in C=inance No. 331 of CITY when DEVELOPER is
notified by either the City a-queer or the Pacific Gas and Electric
Canwany and/or PACIFIC Emi. Ccmnany that said fees are due and payable.
7
2 G. E ASEME15 AND RIGHT-OF-NAY
it is further agreed that arty easement and riot-of-way necessary for
completion of the Project shall be acquired by the MMOPER at his own
cost and expense. it is provided, however, that in the event eminent
dcsnain proceedings are required by the CM for the purpose of securing
said easement and right-of-way, that the DEEPER shall dqX-Sit with CITY
a sum covering the reasonable market value of the land proposed to be
taken and to be included in said sum shall be a reasonable allowance for
severance damages, if any. It is further provided that in addition
thereto, such sums as may be required for legal fees and costs,
engineering, and other incidental costs in such reasonable arts as the
CITY may require shall be deposited with the City of Cupertino.
21. FOIA HA144LESS
it is further agreed that, cammming with the performance of the Work
by the DEVELOPER or his contractor and continuing until the coWletion of
the maintenanoe of the Work, the DEVELOPER shall i.n 1mdfy, hold harmless
and defend the CITY fz and against any or all loss, cost, expense,
damage or liability, or claim thereof, occasicned by or in any way
whatsoever arising out of the parformano® or nonpe:.'formancs of the Work or
the negligence or willful misconduct of the MN OPER or the MMOPERIS
agents, employees and indeperr1ent contractcrs.
22. INSURANCE
It is further agreed that: The DEVEIOFEt shall take out, or shall
require any contractor engaged to perform the Work to take out, and
maintain at all times during the perfosmar and maintenance of the Work
called for or required to be done herazdw, a policy of insurance naming
the = and members of the City Council of the City of 04p rtino,
individually and collectively, and the officers, agents and employees of,
the City indivi&ally and collectively, as insured. Said separate policy
shall provide bodily injury aid party damage coverage to the foregoing
named CITY and individuals covering all the Work performed by, for, or on
behalf of said DEVELOPER. Batli bodily injury and Property daoa9e 1nsuranMP-
must be on an occur Wm basis; and said policy or policies shall provide
that the coverage affarded thereby shall be primary coverage to the full
limit of liability stated in the declaraticns, and if the city, its
members of the City Council individually and collectively, and the
officers, agents, and employees of the CITY, individually and
collectively, have other insurance against the lose covered by said policy
or policies, that other insurance shall be eon insurance only.
The insurance carrier shall provide proof of their ratings. All ratings
shall be a minimum of "Best A-7" in accordance with ABAG policies.
d
A, Each of said- policies of insurance shall provide coverage in the
following minimum : For fly injury, $100,000 each person;
,.300,000 each occurrence, Property age, $50,000 m account unt of any
one occurrence with an aggregate limit of not less than $200,000.
H. The SAFER shall file with the City Engineer at or prior to
the time of exeiaution of this AGFMHEW by the MVELOPER such evidence
of said foregoing policy or policies of insurance as shall be
satisfactory to said City Engineer. Each such policy or policies shall
b ar an endorsement precludirg the cancellation or reduction in
coverage without giving the rity Engineer at least ten (10) days
advance notice Laereof.
G. in the event that the Project covered herein should be mutually
situated in or affect the area of jurisdiction of a separate
municipality or political subdivision of the State of California, the
policies of insurance required herein and above shall co-name such
municipality or political subdivision and the provision set forth
herein and above for the protection of the CITY shall equally apply to
municipality and political subdivision.
23. MAPS AND/CR IMPR(7VEMEWP PLANS
It is further agreed that the CITY shall obtain the following map
and/or plans at the MVEMPER°S expense:
A. A mylar sepia and seven (7) prints of fully executed parcel map.
B. A mylar sepia and ten (10) prints of folly executed improvement
plans.
C. A direct duplicating silver negative microfilm aperature card of
all executed improvement plans and map.
The mVF,Lom agrees to pay the CM fnm the development maintenance
deposit the cost for all prints of plans and map required under Item 23.
24. SUCCESSCVS
This AGREn NT shall bind the hairs, administrators, woetutors,
suaiessor, assignee and transferrees of the MVELOPER. The assignment of
this AMMMM shall not be w4s without approval by the City Council of
the City of a4=tim.
9
CAT. NO. N-NO0627
TO 1944 CA 19-84) �
ffing °TIC®R TITLE INSURANCE
(Individual)
S"rATE:OF CALIFORNIA
COUN'1'V OF Santa Clara } SS.
On Ma 21 , 1991 before me, the undersigned, a Notary Public in and for
m
said State,personally appeared Ony Ong and Cathy Tsang
m
personally known to me or
iproved to me on the basis of satisfactory evidence to be
the person S whose names are subscribed to the
within instrument and acknowledged that they exe- 5 d -
cured the same. �t; { . GRACE CHEN
, ' NOTAtiy PURL1C-CALIFURMA
WiTNEISS my hand and official seal, > + �
camnialeion axplM LINTY
June tA,t9y1
1-t7- -
Signature
(This area for official notarial seal)
's
IN WIM ESS F, CITY has caused its name to be Yeramto affixed by
its mayor and City Clerk, ttaer unto duly authorized by resolution of the
City Council and said MVELOPE R has hme+aft caused his name to be affixed
the day and year first above written.
CITY OF C(JPE RMIO:
j lI
Approved as to form:
Mayor
Ci Attorney
City Clerk
MVIMPER:
Notary Ac'amled7mt Rewired `f
Exhibit A Atta&md
CITY OF CUPERTINO
INTERDEPARTMENTAL Date JUNE 18, 1991
To CITY CLERK From PUBLIC WORKS--SUMI J
C1 Information MESSAGE: TONY WONG AND CATHY TSANG (CC 6/17/91)
C) Implement 22561 POP'Y DRIVE
Investigate
CI Discuss 1. THREE SETS OF AGREEMENT FOR PROCESSING,
See me 2, CERTIFICATE OF INSURANCE, 5/16/91.
� Reply
3. BOND--CASH ON DEPOSIT.
SM
ATTACH.
Reply: DEVELOPER: TONY WONG
19028 STEVENS CREEK BLVD. #L
SIGNED: DATE
Send parts 1 and 2; retain part 3 for follow-up; part 2 to be returned with reply
4
i$SU1E GATE(MMIDOfYY)
R��*
® ® ` 5116191
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. Tt4IS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
ATTERERY INSUPANCE AGENCY POLICIES BELOW.
3730 HCPYARD ROAD,STE. 101 COMPANIES AFFORDING COVERAGE
CA 9,4588
COMPArt'�
_E-'TER A N A I C C
4 1 5 846 1 0 0 0 --- -- -_��
INSURED
COMPANY a SCOTTSDALE
LETTER
COMPANY c
LETTER
T.W. INTERNATIONAL -
19028 STEVENS CREEK BLVD. .STE LVTER� D
CUPERTINO, CA 95014 -COMPANY
LETTER
a
THIS IS TO CERTIFY THAT 'HE 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.
I—T, --
CO TYPE OF INSURANCE f POLICY NUMBER FP,LI.TCY EFFECTIVE POLICY EXP;RATION LIMITS
LTR tMM!DD!YY) DATE(MMfDDIYYI
GENERAL LIABILITY ) BODILY INJURY OCC, 1 S
COMPEHNSINIF IORB BODILY INJUR} AGG__!i
I'
Xlj PP.EMISESK)PERAT IONS ' PROPERTY DAMAGE OCG. $
UNDERGROUND I+ } ttPROPERTY GRMACaEAGG. S
EXPLOSION&COLLAPSE 4AZAR,7
X PROOUCTSICOMPLETED OPER t G L S 3 5 9 8 1 9 1 9/ 1 1 /9 0 9/1 1 /9 1 BI&PO COMBINED OCC. S1 , 000000
X CONTRACTUAL I , ( BI 3 PD COMBINED AGG. $ , 0, 0 Q
X INDEPENDENT CONTRACTORS { PERSONAL INJURY AGG. S +
X'BROAD FORM PROPERTY DAMAGE ((
X I PERSONAL INJURY
AU70MOSILE LIABILITY BODILY INJURY
^�A14Y AUTO I iPer per•,.nn1..-..—__—.. S
_ ALL OWNED AU tPS P•r. Pass BODILY INJURY
E
I ')`.h�.T!�aa `Par acocie"o
ALL OWNED AUTO p.v.Pass
f }HN1EC�AISTC)S z +
�-----7P ROPEEIiY i).4VkCsE �
i `JON CI 1,NED f t/i O.',;
I (GARAGE L!AFT;Ts' RJDIU l,lRY 8
PROPERTY DAaeACF �S
` t ) :;(J4IBINFU
EXCESS LIABILITY i IfACH I)CCLi RF+ENCE 5
UMBRELLA FORM
OTHER VHAM UMBRELLA FORM I ` --------
1'AT!1TOR4"LIMIIS
WORKER'S COMPENSATION -_____� -----^--
E;AC�AC'ClDlN. �js� 00000
A� AND S FW C 2 0 0 0 10 1 8 3 �1 1 /9/9 0 ± 1 1 /9191� ilse�s� Ro��v(_;MIT S 500000
EMPLOYERS'IiABIIi-i'}° { ) EZEE-VACHEMPLDYEE f.' �0 0600
OTHER —� I
DESCRIPTION OF OPERATIONSILOCATIONStVEHICLESISPECIAL ITEMS
GENERAL CONTRACTOR
ADDITIONAL INSURED LISTED BELOW:
a
The City and Membeha 06 ,the. City SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
COunCef O6 the City O$ Cu�lehten0 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
Ct-Cv e�y , MAIL-la-DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
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LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
the 0 6�j-( C eh4 , ag ent�5 and emp.�0 ye eA
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o 6 the e City -i�ndividuatt y and colt e, LBILfTY OF ANY KIND UPON THE COMPANY )7S AGENTS OR REPRESENTATIVES.
tiv el y, AUTHORIZED REPR£SE
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