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AT&T - Right of Entry Agreement (Gilroy Garlic Festival)
Market: Northern California Cell Site Number: CCU2995 Search Ring Name: Gilroy Garlic Festival Cell Site Name: Gilroy Garlic Festival (CA) Fixed Asset Number: 10149850 RIGHT OF ENTRY AGREEMENT This Right of Entry Agreement ( "Agreement ") is entered into as of the date of the latter of the two signatures below ( "Effective Date "), and is made by and between City of Gilroy ( "City ") and New Cingular Wireless PCS, LLC, a Delaware limited liability company ( "AT &T "). 1. Right of Entry. City hereby grants permission to AT &T, and its agents, employees, consultants, contractors, subcontractors and material suppliers, and which permission shall be irrevocable during the Term, to enter upon City's property known generally as Christmas Hill Park Ranch Site at 7049 Miller Ave., Gilroy, CA, Assessor's Parcel No. 808 -18 -022 (the "Property "), for the purpose of investigating and creating a suitable work scope for the use of existing underground conduit owned by the City through which AT &T will have the right, but not the obligation, to install and operate fiber connectivity to support AT &T's operation of its temporary portable wireless communication facility ( "COW ") during the annual Gilroy Garlic Festival ( "Work"). Notwithstanding the foregoing, prior to any entry by AT &T under this Agreement for the purpose of performing the Work, AT &T must obtain the prior written approval of AT &T's proposed plans for the Work from City. AT &T either has obtained, or will obtain, the right to install and operate the COW pursuant to a separate agreement with the Gilroy Garlic Festival Association. The City's permission granted to AT &T for the Work herein shall include the right, but not the obligation, for AT &T to install pull cords in and through the City's conduit for possible future installation of fiber. AT&T covenants to the City that AT &T's installation of such pull cords shall not damage the City's conduit or the existing infrastructure installed therein by Verizon. AT &T shall, at no cost to City, perform the Work, if at all, obtain all governmental permits and authorizations required for the performance of the Work and will comply with and will cause all employees, agents and representatives to comply with all applicable governmental rules, laws and regulations. AT &T shall be solely responsible for the health and safety of its employees, licensees, agents and representatives that enter onto the Property under this Agreement. AT &T shall not materially and adversely interfere with City's use of the Property. Except to the extent expressly provided herein, upon completion of the Work, AT &T shall restore the portion of the Property where the Work was performed, to the condition existing immediately prior to the commencement of the Work, reasonable wear and tear and loss by casualty or other causes beyond AT &T's control excepted. 2. Term. The initial term of this Agreement shall begin upon the Effective Date, and shall end on August 15, 2015. Upon the expiration of the initial term, the Agreement shall continue on a month to month basis on the same terms and conditions provided that City shall not exercise its right to terminate this Agreement on thirty (30) days' notice to AT &T until a date which is six (6) months from the Effective Date. Once the Agreement is terminated by either the City or AT &T pursuant to this Agreement, AT &T may leave the pull cords in place unless AT &T is specifically directed by the City in writing to remove same, in which case AT &T shall promptly remove the pull cords. Notwithstanding anything to the contrary set forth herein, AT &T Site CCU2995 (Gilroy Garlic Festival) 03.26.15 Version AT &T hall have the right to terminate this Agreement at any time for convenience provided that AT &T delivers at least ten (10) days prior notice to City of AT &T's election to terminate this Agreement. 3. Cooperation. The City and its agents hereby agree to cooperate with AT &T, its agents, employees, consultants, contractors, subcontractors and material suppliers in connection with their respective entry onto the Property and performance of the work authorized under this Agreement. 4. No Liens; Indemnity. All work performed in accordance with this Agreement shall be completed at the sole cost and expense of AT &T. AT &T shall keep the Property free and clear of all liens and other encumbrances arising out of AT &T's entry onto the Property or activities conducted by AT &T or any other parry under the supervision and control of AT &T pursuant to this Agreement. AT &T shall indemnify and hold the City harmless from any loss, damage, claim, liability, cost, or expense caused as a direct result of- (i) loss of or damage to property and injuries to or death of any person due to entry onto the Property by AT &T or any other parry under the supervision and control of AT &T pursuant to this Agreement; (ii) performance of the Work authorized by this Agreement to the extent caused by the active negligence or willful misconduct of AT &T's agents, employees, consultants, contractors, subcontractors and material suppliers; and (iii) the breach of this Agreement by AT &T or AT &T's violation of federal, state, or local law. AT &T hereby releases and forever discharges City, its employees, agents, representatives, successors and assigns from any and all claims, actions, causes of action, obligations, costs, losses, expenses and demands relating to, arising from or connected with the Work performed under this Agreement, except to the extent caused as a direct result of (i) the active negligence or willful misconduct of City, or its agents, employees or contractors or (ii) breach of this Agreement by City. AT &T shall at all times during the term of this Agreement comply with the insurance requirements attached to this Agreement as Exhibit A. 5. Notice. All written notices or other communications of the parties under this Agreement shall be in writing and shall be deemed effective when properly sent and received, refused or returned undelivered. Notices may be sent by overnight delivery, or by certified or registered mail, return receipt requested, postage prepaid, addressed as follows: City: City of Gilroy 7351 Rosanna Street Attention: Bill Headley Gilroy, CA 95020 AT &T: New Cingular Wireless PCS, LLC Attn: Network Real Estate Administration Re: Cell Site #: CCU2995 Search Ring Name: Gilroy Garlic Festival Cell Site Name: Gilroy Garlic Festival (CA) Fixed Asset No: 10149850 575 Morosgo Drive NE Suite 13F, West Tower Atlanta, GA 30324 AT &T Site CCU2995 (Gilroy Garlic Festival) 03.26.15 Version With a required copy to AT &T Legal Department: New Cingular Wireless PCS, LLC Attn: AT &T Legal Dept — Network Operations Re: Cell Site #: CCU2995 Search Ring Name: Gilroy Garlic Festival Cell Site Name: Gilroy Garlic Festival (CA) Fixed Asset No: 10149850 208 S. Akard Street Dallas, TX 752024206 Each party to this Agreement may change the address to which written notices must be sent, by sending written notice in accordance with this Paragraph. 6. Counterparts. This Agreement may be executed in counterparts, each of which shall be deemed an original, an all of which shall constitute one and the same agreement. 7. Entire Agreement; Governing Law, Venue. This Agreement constitutes the entire agreement between the parties with regard to the Work and AT &T's entry onto the Property to perform the Work, and supersedes all prior or contemporaneous oral agreements or understandings. This Agreement may not be modified except in writing signed by both parties. This Agreement shall be governed and construed in accordance with California law. Venue shall be proper exclusively in Santa Clara County. 8. Captions. The captions of this Agreement are for convenience only, and shall not be used in interpreting any provision of this Agreement. 9. Representations And Warranties. City represents and warrants that (i) it solely owns the Property in fee simple; (ii) to the best of City's knowledge, the Property is not encumbered by any liens, restrictions, mortgages, covenants, conditions, easements, leases, or any other agreements ( "Encumbrances ") not of record which would adversely affect the rights expressly granted by City to AT &T pursuant to this Agreement; (iii) after the Effective Date and during the term of this Agreement, the Property will not be encumbered with any Encumbrances of record or not of record which would materially and adversely affect the rights expressly granted by City to AT &T pursuant to this Agreement; and (iv) City's execution and performance of this Agreement will not violate any laws, ordinances, covenants or the provisions of any mortgage, lease or other agreement binding on the City. IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the Effective Date. [signatures on following page] AT&T Site CCU2995 (Gilroy Garlic Festival) 03.26.15 Version "AT &T" New Cingular Wireless PCS, LLC, a Delaware limited liability company AT &T Mobility Corporation Its: Manager By: nar i Name: 'Director Its: Construction & Englneerin, Dated: q — K , 2015 "CITY" ity of ilroy By: Thomas Haglund Its: City Administrator Dated: Q— , 2015 APPRoveO A r YB fD G-1 <Y POT O2NF- Y AT &T Site CCU2995 (Gilroy Garlic Festival) 03.26.15 Version Exhibit A Insurance Requirements AT &T to Provide Proof Of Insurance. Prior to any use of the Property, AT &T shall deliver to City an original signed Certificate of Insurance or certified duplicate liability insurance; including City (or any successor), and other designees of City as the interest of such designees shall appear, as additional insureds, with the following coverage: 1. Worker's compensation insurance in not less than the minimum amounts required by law to be evidenced by the delivery of an ACORD certificate or certificates; 2. Commercial general liability insurance (at least as broad as the most commonly available ISO Commercial General Liability policy form CG 00 01), or equivalent, for the mutual benefit of City and AT &T, against claims and liabilities arising out of the ownership, use, occupancy or maintenance of the Property, or AT &T's activities thereon. The limit of coverage of such policy shall be in the amount of One Million Dollars ($1,000,000) per occurrence and annual aggregate, shall include contractual liability coverage, and shall contain a severability of interest clause or a cross liability endorsement. ; and 3. Business automobile liability insurance having a combined single limit of One Million Dollars ($1,000,000) per occurrence and insuring AT &T against liability for claims for bodily injury, death, or property damage, arising out of ownership, maintenance, or use of any owned, hired or non -owned automobiles. 4. General Requirements. No required policy maintained by AT &T under this Agreement shall contain a deductible greater than Two Thousand Five Hundred Dollars ($2,500). AT &T shall provide at least thirty (3 0) days prior written notice to City (except for nonpayment which shall require not less than ten (10) days notice) of any cancellation of required coverage that is not replaced. Such policies of insurance shall be issued as primary policies and not contributing with or in excess of coverage that City may carry, by an insurance company eligible to do business in California for the issuance of such type of insurance coverage and having an AM Best financial strength rating or A -minus VII or better. All deductibles shall be deemed self - insured with full waiver of subrogation. All required AT &T policies shall contain an endorsement that the insurer waives its right to subrogation. AT &T's obligations under this Agreement shall not be limited to the amount of any insurance required of or carried by AT &T under Paragraph E and AT &T is responsible for insuring that the amount of insurance carried by AT &T is sufficient for AT &T's purposes. All insurance required to be carried by AT &T hereunder shall be in companies, on forms and with loss payable clauses satisfactory to City and evidence of such shall be delivered to City by AT &T prior to the Commencement Date. The liability policies to be carried by AT &T under this Agreement shall include City and its agent and employees as additional insureds. All required policies shall provide coverage on an occurrence basis and not on a claims made basis. 5. The parties hereby intend that the risks of loss, damage, and injury in connection with this Agreement, City's ownership and operation of the City Property, and AT &T's use and occupancy of the Property are to be allocated as far as possible to insurance. Therefore, City and AT &T each waive, and shall cause their respective insurance carriers to waive, all claims, actions, causes of action and demands against each other and their respective trustees, principals, beneficiaries, partners, officers, directors, agents and employees, for any loss, damage or injury to business, persons or property of any kind or nature, to the extent such loss, damage, or injury is compensated by insurance or required to be insured under this Agreement. AT &T Site CCU2995 (Gilroy Garlic Festival) 03.26.15 Version 6. Liability For Personal Property. CITY SHALL HAVE NO LIABILITY FOR LOSS OR DAMAGE TO ANY ITEMS STORED IN OR ABOUT THE PROPERTY UNLESS DUE TO CITY'S GROSS NEGLIGENCE OR WILLFUL MISCONDUCT. AT &T Site CCU2995 (Gilroy Garlic Festival) 03.26.15 Version Fiber Run for Temp COW Location 2015 Gilroy Garlic Festival [Appears on Following Pages] AT &T Site CCU2995 (Gilroy Garlic Festival) 03.26.15 Version AT &T Site CCU2995 (Gilroy Garlic Festival) 03.26.15 Version SITE NUMBER: jr, at &t CCU2995- CCU2999 PLEAIWMK G.,� at&t SITE NAME: GILROY GARLIC FESTIVAL (COW) PROJECT: ATT ETTCS_NCA �� FA- NUMBER: 10138303 VINCULUMS COORDS: 36.999489 -121.590937 To l`�°"�" .l xmwc. v.txncxv, case SITE ADDRESS: 7051 MILLER AVE. GILROY, CA. 95050. U8A NjMh .w...w.ew9.rw '•'��"" Bit 1800 221 X600 c.��...,... LOCATION MAPS VICINITY MAP PROJECT DESCRIPTION LOCAL MAP °`°°"° °°° _ `"°°" / '° "` "m SITE INFORMATION 'E DRAWING INDEX -_ SHEET N0: SHEET TITLE omu� m[ siw (s wwurwq 'I A -- • NfV90 wn p ranrMO O. -'- R-3 m9rrwr .uw / csw " M 9008 6 YAIiI / �99UWII.wl9 uG 9—N PICf09 M1D /001191Y� 19gIWlILYI PROJECT TEAM � unvn.a= �rrrv:s gar.• DRIVING DIRECTIONS sw .. , DO NOT SCALE DRAWINGS . „,. 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W Tii H. •T(i tE I n_ -mom 'v aq �IIPO1 IiWNII 1151 N..1 1 Vllll f1�11 p11M •N ulam a v+usi Mkt /RL ^NOi05 sllr IarfM F,H `,T, I Hc >T l B-6 ` n l CD s� IMP at &t PK Wlgw fr�e t,. P H UTO t ' W)TO An.vn -ra)Utl aunt "Mc «smut (oars "I rua of aum w •m» MR Tf1l I` lID)OS MIR 4 ®® CERTIFICATE OF LIABILITY INSURANCE - DATE 04/2Z/2015 /2015 /YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh USA Inc. 701 Market Street, Suite 1100 St. Louis, MO 63101 Attn: ATT.CertRequest @mamh.com CONTACT NAME: PHONE Fvc No l: E-MAIL ADDRESS: GENERAL LIABILITY - INSURERS AFFORDING COVERAGE NAIC 9 INSURER A: Old Republic Insurance Company 24147 018566 -GAW- CRT -14-15 INSURED New Cingular Wireless PCs, LLC INSURER B: INSURER C : One AT&T Plaza 208 South Akard Street, Room 2731 INSURER D: 1,,000,000 $ INSURER E:. $ N/A Dallas, TX 75202 INSURER F COVERAGES CERTIFICATE NUMBER: CHI- 005146083 -05 REVISION NUMBER: THIS IS TO CERTIFY THAT THE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR' TYPE OF INSURANCE _ ADDLSUBR POLICY NUMBER POLICY EFF MMIDD NYYY) POLICY EXP. (MMIDDIYYYYI LIMITS A GENERAL LIABILITY - MWZY 302356 06/01/2014 06/01/2015 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR -DAMAGE TO PREMI E E occurrence 1,,000,000 $ MED EXP (Any one person) $ N/A PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 1,000,000 X _ POLICY_' PRO- LOC JFCT $ A A AUTOMOBILE LIABILITY ANY AUTO MWTB 302129 MWZX 302130 (MI) See Second Page 06/01/2014 06/0112014 06101/2015 06/01/2015 COMBINED SINGLE.uMIT 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS - BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per ac en $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LUAB OCCUR EACH OCCURRENCE $ RXED AGGREGATE $ CESS LIAB CLAIMS -MADE I I RETENTION $ $ _ A WORKERS COMPENSATION MWC 302340 00 06/01/2014 06/01/2015 X WC'STATU, OTIT AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If y- describe under DESCRIPTION OF OPERATIONS below N / A E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE _$ 1,000,000 E.L. DISEASE -. POLICY LIMIT $ 1,000,000 A Excess Workers' Compensation / MWXS 302341 (OH -WA) 06/01/2014 06/01/2015 EL Each Accident / EL Disease 1,000,000 Employers' Liability See Second Page EL Disease - Policy Limit 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: Running fiber lines across city property to COW installation; CCU2995, FA 10149850, Gilroy Garlic Festival COW, Christmas Hill Park, 7050 Miller Avenue, Gilroy, CA 95020 City of Gilroy, its officers and employees is /are included as Additional Insured under the General Liability policy but only with respect to the requirements of the contract between the Certificate Holder and the Insured. City of Gilroy Attn: Thomas Haglund 7351 Rosanna Street Gilroy, CA 95020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee _ VK-9 %A,04&►.► ©1988 -2010 ACORD CORPORATION. All rights ACORD 25 (2010105) . The ACORD name and logo are registered marks of ACORD AC E ® `6ft� AGENCY CUSTOMER ID: 018566 LOC #: St. Louis ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA Inc. New Cingular Wireless PCS, LLC One AT &T Plaza 208 South Akard Street, POLICY NUMBER Room 2731 Dallas, TX 75202 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Excess Workers' Compensation - MWXS 302341 (OH -WA) Self- Insured Retentions OH - $500,000,000 WA - $500,000,000 Excess Automobile Liability - MWZX 302130 (MI) Combined Single Limit - $9,000,000 Self - Insured Retention - $1,000,000 ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IL 10 (12106) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Paragraph 2. of SECTION II - WHO IS AN INSURED is amended to include any person or organization for whom you have agreed under contract or agreement to provide insurance. However, the Insurance provided shall not exceed the scope of coverage or limits of this policy. Notwithstanding the foregoing sentence, In no event shall the insurance provided exceed the scope of coverage or limits required by said contract or agreement Where required by contract, we will consider our policy to be primary under any other insurance maintained by the additional insured for injury or damage covered by this endorsement and that their policy will be noncontributing with this insurance. GL 739 006a 0609 MVVZY302356 A781 fnc. 06/0/12014 - 061012015 MCKU14 OP ID: LC CERTIFICATE OF LIABILITY INSURANCE 18 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS — ,CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: H the cerfilicats holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. N SUBROGATION 13 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certlflcate does not confer rights to the certificate holder In lieu of such end s . DUbEk Phone: 408- 842:2131 P aoHe Diversned Insurance Gi spy p Fam.408 -842 -0867 9W 5 Murray Avenue 0110 1311 CA 85020 lowACT AIM PHONE Ne AOSO080400 Big ;k GISURERM AFFORD003 COVERAGE NAN:e MWER A:Ironshore Specialty Ins. Co. 25445 MED E7w ate Daum Mc Kuin Pipeline, Inc. AmmmeAlled insurance Company 23787 320 Hunter Lane Hollister, CA 95023 me~ C: Admiral Insurance Co. 124856 INSURER D: State COMPOnWdOn Iris. Fund 85076 mumn E: Navigators Specialty Ins. Co. 36056 mum F; B COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF QVIUMANCE !2UL sum POLICY NUMBER POUCY a Bmmwrnnn 10Hti12015 LmIns A GENERALLNUNLRY X culERCwLCmRERALLweam CLAWMADE ® OCCUR X AOSO080400 10M612014 EACH OCCURRENCE i 1,000 DAMAM 110 c E _ 50,00 MED E7w ate $ 6 _ PERSONAL 8 ADV INJURY i 1,000M AGGREGATE _ 2,000,00 GEML AGGREGATE LIMIT APPLIES PER Poucr NXI LOC PRODUCTS - COMPIOP AGO i '24000,0 S B AUTOMOSLE L&ASLITY X ANYAUTO OS SCHEDULED AUT AUTOS X HOW AUTOS X AUTOS ACPRA7835212974 10/1& M4 10815/2015 C 11000, BOOLYImAmy (Pa pmm) t BOOLY INJURY (Per ooddeed) E P PE =?AMAGE S C UCLA LU1B OwEssuAs OCCUR CLAIMS -BADE EXGO M3751 -02 10/15/2014 101151 MS EACH OCCURRENCE X .X AGGREGATE S 001_. RETENTIO N S G iINN "or RnCOIWENSATION UABLITY OFFICERNA NIQIe � D(RTNERA CUTIVE Y❑ e deoae,e aF w n0 N 8 below NIA 9414 11/02/2014 11/02/2015 X YVCaTATi I I OTH- E.L. EACH ACCIDENT $ 1,000,0 DISEASE - EA EMPLOYE E L 0 $ 1 ,000. E.L. DISEASE -POLICY UMFT S, 11000, E riudon flab F14ECP3002091C 08/21/2014 1081512015 Aggregate 2,000, __ Ea. Oct 1,000 DESCRPT10N OF OPERATNRNs i LOCATIONS i VEHICLES IAtuh ACORD 101, AWdoml RamAm Sdwdui% K oma ePtteo b m**8d) : AT&T Fiber cabling frog Miller Ave. to CEP Ranch Site TSSC Building City of Gilroy, its officers, officials and employees are named as an additional insured with respects to the General Liability per this attached en"reassent. CR YOFG City of Gilroy 7351 Rosanna Struet Gilroy, CA 95020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOAZ D) REPRESENTATM CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD POLICY NUMBER:. AGS0080400 COMMERCIAL GENERAL LIABILITY CG 2010 OT 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. i-- I 1- l.f ,i� e�i � — _I_ .� � ! `' __ t —_ � i1]1 =' \ � � ., Ce �i �� {•'' h,\€ I.i iii This endorsement modffies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or nization s : Locations Of Covered Operations Additional Insureds shown in a written contract, or written Any location. agreement that includes primary and non - contributory wording. The inclusion of one or more Insured under the terms of this endorsement does not increase our limits of liability. All other terms and conditions remain unchanged. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. SECTION II — WHO IS AN INSURED Is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by. 1. Your ads or omissions; or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional Insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This Insurance does not apply to "bodily injury" or "property damage" occurring after. 1. All work, Including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional Insured(s) at the location of the covered operations has been completed; or 2. That portion of your work" out of which the Injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CO 2010 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 0 POLICY NUMBER: AGS0080400 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. {•� �`t�' a � �� � ''� - � 1�: ��r� ��i L_ y- r � C) 1�� ��' �F- � � ��� h�� .` This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional insured Person(s) Or Or anization s : Location And Description Of Completed Operations, Additional Insureds shown to a written contract, or The insurance afforded by this policy for the benefit of written agreement that includes primary and the additional insured does not apply to non - contributory wording where required. 'property damage' to any building, structure or appurtenant structure intended to be occupied as The inclusion of one or more Insured under the terms of a 'private residence'. The term "private residence" includes single family homes or residences, this endorsement does not increase our limits of multi -family homes or residences. liability AD other terms and conditions remain unchanged. Information required to complete this Schedule if not shown above will be shown in the Declarations. Section 11 — Who is An Insured Is amended to include as an additional insured the person(s) or organizations) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard ". CG 20 37 07 04 ® ISO Properties, Inc., 2004 Page 1 of 1 ❑ City of Gilroy -$ • Public Works Department I Engineering Division 735J Rosanna Street I Gilroy, California 95020 Phone (408) 846 -0451 1 Fax (408) 846 -0429 www.cityofgilroy.org ❑ Construction — Private Facilities CITY USE ONLY Permit No.: / -'5-6 V00 4/ 5' Issue Date: 9-16 15 Expiration Date: 16 -/ S Permit for Encroachment (Non - Transferable) Construction — ❑ Emergency Public Facilities APPLICANT INFORMATION: Complete all fields Name: OSL'3 (LI�. Q_�r Mailing Address: I - LEM ❑ Other Email: �ZS31�+- ►'tq,d10564C (Q,D,'�'l La►,. Home / Office #: . — Cell #: `AIS S q— t t l in Pi ua t State- certified Communication Co. ❑ Gilroy Franchised Utility ❑ Other Project Location: Project Description: CONTRACTOR INFUKMA I IUN: Complete all fields v4A I i t Q v r� / ����.1� AS T►2y t^ �P.Z Contractor Name: &I c tai n Pi ,� Address: 2j2,() i 4y,4Ao/ : //t✓ZO REQUIRED SUBMITTALS: ❑ Improvement Plans ❑ Construction Schedule ❑ Traffic Control Plans ❑ Other ❑ Construction Cost Estimate for all City infrastructure work in public right -of -way such as remove & replace curb, gutter, sidewalk, pavement, striping, etc. (1M not Include non -City infrastructure such as conduits utility boxes, etc.) Construction Estimate: $ Final Amount: INSPECTIONS REQUIRED: Inspection Type Subgrade Form Place Final ❑ Waived Sidewalk _ff Waived ❑ In rance Endorsement ❑ Waived ermit Fee E ❑ Waived Driveway Gas Curb 0 Gutter ❑ Water Paving Tele one ADA Curb Ramp(s) Electric Alley Construction ❑ Other ❑ Other Email: rA(,1&i t Office #: 24 -hr. Emergency #: Ale CITY PPROVAL CHECK LIST: City Business License (for contractor) REQUIRED ❑ Class CA Contractors License REQUIRED ❑ Bond ❑ Waived ❑ Insurance Certificate _ff Waived ❑ In rance Endorsement ❑ Waived ermit Fee E ❑ Waived ,... pnyauw w: Vlry or bllroy Inspection Type Trench Install Backrill Final Storm Sewer Gas ❑ Water Tele one Electric ❑ Other Contractor must call (408) 846 -0451 two (2) working days prior to beginning any work and for each inspection request. UNINSPECTED WORK WILL BE REJECTED. Applicant Acknowledgement and Signature I understand the State of California Contractors License Requirements. I have read the General Conditions attached to this application and will comply with them, any special conditions, and all provision of Gilroy Municipal Code Chapter 20, Article IX, Section 20.7 through 20.114. Note: Applicant mu gn Page 5 of Permit Conditions. 5v/1xl(L � I I s' Name of Applicant 1 gent (Print) Signature of Applicant I Agent Date City of Gilroy Official Approval Permission is hereby granted to the above -named applicant for Encroachment at the specified location on or between designated dates in the above application, subject to the attached conditions and' City of Gilroy Municip I Code Chapter 20, Article IX, Section 20.7 through 20.114. y/ Name of Public Works Department Official (Print) Signature of public Works epartment Official Date Gilroy Encroachment Permit—Application FINAL3 01.16.2014 City of Gilroy I Public Works Department _ e s Encroachment Permit • ; General Conditions of Approval NOTE: Below are general requirements for work within all public street or utility easement areas. The Permittee also must comply with all the terms, conditions, rules, and procedures of the Encroachment Ordinance, Encroachment Agreement, and the Standard Specifications and Details ( "City of Gilroy Standards ") of the City of Gilroy. 1. Encroachment Permit Compliance Required. No person shall make a right -of -way encroachment or cause any street cut to be made without having secured the proper permit two (2) working days in advance of the date specified to begin work except when an emergency street cut is necessary. All work shall be performed in strict compliance with the terms and conditions of this permit. (Gilroy Muni Code 20.72b) 2. Failure to Comply. Failure to comply with the requirements of this permit may result in one or more of the following: A. The City Engineer shall order immediate suspension of work until non - compliance is resolved. B. Should the Permittee or the Permittee's contractor fail to correct the non - compliances, the City Engineer may cause removal and replacement of deficient work and /or completion of work to bring the project into compliance at the Permittee's expense. C. The City Engineer shall cause traffic controls to be set, as deemed necessary by the City Engineer, at the expense of the Permittee. D. If the City Engineer deems emergency repairs necessary, he or she will attempt to notify the Permittee. If the Permittee cannot be contacted or fails to respond in a timely fashion, the City Engineer shall cause the work to be done at the Permittee's expense. Where corrective work described above is ordered by the City Engineer, the cost of that work shall be charged to the Permittee on a Labor, Equipment and Materials basis plus overhead to reimburse the City for its actual costs. 3. Notification. The Permittee shall notify the City at least two (2) working days prior to start of work and at that time shall providg a project schedule. Permittee shall notify the Police Department if the work may impede the passage of emergency vehicles (Gilroy Muni Code 20.72b). Temporary "No Stopping," "No Parking," and /or "Tow- Away" signs shall be posted by the Contractor at least seventy -two (72) hours prior to commencement of work. Signs shall state days and hours when restrictions apply. 4. Emergency Street Cut. A permit for an emergency street cut shall be secured no later than the working day immediately following the emergency street cut. If the emergency street cut is performed during business hours, the Permittee shall attempt to reach the City Engineer by telephone in advance of the work. (Gilroy Muni Code 20.73h, 20.95c) 5. Time Extension. If the completion /expiration date stated on the permit will be exceeded, an application for a time extension must be filed and approved by the City Engineer. The new completion date shall be indicated on the permit. (Gilroy Muni Code 20.83) 6. Inspection. Work shall be inspected as indicated on the permit. Uninspected work shall be removed as deemed appropriate by the City Engineer. To request an inspection, call (408) 846 -0450 at least Gilroy Encroachment Permit—Conditions of Approval FINAL 11.27.2013 Page 1 of 5 one (1) working day in advance of requested inspection time. Inspection shall be scheduled Monday through Friday, except holidays, from 8:15 A.M. to 4:15 P.M. (Gilroy Muni Code 20.85b) 7. Underground Alert. The Permittee must telephone Underground Service Alert (USA) at (800) 227- 2600 to verify utility locations at least two (2) working days prior to any excavation. Failure to do so shall result in issuance of a Stop Work Notice. Permittee is responsible for all utility relocations. (Gilroy Muni Code 20.95a) 8. Unknown Underground Facility. If an unknown underground facility is encountered, work shall cease immediately and both the City Engineer and the utility believed to own the facility shall be notified. Work shall not proceed until permission is granted by the City Engineer. (Gilroy Muni Code 20.95b) 9. Posting. The Permittee must keep the signed permit at the worksite or on the premises of the encroachment at all times. (Gilroy Muni Code 20.84a) 10. Emergency Call -out. A Permittee shall provide a 24 -hour emergency telephone number on the application and shall display its company name and emergency telephone number on its barricades. Failure to respond to an incident promptly shall require corrective measures by the City, the cost of which shall be borne by the Permittee. (Gilroy Muni Code 20.84c, 20.100) 11. Standards. Work shall be constructed in accordance with applicable ordinances, codes, and Gilroy Standards, for the City of Gilroy. A copy of the City of Gilroy Standards can be purchased at the Public Works Department at City Hall. (Gilroy Muni Code 20.89; 20.101) 12. Other Regulations. It is the Permittee's responsibility to comply with all City laws and regulations and to obtain all necessary permits. Such laws, regulations, and permits include, but are not limited to, the City Business License, Americans with Disabilities Act (ADA) and Division of Occupational Safety 8 Health standards. (Gilroy Muni Code 20.75c, 20.89a, 20.97c, 20.88a,) 13. Access. The Permittee shall provide access to all areas in the vicinity of the encroachment and shall provide necessary temporary sidewalk and warning signs. (Gilroy Muni Code 20.74b, 20.88, 20.96, 20.97) 14. Public Safety. The Permittee shall furnish, erect, and maintain barricades, lights, signs, flagmen, fencing, and other safety measures to give adequate protection to the public at all times. Failure of the Permittee to set required warning devices may result in a project shutdown and charges to the Permittee for costs incurred by the City. (Gilroy Muni Code 20.88) 15. Site Maintenance. Work areas shall be maintained in a neat, clean and safe condition at all times. Debris shall be removed daily. The site shall be treated for dust control as necessary. Dirt tracked from the work site shall be cleaned from City streets, curbs, gutters, and sidewalks. The flushing of dirt and debris to storm drain or sanitary sewer facilities is strictly prohibited. The Permittee shall employ construction practices that will prevent pollutants such as mud, silt, chemical residue, and washings from concrete and saw cutting from entering storm drains. The site shall be properly secured during non -work hours. (Gilroy Muni Code 20.89d) 16. Excavations. All trenches created in existing pavement shall be neatly saw cut. Trench spoils shall be removed from the job site. Backfill shall consist of sand or approved granular material compacted to 95% Relative Compaction. Excavations within the public right -of -way shall be backfilled, compacted, and temporarily paved with cold mix "cut back" type A.C. prior to 4:00 P.M. to allow.for vehicular and pedestrian traffic. The use of non -skid trench plates is allowed, provided the Contractor covers all edges of the plates with cold mix material. It shall be the Permittee's and the Contractor's responsibility to maintain on a daily basis, including weekends and holidays, the Gilroy Encroachment Permit—Conditions of Approval FINAL 11.27.2013 Page 2 of 5 amount of material necessary to maintain the trench surface flush with the existing street or sidewalk. In addition, the Contractor shall respond to and correct shifting trench plates regardless of the time of day. If Contractor fails to correct sinking backfill material or shifting trench plates in a timely manner, City reserves the right to correct the problem at the expense of the Contractor. All trenches shall be fully restored within thirty (30) days of first street cut. (Gilroy Muni Code 20.89d) 17. Vehicle & Pedestrian Traffic. The Permittee shall follow Caltrans standards for traffic control. The parking of any construction- related vehicles or storage of any material is not allowed on a public street or sidewalk unless approved in advance by the City Engineer. (Gilroy Muni Code 20.88, 20.103) 18. Travel Lane & Sidewalk Closures. The Permittee shall assure that all City streets, travel lanes, and sidewalks remain open at all times, unless a traffic control plan has been approved in advance by the City Engineer or his or her representative. A traffic control plan shall be submitted to the City Engineer or his or her representative for review and approval with Encroachment Permit Application. Depending on project scope and site conditions, traffic control plans may need to be prepared by a California- licensed Traffic Control Firm. Traffic control plans must follow the current edition of the California Manual on Uniform Traffic Control Devices (CA MUTCD). Plans must be specific to the project site and conditions and phased, as appropriate, to the address construction of project improvements. Sample plans are not allowed. City approval of the traffic control plan must precede notification of any closures. The City Engineer shall be notified of closure dates and duration at least five (5) working days in advance of proposed closure. (Gilroy Muni Code 20.89d) 19. Construction Staging Areas. Proposed locations of construction staging areas shall be approved by the City Engineer. Any construction staging area proposed outside of the public right -of -way shall be disallowed unless the Permittee has secured the prior written approval of the owner. (Gilroy Muni Code 20.89d) 20. Street Cuts. The Permittee shall use boring and jacking as an alternative to open cut of streets if required by the City Engineer. No street pavement shall be cut unless specifically approved in writing pursuant to an Encroachment Permit. Trench restoration shall be according to the Gilroy Standards, except as modified by additional Special Conditions of Approval or a design by a licensed civil engineer approved by the City Engineer. (Gilroy Muni Code 20.92) 21. Hazardous Materials. The Permittee is responsible for satisfying all applicable procedures and regulations in the event hazardous materials are encountered. This includes notification to emergency phone number 911. (Gilroy Muni Code 20.89d) 22. Monument Preservation. Location of monuments shall be tied out prior to work. Any City monument damaged, displaced, or destroyed by Permittee's work shall be replaced by Permittee at Permittee's sole expense. (Gilroy Muni Code 20.106) 23. Removal of Markings. All sidewalk and /or pavement, markings painted by Underground Service Alert (USA), utility companies, or Permittee shall be removed to the satisfaction of the City Engineer within ten (10) working days after completion of construction. (Gilroy Muni Code 20.90) 24. Work Hours. All work in the public right -of -way is restricted to non - holiday weekdays 7:00 A.M. to 7:00 P.M. and Saturdays 9:00 AM to 7:00 PM except as noted in Additional Special Conditions of Approval or Construction Guidelines for Continuing Encroachment Installations, if applicable. Work is not allowed Sundays and City holidays. (Gilroy Muni Code 20.89d) Gilroy Encroachment Permit Conditions of Approval FINAL 11.27.2013 Page 3 of 5 25. Traffic Striping and Pavement Markings. Any traffic striping and /or pavement markings damaged or destroyed by Permittee's work shall be replaced by Permittee to the satisfaction of the Traffic Engineer at Permittee's sole expense. (Gilroy Muni Code 20.90) 26. Additional Special Conditions of Approval: (a) Design and construction of the encroachment that is the subject of this Permit shall be coordinated with the City of Gilroy and all utilities having jurisdiction. (b) Master Plan and Schedule of Work shall be updated weekly. (c) Work site(s) shall have full -time Site Superintendence. (d) 24 -hour emergency phone numbers shall be updated as changes occur. (e) Method of trench restoration shall be approved in advance of permit and shall be made an attachment to the permit. The following to be completed by Public Works staff, as necessary. (f) (9) (h) 27. City License. Contractors and Subcontractors must obtain a City of Gilroy Business License. (Gilroy Muni Code 20.88a) 28. Bonding. The Permittee is responsible for furnishing a performance bond to be executed in the face amount not less than one hundred percent (100 %) of the total construction cost. (Gilroy Muni Code 20.77, 20.78) 29. Insurance. The Permittee is responsible for furnishing a completed Certificate of Insurance with proper endorsements naming as additional insured the City of Gilroy, its Officers, Officials, Representatives, Agents, Employees, and Volunteers. Certificate of Insurance forms are available at the Public Works Department at City Hall. (Gilroy Muni Code 20.76) 30. Indemnification. To the fullest extent permitted by law, Permittee shall defend through counsel approved by City (which approval shall not be unreasonably withheld.,) indemnify and hold harmless the City of Gilroy, its officers, officials, representatives, agents, employees, and volunteers against any and all suits, damages, costs, fees, claims, demands, causes of action, losses, liabilities and expenses, including without limitation attorneys' fees, to the extent arising or resulting directly or indirectly from any act, errors or omissions of Permittee or Permittee's assistants, employees or agents, including all claims relating to the injury or death of any person or damage to any property. (Gilroy Muni Code 20.76) Gilroy Encroachment Permit Conditions of Approval FINAL 11.27.2013 Page 4 of 5 31. Permit Commencement and Duration. This Permit is valid for one hundred twenty (120) days from date of issuance unless stated otherwise in the Additional Special Conditions of Approval. This Permit will become void if work is not begun within sixty (60) days from date of issuance. Final inspection and acceptance of work shall close this Permit. (Gilroy Muni Code 20.82, 20.83) 32. One -Year Warranty. The Permittee shall assume a one (1) year warranty period from the date of acceptance for all material and workmanship for all work performed under this Permit in the City right -of -way. Between thirty (30) and forty -five (45) days after notice of completion, the Permittee shall check for trench settlement and make necessary adjustment, if any, and then call for an inspection. Permittee shall be released one (1) year after completion notice from all requirements to maintain trench pavement and patches. (Gilroy Muni Code 20.77b, 20.78, 20.102) 33. Acceptance. The Permittee's acceptance of this Permit shall constitute acceptance of and agreement to all of the conditions and requirements of this Permit and the ordinance authorizing issuance of such permit. Permittee's acceptance of this Permit acknowledges that it is revocable by the City of Gilroy, and that upon notification of revocation Permittee shall remove the encroachment at Permittee's own expense, without cost or obligation to the City. The Permittee acknowledges that the Permittee is subject to, and must comply with, all sections of Chapter 20A of the City Code. (Gilroy Muni Code 20.78) Applicant Acknowledgement and Signature Signature of Permittee or Authorized Representative accepting General Conditions of Approval: Print Name Title -r--� Date C �- Signa re Representing (Name and Address) Note: Applicant must also sign Encroachment Permit application. OFF CE USE ONLY Permit No.: Issue Date: Expiration Date: Gilroy Encroachment Permit—Conditions of Approval FINAL 11.27.2013 Page 5 of 5