89-148 Improvement Agreement 11061 S. Stelling Rd, Reso 7963 APN 362-18-002 Citi of Cupertito
�1
10300 Torre Avenue P.O. Box 580
Cupertino,California 95014 Cupertino,California 95015
Telephone: (408) 252-4505
DEPARTMENT OF THE CITY CLERK
November 14, 1989
Robert SChWartZ
No. 6
800 San Antonio Road
Palo Alto, CA 94303
AMUZ14M - 11061 S. STELLING ROAD
We are enclosing to you for your files one (1) copy of the Agreement by
and between the City of Cupertino and Robert S. Schwartz & Louis H.
Fisher, which has been fully executed by City Officials, along with one
(1) DOPY of Resolution No. 7963 which was enacted by the City Council of
the City of CupPatino, at their regular meeting of Monday, November 6,
1989.
Sincerely,
DOROTHY OORNELIUS
CITY CLERK
CITY OF COPE=O
DC/so
encl.
cc: Department of Public Works
RES0LUTION NO. 7963
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CUPERTINO
APPROVING FINAL PLAN FOR THE IMPROVEMENT OF FRONTAGE
LOCATED 11061 SOUTH STEELING ROAD; DEVELOPER,
ROBERT S. SCMWM AND LOUIS H. FISHER, AURJORIZING
THE CITY ENGINEER TO SIGN THE FINAL PIAN; AND ADMiORIZING
EXECUTION OF AGREEMENT IN CONNECTION THEREWM
WMEAS, there has been presented to the City Council for approval of
the final plan for the improvement of street frontage located at 11061
South Stelling Road by Robert S. Schwartz and Louis H. Fisher; and
WHEREAS, there has been presented to the City Council a proposed
agreement for the construction of streets, curbs, gutters, sidewalks, and
for other improvements, and good and sufficient bonds, fees and deposits
as set forth in Exhibit "A", having been presented for the faithful
performance of said work and the carrying out of said agreement; and said
plan, agreement, and bonds having been approved by the City Attorney;
NOW, ARE, HE IT RESOLVED that said final plan for the
improvement of street frontage at 11061 South Stelling Road 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 6th day of November , 1989, by the
following vote:
Vote Members of the City Council
AYES: Gatto, Johnson, Koppel, Rogers, Plungy
NOES: None
ABSENT: None
ABSTAIN: None
AT'TES'T: APPROVED:
/s/ Dorothy Cornelius /s/ John J. P1ungy, Jr.
City Clerk Mayor, City of Cupertino
RESO=CN NO. 7963 ,
EXIH= "Ale
SCID= OF BOND, FEES AND DEPOSITS
DEVELOPMERr: Sn4=-FAb=
SOIL-FISHER
10CATION: 11061 SOUTH STE TTNG ROAD
A. Faithful Performance Bond: $ 13,900.00
THAT THOUSAND NINE ffiJNDRED AND 00/100 DOLLARS
B. labor and Material Bond: $ 13,900.00
TMUEEN THOUSAND NINE HUN@3ED AND 00/100 DOLLARS
C. Checking and Inspection Fee: $ 695.00
SIX H[JNDRED NINETY-FIVE AND 00/100 DOT T ARS
D. Indirect City Expenses: $ 104.00
ONE HIM= FCJR AND 00/100 DOLLARS
E. Development Maintenance Deposit: $ 500.00
FIVE HIJNDRED AND 00/100 DOL1ARS
F. Storm Drainage Fee: $ 271.00
TWO HUNIEMD SEVENTY-ONE AND 00/100 DOLLARS
G. One Year Power Cost: N/A
H. Street Trees: By Developer
I. Map Checking Fee: N/A
J. Park Fee: N/A
K. Water Main Extension Deposit: N/A
L. Maps and/or Improvement Plans: As specified in
Item 23 of agreement
• AGREEMENT
11061 S. STELLING ROAD
APN 3',K2-18-002
T�
This A=MEW made and entered into this r day
of (Q C'r—c. 8:5:e— , 19_a_, by and between the CITY OF
CUPERT1N0, a mmnicipal corporation of the State of California, hereinafter
designated as CITY, and ROB ERT S. SCHWARTZ & LOUIS H. FISHER
hereinafter designated as DEVELOPER.
WITNESSETH
WHEREAS, the DEVELOPER has rade 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 the improvement plans and specifications
prepared for the Project by JOE L. AKERS
a true copy of which improvement plans and specifications are on file in .
the office of the City Engineer of Cupertino; and
WHEREAS, the same are incorporated herein by reference, the same as
though set out in full;
NOW, 'FORE, said improvement plans and specifications shall be
hereinafter called the "Plans," and the work to be done under the Plans
shall be called the "Work."
WHME'AS, pursuant to the provisions of this AGREEMERr, the CITY hereby
established the amounts of Bonds, Fees, and Deposits as set forth in the
following schedule:
SCHEDULE OF BONDS, FEES AND DEPOSITS
Street Improvement Category:
PART A. Faithful Performance Bond:
THIRTEEN THOUSAND NINE HUNDRED DOLLARS AND N01100 $13,900.00
PART B. Labor and Material Bond:
THIRTEEN THOUSAND NINE HUNDRED DOLLARS AND N0/100 $13,900.00
PART C. Checking and Inspection Fee:
SIX HUNDRED NINETY FIVE DOLLARS AND NO/100 $ 695.00
PART D. Indirect City Expenses:
ONE HUNDRED FOUR DOLLARS AND N0/100 $ 104.00
PART E. Develcpient ME'j tenance Deposit:
FIVE HUNDRED DOLLARS AND N0/100 $ 500.00
PART F. Storm Drainage Fee: <
TWO HUNDRED SEVENTY ONE DOLLARS AND N0/100 $ 271.00
PART G. One Year Power Cost:
N/A
PART H. Street Trees: By Developer
PAS' I. Map Checking Fee:
N/A
PART J. Park Fee:
N/A
PART K. Water Main Extension Deposit:
N/A
PAPP L. Maps and,/or, Improvement Plans:
As Specified in Item 23
2
NOW, M=URE IT IS HEREBY NUMALLY 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 execution of this AGREEmEar the DEVELOPER agrees to
deliver a properly executed grant deed to the CI'T'Y of the real property
described in Exhibit "A", and such other executed conveyances, or
instruments necessary to convey clear title as herein required. The
DEVELOPER shall provide, at the DEVELOPER'S sole cost and expense, to the
City:
(1) A preliminary title report issued by a title insurance
company 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 free and clear of all liens or
encumbrances except those as the CITY shall expressly waive in
writing; said policy shall be furnished at the time of acceptance
of dedication and recordation of deed.
C. Upon the condition precedent that the DEVELOPER shall
Perform each and every covenant and condition of this AGREEMENT, the CITY
agrees to accept said real property offered for dedication.
2. INRTALLA=0N OF WORK
It is further agreed that:
A. The DEVELOPER shall install and ccuplete the Work within one (1)
year from the date of execution of this AGREEMERr, or such longer period
as may be specifically authorized in writing by the City Engineer. In the
event the DEVELOPER fails or refuses to amrplete the Work within the
specified—period of-tine' the CITY, at its sole option, shall be
authorized to oonplete the Work in whatever manner the CITY 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 DEVELOPER shall install and ca plete the Work in a good and
workmanlike manner in accordance with the plans as approved by the City
Engineer of Cupertino. The Work shall be done in accordance with existing
ordinances and resolutions of the CI'T'Y and in accordance with all plans,
specifications, standards, sizes, lines, and grades approved by the City
Engineer. The Work shall be done in accordance with all State and County
Statutes applicable hereto. The decision of the City Engineer shall be
final as to whether any material or workmanship meets the standards,
specifications, plans, sizes, lines and grades as set forth.
3
C. It is further agreed that the Work shall be done in accordance
with the most current Standard Specifications of the Department of Public
Works, California Department of Transportation, State of California, and
in accordance with the specifications of the Cupertino Sanitary District
where applicable.
Wherever the words "State" or "California Division of Highways" are
mentioned in the State Specifications, it shall be considered as
referring to the CITY of Cupertino; 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 and the
specifications of the CITY and/or the Cupertino Sanitary District, the
specifications of the CITY and/or the Cupertino Sanitary District shall
take precedence over and be used in lieu of such conflicting portions.
3. EXCAVATION PERMIT
It is further agreed that the DE"VELOPER shall ccuply with Section
Three of Ordinance No. 130 of the CITY by obtaining an excavation permit
frc m the City Engineer before the 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 DEVELOPER shall
notify the City Engineer of the exact date and time when the proposed
excavation is to comtience.
4. QLUTCIAIM DEED
It is further agreed that the DE MOPER, when requested by the CITY, .
shall quitclaim all his rights and interests in, and shall grant to CITY
authorization to extract water from the underground strata lying beneath
said project and DEVELOPER agrees to execute a "Quitclaim Deed and
Authorization" in favor of CITY, when presented to him for signature.
5. BONDS AND OTHER SECURITY
A. Upon the execution of this AGREEMENT,, the DEVELOPER shall file
with the CITY a faithful performance bond to assure his full and faithful
performance of this AGREEMENT. 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 AGREEMENT. In the event that
.,,.improvements are to be,.made..under this AGEM04T, the DEVELOPER shall, in
addition to said faithful performance, file with the CITY a labor and
materials bond in a penal sura adequate to assure full payment of all labor
and materials required to construct said improvements. The amount of said
bonds shall be as designated by the City Engineer. Said bonds shall be
executed by a surety company authorized to transact a surety business in
the State of California and mast 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 covenants and conditions of
this AGREE, or to make any payment, or any dedication of land, or any
improvements herein required, the CITY shall call on the surety to perform
this AST or otherwise indemnify the CITY for the DEVELOPER'S failure
to so do.
A
B. In lieu of a"surety bond, the DEVELOPER may elect to secure this
AGREEMENT by depositing with the CITY:
1. Cash; or,
2. A cashier's check, or a certified check payable to
the order of the City of Cupertino; or,
3. A certificate of deposit, or instrument of credit meeting
the requirements of Goverrnnent Code Section 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 AGREEMENT, 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 except upon approval of the City Council.
E. No interest shall be paid cn any security deposited with the
CITY.
6. CDEX2 NG AND INSPECTION 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 execution of this AGREEMENT, the amount as set forth herein
at Page 2 (Part C) . Should construction cost vary materially from the
estimate front 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 DEVVKDPER shall pay to CITY, prior to
execution of this AGREMENT, indirect expense allocable to processing
these impravements, the amount as set forth herein at Page 2 (Part D) .
8. MAP CHECKING FEE
It is further agreed that the I7NMOPER shall deposit with CITY, prior
to execution of this AGREEMENT, for office checking of final map and
field checking of street m mmwTts, in compliance with Section 4:1 of
Ordinance No. 47 (Revised 12/04/61) of CITY, the amount as set forth
herein at Page 2 (Part I) .
9. DEVELOPMENT MAINIENCE DEPOSIT
It is further agreed that the DEVELOPER shall pay to the CITY, prior
to execution of this AGREEMENT, the amount set forth herein at Page 2
(Part E) as a development maintenance deposit to insure proper dust
control and cleaning during the construction period. Mme 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 MNELOPER oomplete the required repairs to
the entire satisfaction of the CITY, the unused balance will be returned
after the release of the improvement bonds.
10. STOM DRAINAGE FEE
It is further agreed that the DEVELOPER shall deposit with the CITY,
prior to execution of, this AGREEMENT, a storm. drainage charge .in
connection with 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 MIN EXTENSION DEPOSIT
The DEVELOPER further agrees to deposit with the CITY those monies
required to comply with "Policy on Water Main Extensions Work and
Deposits" dated 9/30/77. the deposit shall be held by the CITY until said f
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 AGMEN', the am unt as set forth herein at Page 2
(Part G) , which amount represents the power cost for street lights for one
year.
13. THE INSTAr r CN OF STREET TREE$
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
"Park Dedication Ordinance" NWWoer 602, 1972, and which is further
stipulated under Part J, Page 2 herein.
• 14-A. PP.RK FEE AD,JUSIMU VTISICNS
The value of the land used in establishing the "Park Fee" outlined
herein on Page 2, Part J, requires formal confirmation. The CITY
shall employ a qualified local appraiser to provide a market value of the
land. The City Will calculate the "Park Fee" based on the appraisal, The
Developer agrees to pay for any deficiency`within thirty (30) days and the
City agrees to refund overage within thirty (30) days- Adjustments shall
be made prior to acceptance of the subdivision improvements.
15. MAZNTEWCE OF MRK
It iS further agreed that the DEVELOP—;7t shall maintain the Work until
all deficiencies in the Work are corrected to conform to the plans and the
City st arra and sveci.ficati.ons for the Work. The DEVEILPER Shall, �n
writ"6en notice thereof, immediately repair or replace, without C.-st or
obligation to the. City of Cupertino, and to the entire satisfaction of
said CITY, all defects .and imperfections arising out of or due to faulty
workmanship and/or materials appearing in said Work.
16. SANT= DISTRICT
It is. further agreed that the DEVELOPER shall file with CITY, upon
execution of this AGEMM? ', a letter from the Cupertino Sanitary Distric,_-
stating that the DE=PM has entered into a separate AGtMENT with the
said District to install sanitary se<aers to serve all lots within said
Project and stating that a bond to insure full and faithful performance of
the construction of the said sanitary sewers and to insure mainterance of
said sanitary sewer in - conformance, with, the pzMvisions as set forth in
Paragraph 15 above has been filed.
17. GCVZIUZ= CODE
It is further agreed that DEV=PER shall file with CITY, =on
execution of this AGZza=, substantial evidence that all provisions of
Section 66493, Article 8, Chapter 4 of the Gove==ent Code, pertaining n;ng to
special assessments or bonds have been
complied with.
18. CENT= FM DISTRICT
It is further agreed 'that the MV=PER shall file with the CM, upon
execution of this AGREEMTI, a letter from the Central F=e Protection
District of .Santa Clara County, stating that the DEVELOPER has ,entered
into 'an AGMT � th' said District -to install fire hydrants to serve
said Project and stating that all necessary fees have been deposited with
said District to insure installation and five (5)
hydrants. year rental fee of said
. •
19. PAC=FIC CAS AND REE=C,/PACIF'IC BELL
It is further agreed that the DE =PERK Sha 11 pay to Pacific Gas and
Electric Company and/or to PACIFIC EELS, Company any and all fees refired
for installation of overhead and/or MdergZUUnd wiring circuits to all
electroliers within
said PAY and any and, all fees required for -
underg=undingas Provided in Ordinance No. 331 of CZ'I'Y when MVELOPER is
notified by either the City Engineer or the Pacific Gas and Electric
C=any and/or PACIFIC MML Ccamany that said fees are due arra payable.
7
2 0. EASEMENTS AND RIGHT-OF-+MY
It is further agreed that any easement and right-of-way necessary for
completion of the Project shall be acquired by the DEVELOPER at his own
cost and expense. It is provided, however, that in the event eminent
domain proceedings are required by the CITY for the purpose of securing
said easement and right-of-way, that the DEVELOPER shall deposit 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 amounts as the
CITY may require shall be deposited with the City of Cupertino.
21. HOLD BAR aMS
It is further agreed that, commencing with the performance of the Work
by the DB'VE DPER or his contractor and continuing until the completion of
the maintenance of the Work, the DEVELOPER shall indemnify, hold harmless
and .defend the CITY from and against any or all loss, cast, expense,
damage or liability, or claim thereof, occasioned by or in any way
whatsoever arising out of the performance or nonperformance of the Work or
the negligence or willful misconduct of the DEVELOPER or the DEVELOPER'S
.agents, employees and independent contractors.
22. INSURANCE
It is further agreed that: The DEVELOPER shall take out, or shall
require any contractor engaged to perform the Work to take out, and
maintain at all times during the performance and maintenance of the Work
called for or required to be done hereunder, a policy .of insurance naming
the CITY and members of the City Council of the City of Cupertino,
individually and collectively, and the officers, agents and employees of
the City individually and collectively, as insured. Said separate policy
shall provide bodily injury and property damage coverage to the foregoing
named CITY and individuals covering all the Work performed by, for, or on
behalf of said EE'VELOPER. Both bodily injury and property damage insurance
must be on an occurrence basis; and said policy or policies shall. provide
that the coverage afforded thereby shall be primary coverage to the full
limit of liability stated in the declarations, 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' inazwlcs' against the loss covered by said policy
or policies, that other insurance shall be e=ess 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.
A. Each of said policies of insurance shall provide coverage in the
following minimum amounts: For bodily injury, $100,000 each person;
$300,000 each occurrence, property damage, $50,000 on account of any
one occurrence with an aggregate limit of not less .than $200,000.
B. IIhe DEVELOPER shall file with the City Engineer at or prior to
the time of execution of this AG 1T by the DEVEWpER such evidence
of said foregoing policy or policies of insurance as shall be
satisfactory to said City Engineer. Each such policy or policies shall
bear an endorsement precluding the cancellation or reduction in
coverage without giving the City Engineer at least ten (10) days
advance notice thereof.
C. 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 retired 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. NEAPS AND/CR naTavMMU PLANS
It is further agreed that the CITY shall obtain the following map
and/or plans at the DEVEMPER'S expense:
A. A mylar sepia and seven (7) prints of fully executed parcel map.
B. A mylar sepia and ten (10) prints of fully executed improvement
plans.
C. A direct duplicating silver negative microfilm aperature card of
all executed improvement plans and map.
The DEVEMPER agrees to pay the CITY from the development maintenance
deposit the cost for all prints of plans and map required under Item 23.
24. SUCCESSCM
This AGREEMENT shall bind the heirs, ami ni strators executors,
successor, assignee and transferrees of the DEVELOPER. The assignment of
this AGRM' shall not be made without approval by the City Council of
the City of Cupertino.
SOUTHLAND TITLE
rn STATE OF CALIFORNIA l CORPORATION
° COUNTY OF Los Angeles }SS.
3 FOR NOTARY SEAL OR STAMP
0
On this 1 2 th day of O ob r ,in the year_,
a before me,the undersigned,a Notary Public in and for said County and State,
J12' personally appeared Robert S. Schwartz and
Louis H. Fisher ` .•• °;'4, O�ICIAL SEAL
r personally known to me(or proved to me on the basis of satisfactory evidence)to o�� ®AVID SUZUKAWA
„O be the person whose name is subscribed to this instrument,and acknowledged Notary Public-Catifornla
to that he(she or they)executed it. ` LOS ANGELES COUNTV
a My Commission Expires
w ••' August 16, 1993
0
Signature
No fic in a d or said County and State
IN WrnIESS WHEREOF, CITY has caused its name to be hereunto affixed by
its Mayor and City Clerk, thereunto duly authorized by resolution of the
City Council and said EIEVVELOPER has hereunto caused his name to be affixed
the day and year first above written.
CITY OF CUPERrINO:
Approved as to form:
r I
City Attorney
City Cler
DE'V IDPER:
Notary Acknowledgment Required
(7 ! 2
i
m
CITY OF CUPERTINO
INTERDEPARTMENTAL Date Nov. 7, 1989
To CITY CLERK From PUBLIC WORKS--SUMI
CI Information MESSAGE: ROBERT S. SCHWARTZ & LOUIS H. FISHER (CC 11/6/89)
CI Implement 11061 S. Stelling Road
CI Investigate
CI Discuss 1. Three sets of improvement agreement for processing. _
See me
J� Reply 2• Certificate of Insurance, 10/10/89
Insured: Dave Jacobson Construction
3. Bond: Certificate of Deposit on file with Finance Dept.
sm
attach.
Reply:
Robert Schwartz
800 San Antonio Road, No. 6
Palo Alte, GA 94303
SIGNED: DATE
Send parts 1 and 2; retain part 3 for follow-up; part 2 to be returned with reply
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DESC:RIPI[ON Or 01'('.IIA'IION(;11OCA IIONS/Vt IIIQI I 5:1!NI'I(:IAI I11'M!, �
***ADITIONAI, 1.NSURJ1D*** CTTY OF C11PRRTTNO AND THE MEMBERS ON THE CITY COUNCu.,
OFFICERS, & EMYLOYB1?S Or THE CITY INDIVIDUALLY & CUL,1,10,CTIVELY.
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Rt�J�1:1. .A' 'Z' YY77 C �f.5�C•I ;1,-.. •, ..t...._., .. •r._�..,; :1. ::r^'--;�--
CITY 0*. C),)PI wr jN0 6HQIJI.0 ANY UI flit AROVb OF Nt11Ri11'0 POI It':il'S Fir CAN(:F1-1-17p[uou TIIE EX-
J3IJILI)INC DEPARTMENTPIIIA'tQf!1-lLIAl-k. '11M It VIIE I:;HH1NU COMPA ' Wjj.L,xpggT(pA>p> p
10300 '1'UhRL llR,l V1: MAIL 1(J DAY'* fl .. NO'I'I(,C 10 Tril CkR'IIFif I L pER }L ):�[ffm_ga(Y/$xf�
X1Cii&tCri7;t�1 ' 6 btKltCfCb)E?:b�(Ctii ;W?D
CUPER111'N0, CA 95014 I (Yi%A4�N v :••taR�K't(n5(� >AC {�5K
AUTHORI D ti' IIVF
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0) 111(. (.Xi"I vI I(.(., ow I 1111'1 111 i Ir 1);111, (.()1 vJ I I I ri Iol 1, 1!11..(.1 ()11 (.,1 rvmov;.i I (if tI(Ivj-It I:j I q J1;11!•. %wr I j I j!!, 11 Ip .
cell al clltrafwt��;, (.o;II 11o1w,, tI;Iv(!woy'." !.kiewallivauits. %twvt
banners or decoraHms(incl AMOK mmmumn;
(2) the con,.---uction, erect ior,ril r(!nI()vjIi of pl(�vators. ;
(3) the own"Irship, maintunaw!or unt!of ally(.&..!vat0r9 covvrod by 1111!policy.
Designation of State or Pcililical 'Subdivisioll
(0) State or Political 'Subdivinions ..- Pvrmil!;:
It is agreed that the PILRONS INSURED provision is mnemled to AM as an insured any state or political
subdivision thereof designated brdr)W, subjent to the following additional provisions:
1, The insurance applies,only with wyn W opmatimm peNa"wd by or on behalf of the nained insured for which
the State or political stibdivision hil ; iSSLIOd a permit.
2. The insurance does not apply to bodily injuny or property danIage
ariAng out of opwalknb pedo"ned for the slate or "audWpality,or
(b) included within the cornploted operations Iward.
DepJignAtion of State or Polifi(:ai Smi),livi%jor,
('11.1'Y OV CUPEIR11.1 No
13U3LDING DHPARTMKNT (ALONG WJTH MEMBERm OF WE CITY COUNCIL,
10300 TORRE DRIVE UYVICUHS,
CUPERTINO, CA 95014 AMI EMPLOYERS OV THE Cjjy INUIVILIVIALIN AND COLLECTIVI&LY) .
M Machinery Lpased to the Naijwd In%uroci:
It is At;:Ived that the PF'R!;ON!; IN`URI 1) priwkion k w1wildell to i"chillo A a" knuml A Mason or organization
deslignaWd below, but only wills r(:specl to bodily injury or property darnage arising o"t of the named insureds
nwimenaw use, loadinij or unloat..Jing of the property cje%igwited below.
Name of
Description of Property Person or Organization