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4365a ` NO. f} �:- With•,pr.oper,v ;ion <' . this forconstitutesAft encroachment permit ' CITY OF LA QUINTA APPLICATION FOR PERMIT 1 ~'PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) - ;4 ,_ . For theconstruction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and other like public works -improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit —Class III DATE: 03-28-05 -- - • Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION S$fl �� 6�1tD �• (Street address or Description of Location) PURPOSE OF CONSTRUCTION MK_L 1K_A1J IjAE% IN.VKATIf Sketch (attach construction plans if appropriate). DESCRIPTION OF CONSTRUCTION DRY itlfM I.Z'tTRE TXqTALL. DIMENSION OF INSTALLATION OR REMOVAL - AS SPl?I:7 FTJM ON PLMS. SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 01--7i1t_!AS IrrOn tt�lu LM4R 2.9 zoos clry--� APPROXIMATE TIME OF COMPLETION Z "ll" FIIygNC QVINTq ESTIMATED CONSTRUCTION COST $ : #UUU.UU EDEPT (Including removal of.all obstruction, materials, and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvemenfs)' In' consideration of the granting of this permit, the applicant hereby agrees to: Indemnify„defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application.' RI Notify the Administrative Authority at least twenty-four (24) hours in advance of the time wheri work will be started. Comply with all applicable City Ordinances, the terms and conditions of the permit and all applica le rules and regulations of the City of La Quinta and to. pay: for any additional replacement necessary as the result of this work. Ar Signaturd"of Applicant or'Agent .r CROICE 211TEMISE (TIM OU)S/1®AVID SECM.L0) ` . 74-916 HWY lli, INDIAN WELLS, CA 760--578-2119 Name of Applicant (please print) Business Address Telephone No. . JOHN GRIFFIN CON.TfRUCTION 244 JASON CT., CORM, CA 92879 95A-278->23.77 Name of Contractor and Job Foreman Business Address. Telephone No. 618983 9974 CJontractor's License No. City Business License No. Applicant's, Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class III Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction cost Minor Improvement Permit -Class IV: See�attached schedule NA 46 Inspection Fee $ PERMIT VALIDATION Permit Fee a..� I.-00 PERMIT NO: 4365 Penalty Cash Deposit -Surety Bond DATE APPROVED If required 100.00 �� /�p EXPIRATION' DATE TOTAL: $ DATE ISSN''ED W "`S:c� Receipt No. r\ Received by Date i I By Administrative Authority Recorded'by i)' : Telephone; (760) 777-7075 Sent B:y:_GRIF.F.IN CONSTRUCTION; 909 278 8956; Mar-28-05 5:31PM; Page 3/6 Date: 3f M&= u 1.40 rive From: paMa hpP S Assodateg Fax1D 619.906-3110 ®V Tb; John GrIP6n Canuatlon Inc 899178 — CG 20 10 10 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY . ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS. (FORM B) This endorsement modifies insurance provided under the -following: COMMERCIAL GENERAL LIABILITY COVERAGE PART This endorsement changes the'poGey e1I'eetivc on the inception Idate of the policy unless another date is . indicated below. Endorsement. effective Policy Number 12:01 A.M. standard time 899178 Named Insured Countersigned by. . John Griffin Construction Inc Authorized Representative) + SCHEDULE Name of Person or Organization; i City of La Quints 78-495 Calle Tampico l.a Quinta, CA 92253 Of no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INS,URFD (Section H) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. Copyright; insurance Services Office,1nc., 1992 Sent By: GRIFFIN CONSTRUCTION; 909 278 8956; Mar-28-05 5:32PM; Page 4/6 �,:�—•._.--:-�...�_„�,' .. ITC: �lLw.cw� v ......., . -v-• - From: Dania Canlze(es At Japp a Assodat" F1910: 010-90S-3710 To: John f3r06 CortsffuCtlon Inc OP 1D D DATE t q05 CERTIFICATE OF LIABI�.ITY INSURAIVlcIE1JEDASrITT�OFINFOKMATEON Snapp a Associates Insurance services, Inc. 439 L",amiAO. del Rio So. $112 San Diego CA 92100 Phone:619-906-3100 FaX:619-908-3110 .4 Griffin construction Inc 244 Jason Co1iX� Corona CA 928 THEE CdtTIFIGI ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE D0Es NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY T14E POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC A INSURER A Loll en 7M1�ana� INsuaERe Mlsreusy CaLla slt Company 27988 R'SURERC. Yi gwsl surwty C ory Tue nuSuaERD: r.rtfar4 ru.. mk UX& e• Co. 19682_ p� E: COVERAGES T}E POLICIES OF tNSUP—E LISTED *1 OW HAVE BFFN ISSUED TO THE Pi51ATE0 Nx%fn ABOVE FOR'THE POLICY PERIOD INDICATED. M ANY RECAAREMm'TT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHCH 111IS CERnFIWE MAY ITC I MAY PERTAIN, THE INSURANCE AFFORDED EJY THE MI(: S DESCRRZD HEREIN IG SUBJECT TO ALL THE TEING, ExG I I.SIONS AND COND POLICIES AGGREGATE LMMTT, FMOWN MAY HAVE BEEN RFMjCEO BY PAID CLAIMS _ . — ...� ..� ..,., b..,..�� POLICY t•AIMBER DATE F7FIL LIABILITY MAEFTCIAL GENERAL LIABLUTY CLANG MADE a D( CL Rner/Coat Prot. GREGATE LIMB APPLIES PER: ICY ,F4CTLOC AuTomaB LB LIABLITY B ANY AUTO a.l. OWNED aRQS X SCrIFoL a FD AUTOS X IUREO AUTOS x NON -Ow FD AIJTOS GARAGE LIABILITY 7 ANY AUTO 899178 AIC11069420: ExCEY$KJM RELLA LIABU Y A X� OCCUR CLAIMS MATE 7249794 X�lDEDUCTIBLE RETENTION $10000 wamoM CDMPEMBATION AND C a�PLDY!<T rs MB LT►Y ISSUED BY CARRIER ANYY I�ARLT�� CUTIVE 03/12/051 03/3.2/06 03/12/051 03/12/06 03/12/051 03/12/04 01/01/051 01/01/01 13 I &quipment Floater 172SBAM100 I 03/12/05 I 03/12/04 ESCRiPT -N T10N6 ( LDCATTONS I VEHICLES I X BY E TOOR IEMENT ISPEC" PROVISIONS Re: Operations of the named insured'guAject to the terms and cond,' the policy. Certificate holder is n=Wd additional insured per th, Ce 2010 1093 form. 10* days notice of cancellation in the event o. nonpayment of premium. ITWITHSTAM]NG ;SUED OR nom OF SUCH ........ LJiM EACH OCCURRENCE $ 1 , 0 00 , 00 0 PREMISES toomaence s 50 000 MEu Exp (Any am person) s L`xcluded s 1,000 1000 PERSONAL. A ADV INJURY GENERAL AGGREGATE $2 , 00 0 , 0 00 DUCTS - coMPJOP Acc 1 1, 000 , 00 0 COM80,IEDSINGLE LIMIT $ 1000000 (Eo pcc�d.ntl BODILY ft"Y s (Pa- parson) BMILY INJURY s (Per ecclom) P ER DAMAGE s wde $ AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC i i Auto OPB.Y: AGO EACH OCCURRENCE f 5000000 AGCRECATF 45000000 . 1 Y s _ f X TORS LON 5 ER E.L.EACHACCOENT 11000000 E.L. DIIStASE - EA E..NKUYEE $ 1000000 E.I. oIsEAsE • MICY LMT I 1 1000000 Mated Eq $20000 item $50000 Max Ltions Of I attached E E HOLDER - CROICB.'8 SQkaD ANY of 7}fE1 /,COVE DE9CR6® POLICIES BE WNCTiLIEO BEFORET'NE BxpoULTtoN DATE THEREOF, THE MU NC UJBURER WILL pwEAVOR TO PAIL 30 * DAY91N♦07T14 NOTICE TO THE GERRFICATE NDLOER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL Choice Rnterpri3Le INPogg NO oeUOATMTN OR LIATLRM OF ANY KW UPON THE INSURER, Tre AGENTS OR 74-923 RWy •111 Suite 114 RLpRESENTATNES. Indian Wells CA 92210 25 (2001 Sent By: -GRIFFIN CONSTRUCTION; 909 278 8956; Mar-28-05 ,5:32PM; Page 5/6 . .. . ........:. ........ . ..�.�•...'�. _ Y 08-3110 To: John Grlfiti Ca��UuCflan Inc From-,Canizal�s At; Si�Wp 8 Aseodatas Fax1D; e19-8 899178 r : CG 20 1010 93 THIS.ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS '(FORM B). This endorsement modifies insurance provided under the following: COMMERCIAL GENER.ALILIABILITY COVERAGE PART This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement effective Policy Number 12.01 A.M. standard time 899178 Named Insured Countersigned by John Griffin Coru&uction Inc i (Authorized Representative) SCHEDULE Name of Person.or Organization: ' - Choicc.Enterprise 1 74.923 Rwy 111, Suite 114 Indian Wells, CA 92210 { (If no entry appears above, information required to complete this endorsement will be shown in the lleelarations as applicable to this endorsement) WHO IS AN INSURED (Section II) is amended to include as an insured tho person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured Copyright, Insurance Services Office; Inc., 1992 „ . A A Sent By: GRIFFIN CONSTRUCTION; 909 278 8956; Mar-28-05 5:32PM; From; Dania Cankaalea At; sgapp s Aasodstas Fe D 619-90&3110 To: John Griffin Consb umn Inc .._ _._---- Page 6/6 DATE(WMDWYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 03/28/05 THIS •C 1FICATE I ISSUED AS A •MAiTfR OF tNFOliI ICA7N FROPUCMAU Iasuraaco services ONLY AND CONFERS NO R1014TS UPON THE CERTIFICATE po Box 281900 HOLDi^R THIS CER7lFICATT%� DOES NOT AMEND, EXTEND OR P a n F r a ac B c o, CA 94120 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (B 7 7) 2 3 4- 4 4 2 D INSURERS AFFORDING COVERAGE NAIC INMIRERN Virginia SnrSty COC"Oy, IMsU�fl INSLg�a a: John F. Griffin Construction, Inc. 244 Jason Court INSURERC: — Corona, CA 92079 INSUREFtD: C T L 1 2 1 3 2 2 7 0 0 D UISUKERF: COVERAGES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY RE ISSUED OR MAY PERTAIN, THE INSURANCE AFF(JRDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. tams .. — iYPEOF.ML6URl►NCE pOLICYMU1r�ER TE AT6 . FACNOCClO:AMCE , . ti ..... ..- OEi4 M I IABLRT . COMMERCIAL GENERAL LIABILITY PR• EfiNSES.. a octtV _ . CLAIMS MADE DOCCUR biEDQ�,. i Anv "justy � - AGG LA0wE43ATELBIRAPPLI[S PER p-tCY PRO LOC LIMIT f Omme UABa:PrLGlP ANAUTO 80DLrINUY S ALLOWEDAUTOS (P4Ppn) SCMEOULEDAUTOS gOYNIUiY s>5 tEDWUS (Pm etOM+ NON-9AO E FrryQAMAGE . �f TONY-FAACCID[ TWRnAN EAACC 9 jI �G $�ELMR(rV ADONLY:IWAUTO OCCUR 1 1-ma MADE I f DEDucT$a 1 i RE=aaoOM $ X wofiKEaSCOMP "*mmAMD E.L.FACHACCO841 i 1, 0 D D., 00 0 BMPk0Y6R0'LLiBk►YV A ,WYPRCL'RJETOaPARTNBRrE>ECUTNE p 0 5- O:D 0 2 2 7 5 9 0 1/ D 1/ O S 01 / 01 / 0 6 1, 0 0 0, 0 0 0 ANypER/1�M8EREXCWOEDi E.L.DREASE-EA.EMPLOYEE ayF amdDeu+Cer E.L•MSeASV' ppti(YLOAR 000 SDEZTAL pROV�lONS 6ebrr O:1Bt pEBL7dpTto%CFCnWATTOUSI LOCATIMSI VENCLESIEXM5gMSAD=By MOORUMIER/SPEC1ALTi40Vl61014>s CERTIFICATE HOLDER SNOVLO A4LY OF TTQ< A$OVQ 0�1Ba=0 Pou=4 or. CAMcu= RWOf41 Im MO" * Choice S II t e r p r i 6 9 OATS YHH1t�P. THE ISSUNG V4TL L EM IAVOR TO MILL sn DAYS WRTT'llr MOTiCB iTPOSE 7 4 - 9 7 3 Hwy 1 1 1 TO THE CBRTTTK.ATE 1�C4 NAMED To TM LIM. DUT FARURIF TO 00 50 6W►LL G u 1 t• 114 fT8AOH1iSppl sEKTATfv66 Indian Walls, CA 92210 IpcDuo�TgNaRUAecrtroFa4+'w� AUTkWdM RiPRQ!<QNTATrA O D 7 8 3 3 6 ® ACORD COIRPORATION 1989 ACORD 26 (2001108) i' )RKS'DEPARTMENT nON FOR PERMIT Location of Construction: Purpose of Construction: '�dZ-,7 1/J 22 Description of Construction: Dimension of of Installation 'or Removal: S� . mPpuummate %-onstructlon Start Date: � g/ Approximate. Construction Completion Date: 01r 2-- Estimated Construction Cost: $ _moo, Estimated Construction Cost shall include the removal of all obstructions, materials, and debris, back -filling, compaction and placing permanent resurfacing and or replacing improvements Contact Name: uf/bPhone Number: Name of Applicant: _�?c Applicant Address: 7 �/-9� 3 /mowy ripi:gry We&e C.4 Applicant Telephone Number: Name of Contractor. _ --j� F-FetJ o NSfRL4 4 ; o AJ Contractor. Address:. yq -a� _ CT i 'o R r),(IA CA, Contractor Telephone Number: qs'l - a 7g a. 9 l 7 Contractor State License Number:{ Contractor City Business License Number: ► A COPY OF THE CURRENT INSURANCE CERTIFICATE MUST BE PROVIDED -4 Applicant or Contractor General Liability Insurance Company: O �e / Applicant .or Contractor General Liability Insurance Policy umber: �a v9 Qvi i'y i; OX/ �/. Office Use Only: Inspection Fee: .N�. Permit Fee: �OO,u J As -Built Deposit: Dust Control Deposit: �— Credit Amount: tOTAL FEE DUE: Office Use Only: Assigned Permit Number:. 45 Approval Date: Expiration Date: issue Date: Administrative Authority: ' ,7 w'::'. {I $f:1 h " r,►Q t - Pr r d `r �'ll �I y, �a 4� �3 !- w.,l "Y S 78 495 ealle Tanipico�},['La Quinta; CA 92253 l y t'�.� "- ' i-it (/4V O E /' / / UOOP I - i� C, III'. '' V • '�'i t'S. , \S} N, !'tY \� a III r d V'�'tI'= + C L2TI I A� . M:OF TNT - ?�x , t w NON TRANSFERABLE ��'-`_- Ti �,;, ':{ }� 1! !NY�, { �'_';'�� I ;{ _i•.. �- i}4 _ . , i I'' r .�.1 'i tl :t h��_� + ti � I �. .. 9. ,.; �I;�' �,��`� OUTSIDE""'CITY. LLMI TS Plense be uwuce.thnt rssuiitice of a:busmess, license by the"City does riot uutlio't izc you to.cotiduct busmcss in a bulldirtg or fcuunt sltube that has not been 6pproved for occupuncy;by the Bud'dinl acid,Sufcly Depnrttucnt _I 'you'Iulvc my gilestioiR"' gcGariding this;,issuc; or iC.you nre tiot�su e;if n Certificlil'c`of Occuj ftLcy Itus2bccu�' Issucd for out;' ibtie ofib'usuless"lens coti'tiict Buildiri .nr l Sufek nt`- SNMI €' 1 1_'.('160)777 7012i1, ! 9gl a;� 's}s.. y1 BUSINESS NAME GRI FFI.N3 CONSTRUCTION, INC JOHN 'PheLkensce unmed herein huvuigyuld to the City of Lu Quiutu pil, fees ee1 uired license Ishcrcb'= `routed cui ;licensee to trulis i'ct thelbus,iiri slhcrci i y g d 1, US;I'N,ESS!' DIZESS2'4'4- �7ASON COURT set ;forth, for tl,e perloil stutcd ui eTo`ntunwty;with the Yru'viawrn ul OrduiliYive i '5' �E,, I Nui 2 0l tlus C yy 1lira I icensce rs.ISsueri:wilhout veriliqutiton IIu11'1.1153hcmhcc i :�;�„� CORONA t - 92t'8,�%;9 �.i� a.,;-,yl t., I:.q,,.,.L;is sobject_to or�cxenlpt fcoin Iiccli`suigby tlle•C[nte ofCulifonun pl h rF. ,.qo ;CZ' iBUSINESS:LICI�O , 74'` �#- ti' . - - ��,`:, 1 ' 1 I • !,'. ilk `i 4 - _ *CI ASSIFICATIQN G j qp cONrRAcT{o_R �� 8 Pt>� t, I " EXPIRATION DATE ^ i/ 3 i /:0 6 ,.?4 �1 � iy, i k�k' 7%!l a� ,i�l- �. � _ =�` "�.. '.+ t#' y�4 -f��-. �I �,'.i' rl �'I + r + I u�,.,�.,'' � I �,M�- � P,I�;d I+� I;',;'�j. ,_yt 1 y�il _,I',li i '�� I�'Ii;l�',�11 { � •',i'1� 11 � �, ,.;',�� +,! �{, I "�- �rtii �:.' Irk 4 I'� i:;w + • a .. .. 3 } _ s ; � r.. k f 4 � l' r I, IJr i {. I � rl , . I r { � Y .I�.:'� I t ;,'� cur'• ,� d awlw'^^ _ x��a '� '� P r +,�. I IY� ,I °+� I ' tc�, I, �,li 7, �,I I�. '�.11c1, a a, i '.3' "��. LV U xx3 �. { ,.L7 I t1 .a•`4r I'jt f1 I r it l �� 1p _ afi4 - �. `� �..,. ; i' ' N a - { ��. 7,. I+ , .. _�� t 1 �: „P P I 4' t 4 •!II.*��s� �'~ ' ,p,+ t� w 1IpVI {p1 i,','a 5. I'� jy Lea. u-•R �A .n 1,:. r y, '1 -� a11. � 11 , I ,,I A 'fit � p Pt 5 4 :,� n+ t. � Ic s'„w' ',�.'i � '.':3�S _�i <�.� � � �'-•w, t L:. � '�...W. '" d,,N I,uW lit'. M� i,+,.{I�, M..r{� vl„,�*^,,� .:!'�`_Zit_ _�� .�• � ..��,i1 it i '',' J, 1 � RI � { yl:. M1-i 7 11 r1 It y{ �Y ,� '4 h 6 uaw,� •a' . �i+: � i�. � �� '�„ a` _i. _ � , v , ti AI.1. " � �s'S� ._ •`spa 1 gst'� iceMAN ?,.I'A� i i x9S[.tc '_� 'I',P' �w'.��7� r 3f a�arsa lit :. 1r �,,:P 1� 1r r AC__bR ? CERTIFICATE OF LIABILITY PRooucER Snapp & Associates Insurance Services, Inc. 438 Camino del Rio so. 0112 INSURANCE G OP ID OAT12(N ODrYTYY) /05 THIS CERTIFICATE IS ISSUED AS A MATT R IF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT END, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, San Diego CA 92108 Phone:619-90B-3100 Fax:619-908-3110 INSURED - •'fIly O/" /J INSURE:RSAFFORDINGCOVERAGE INSURER A: eartroxd Piro Ineurancr Co. NAIC III 15682 INSURER B: Virgin" surety many I" John Griffin Construction Inc CoronaeCA C92879 INSURERC: Mercury Insurance Cc 27988 INSURER D: Lexington Ineurenee Caweny INSURER E: rnvcnan_�c THE POLICIES OF INSURANCE LISTEn RF(•OW NAVE RFFN ISSUFD TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTAHpINO ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYUE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT To ALL THE TERMS-) EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER Dp LIMITS D GENERAL COMMERCIAL GENERALLIABRrry CLAIMS MADE X ] OCCUR Owner/Cont Prot. 5315601 03/12/04 03/12/05 EACH OCCURRENCE i 1 000 000 X PREMISES Eaockur.noal— 850�000 s excluded X MED EXP (Any o4 person) PERSONAL R ADV INJURY $1 0 0 0 0 0 0 GENERAL AGGREGATE s 2 000 000 ._L.....__L _ GENLAGGREGATE POLICY jRe APPLIES PER: LOC PRODUCTS -004P/OPAGO $ 1 000 000 AUTOMOBILE 11Amu f C ANY AUTO AC11055357 03/12/04 03/12/05 CONBINFD SM W LIMIT (E°i6'd°""► % 1000000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJUftY (Per person) i X X HIRED AUTOS _.._.... X NON•OWNED AUTOS BODILY INJUAY (Per accident) 3 PROPERTY DAMAGE (Per emidmit) 3 — CAM43E LImLRv ANY AUTO AUTO ONLY- EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY. AGG 9 _......... . ••--...-- 9 D ExCeSSAAYpRELLALUIBILRY X OCCUR EICLAIMSMADE 5642820 03/12/04 03/12/05 EACH OCCURRENCE S 5j000000 AGGREGATE S 5000000 a DEDUCTIBLE • X RETENTION 910000 s .•.............. WONKBRS COMPENSATION AND la ENPLOYE,ItB' LU101LTIY ANY PROPRIETORIPARTNERIEXEcUTIVE 00500015537 01/O1/05 01/01/06 OFFICEWMEMSER EXCLUDED? X TORY LtMITB ER ..-_ _• E.L.EACHACCIDtNT T 1000000 HyY��s dnvnl� under SPEHEIAL PROVISION6 babes OTN@R E.L. DISEASE-EA?EMPLO EL DISEASE. POLICY LIMIT i 1000000 $ 1000000 A Equipment Floater 72SEANE2100 03/12/04 03/12/05 :Wnte:d Eq $20000 item DESCRIPTION OF OPERATIM / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVINONS RE: Cable installation operations subject to the terms and conditions of that policy. $50000 mg]C CERTIFICATE HOLDER ' FORINFO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE I&SUINO INSURER WILL FNDEAVOR TO NAIL 10 DAYS WRITTEN For IT3fOrmatlOA Pu NICE TO THE CERTIFICATE MOLDER NAMED TO THE LIFT, BUT FAILURE TO OO SO SHALL rposes Only IMPOSE NO OBLIQATLDN OR LIABIuIY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRlSCNTATTVES. Ev EPEE ACORD 26 (2001106) ®ACORD CORPORATION 1988 Z/Z abed r•Wd61:Z1 SO-BZ-uer •r9569 8LZ 606 •rNOI onuiSNOO NIddIHD :As juaS PERMIT NO.4365 Desert Shell Estates-/ Dry Utilities / Tract No. 32201 In addition to the standard permit conditions, the following shall apply: L Pursuant to. Section 14.16.320 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), all work shall be performed in accordance with the latest edition of the Standard Specifications For Public Works Construction (SSPWC) and as directed by and to the satisfaction of the City Engineer. i 2. John Griffin Construction, hereinafter referred to as "Permittee", shall be responsible for providing continuous dust and erosion control. 3. This permit or copy of it shall be on the work site (usually the job trailer) for inspection during the actual work performed. 4.- The issuance of�this permit and the City approval of the related construction improvement plans do not provide a vested entitlement for all design parameters that may have been utilized for the plans. As such, plans approved for this permit may be "at risk" for further modifications as it relates to any follow up improvement plan requirements as required by ,the city or existing errors & omissions by the architect or engineer of record. 5. Streets shall be kept -clean: They shall be completely cleaned at the end of each working day and more frequently, if required. 6. Pursuant to Section'6.08.050 of the La Quinta Municipal -Code (Ordinance 18 § 1,1982), throughout the work site, the Permittee shall comply with City regulated work hours: Operation and maintenance of equipment within one-half mile of human occupancy shall be performed only during the following time periods: October 1 st to April 30: Monday -Friday 7:00 a.m. to 5:30 p.m. v7 Saturday 8:00 a.m. to 5:00 p.m. May 1st to September 30: Monday -Friday 6:00 a.m. to 7:00 p.m. Saturday 8:00 a.m. to 5:00 p.m. Work shall be prohibited on''legal holidays and Sundays. Note: _Construction work (including setting up traffic control devices) is not permitted on any Arterial street (ie any 4 lane street) before 8:00 a.m. 7. Work within 500 feet of a signalized intersection shall be performed between the hours of 9 a.m. - 3 p.m. Traffic control shall be set up after 9 a.m.. and removed before 3 p.m. The Permittee shall contact the Riverside Country Traffic Signal Maintenance Department at (951) 955-6894 if signal operation at the intersection is to be altered in any way. Special Conditions / Page 1 of 4 PERMIT NO.4365 Desert. Shell Estates / Dry Utilities / Tract No. 32201 8. Pursuant to Section 14.16. f 10, of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), Permittee shall assume responsibility for repair of any -pavement damage to any public or private street, and for any damage to other City streets or facilities as a result of work performed under this permit. 9. Pursuant to Section 14.16.250 of the La Quinta Municipal Code (Ordinance 10- § 1 (part), 1982); advance warning signs and traffic control shall be installed and maintained in accordance with Cal Trans Standards or the Work Area Traffic Control Handbook (WATCH Manual). A traffic control plan shall be prepared in accordance with the WATCH Manual and submitted to the City for review and approval one (1) week prior to starting any construction. It shall be the Permittee's responsibility toappropriately'detour and barricade all construction sites. Pursuant to Section 14.16.290 of the La Quinta Municipal Code (Ordinance .10 § 1 (part), 1982), street closures shall not be permitted. A minimum of two (2) travel lanes of paved surface shall be maintained at all times. 10. Prior to excavating, if required, the Permittee shall contact Underground Service Alert at 1-800-422-, 4133. It shall be the Permittee's responsibility to notify the Public Works Department of anticipated excavation which impact City facilities, including but not limited to traffic signal conduits and loops, irrigation lines, electrical conduits, and storm drain facilities. 11. Should additional work, materials, or modifications of the work be required in order to meet City standards, safety requirements, signage requirements, or to fit actual field conditions, the work shall be performed by the Permittee as directed.by and to. the satisfaction of the City Engineer at no cost to the .City of La Quinta. 12. Pursuant to Section 14.16.370 of the La Quinta Municipal Code (Ordinance 10 § '1 (part), 1982), backfill compaction within street rights -of -way shall conform with.Section 306-1.3 of the latest edition of the Standard Specifications For Public Works Construction (SSPWC), except as otherwise specified herein. Native material may be used as backfill material provided that minimum compaction, achieved in the manner prescribed herein, is achieved. Backfill shall be performed by mechanical means;.no water densified compaction via jetting or flooding or other means shall be allowed. It shall be the Permittee's responsibility to provide appropriate geotechnical supervision, testing, and inspection, onsite, at all times during backfill operations. Backfill compaction shall be achieved by the following conditions: A. When a firm foundation is not encountered. due to soft, spongy or other unsuitable material, such material shall be removed to the limits directed by the Geotechnical Inspector and/or the,City Inspector and the resulting excavation backfilled with pipe bedding material. B. Backfill materials shall be brought to or maintained at _appropriate moisture content for compaction. The appropriate moisture ' content range shall be established at the onset of the project and ensured prior to use of the materials through progress testing on the stockpiles. Special Conditions Page 2 of 4 e� PERMIT NO.4365 Desert Shell Estates / Dry Utilities / Tract No. 32201 C. The first length of trench backfilled shall be backfilled in the presence of the City Inspector. Compaction ,shall be tested at random depths at approximate three-foot vertical intervals as backfill is placed to ensure the effectiveness of the compaction methods and to establish the depth of lift that can be compacted. D. If lifts greater than one foot are attempted in this'trial length of trench, compaction tests shall be taken within the lifts io ensure that the. full depth of the lift is compacted. Upon satisfactory completion of this portion of trench, the City Inspector shall establish the maximum lift thickness to be compacted for the remainder of the project. E. In subsequent lengths of trench, the frequency of compaction tests shall equal'one per each lift of backfill, per 3001inear,feet of open trench, at randomly selected locations within the open length of trench. F: The depth of the randomly selected compaction tests shall also be randomly selected except that where multiple tests are required in a given length of trench, the tests shall be no closer than three feet (vertically) from each other. G. If any compaction test'fails, previously placed backfill (in the same length of open trench or previous lengths of trench) which is represented by the failing test (as determined by the City Inspector), shall be tested for compliance with compaction requirements. H. All costs incurred due to the conditions above shall be borne by the Permittee. Copies of all test results shall be furnished to the City Inspector. 13. All excavations within City of La Quinta right-of-way shall be backfilled, and temporarily paved if within the existing travel way, at the end of every workday as directed by and to the satisfaction of the City .Engineer for the protection of the public. Lengths of open trench shall not greatly exceed that. which can not be backfilled in the same day. Excavated trenches shall not be allowed open overnight, however, Permittee may leave a length of excavated trench, not to exceed twenty (20) feet irr length, open overnight at a point where construction will begin the next day, provided that this length of trench is completely covered by steel plating. 14. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced to its original condition. 15. Access and egress to all local 'properties shall be maintained at all times. 1 16. Pursuant to Section 14.16.375 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), permanent'pavement replacement shall be completed no later than seven (7) days after the completion of the work. Permanent pavement replacement shall conform to the following conditions: Asphalt work is not apart of this work scope nor allowed within this permit. SpecilirConditions ti Page 3 of 4 • i PERMIT NO.4365 Desert Shell Estates./ Dry Utilities / Tract No. 32201 f 17.: Permittee shall permanently stabilize any and all soil that was disturbed as a result of work performed under this permit with an approved dustcontrol treatment.. Soil stabilization shall be done immediately after completing the operation. 18. ^ Pursuant to Chapter 12.564of the La Quints Municipal Code (Ordinance 10 § 1 (part), 1982) the City has designated certain city lstreets as Track Routes. The weight limit for restricted streets (i.e., streets not part of the Truck Route network) is three (3) tons; trucks exceeding the weight limit may use a restricted street if making a delivery or pickup on the subject street, or if this permit specifically grants permission to use the street to deliver- street construction materials and/or equipment. 19. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time. . 20. The permittee shall indemnify, hold harmless and assume the defense of the City from all damages, delay costs, costs or expenses in law or equity that may arise out of work under this, permit., r A • Page 4d4- Special Conditions City of La Quinta The following General and Special Provisions are attached to and made a part of Permit Number 4365 The following shall always apply: .ENCROACHMENT ON PRIVATE PROPERTY:. This permit authorizes work to be accomplished within the City of La Quinta's right of way ONLY. Whenever construction extends within private property, it is the responsibility of the permittee for his contractors to secure permission from abutting property owners. Such authorization must be secured by the permittee prior to starting work. TRACK -LAYING CONSTRUCTION EQUIPMENT: Cleated track -laying constriction equipment shall not be permitted to operate on any paved surface unless fitted with smoother -faced street pads. All mechanical outriggers shall be fitted with rubber street shoes to protect the paving during excavations. Rubber -tired equipment only shall be used in backfill operation in paved areas. If the existing pavement is scarred, spalled, -or broken during the term of this contract or if the pavement is marred, City of La Quinta shall request that these portions of road be resurfaced over their entire width. Resurfacing shall consist'of one coat of two inches (2") of A.C. surfacing plus appropriate seal coat as specified above. PROTECTION OF TRAFFIC: All excavations and work areas shall be properly lighted and barricaded as deemed necessary by the City Engineer or City of La Quinta Public Works Inspectors. Suitable detours and detour signs shall be placed and maintained for the duration of the project. The City shall be notified twenty7four hours (24) in advance of any traffic detours or delineation. CARE OF DRAINAGE STRUCTURES: Any drainage structure to include corrugated metal pipe, concrete pipe, steel culvert and concrete structures encountered during excavation which necessitate removal shall be replaced in kind. In the event it becomes necessary to remove or cut existing drainage structures, City of La Quihta shall be notified prior to commencement of this work. Drainage structures and open drains shall be kept free of debris at all times for proper drainage. RIGHT-OF-WAY CLEANUP: Any surplus material resulting from excavation and backfill operations shall be removed from the right of way. All paved surfaces shall be.broomed clean of earth and other objectionable materials immediately after backfill and compaction. Existing gutter line and drainage ditches shall be replaced to their original standard or better. All excess material shall be removed prior to paving. Water tanker shall be used, as required, to sprinkle the job site to keep down dust conditions and shall be used immediately after backfill. DE -WATER OPERTATIONS: If de -watering operations are required and pumps are forcing water on City of La Quinta roads, it shall be the responsibility of the permittee (contractor) to control this water and to provide off-street barricades when necessary. CLOSING STREETS: No street shall be closed. A minimum of one lane of traffic shall be maintained at all times to provide limited access for the adjoining property owners and emergency vehicles. In the event it is felt by the permittee that he must close a street for any length of time, permittee shall contact this office to obtain the necessary permission. SPECIAL PROVISIONS The following shall apply when indicated: ® R1 NOTIFICATION: Permittee shall be notified the City at (760) 777: 7097 at least forty-eight hours (48) in advance of starting construction. ® R2 UTILITY CLEARANCE:'(Substructures) Prior to making any excavations within the City of La Quinta right-of-way authorized by permit, the permittee shall contact all concerned utility companies relative to the location of existing substructures. Damage to existing substructures resulting from operations conducted under this permit shall be the. sole responsibility of the permittee. ® R3 UTILITY CLEARANCE (Surface Structures) No work shall be done under this permit until all utilities are clear of the proposed work site. The permittee shall notify all concerned utility companies of the proposed work. ❑ R4 PAVEMENT WIDENING:iArea between.the proposed concrete gutter line and,the existing road pavement shall be surfaced with ( `* N/A *' ) inches of A.C. paving placed on ( ** N/A ** ) inches of ( ** N/A ** ) aggregate sub -base course having an "R" value of not less than (*` N/A") and in conformance with the City of La Quinta Road Improvement Standards and Specifications, Ordinance,#461. ® R5 PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall be graded to a slope of one-fourth inch ('/") to one foot (1'). ❑ R6 GRADE CHECKING: City of La Quinta shall check grades upon receipt of plan and profile and/or grades as established by a licensed engineer. ❑ R7 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter (** N/A'") feet shall be removed. Curb and/or curb and gutter shall be saw cut prior to removal. . Depressed curb, matching concrete gutter and concrete driveway approach shall be constructed in conformance with City of La Quinta Standard #207. I 0 R8 DRIVEWAYS: A.C. driveways shall be constructed as not to alter existing drainage pattern. Surfacing between the property line and the existing road paving shall be two and a half inches (2 /z") of A.C. paving,on ('" N/A *') of class (*` N/A " ) aggregate base. 1 ® R9 SIGHT CLEARANCE: Sight Clearance of six -hundred feet (600') in all directions shall be assured and maintained at all times. ❑ R10 SOIL STERILIZER: The area to be surfaced shall be treated with soil strerilizer. Rate of application shall comply with the manufacturer's specifications: City La Quinta r of ® R11 COORDINATE WORK: The proposed work shall be subordinated to any operation, which the State of California or City of La Quinta may conduct in this area during the period of this permit. Work shall be coordinated with the State or City of La Quinta forces to preclude delay or interference with State or City of La Quinta projects. ® R12 SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments which exist on the centerline of all streets or property lines when included shall be completely tied out so they may be readily and correctly, replaced by a licensed civil engineer or surveyor at the expense of the permittee. A complete set of notes showing the ties to these monuments shall be furnished to the City Engineer prior to the removal of any monuments. This office shall be notified upon completion or replacement of all survey monuments for proper clearance. ❑ R13 PAVEMENT CUTTING: Pavement will be mechanically saw cut to a straight edge prior to excavation. Method of pavement cutting shall be approved through the office of the City Engineer. (Under no circumstances shall excavating equipment be used to excavate prior to cutting or pavement.) Excavation material shall be placed in such a position as to best facilitate the general flow traffic. Prior to final paving operations, any damage to pavement straight edges shall be corrected. ❑ R14 LIMIT OF EXCAVATIONS: -Excavations shall be limited to one -thousand feet (1000') of open trench before backfill operations must begin. All excavations shall be properly barricaded with lights overnight, on weekends and holidays for the protection of the traveling public. The Public Works Inspector shall determine the suitability of excavation barricading in each case. No excavation shall remain open for a period exceeding five (5) days. No excavation shall be made unless the construction material is actually on the work site. ❑ R15 BACKFILL MATERIAL: Backfill shall be free of brush, roots or other organic substance detrimentakto its use for purposes of producing and adequately consolidated backfill. Ant material which the City of La Quinta deems unsuitable (spongy or saturated material) which is encountered during excavation shall not be used for backfill, but shall be supplemented or replaced by an approved sand or gravel. ❑ R16 BACKFILL SAND: Backfill shall be approved transit -mix sand or equivalent and shall be placed on lifts not greater than three feet (3'), and vibrated using vibrostamper or equivalent equipment. Alternate methods may be substituted, but in any case, a relative compaction of ninety-five percent (95%) shall be maintained with the structural section of the roadway. ❑ R17 BACKFILL PLACEMENT: Backfill shall be applied in layers of not more than fifty percent (50%) of the total depth of the trench before flooding or a maximum of five feet (5') lifts where trenches are of excessive depths. Care is to be exercised that the backfill material is not, subjected to extreme swell by flooding operations. Backfill material shall be placed so that the resulting compaction shall not be less than ninety percent (90%) or equivalent to the surrounding ground, whichever is the greater compaction. Where ponding or flooding is used for a maximum settlement, adequate dikes will be constructed to retain the water. Where jetting is used, the jets shall be of sufficient length to reach the bottom of each layer and the water supply shall be continuos. ❑ R18 COMPACTION TESTS: If so required by the inspector, compaction test shall be made at intervals of not more than one - thousand (1000') feet and a maximum of one (1) test on each road. One (1) copy of each test shall be forwarded tot the City Engineer for approval and filed prior to making permanent repairs. Compaction tests shall be made as outlined in.Section 6.3.01 of the Standard Specifications, Division of Highways, State of California, dated January 1973. ® R19 COMPACTION TESTS: If so required by the Inspector, compaction tests shall be made for each crossing or service line. One (1) copy of each test shall be forwarded to the City Engineer for approval and filed prior to making permanent repairs. Compaction tests shall be made as outlined in Sections 6.3.001 of the Standard Specifications, Division of Highways, State of California, dated January 1973. ❑ R20 TEMPORARY PAVEMENT REPAIRS: After completion of backfill and compaction operations, a temporary patch consisting of two inches (2') of SC-800 shall be placed on a prepared sub -grade. The SC-800 temporary paving shall be placed after a maximum of three -thousand linear feet (3000') or trench has been excavated and backfill operations completed, but in no case shall the placement of the temporary pavement exceed a five (5) day limit. ❑ R21 PERMANENT PAVEMENT REPAIR: After backfill and compaction have been completed, a temporary patch consisting of two inches (2") of SC-800 shall be placed immediately. A permanent patch of.( "" N/A " ) inches of A.0 surfacing placed on a ( ** N/A ** ) inch ('" N/A "",) aggregate base shall be placed no later than (" N/A *') days after completion of temporary road repair. ❑ R22 FOG SEAL: A fog seal coat consisting of an application of*asphaltic emulsion shall be applied over all patch areas as determined by the City Engineer. ❑ R23 STREET RESTRIPING: Where street striping is still visible on street to be excavated, such striping shall be replaced upon completion of permanent repairs. ❑ R24 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quinta road right-of-way shall be accomplished by a licensed, bonded and insured tree service, and handled safely without interference or hazard to the traveling public. It shall be the responsibility of the permitte to maintain the tree in a vigorous growing condition at its new location. Trees to be removed shall be in sections, which can be handled safely without interference or hazard to highway traffic. The entire width of the tree stump, shall be removed and disposed of so that no debris remains in view of the highway. The stump hole shall be backfilled and thoroughly compacted as specified in the following paragraph. Where it becomes necessary to restrict traffic, the work shall be restricted to a.maximum of five -hundred feet (500') at any one time. Adequate signs, flagmen and or barricades shall be provided to protect the traveling public at all times. Large holes resulting from tree removal shall be backfilled and compacted to not less than ninety percent (90%) or equivalent tot the surrounding ground, whichever is the greater compaction as determined by the impact or field method. Compaction tests shall comply with Section 6.3.01 of the Standard Specifications, Division of Highways, State of California, dated January 1973.