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Home My WebLink AboutDOC080618-002i ENCROACHMENT PERMIT CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE BAKERSFIELD CA 93301 (661) 326 -3724 TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD CALIFORNIA: Pursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a permit to place, erect, use and maintain an encroachment off public property or right of way as therein defined. Application Number . . . . . 10- 30000039 Date 9/27/10 Property Address . . . . . 1919 COLUMBUS ST Application type description PW - ENCROACHMENT PERMIT Owner Contractor ----- ------------- - ----- ------------------------ B S & E CO INC OWNER 6319 DISTRICT BL BAKERSFIELD CA 93313 ( 66) 834 -2700 ---------------------------------------------------------------------------- Permit . . . . . . ENCROACHMENT PERMIT Additional desc . . Phone Access Code . 1036268 Permit Fee . . . . 208.00 Issue Date . . . . 9/27/10 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 208.00 ---------------------------------------------------------------------------- Special Notes and Comments 6' high ornamental iron fence set just inside sidewalk. Contact person: Mike - 834 -2700 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- ---- Due - - - - -- - --- --- ---- Permit Fee Total 208.00 208.00 .00 .00 Grand Total 208.00 208.00 .00 .00 Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the permit at any time. rj f IF Signature of Applicant (Owner /Agent) Print Name I HEREBY CERTIFY THAT I HAVE MADE AN INVESTIGATION OF THE FACTS STATED IN THE FOREGOING APPLICATION AND FIND THAT THE MAINTENANCE OF SAID ENCROACHMENT (1) WILL (NOT) SUBSTANTIALLY INTERFERE WITH THE USE OF THE PLACE WHERE THE SAME IS TO BE LOCATED AND (2) WILL (NOT) CQUUITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS THEREFO (RANTS (DENIED). Said permit shall expire on date stated above. Signature of City Engineer Additional Terms on the Back �Z_ ... . . ....... - ......... ... - "\, qly -Z--� t-- 5Z7 1V B A K E R S F I E L L) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ralph Korn, Risk Manager FROM: Bob Wilson, Supervisor II, Subdivisions DATE: September 28, 2010 SUBJECT: Encroachment Permit Application for: 1919 Columbus St Name of Applicant: BS &E Co. Inc. Description of Encroachment: Install 6' high ornamental iron fence set inside sidewalk. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. Q� S: \PERMITS \ENCROACH \INSURANC \1919 Columbus St.doc B A Imo. E R. S F I E L 1") PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer II FROM: Bob Wilson, Supervisor II, Subdivisions DATE: September 28, 2010 SUBJECT: Encroachment Permit Application for: 1919. Columbus St Name of Applicant: BS &E Co. Inc. Description of Encroachment: Install 6' high ornamental iron fence set inside sidewalk. Please review the attached encroachment permit and return to me at your earliest convenience oc nyjoo >r i? I�tfJ� S: \PERMITS \ENCROACH \TRAFFIC \1919 Columbus St.doc DATE(MMIDD/YYYY) L'd CERTIFICATE OF LIABILITY INSURANCE °sss°EC81 09/27/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO James C Jenkins Ins Srvc Concd ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License No. 0545478 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 5668 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOV Concord CA 94524 Phone: 925- 798 -3334 Fax: 925- 609 -5381 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Star Insurance Company 18023 INSURER B: Nova Casualty Company 42552 B.S. & E go . , Inc. INSURER C: 6319 District Blvd. INSURER D: Bakersfield CA 93313 i INSURER E: 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 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER PO CY EFFECTIVE DATE MM /DDIYYYY POLICY EXPIRATION DATE MM /DD/YYYY LIMITS REPRESENTATIVES. AUT D REP ENTATIVE GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000,000 • X X COMMERCIAL GENERAL LIABILITY RNTCL00100402 11/01/09 11/01/10 PREMISES (Ea occurence) $ 300,000 CLAIMS MADE I[ir7i OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERALAGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2 , 000 , 0 o o X POLICY PRCT O- LOC JE Ben. 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 B X ANY AUTO RNTCL00100402 11/01/09 11/01/10 (Ea accident) BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS (Per accident) X COMP $1000 PROPERTY DAMAGE $ COLL $1000 (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR EI CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION X TORY LIMITS ER AND EMPLOYERS' LIABILITY YIN E.L. EACH ACCIDENT $1,000,000 • ANY PROPRIETOR/PARTNER/EXECUTIVE WC0470602 04/01/10 04/01/11 OFFICER/MEMBER EXCLUDED? l-1 E.L. DISEASE - EA EMPLOYEE $ 1,.000,000 (Mandatory in NH) If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1 , 00 0 , 0 0 0 OTHER • Equipment Floater RNTCL00100402 11/01/09 11/01/10 Spec Form $3,000,000 Re 1 Cost $1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE: Installation of an Ornamental Iron Fence @ 1919 Columbus St. Bakersfield CA. The City of Bakersfield, its mayor, council, employees, and volunteers as their respective interest may appear as per written contract are named as Additional Insured with respects to General Liability per the attached endorsement. 10 Day notice applies if cancelled for non - payment of premium. Ktl4C4It2LOY- 11QN: Lei 4Ja: N_U[yaA W111I Is] 0 AGUKU ZO (ZUUV1U7) v 1955 -ZUU9 AGUKU CORPOKAI ION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION BAKE -02 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Bakersfield NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Public Works Dept. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1501 Truxtun Ave Bakersfield CA 93301 REPRESENTATIVES. AUT D REP ENTATIVE AGUKU ZO (ZUUV1U7) v 1955 -ZUU9 AGUKU CORPOKAI ION. All rights reserved. The ACORD name and logo are registered marks of ACORD -Policy Number: RNTCL00100402 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU – PRIMARY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability arising out of your ongoing operations performed for that insured. A person's or organization's status as an insured under this endorsement ends when your operations for that insured are completed. This insurance applies on a primary basis if that is required by the written contract, written agreement or permit. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: 2. Exclusions This insurance does not apply to: a. "Bodily injury ", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and (2) Supervisory, inspection, architectural or engineering activities. b. "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 site 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. NCC -HAC -002 (12/05) Page 1 of 1 Id - :2000�)o a� t, Public works oepanment '1501 Truxtun Avenue Bakersfield. California 83301 (661) 326 -3724 APPLICATION FOR ENCROACHMENT PERMIT Permit Fee $208.00 To the City Engineer of the City of Bakersfield, California., Pursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a permit to place. erect, use and maintain an encroachment on public property or right- of -�way as therein defined. 1. Full name of applicant and complete address including phone number: ,SSnF /�;v'r. - / ?t9 S-_ �Q— e4l ZY 05 to 934-.1:217®a - 2, Nature or description of the encroachment for which this „a,P Ii cation is made: (Exam le: Wood or wrought iron fee�n//cc-e, concrete block wall, raised planter, etc...) ,l 1&-eff % 1121V AAOrAL 4l2ak �16Ndc S�'r” 3. Location of proposed encroachment: (Example: Side yard at back of sidewalk or front yard at back of sidewalk) > ,LIB YOk 9-• 4. Period of time for which the encroachment is to be maintaine l or Other se Circl 5. Is property part of a Homeowner's Association Yes No Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless the City, its officers agents and employees against any and all liability, claims, actions, causes of action or demands, whatsoever against them, or any of them, before administrative, quasi - judicial, or judicial tribunals of any kind whatsoever, arising out of, connected with, or caused by applicant's placement, erection, use (by applicant or any other person or entity) or maintenance of said encroachment. The applicant further agrees to maintain the aforesaid encroachment during the life of said encroachment or until such time that this permit is revoked. Applicant further agrees that upon the expiration of the permit for which this application is made, if granted or upon the revocation thereof by the City engineer. applicant will at his own cost and expense remove the same from the public property or right of way where thg same is located, and restored said public property or right of way to the condition as nearly as that in which it was before the placing, erection, maintenance or existence of said encroachment. Applicant further agrees to obtain and keep all liability Insurance required by the City Engineer in full force and effect for however long the encroachment remains. Applicant shall furnish the City Risk Manager with a Certificate of Insurance evidencing sufficient coverage for bodily injury or property damage liability or both and required endorsements evidenc- iq the insurance required. The type(s) and mount(s) of in�s urance coveragq Applicant acknowlodgos the right of the City Engineer, pu {suant to Bakersfield Municipal Code Chapter 12.20 to revoke the permit at any lime. S: %EncrnachmaniParrnitsApp IicatlonforE ncroachment snowm00 3sa:WOJJ 2z:ET 0To2- go -9nu