24160684 - Fire Hydrant Painting / ID Tags - Polychrome Construction, Inc. - Recorded 04/19/2019RECORDING REQUESTED BY:
City o3 Gilray
WHEN RECORDED, MAIL TO:
Shawna Freels
City of Gilroy
7351 Rosanna Street
Gilroy, CA 95020
RECORD WITHOUT FEE UNDER SECTION 27383
GOVERNMENT CODE OF STATE OF CALIFORNIA
24160684
Regina Alcomendras
Santa Clara County - Clerk -Recorder
04/19/2019 11:08 AM
Titles: 1 Pages: 3
Fees: 0.00
Taxes: 0
Total: 0.00
■III KFAN P16 NIN 11 of M 1WHOINAH1��
(SPACE ABOVE THIS LINE FOR RECORDER'S USE)
Notice of Acceptance of Completion
Fire Hydrant Painting / ID Tags
Project No. 18-PW-243-2
Polychrome Construction, Inc.
SEPARATE PAGE PURSUANT TO GOVT. CODE 27361.6
NOTICE OF ACCEPTANCE OF COMPLETION
NOTICE IS HEREBY GIVEN that, as of the 4th day of March, 2019, the City of Gilroy, California ("City") has
accepted as completed the work required to be performed under the following agreement ("Agreement") by and
between Polychrome Construction, Inc., ("Developer") and City:
Fire Hydrant Painting / ID Tags
Project No. 18-PW-243-2
Polychrome Construction, Inc.
Project No.: 18-PW-243-2
Developer Name: Polychrome Construction, Inc.
Developer Address: 8908 Balboa Blvd. Northridge, CA 91325
Surety on Contract: Old Republic Surety Company
Location of Project: Gilroy, California
Description of Work:
The project included painting of 1750 fire hydrants, placing ID tags, Installing blue reflectors, GPS mapping and
Maintenance Management Software to track maintenance of the fire hydrants in the City. Work also included painting
of additional 107 fire hydrants and adding hydrant ID tag numbers to GIS.
Interest of City: Owner in Fee
Vendee under Agreement to Purchase
Lessee
Owner of Easements
Holder of License
Owner of Streets
X Owner of Utilities, Water, Sewer, Storm Systems
Owner's Name/Address: City of Gilroy, 7351 Rosanna St., Gilroy, CA 95020
Work Done: See above, Description of Work
This notice is given in accordance with the provisions of Section 3093 of the Civil Code of the State of California.
The undersigned, being duly sworn, deposes and say:
That I am an officer of the City of Gilroy, that I have read the foregoing Notice of Acceptance of Completion and
know the contents thereof, and that the same is true of my own knowledge, except as to those matters that I believe to
be true. I certify under penalty of perjury that the foregoing is true and correct.
Executed at the City of Gilroy, County of Santa Clara, State of California, on Z /JY19 .
CITY OF GILROY
BY:
Zaryp
TI City Engineer
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 11:
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California )
County of Sct1'1"Pa G(ara )
On EebrtAaru Si 2011t before me, Snaca E• I�IaVA I�{o-1ror ek1b C
Da et Here Insert Name and Title of the 0117cer
personally appeared
of Signers)
who proved to me on the basis of satisfactory evidence to be the persono) whose name(a) is/arL
subscribed to the within instrument and acknowledged to me that he/sp /thg.y executed the same in
his/I}Qr/ter authorized capacity(iefs), and that by hisRler/their signature(y) on the instrument the person(a'f,
or the entity upon behalf of which the personal acted, executed the instrument.
aMySANDNA E. NAVA
Notary Public. California
Santa Clara CountyCommission R 2112111 Comm. Expires Nov 11, 2022'
Place Notary Seal Above
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal.
Signature _,9� E . ! a/u-m
Signature of Notary Public
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document le}; o, 1
Title or Type of Document: No+ice j Rcceetonce o� (D', PDocument Date: fiekr�1 201
Number of Pages: Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
fl Other:
Signer Is Representing:
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
fl Other:
Signer Is Representing:
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