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21-116 Encroachment Agreement, GTE Mobilnet of California Limited Partnership, dba Verizon Wireless, R.O.W, 10335 North Tantau Avenue1.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be finally rejected; (ii) any Governmental Approval issued to Licensee is canceled, expires, lapses, or is otherwise withdrawn or terminated by governmental authority; (iii) Licensee determines that such Governmental Approvals may not be obtained in a timely manner; (iv) Licensee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 CA_SJ_CUPERTINO_316 10335 N Tantau Ave, 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”: 545461 DocuSign Envelope ID: 2AF402F9-E4FE-49CE-A224-F23EE644947BDocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54 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: 2AF402F9-E4FE-49CE-A224-F23EE644947BDocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54 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: 2AF402F9-E4FE-49CE-A224-F23EE644947BDocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54 Mar 25, 2021 Heather Minner Apr 5, 2021 Chad Mosley City Engineer Apr 5, 2021 Apr 5, 2021 Attachment 1 Licensed Area See attached. DocuSign Envelope ID: 2AF402F9-E4FE-49CE-A224-F23EE644947BDocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54 T-1 TITLE SHEET DRAWN BY: CHECKED BY:BM 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 08/13/20 100% CD REV DATE DESCRIPTION MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 APPROVED BY:LJB CA_SJ_CUPERTINO_316 VERIZON WIRELESS 2785 MITCHELL DRIVE, SUITE 9 WALNUT CREEK, CA 94598 (NEAR) 10335 N TANTAU AVE, CUPERTINO, CA 95014 1 12/17/20 100% CD PLAN CHECK SITE INFORMATION 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° 19' 46.58 N NAD83 122° 0' 21.58" W NAD83 SANTA CLARA PUBLIC RIGHT OF WAY NEAR 316-06-064 CITY OF CUPERTINO 162.30' AMSL VICINITY MAPPOLE PHOTO N DRAWING INDEX T-1 SHEET NO. TITLE SHEET T-2 GENERAL NOTES A-1 SITE PLAN & ENLARGED SITE PLAN A-2 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 E-1 ELECTRICAL GENERAL NOTES E-2 ONE-LINE DIAGRAM & GROUNDING SCHEMATIC E-3 ELECTRICAL DETAILS 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. 10335 N TANTAU AVE SURVEY PROJECT TEAM PROJECT DESCRIPTION D-2 DETAILS 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 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 APPLICANT: VERIZON WIRELESS 2785 MITCHELL DRIVE, SUITE 9 WALNUT CREEK, CA 94598 CONTACT: CHRIS MOLLER PHONE: (925) 339.2778 EMAIL: CHRIS.MOLLER@VERIZONWIRELESS.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 SITE C-1 A-3 ELEVATIONS VERIZON WIRELESS PROPOSES TO INSTALL A NEW WIRELESS COMMUNICATION SITE ON A LIGHT POLE IN THE PUBLIC RIGHT-OF-WAY. SCOPE: ·INSTALL (2) 5G ANTENNA/RADIOS INSIDE NEW FRP CONCEALMENT SHROUD ON TOP OF POLE ·INSTALL (1) NEW DISCONNECT / SMART METER ON SIDE OF POLE ·INSTALL NEW POLE AND FOUNDATION TO REPLACE EXISTING D-3 POLE SPECS (NEAR) 10335 N TANTAU AVE CUPERTINO, CA 95014 (NEAR) 10335 N TANTAU AVE CUPERTINO, CA 95014 CA_SJ_CUPERTINO_316 SITE ID: SITE TYPE: POLE #: CX PROJECT ID: COUNTY: PSLC: CA_SJ_CUPERTINO_316 LIGHT POLE 7208 20191962640 SANTA CLARA 545461 A-4A CIRCUIT DIAGRAM D-4 CITY STANDARD DETAILS A-4B CIRCUIT DIAGRAM A-4C CIRCUIT DIAGRAM DocuSign Envelope ID: 2AF402F9-E4FE-49CE-A224-F23EE644947BDocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54 FI B E R S/ L S/ L S / L F I B E R F I B E R S / L S/ L S/ L S/ L S/ L S/ L S/ L DRAWN BY: CHECKED BY:BM 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 08/13/20 100% CD REV DATE DESCRIPTION MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 APPROVED BY:LJB CA_SJ_CUPERTINO_316 VERIZON WIRELESS 2785 MITCHELL DRIVE, SUITE 9 WALNUT CREEK, CA 94598 (NEAR) 10335 N TANTAU AVE, CUPERTINO, CA 95014 1 12/17/20 100% CD PLAN CHECK A-1 SITE PLAN 1ENLARGED SITE PLAN N SITE PLAN2 N 2 A-1 ENLARGED SITE PLAN 1&2 A-3 1&2 A-2 (E ) LA N D S C A P E 1/16"=1'-0" SCALE 1/2"=1'-0" SCALE (E) LIGHT POLE & FOUNDATION TO BE REMOVED. (N) LIGHT POLE & FOUNDATION TO BE INSTALLED IN PLACE (N) LOCATION OF VERIZON WIRELESS ANTENNA IN FRP SHROUD MOUNTED ON LIGHT POLE PR O P E R T Y L I N E (E) FACE OF THE CURB 2'-7"± BACK OF POLE TO ROW LINE (N) LOCATION OF VERIZON WIRELESS ANTENNA AND EQUIPMENT N T A N T A U A V E A.P.N.: 316-06-065 ELECTRICAL LINE STREET LIGHT LINE E S/L FIBER LINE(S)FIBER LEGEND NC 1 (N) STEEL MAST ARM (N) LUMINAIRE N1 EC 2 N C 2 NC 3 (E) INLET PR O P E R T Y L I N E (E ) LA N D S C A P E (E) FACE OF THE CURB FENC E N T A N T A U A V E 2'-7"± BACK OF POLE TO ROW LINE EC1 10300 N TANTAU AVE CUPERTINO, CA 95014 SE C T O R AZ I M U T H 1 8 0 5G B SE C T O R AZ I M U T H 0 5G A E1 (N) 2'-6" x 4'-0" x 6" THICK CONCRETE CAP PER CITY STANDARDS TO REPLACE EXISTING 6 " M I N . (E) MANHOLE (E) PULLBOX (E ) LA N D S C A P E PR O P E R T Y L I N E (E) WATER VALVE TYP. (E) MANHOLE PROP E R T Y L I N E (E) FIRE HYDRANT (E) DRIVEWAY A.P.N.: 316-06-064 10335 N TANTAU AVE CUPERTINO, CA 95014 EC 2 CO N C R E T E S I D E W A L K (E ) LA N D S C A P E (E ) LA N D S C A P E CO N C R E T E S I D E W A L K 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. NOTE: CARRIER GROUND WIRE TO BE LABELED IN FIELD Label carrier gnd line in City box Repl inductive with (N) LED DocuSign Envelope ID: 2AF402F9-E4FE-49CE-A224-F23EE644947BDocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54 SHUTDOWN DRAWN BY: CHECKED BY:BM 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 08/13/20 100% CD REV DATE DESCRIPTION MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 APPROVED BY:LJB CA_SJ_CUPERTINO_316 VERIZON WIRELESS 2785 MITCHELL DRIVE, SUITE 9 WALNUT CREEK, CA 94598 (NEAR) 10335 N TANTAU AVE, CUPERTINO, CA 95014 1 12/17/20 100% CD PLAN CHECK A-2 EXISTING & PROPOSED ELEVATIONS 12PROPOSED ELEVATIONEXISTING ELEVATION 1/2"=1'-0" SCALE 1/2"=1'-0" SCALE EXISTING SURFACE 0'-0" AGL EXISTING SURFACE 0'-0" AGL (E) FOUNDATION (E) LIGHT POLE TO BE REPLACED (E) LUMINAIRE (E) ROAD SIGNS 2'-7" BACK OF POLE TO ROW LINE 4 D-2 (N) FOUNDATION (N) 10'-0" MAST ARM 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 B.O. (E) SIGNS 9'-5" AGL B.O. (E) SIGNS 7'-0" AGL T.O. (E) LIGHT SENSOR 31'-6" AGL (E) LIGHT ARM 28'-4" AGL T.O. (E) STEEL LIGHT POLE 28'-8" AGL T.O. (E) SIGNS 8'-6" AGL (N) LIGHT POLE (N) (2) 5G ANTENNAS IN FRP SHROUD 6 D-1 (N) FRP CONCEALMENT SHROUD 1 D-1 T.O. (N) STEEL LIGHT POLE 29'-11" AGL RAD CENTER OF (N) 5G ANTENNA 31'-7" AGL T.O. (N) CONCEALMENT SHROUD 35'-6" AGL 8 D-1 3 E-3 B.O. (N) DISCONNECT/B.O. (E) SIGNS 7'-0" AGL T.O. (N) DISCONNECT 8'-9" AGL (N) SMART METER / DISCONNECT w/ SHUTDOWN SIGNAGE 4 D-1 5 D-1 PORT HOLE LOCATION FOR DISCONNECT 1 D-2 (E) ROAD SIGNS (N) LUMINAIRE 1 D-3 7 E-3 2'-7" BACK OF POLE TO ROW LINE T.O. (E) LIGHT SENSOR 31'-8" AGL (N) NOTICE SIGNAGE, TYP. OF (1) FACING STREETSIDE 9 D-1 T.O. (N) NOTICE SIGNAGE 25'-2" AGL T.O. (E) SIGNS 11'-11" AGL B.O. (E) SIGNS 9'-5" AGL T.O. (E) SIGNS 8'-6" AGL T.O. (E) SIGNS 11'-11" AGL DocuSign Envelope ID: 2AF402F9-E4FE-49CE-A224-F23EE644947BDocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54 Certificate Of Completion Envelope Id: 2AF402F9E4FE49CEA224F23EE644947B Status: Completed Subject: Please DocuSign: CA_SJ_CUPERTINO_316_Encroachment Agreement.pdf 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 3/3/2021 8:31:22 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: 3/3/2021 8:33:42 PM Viewed: 3/9/2021 11:31:35 AM Signed: 3/9/2021 11:31:49 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: 3/3/2021 8:33:42 PM Viewed: 3/10/2021 10:27:29 AM Signed: 3/10/2021 10:37:44 AM Electronic Record and Signature Disclosure: Accepted: 3/10/2021 10:27:29 AM ID: 01f257ae-9025-4fd2-a53b-b4f49a3aae78 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: 3/3/2021 8:33:42 PM Viewed: 3/4/2021 8:06:19 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign Witness Events Signature Timestamp DocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54 Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 3/3/2021 8:33:43 PM Certified Delivered Security Checked 3/10/2021 10:27:29 AM Signing Complete Security Checked 3/10/2021 10:37:44 AM Completed Security Checked 3/10/2021 10:37:44 AM Payment Events Status Timestamps Electronic Record and Signature Disclosure DocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54