NOC - Intermountain Slurry Seal - Project No. 17-PW-237RECORDING REQUESTED BY
City of Gilroy
WHEN RECORDED, MAIL TO
Shawna Freels, City Clerk
City of Gilroy
7351 Rosanna Street
Gilroy, CA 95020
23935444
Regina Alcomendras
Santa Clara County - Clerk- Recorder
05/17/2018 03:01 PM
Titles: 1 Pages: 3
Fees: 10.00 0.00
Taxes: 0
Total:
§III W!FjM« N�1r�F �k'��i�����M:' hL��rP��'�Iti i �' E h��L � 1111
RECORDED WITHOUT FEE PER CALIFORNIA GOVERNMENT CODE SECTION 27383
(SPACE ABOVE THIS LINE FOR RECORDER'S USE)
CE OF ACCEPTANCE OF COMPLETION
CITY OF GILR 0 Y PA VEMENT IMPROVEMENT PROJECT
Project No. 17 -PW -237
Intermountain Slurry Seal
SEPARATE PAGE PURSUANT TO GOVERNMENT CODE SECTION 27361.6
SEPARATE PAGE PURSUANT TO GOVT. CODE 27361.6
RECORDING REQUESTED BY:
City of Gilroy
WHEN RECORDED MAIL TO:
Shawna Freels
City of Gilroy
7351 Rosanna Street
Gilroy, CA 95020
NOTICE OF ACCEPTANCE OF COMPLETION
NOTICE IS HEREBY GIVEN that work agreed to be performed under the property agreement
between the City of Gilroy, a municipal corporation, whose address is 7351Rosanna Street, Gilroy,
CA 95020, and the Contractor mentioned below who developed said project, was accepted as
completed by the City of Gilroy on the 196 Day of March, 2018.
Project No.: 17 -PW -273
Contractor Name: Intermountain Slurry Seal
Contractor Address: 9062 Union Park Way, Elk Grove CA 95624
Surety on Contract: Federal Insurance Company
Location of Project: City of Gilroy, CA 95020
Description of Work: Asphalt grind and hot mix overlay, asphalt point repairs cape seal and micro -
surfacing and striping on various streets throughout the City.
Interest of City: Owner in Fee: Vendee under Agreement to Purchase; Lessee;
Owner of Easements; Holder of License; x Owner of Streets;
Owner of Utilities, Water, Sewer, Storm Systems
Owner's Name: City of Gilroy
Work Done: September 25, 2017.
This notice is given in accordance with the provisions of Section 3093 of the Civil Code of the State of
California.
The undersigned declares:
That he is an officer of the City of Gilroy, that he has read the foregoin Notice of Acceptance of
Completion and knows the contents thereof; and that the same is true o his own knowledge, except as
to those matters that he believes it to be true.
I certify under penalty of perjury that the foregoing is tree and correct. Executed at the City of Gilroy,
County of Santa Clara, State of California on March 19 , 2018.
CITY OF GILROY
STATE OF CALIFORNIA
COUNTY OF SANTA CLARA BY
ary Heap
TLE City Engineer
This document is for the benefit of the City of Gilroy. Request for Recordation without fee is made in
accordance with Section 27383 of the Government Code ofthe State of California.
CALIFORAIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 118S
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 S ca n t o C l el r G
On iU� i zG i before me, S and r G V f y
Date Here Insert Name and Title of the Officer
personally appeared C ea r U 14 �'6t P
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person() whose name) is /Oe
subscribed to the within instrument and acknowledged to me that he /she /they executed the same in
his /hdr /th,efr authorized capacity*), and that by his /l)er /tt7elir signature(s) on the instrument the person(,
or the entity upon behalf of which the personjs) acted, executed the instrument.
SANDRA E. NAVA
Commission # 2066119
z .�e Notary Public - California z
Z ' Santa Clara County
My Comm. Expires Nov 11, 2018
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 's -Lf/i/ � - -fi ",V'A-
Signature of Notary Public
Place Notary Seal Above
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 lv 0s'1
Title or Type of Document: � o F c e 6 F A 6c -Iz n�e (4 % DDocument Date: _ M a (A I of 2 0 i S
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
❑ Other:
Signer Is Representing:
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
• Trustee ❑ Guardian or Conservator
• Other:
Signer Is Representing: