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NOC - Polychrome Construction - Project No. 18-PW-243-2RT_�-.CORDING REQUESTED BY: City of Gilroy 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 04/19/201S 11:08 AM Titles: 1 Pages: 3 Fees: 0.00 Taxes: 0 Total: 10.00 1111 klp11111101 tiff (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: Polvchrome 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 proiect 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 /mil y CITY OF GILROY BY: � ary Heap TI��. City Engineer CAL.i. :l K +Al ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE -.ill t�-- -- 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 Sein-+a Clan-cA On S,'Zcl`1 beforeme, Sandra E- Nnv1,i/ t,�ro-tace"�WI C, Date Here Insert Name and Title of the icer personally appeared &-ct f, (i Names) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person() whose name(g) is/are' subscribed to the within instrument and acknowledged to me that he/syi'e/th,g.y executed the same in his/f 46r/thoir authorized capacity(iis), and that by his/her/thdir signature(s) on the instrument the person(Ol or the entity upon behalf of which the person() acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. SANDRAE. NAVA WITNESS my hand and official seal. IaMy Notary Public - California Santa Clara CountyCommission N 2262752 Comm. Expires Nov 11, 2022 � Signature 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 M 1�-; 0"') Title or Type of Document: t�O+lee 4 Aicc,ePtunce o-F �° Document Date: fie6ruary 5. 261I9 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: y�•c-svr�t.�+<��:`�/'� �� 5:t -` � � r ��S�r.� ��=r..�i .:e L L ��z�� � L � r ��".r is � uc �.r <=sSraas ©2014 National Notary Association • www.NationalNotary.org ^ 1-800-US NOTARY (1-800-876-6827) Item #5907