21-103 Encroachment Agreement, GTE Mobilnet of California Limited Partnership, dba Verizon Wireless, R.O.W, near 19515 Howard Court1.Encroachment Agreement. This is an Encroachment Agreement as referenced in that
certain Small Cell License Agreement between Licensor and Licensee dated May 16, 2017
("Agreement"). This Encroachment Agreement shall serve as an encroachment license. All of the
terms and conditions of the Agreement are incorporated hereby by reference and made a part hereof
without the necessity of repeating or attaching the Agreement. In the event of a contradiction,
modification or inconsistency between the terms of the Agreement and this Encroachment
Agreement, the terms of the Encroachment Agreement shall govern. Capitalized terms used in this
Encroachment Agreement shall have the same meaning described for them in the Agreement unless
otherwise indicated herein.
2.Project Description and Locations. Licensee shall have the right to use the ROW for a
Small Cell at the designated areas in the ROW as further described in Attachment 1 attached hereto
(the “Licensed Area”).
3. Equipment. The Small Cell to be installed at the Licensed Area is described in Attachment
1 attached hereto.
4.Term. The term of this Encroachment Agreement shall be as set forth in Section 2 of the
Agreement.
5.Fees. The initial Rent for the term of this Encroachment Agreement shall be $1,500.00, as
determined in accordance with Paragraph 5.1 of the Agreement, as adjusted by Paragraph 5.2.
6.Commencement Date. The first day of the month following the date Licensee has
Commenced Installation of its Equipment at the Licensed Area.
7. Approvals/Fiber. It is understood and agreed that Licensee's ability to use the Licensed
Area is contingent upon its obtaining all of the certificates, permits and other approvals
(collectively the "Governmental Approvals") that may be required by any Federal, State or Local
authorities, as well as a satisfactory fiber and electrical connection which will permit Licensee use
of the Licensed Area as set forth above. In the event that (i) any of such applications for such
Governmental Approvals should be finally rejected; (ii) any Governmental Approval issued to
Licensee is canceled, expires, lapses, or is otherwise withdrawn or terminated by governmental
authority; (iii) Licensee determines that such Governmental Approvals may not be obtained in a
timely manner; (iv) Licensee determines that it will be unable to obtain in a satisfactory manner,
or maintain any fiber or power connection; or (v) Licensee determines that the Licensed Area is no
SF_CUPERTINO_039
(NEAR) 19515 Howard Ct, Cupertino, CA 95014
ENCROACHMENT AGREEMENT
This Encroachment Agreement (“Encroachment Agreement”), made as of the last date
signed below (“Effective Date”) between the City of Cupertino, a political subdivision of the
State of California, hereinafter designated “Licensor” and GTE Mobilnet of California Limited
Partnership, d/b/a Verizon Wireless, with its principal offices at c/o Verizon Wireless,
180 Washington Valley Road, Bedminster, New Jersey 07921, hereinafter designated
“Licensee”:
417733
DocuSign Envelope ID: 6B6F8821-8FAC-406F-9404-7FD21CA88689DocuSign Envelope ID: D1AB1D46-CF35-4B02-8CC9-AE3D582A970E
longer technically compatible for its use, Licensee shall have the right to terminate this
Encroachment Agreement. Notice of Licensee's exercise of its right to terminate shall be given to
Licensee in writing by certified mail, return receipt requested, and shall be effective upon the
mailing of such notice by Licensee, or upon such later date as designated by Licensee. All rentals
paid to said termination date shall be retained by Licensor. Upon such termination, this
Encroachment Agreement shall be of no further force or effect except to the extent of the
representations, warranties and indemnities made by each party to the other hereunder. Otherwise,
Licensee shall have no further obligations for the payment of Rent to Licensor.
8.Miscellaneous. N/A
[Signature page follows]
DocuSign Envelope ID: 6B6F8821-8FAC-406F-9404-7FD21CA88689DocuSign Envelope ID: D1AB1D46-CF35-4B02-8CC9-AE3D582A970E
EXECUTED to be effective as of the last date shown below.
LICENSOR:
City of Cupertino, a political subdivision
of the State of California
By: ___________________________
Name: _________________________
Title: __________________________
Date: ___________________________
ATTEST:
Date: ___________________________
APPROVED AS TO FORM CITY
ATTORNEY’S OFFICE
BY: __________________________
Print Name: _____________________
Date: __________________________
City Attorney
LICENSEE:
GTE MOBILNET OF CALIFORNIA
LIMITED PARTNERSHIP, D/B/A
VERIZON WIRELESS
by Cellco Partnership, its
General Partner
By:
Date: ______________________________
Name: Alba Barber
Title: Senior Real Estate Manager
Exhibits:
Attachment 1
, Clerk
DocuSign Envelope ID: 6B6F8821-8FAC-406F-9404-7FD21CA88689DocuSign Envelope ID: D1AB1D46-CF35-4B02-8CC9-AE3D582A970E
Jul 7, 2021
Jul 7, 2021
Heather Minner
Chad Mosley
City Engineer
Jul 7, 2021
Jul 12, 2021
Attachment 1
Licensed Area
See attached.
DocuSign Envelope ID: 6B6F8821-8FAC-406F-9404-7FD21CA88689DocuSign Envelope ID: D1AB1D46-CF35-4B02-8CC9-AE3D582A970E
T-1
TITLE SHEET
DRAWN BY:
CHECKED BY:BPM
APE
IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS
THEY ARE ACTING UNDER THE DIRECTION OF A LICENSED
PROFESSIONAL ENGINEER, TO ALTER THIS DOCUMENT
0 10/12/20 100% CD
REV DATE DESCRIPTION
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA
94108
APPROVED BY:LJB
VERIZON WIRELESS
2785 MITCHELL DRIVE, SUITE 9
WALNUT CREEK, CA
94598
CUPERTINO_CUPER039
(NEAR) 19515 HOWARD CT
CUPERTINO, CA 95014
1 10/26/20 100% CD PLAN CHECK
2 11/04/20 100% CD PLAN CHECK
3 03/19/21 100% CD
SITE INFORMATIONVICINITY MAPPROPOSED POLE PHOTO
N
DRAWING INDEX
T-1
SHEET NO.
TITLE SHEET
T-2 GENERAL NOTES
A-1 SITE PLAN & ENLARGED SITE PLAN
A-3
A-4
ELEVATIONS
CIRCUIT DIAGRAM
D-1 DETAILS
CODE COMPLIANCE
ALL WORK AND MATERIALS SHALL BE PERFORMED AND INSTALLED IN ACCORDANCE WITH THE CURRENT
EDITIONS OF THE FOLLOWING CODES AS ADOPTED BY THE LOCAL GOVERNING AUTHORITIES. NOTHING
IN THESE PLANS IS TO BE CONSTRUCTED TO PERMIT WORK NOT CONFORMING TO THESE CODES.
·2019 CALIFORNIA CODE
·2019 CALIFORNIA BUILDING CODE (CBC), BASED ON THE 2018 IBC
·2019 CALIFORNIA RESIDENTIAL CODE (CRC), BASED ON THE 2018 IRC
·2019 CALIFORNIA ELECTRICAL CODE (CEC), BASED ON THE 2017 NEC
·2019 CALIFORNIA MECHANICAL CODE (CMC), BASED ON THE 2018 UMC
·2019 CALIFORNIA PLUMBING CODE (CPC), BASED ON THE 2018 UPC
·2019 CALIFORNIA GREEN BUILDINGS STANDARDS CODE (CALGREEN)
·2019 CALIFORNIA FIRE CODES WITH ALL LOCAL AMENDMENTS
·ANY LOCAL BUILDING CODE AMENDMENTS TO THE ABOVE
·CITY / COUNTY ORDINANCES
SHEET TITLE
ACCESSIBILITY REQUIREMENTS FOR PERSONS WITH DISABILITIES:
FACILITY IS UNMANNED AND NOT FOR HUMAN HABITATION. ACCESSIBILITY IS
NOT REQUIRED IN ACCORDANCE WITH CALIFORNIA ADMINISTRATIVE STATE
CODE PART 2, TITLE 24, CHAPTER 11B, SECTION 1103B.
SURVEY
PROJECT TEAM PROJECT DESCRIPTION
D-2 DETAILS
VERIZON WIRELESS PROPOSES TO INSTALL A NEW WIRELESS COMMUNICATION SITE ON A LIGHT POLE IN THE PUBLIC RIGHT-OF-WAY.
SCOPE:
·INSTALL (1) NEW CANISTER ANTENNA INSIDE NEW FRP CONCEALMENT SHROUD ON TOP OF POLE
·INSTALL (2) 5G ANTENNA/RADIOS
·INSTALL (2) RRUS-32 RADIOS
·INSTALL (2) PSU-AC08 BEHIND RADIOS
·INSTALL NEW COAX FROM EQUIPMENT TO NEW ANTENNA WITHIN POLE
·INSTALL (1) NEW SMART METER / DISCONNECT ON SIDE OF POLE
·INSTALL NEW POLE AND FOUNDATION TO REPLACE EXISTING
THE UTILITIES SHOWN HEREIN ARE FOR THE CONTRACTORS CONVENIENCE
ONLY. THERE MAY BE OTHER UTILITIES NOT SHOWN ON THESE PLANS. THE
ENGINEER/SURVEYOR ASSUMES NO RESPONSIBILITY FOR THE LOCATIONS
SHOWN AND IT SHALL BE THE CONTRACTOR'S RESPONSIBILITY TO VERIFY
ALL THE UTILITIES WITHIN THE LIMITS OF THE WORK. ALL DAMAGE MADE TO
THE (E) UTILITIES BY THE CONTRACTOR SHALL BE THE SOLE RESPONSIBILITY
OF THE CONTRACTOR.
CALL 811 BEFORE YOU DIG
IT'S THE LAW
APPLICANT:
VERIZON WIRELESS
2785 MITCHELL DRIVE, SUITE 9
WALNUT CREEK, CA 94598
CONTACT: CHRIS MOLLER
PHONE: (925) 339.2778
EMAIL: CHRIS.MOLLER@VERIZONWIRELESS.COM
D-3 POLE SPECS
C-1
A-2 ELEVATIONS
SITE ID:
SITE TYPE:
POLE #:
CX PROJECT ID:
COUNTY:
PSLC:
SF_CUPERTINO_039
LIGHT POLE
51208
TBD
SANTA CLARA
417733
CUPERTINO_CUPER039
SITE ADDRESS:
OWNER:
APPLICANT:
LATITUDE:
LONGITUDE:
COUNTY:
ASSESSORS PARCEL NUMBER:
ZONING:
ELEVATION:
CITY OF CUPERTINO
10300 TORRE AVE
CUPERTINO, CA 95014
VERIZON WIRELESS
2785 MITCHELL DRIVE, SUITE 9
WALNUT CREEK, CA 94598
37.315466 N NAD83
-122.013396 W NAD83
SANTA CLARA
PUBLIC RIGHT OF WAY
NEAR 36916026
CITY OF CUPERTINO
210.71' AMSL
19515 HOWARD CT
(NEAR) 19515 HOWARD CT
CUPERTINO, CA 95014
SITE
CUPERTINO, CA 95014
(NEAR) 19515 HOWARD CT
MODUS PROJECT MANAGER:
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA 94108
PHONE: (415) 989.1102
EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM
CONSTRUCTION/IMPLEMENTATION MANAGER:
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA 94108
PHONE: (415) 989.1102
EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM
A&E PROJECT MANAGER:
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA 94108
PHONE: (415) 989.1102
EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM
LAND USE PLANNER:
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA 94108
PHONE: (415) 989.1102
EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM
SITE ACQUISITION:
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA 94108
PHONE: (415) 989.1102
EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM
E-1 ELECTRICAL GENERAL NOTES
E-2 ONE-LINE DIAGRAM & GROUNDING SCHEMATIC
E-3 ELECTRICAL DETAILS
D-4 CITY STANDARD DETAILS
DocuSign Envelope ID: 6B6F8821-8FAC-406F-9404-7FD21CA88689DocuSign Envelope ID: D1AB1D46-CF35-4B02-8CC9-AE3D582A970E
S/
L
S/L
FI
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FI
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FIBE
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S/L
S/L
S/L
S/L
S/L
S/L
S/L
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DRAWN BY:
CHECKED BY:BPM
APE
IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS
THEY ARE ACTING UNDER THE DIRECTION OF A LICENSED
PROFESSIONAL ENGINEER, TO ALTER THIS DOCUMENT
0 10/12/20 100% CD
REV DATE DESCRIPTION
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA
94108
APPROVED BY:LJB
VERIZON WIRELESS
2785 MITCHELL DRIVE, SUITE 9
WALNUT CREEK, CA
94598
CUPERTINO_CUPER039
(NEAR) 19515 HOWARD CT
CUPERTINO, CA 95014
1 10/26/20 100% CD PLAN CHECK
2 11/04/20 100% CD PLAN CHECK
3 03/19/21 100% CD
A-1
SITE PLAN
1ENLARGED SITE PLAN
N
SITE PLAN2
N
1/16"=1'-0"
SCALE
1/2"=1'-0"
SCALE
(N) LOCATION OF VERIZON
WIRELESS CANISTER ANTENNA IN FRP
SHROUD MOUNTED ON LIGHT POLE
(N) LOCATION OF VERIZON
WIRELESS EQUIPMENT
MOUNTED ON LIGHT POLE
ELECTRICAL LINE
STREET LIGHT LINE
E
S/L
FIBER LINE(S)FIBER
LEGEND
(N) STEEL MAST ARM
(N) LUMINAIRE
(N) LIGHT POLE & FOUNDATION
NOTE:
1. FIBER PULLBOX EXACT LOCATION TO BE VERIFIED IN FIELD
2. UPON COMPLETION OF CONSTRUCTION, RESTORE
LANDSCAPE AND IRRIGATION TO LIKE OR BETTER
CONDITION, TEST IRRIGATION.
3. UPON COMPLETION OF CONSTRUCTION, NOTIFY THE
CITY OF NEW STREETLIGHT INSTALLATION SO THAT NEW
BADGE ID NUMBER CAN BE PLACED BY THE CITY ONTO
THE NEW STREETLIGHT POLE.
6"
M
I
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.
NC
1
NC
4
NC
2
NC
3
AZ
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0
°
AZ
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1
8
0
°
(E) FACE OF THE CURB
A.P.N.:
36916026
19515
HOWARD CT
CUPERTINO,
CA 95014
N2
1
A-3
1
A-2
2
A-1
ENLARGED SITE PLAN
(N) LOCATION OF VERIZON
WIRELESS CANISTER
ANTENNA AND EQUIPMENT
(E) FACE OF THE CURB
A.P.N.:
36916026
19515
HOWARD CT
CUPERTINO,
CA 95014
M
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(E) DRIVEWAY, TYP.
MI
L
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HOWARD CT
M
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R
A
V
E
PROPERTY LINE
(E) LANDSCAPE
(E) CONCRETE SIDEWALK
(E) BUILDING
103'-2"± FACE OF POLE TO NEAREST BUILDING
(E) MANHOLE, TYP.
(N) UTILITY TRENCHING,
PER DETAIL 1/D-4
NC4
11'-4"± BACK OF
POLE TO ROW
103'-2"± FACE OF POLE TO NEAREST BUILDING
11'-4"± BACK OF
POLE TO ROW
(N) UTILITY TRENCHING,
PER DETAIL 1/D-4
N1
(N) 2'-6" x 4'-0" x 6" THICK CONCRETE CAP PER CITY STANDARDS
(E) HC RAMP
PR
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)
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K
(E) POLE TO BE REMOVED. (E) ROAD
SIGNAGE TO BE RELOCATED TO (N)
POLE #51208 LOCATION
(E) LIGHT POLE AND FOUNDATION TO BE
REMOVED. OLD BASE TO BE FILLED WITH
CONTROLLED DENSITY FILL WITHIN 12" OF FINISH
GRADE, THEN FILL WITH PLANTING SOIL.
(E) CITY PULLBOX TO REMAIN
EC1 - (E) CONDUIT AND CONDUCTORS FROM
(E) CITY PULLBOX TO (E) LOCATION OF POLE
#51208 TO BE REMOVED
EC2
REMOVE & REPLACE CONCRETE, APPROX.
25 SQ. FT. AT APPROXIMATE LIMITS TO
MATCH EXISTING ADJACENT ELEVATIONS,
REPLACE WHOLE FLAGS, NOT PARTIAL
NOTE:
CARRIER GROUND WIRE TO BE LABELED VERIZON
IN CITY ELECTRIC PULLBOX
(N) CITY SERVICE PULLBOX
REMOVE & REPLACE CONCRETE, APPROX. 25 SQ. FT. AT APPROXIMATE
LIMITS TO MATCH EXISTING ADJACENT ELEVATIONS, REPLACE WHOLE
FLAGS, NOT PARTIAL
4'-0"± MIN. ADA
CLEARANCE
BACK OF POLE
TO EDGE OF
SIDEWALK
(N) CONCRETE SKIRT AS NEEDED TO
ACHIEVE 4'-0" MIN. ADA CLEARANCE
Contact Brad Alexander, Streets Supervisor (408-777-3275) for
direction on removal, consolidation and placement of
signage, including 2 dead end signs, stop sign, and street
name signage.
660
678
Submit photos of removed foundation to City. Photos must
include background features specific to this location.
If a removed pole has 3-hole mast flange, then pole to be returned to City.
Contact Jerry Anderson, Cupertino at 650-921-6832. Return to City corp yard at
10555 Mary Ave
E3/7-Cree RSWS-A-HT-2ME-5L-27K8-UL-
GY-N-Q4 LED Luminaire (50 watt) for
residential areas.
Confirm location with City prior to
excavating foundation.
DocuSign Envelope ID: 6B6F8821-8FAC-406F-9404-7FD21CA88689DocuSign Envelope ID: D1AB1D46-CF35-4B02-8CC9-AE3D582A970E
SHUTDOWN
DRAWN BY:
CHECKED BY:BPM
APE
IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS
THEY ARE ACTING UNDER THE DIRECTION OF A LICENSED
PROFESSIONAL ENGINEER, TO ALTER THIS DOCUMENT
0 10/12/20 100% CD
REV DATE DESCRIPTION
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA
94108
APPROVED BY:LJB
VERIZON WIRELESS
2785 MITCHELL DRIVE, SUITE 9
WALNUT CREEK, CA
94598
CUPERTINO_CUPER039
(NEAR) 19515 HOWARD CT
CUPERTINO, CA 95014
1 10/26/20 100% CD PLAN CHECK
2 11/04/20 100% CD PLAN CHECK
3 03/19/21 100% CD
A-2
ELEVATIONS
12PROPOSED ELEVATIONNOT USED 1/2"=1'-0"
SCALE
1/2"=1'-0"
SCALE
EXISTING SURFACE
0'-0" AGL
T.O. (N) RADIO UNITS
15'-0" AGL
B.O. (N) CABLE SHROUD
12'-1" AGL
4
D-2
(N) FOUNDATION
(N) DISCONNECT / SMART METER
(N) (1) RRUS 32s W/ PSU-08 AND
CABLE SHROUD
B.O. (N) DISCONNECT / SMART METER
7'-0" AGL
(N) LIGHT POLE
(N) NOTICE SIGNAGE, TYP. OF (1)
FACING STREETSIDE
12
D-1
T.O. (N) SIGN
14'-8" AGL
B.O. (N) SIGN
13'-2" AGL
(N) RED "BICYCLE
WRONG WAY" SIGNAGE
T.O. (N) STEEL LIGHT POLE
30'-0" AGL
T.O. (E) LIGHT SENSOR
32'-0" AGL
RAD CENTER OF (N) 5G ANTENNA
31'-7" AGL
T.O. (N) CONCEALMENT SHROUD
35'-6" AGL
RAD CENTER OF (N) CANISTER ANTENNA
34'-3" AGL
(N) (2) 5G ANTENNAS
IN FRP SHROUD
6
D-1
(N) VERIZON WIRELESS
CANISTER ANTENNA
4
D-1
(N) FRP CONCEALMENT
SHROUD
1
D-1
(N) (2) TWIN DIPLEXERS
IN FRP SHROUD
3
D-1
T.O. (N) NOTICE SIGNAGE
25'-2" AGL
T.O. (N) DISCONNECT / SMART METER
8'-9" AGL
5
D-1
8
D-1
10
D-1
10
E-3
11
D-1
7
D-1
4
E-3
3
E-3
PORT HOLE LOCATION
FOR DISCONNECT
1
D-2
PORT HOLE LOCATION
FOR RRUS
1
D-2
9
D-1
5
E-3
11'-4" BACK OF POLE TO ROW LINE
PORT HOLE LOCATION
FOR RRUS
1
D-2
5
D-1
8
D-1
10
D-1
(N) (1) RRUS 32s W/ PSU-08 AND
CABLE SHROUD
5
E-3
T.O. (N) RADIO UNIT
18'-11" AGL
B.O. (N) CABLE SHROUD
16'-0" AGL
NOTES:
1. ALL NEW ANTENNAS, BRACKETS, AND OTHER EQUIPMENT WILL BE PAINTED TO MATCH LIGHT POLE.
2. ALL EXISTING SIGNAGE TO BE RELOCATED SHALL BE FASTENED USING 1/2" STEEL BANDING.
(N) LUMINAIRE
(N) 8'-0" MAST ARM
7
E-3
(E) RELOCATED ROAD SIGNS
T.O. (E) RELOCATED SIGN
11'-5" AGL
B.O. (E) RELOCATED SIGN
8'-7" AGL
B.O. (E) RELOCATED SIGNS
11'-6" AGL
T.O. (E) RELOCATED SIGNS
13'-0" AGL
DocuSign Envelope ID: 6B6F8821-8FAC-406F-9404-7FD21CA88689DocuSign Envelope ID: D1AB1D46-CF35-4B02-8CC9-AE3D582A970E
Certificate Of Completion
Envelope Id: 6B6F88218FAC406F94047FD21CA88689 Status: Completed
Subject: Please DocuSign: SF Cupertino 039 Encroachment Agreement
Source Envelope:
Document Pages: 7 Signatures: 0 Envelope Originator:
Certificate Pages: 5 Initials: 14 BRYAN MCCAFFERY
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
92 Bay Street
Glens Falls, NY 12801
modusdocusign@modusllc.com
IP Address: 24.7.112.21
Record Tracking
Status: Original
6/14/2021 12:23:11 PM
Holder: BRYAN MCCAFFERY
modusdocusign@modusllc.com
Location: DocuSign
Signer Events Signature Timestamp
Chad Mosley
chadm@cupertino.org
Security Level: Email, Account Authentication
(None)
Signature Adoption: Drawn on Device
Using IP Address: 67.164.60.110
Sent: 6/14/2021 12:24:04 PM
Viewed: 6/16/2021 11:51:32 AM
Signed: 6/16/2021 11:51:44 AM
Electronic Record and Signature Disclosure:
Accepted: 1/8/2021 11:03:58 AM
ID: cf965389-d53e-4e7e-9e57-3e9c6593663d
Marlene Dehlinger
Dehlinger@smwlaw.com
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 52.39.49.65
Sent: 6/16/2021 11:51:46 AM
Viewed: 6/17/2021 9:55:08 AM
Signed: 6/17/2021 9:58:54 AM
Electronic Record and Signature Disclosure:
Accepted: 6/17/2021 9:55:08 AM
ID: b0bc1325-fb49-42c8-8fbd-64c38c31670b
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Steve Pagan
stevep@cupertino.org
Security Level: Email, Account Authentication
(None)
Sent: 6/14/2021 12:24:04 PM
Viewed: 6/16/2021 8:05:04 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events Signature Timestamp
DocuSign Envelope ID: D1AB1D46-CF35-4B02-8CC9-AE3D582A970E
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 6/14/2021 12:24:04 PM
Certified Delivered Security Checked 6/17/2021 9:55:08 AM
Signing Complete Security Checked 6/17/2021 9:58:54 AM
Completed Security Checked 6/17/2021 9:58:54 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
DocuSign Envelope ID: D1AB1D46-CF35-4B02-8CC9-AE3D582A970E
Certificate Of Completion
Envelope Id: D1AB1D46CF354B028CC9AE3D582A970E Status: Completed
Subject: SF_CUPERTINO_039/E4179523/Felipe Martinez Review Approved 7-7-2021/VZ Manager to sign.
Source Envelope:
Document Pages: 9 Signatures: 4 Envelope Originator:
Certificate Pages: 5 Initials: 0 felipe
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
felipe.martinez@verizonwireless.com
IP Address: 69.78.66.89
Record Tracking
Status: Original
7/7/2021 9:06:20 AM
Holder: felipe
felipe.martinez@verizonwireless.com
Location: DocuSign
Signer Events Signature Timestamp
Alba Barber
alba.barber@verizonwireless.com
Senior Real Estate Manager
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 69.78.66.88
Sent: 7/7/2021 9:07:28 AM
Viewed: 7/7/2021 11:15:03 AM
Signed: 7/7/2021 11:15:14 AM
Electronic Record and Signature Disclosure:
Accepted: 12/30/2020 2:52:40 PM
ID: e293a4bd-9212-4030-bf70-0115b4008976
Heather Minner
Heatherm@cupertino.org
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 52.39.49.65
Sent: 7/7/2021 11:15:15 AM
Viewed: 7/7/2021 2:34:55 PM
Signed: 7/7/2021 2:35:10 PM
Electronic Record and Signature Disclosure:
Accepted: 7/7/2021 2:34:55 PM
ID: 21f51e0c-c0b9-4f10-bb97-62dbc941e5af
Chad Mosley
ChadM@cupertino.org
City Engineer
Security Level: Email, Account Authentication
(None)Signature Adoption: Drawn on Device
Using IP Address: 67.164.60.110
Sent: 7/7/2021 2:35:13 PM
Viewed: 7/7/2021 3:50:39 PM
Signed: 7/7/2021 3:51:04 PM
Electronic Record and Signature Disclosure:
Accepted: 7/7/2021 3:50:39 PM
ID: da04134d-004f-4ff6-9e34-49e882075742
Kirsten Squarcia
KirstenS@cupertino.org
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 162.245.22.179
Sent: 7/7/2021 3:51:05 PM
Viewed: 7/12/2021 9:35:50 AM
Signed: 7/12/2021 9:35:56 AM
Electronic Record and Signature Disclosure:
Accepted: 4/5/2021 1:36:36 PM
ID: 7f043bd1-e00d-4922-961c-f3b1260d7968
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Alissa Ludtke
alissa.ludtke@verizonwireless.com
Security Level: Email, Account Authentication
(None)
Sent: 7/7/2021 9:07:28 AM
Viewed: 7/13/2021 9:22:35 AM
Electronic Record and Signature Disclosure:
Accepted: 7/12/2021 8:03:52 AM
ID: f69dbc24-8f60-4799-a466-8d00afda6a00
Araceli Alejandre
Aracelia@cupertino.org
Security Level: Email, Account Authentication
(None)
Sent: 7/7/2021 11:15:15 AM
Viewed: 7/7/2021 11:40:55 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 7/7/2021 9:07:28 AM
Certified Delivered Security Checked 7/12/2021 9:35:50 AM
Signing Complete Security Checked 7/12/2021 9:35:56 AM
Completed Security Checked 7/12/2021 9:35:56 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, VBG Network Real Estate (we, us or Company) may be required by law to
provide to you certain written notices or disclosures. Described below are the terms and
conditions for providing to you such notices and disclosures electronically through the DocuSign
system. Please read the information below carefully and thoroughly, and if you can access this
information electronically to your satisfaction and agree to this Electronic Record and Signature
Disclosure (ERSD), please confirm your agreement by selecting the check-box next to ‘I agree to
use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign
system.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available
electronically to you by us. You will have the ability to download and print documents we send
to you through the DocuSign system during and immediately after the signing session and, if you
elect to create a DocuSign account, you may access the documents for a limited period of time
(usually 30 days) after such documents are first sent to you. After such time, if you wish for us to
send you paper copies of any such documents from our office to you, you will be charged a
$0.00 per-page fee. You may request delivery of such paper copies from us by following the
procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to
receive required notices and consents electronically from us or to sign electronically documents
from us.
All notices and disclosures will be sent to you electronically
Electronic Record and Signature Disclosure created on: 9/23/2020 1:45:36 PM
Parties agreed to: Alba Barber, Heather Minner, Chad Mosley, Kirsten Squarcia, Alissa Ludtke
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through the DocuSign system all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or made
available to you during the course of our relationship with you. To reduce the chance of you
inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
How to contact VBG Network Real Estate:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: tricsha.fatakia@verizonwireless.com
To advise VBG Network Real Estate of your new email address
To let us know of a change in your email address where we should send notices and disclosures
electronically to you, you must send an email message to us
at tricsha.fatakia@verizonwireless.com and in the body of such request you must state: your
previous email address, your new email address. We do not require any other information from
you to change your email address.
If you created a DocuSign account, you may update it with your new email address through your
account preferences.
To request paper copies from VBG Network Real Estate
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an email
to tricsha.fatakia@verizonwireless.com and in the body of such request you must state your
email address, full name, mailing address, and telephone number. We will bill you for any fees at
that time, if any.
To withdraw your consent with VBG Network Real Estate
To inform us that you no longer wish to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your signing session, and on the subsequent page,
select the check-box indicating you wish to withdraw your consent, or you may;
ii. send us an email to tricsha.fatakia@verizonwireless.com and in the body of such request you
must state your email, full name, mailing address, and telephone number. We do not need any
other information from you to withdraw consent.. The consequences of your withdrawing
consent for online documents will be that transactions may take a longer time to process..
Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The
current system requirements are found here: https://support.docusign.com/guides/signer-guide-
signing-system-requirements.
Acknowledging your access and consent to receive and sign documents elect ronically
To confirm to us that you can access this information electronically, which will be similar to
other electronic notices and disclosures that we will provide to you, please confirm that you have
read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for
your future reference and access; or (ii) that you are able to email this ERSD to an email address
where you will be able to print on paper or save it for your future reference and access. Further,
if you consent to receiving notices and disclosures exclusively in electronic format as described
herein, then select the check-box next to ‘I agree to use electronic records and signatures’ before
clicking ‘CONTINUE’ within the DocuSign system.
By selecting the check-box next to ‘I agree to use electronic records and signatures’, you confirm
that:
You can access and read this Electronic Record and Signature Disclosure; and
You can print on paper this Electronic Record and Signature Disclosure, or save or send
this Electronic Record and Disclosure to a location where you can print it, for future
reference and access; and
Until or unless you notify VBG Network Real Estate as described above, you consent to
receive exclusively through electronic means all notices, disclosures, authorizations,
acknowledgements, and other documents that are required to be provided or made
available to you by VBG Network Real Estate during the course of your relationship with
VBG Network Real Estate.