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HomeMy WebLinkAbout1018 18TH STBA ENCROACHMENT PERMIT �y u0s,,, CITY OF BAKERSFIELD v d PUBLIC WORKS DEPARTMENT .� 1501 TRUXTUN AVE 4,r�ry,y BAKERSFIELD CA 93301 C LIFO (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 on public property or right of way as therein defined. Application Number . . . . . 14-30000068 Date 11/21/14 Property Address 1018 18TH ST Application type description PW - ENCROACHMENT PRRMIT Owner Contractor DAVIS CHARLES D & KATHY L BLACKTOP CYCLERY 15010 VIA NAPOLI DA 1018 18TH ST BAKERSFIELD CA 93306 BAKERSFIELD CA 93301 (661) 869-1140 ---------------------------------------------------------------------------- Permit ENCROACHMENT PERMIT Additional desc . . Phone Access Code 1557743 Permit Fee 208.00 Issue Date . . . . 11/21/14 Valuation . . . . 0 Qty Unit Charge Per Extension 1.00 208.0000 EA PN ENCROACHMENT 208.00 ---------------------------------------------------------------------------- Special Notes and Comments *Bike rack is for public parking, not to be Place 3 bike racks in front of bike shop. used to show bikes for sale.* Contact person: A. Laurence Gueierrez 661-440-3316 ---------------------------------------------------------------------------- FeesummCharged ary Paid Credited Due _--------------------- ---------- -------------------- Permit Fee T0>1 208.00 208.00 .00 .00 Grand Total "1 208.00 208.00 .00 .00 Applicant ac ges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the it t any time. of Applicant pwner/Agent) A, 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) CONSTITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS THEREFORE (GRANTED) (D (D D) Said permit shall expire on date stated above. �Sigof City Additional Terms on the Back AK ENCROACHMENT PERMIT APPLICATION FORM v ro CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE C9LIF0 BAKERSFIELD CA 93301 (66.1)326-3724 Fax: (661) 852-2012 LOCATION OF ENCROACHMENT(Address required where available): /0/6 /C�1 Sfi If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection. FULL NAME OF APPLICANT ' S�KC_AJj' COMPLETE ADDRESS: %O!A PHONE: FAX: / CELL: 661 L/�O SS/6 PROJECT INFORMATION DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised planter, etc.): Erze_l b: Lyrle Cc,t ISS (3) PERIOD OF TIME FOR ENCROACHMENT INDEFINATE o OTHER: ( CONTACTPERSON �. L,IQ[e Cr G V%-}rLT/^eZ: PHONE: bbl `/`/0 - $/6 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, orjudicial 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 tomaintain 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 property or right of way where the same is located and restore said public propertyor 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 evidencing the insurance required.. The type(s) and amounts) of insurance coverage required are: Residences: Homeowners General Liability coverage in an amount of at least $300,000.00 Commercial: Commercial Liability coverage inan amount of at least $1,000,000.00 Encroachment Permit Fee: $208.00 S:\PERMITS\ENCROACH\Encroachment Permit Req Form.DOC January 2009 A'c®Roe CERTIFICATE OF LIABILITY INSURANCEDAmIMM"D" `/ ) 11/21/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS. CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies):must be endomed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Fallga.tter S Rhodes Insurance Services CA Lic# OD94542 1701 G Street Bakersfield CA 93301-4320 CAME:ONTACT Bonnie Shields N PxoxE (661)324-2424 FAM o. 16611324-2121 EMAIL . bousie0 frIDS. coo INSURERS AFFORDING COVERAGE NAICI INSURERA'.ValleV Fore Ins. Co. UNITS INSURED Blacktop Cyclery 612 15th Street Bakersfield CA 93301 INSURERS: INSURERC: Truxtun Avenue INSURER D: Bakersfield, CA 93301 INSURER E: PREMI 3 300,000 INSURER F: X COMMERCIALGENERAL LIABILIT' CWMSWADE 7OCCUR COVERAGESCERTIFICATENUMBER:14/15 GL REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CI -AIMS. INSR TR TypEOF INSURANCE POLICY NUMBER MNM UM Y MMLODIYYYY UNITS Attn: GENERAL LIABIUtt 1600 Truxtun Avenue AUTHORIZED REPRESENTATIVE Bakersfield, CA 93301 EACH OCCURRENCE 3 1,000,000 PREMI 3 300,000 A X COMMERCIALGENERAL LIABILIT' CWMSWADE 7OCCUR 017800384 0/19/2014 0/19/2015 MEDEXP(AMonepemn) S 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AG GREGATELIMIT APPLIES PER'. PRODUCTS - COMP/OP AGS $ 2,000,000 R POLICY PRO LOC $ AUTOMOBILEU MUDY E SUN 051 MLIM BODILY INJURY (P., S ANY AUTO ALL OWNED ASCHEBULED AUTOS UTOS RWILY INJURY(PeraaiOUM) $ PPROPERTY n DAMAGE S HIREDAUTOS AOT05WNED UMBRELLA UAB OCCUR EACH OCCURRENCE 5 AGGREGATE S EXCESS UAB CIAIMSWADE DED I ETEWION$ S MRHERS COMPENSATION VJC BTATU- I I OTCRYH AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNEWEXEOUTIVE❑ EL. EACH ACCIDENT $ OFFICOENEMBER EXCWDEW NIA (Mandalory 1. NH) EL DISEASE - EA EMPLOYE $ E . DIGEASE- POLICY LIMIT 5 I mwlee� .r DESCRIPTION OF OPERATIONS IRb DESCNPTONOFOPEMPONSILOCAMN51VEHICLES(ANacNACORDIGI.AENNanN.e .$h.duNXmonspa isrequimdI The City of Bakersfield, :its payor, council, officers, agentS, employees and volunteers are included as additional insureds per attached form SB -146932-E CFRTIFICATF NEN DER CANCFI.1 GTHON ACORD 26 (20110106) ©1908-2010 ACORD CORPORATION. All rights reserved. INSn25 mm�ns nt Th. ACrTRn U. antl loon am ron i¢4nrnd make of ar.n.n SHOULD ANY OF THE ABOVE DESCRIBED POUCHES. BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Bakersfield Attn: Risk Management 1600 Truxtun Avenue AUTHORIZED REPRESENTATIVE Bakersfield, CA 93301 Chad Rhodes/SBI ACORD 26 (20110106) ©1908-2010 ACORD CORPORATION. All rights reserved. INSn25 mm�ns nt Th. ACrTRn U. antl loon am ron i¢4nrnd make of ar.n.n CNA SB -146932-E (Ed. 06111) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - LIABILITY EXTENSION This endorsement modifiesinsurance provided under the following: I I Gl 7 I U Ord K111T140-TIC] =99101 11 yI Coverage afforded under this extension of coverage endorsement doesnot apply to. any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Policy. 1. ADDITIONAL INSURED- BLANKET VENDORS own ads or omission or those of its employees or anyone else acting on its WHO IS AN INSURED is amended to include as an behalf. However; this exclusion does not additional insured any person or organization (referred apply to: to below as vendor) with whom you agreed, because of a written contract or agreement to provide (1) The exceptions contained in insurance, but only with respect to "bodily injury" or Subparagraphs d. orf.; or "property damage" arising out of"your products" which (2) Such inspections, adjustments, tests or are distributed or sold in the regular courseof the servicing as the vendor has agreed to vendor's business, subject to the following additional make or normally undertakes to make in exclusions: the usual course of business in 1. The insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the .absence of the contract or agreement; b. Any express Warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f. Demonstration, installation, servicing or repair operations, except such. operations performed at the vendors. premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container,. part or ingredient of any other thing or substance by or for the vendor; or h. "Bodily injury" or "property .damage" arising out of the sole negligence. of the vendor for its connection with the distribution or sale of the products. 2. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying. or containing such products. 3. This provision 2. doesnot apply to any vendor included as an insured by an endorsement issued by us and made a part of this Policy. 4. This provision 2. does not apply if "bodily injury" or "property damage" included within the "products - completed operations hazard" is excludedeither by the provisions of the Policy or by endorsement. 2. MISCELLANEOUS ADDITIONAL INSUREDS: WHO IS AN INSURED is amended to include as an insured any person or organization (called additional insured) described in paragraphs 2.a. through 2.h. below whom you are required to add as an additional insured on this policy under a written contract or agreement but the written contract or agreement must be: 1. Currently in effector becoming effective during the term of this policy; and 2. Executed prior to the "bodily injury, "property damage" or "personal and advertising injury," but Only the following persons or .organizations are additional insureds under this endorsement and coverage provided to such additional insureds is limited as provided herein: a. Additional Insured -Your Work: That person or organization for whom you do work is an additional insured solely for liability SB -146932-E Page 1 of 5 (Ed. 06/11) ��//SB-146932-E CNA (Ed. 06111) due to your negligence specifically resulting This insurance does not apply to "bodily from your work for the additional insured injury," "property damage" or "personal and which is the subject of the written contract or advertising injury" arising out of operations written agreement. No coverage applies to performed for the state or municipality. liability resulting from the sole negligence of c. Controlling Interest the additional insured. The insurance provided to the additional Any persons or organizationswith a insured is limited as follows: controlling interest in you but only with respect to their liability arising out of. (1) The Limits of Insurance applicable to the (1) Their financial control of you; or additional insured are those specified in the written contract or written agreement (2) Premises they own, maintain or control or in the Declarations of this policy, while you lease: or occupy these whichever is less. These Limits of premises. Insurance are inclusive of, and not in addition to, the Limits of Insurance shown This insurance does not apply to structural in the Declarations. alterations, new construction and demolition operations performed by or for such additional (2) The coverageprovided to the additional insured. insured by this endorsement and paragraph F.9. of the definition of "insured d. Managers or Lessors of Premises contract" under Liability and Medical A manager or lessor of premises but only with Expenses Definitions do not apply to respect to liability arising out of the ownership, "bodily injury' or "property damage" maintenance or use of that specific part of the arising out of the "products -completed premises leased to you and subject to the operations hazard" unless required by the following additional exclusions: written contract or written agreement This insurance does not apply to: (3) The insurance provided to the additional insured does not apply to "bodily. injury," (1) Any "occurrence" which takes place after "property damage," or "personal and you cease to be a tenant in that premises; advertising injury" arising out of the or rendering or failure to render any (2) Structural alterations, new construction or professional services. demolition operations performed by or on b. State or Political Subdivisions behalf of such additional insured. A state or polifical subdivision subject to the e. Mortgagee, Assignee or Receiver following provisions: A mortgagee, assignee or receiver but only (1) This insurance applies only with respect with respect to their liability as mortgagee, to the following hazards for which the assignee, or receiver and arising out of the state or political subdivision has issued a ownership, maintenance, or use of a premises permit in connection with premises you by you. own, rent, or control and to which this This insurance does not apply to structural insurance applies: alterations, new construction or demolition (a) The existence, maintenance, repair, operations performed by or for such additional construction, erection,. or removal of insured. advertising signs, awnings, canopies, f. Owners/Other Interests — Land is Leased cellar entrances, coal holes, driveways,manholes, marquees, An owner or other interest from whom land hoistaway openings, sidewalk vaults, has been leased by you but only with respect street banners, or decorations. and to liability arising out of the ownership, similar exposures; or maintenance or useof that specific part of the land leased to you and. subject to the following b The construction, erection, or () additional exclusions: removal of elevators; or This insurance does not apply to: (2) This insurance applies only with respect to operations performed by you or on your (1) Any "occurrence" which takes place behalf for which the state or political after you cease to lease that land; or subdivision has issued a permit. SB -146932-E Page 2 of 5 (Ed. 06111) 7./_1 SB -146932-E (Ed. 06111) (2) Structural alterations, new Damage To Property, is replaced by the construction or demolition operations following: performed by or on behalf of such k. Damage To Property additional insured. g. Co-owner of Insured Premises "Property damage" to: A co-owner of a. premises co -owned by you 1. Property you own, rent or occupy, and covered under this insurance but only including any costs or .expenses with respect to the co-owners liability as co- incurred by you, or any other person, owner of such premises. organization or entity, for repair, replacement, enhancement, It. Lessor of Equipment restoration or maintenance of such Any person or organization from whom you property for any reason, including prevention of injury to a person or lease equipment. Such person or organization damage toanother's property; are insureds only with respect to their liability arising out of the maintenance, operation or 2. Premises you sell, give away or use by you of equipment leased to you by abandon, if the "property damage" such person or .organization: A person's or arises out of any part of those organization's status as an insured under this premises; endorsement ends when their written contract 3. Property loaned to you; or agreement with you for such leased equipment ends. 4. Personal property in the care, With respect to the insurance afforded these custody or control of the insured; additional insureds, the following additional 5. That particular part of any real exclusions apply: property on which you or any This insurance does not apply: contractors or subcontractors working directly or indirectly in your behalf are (1) To any "occurrence" which takes place performing operations, if the "property after the equipment lease expires; or damage" arises out of those (2) To "bodily injury;' "property damage" or operations; or "personal and advertising injury" arising 6. That particular part of any property out of the sole negligence of such that must be restored, repaired or additional insured. replaced because "your work" was incorrectly performed on it. Any insurance provided to an additional insured designated under paragraphs b. through It. above Paragraph 2 of this exclusion does not does not apply to "bodily injury" or "property apply if the premises are "your work" and damage" included within the "products -completed werenever occupied, rented or held for a operations hazard" rental by you. 3. The following is added to Paragraph H. of the Paragraphs 1, 3, and 4, of this exclusion e BUSINESSOWNERS COMMON POLICY do not apply to "property damage" (other CONDITIONS: than damage by fire or explosion) to H. Otherinsurance premises: (1) rented to you: 4. This insurance is excess over any other insurance naming the additional insured (2) temporarily occupied by you withthe a as an insured whether primary, excess, permission of the owner, or contingent or on any other basis unless a (3) to the contents of premises rented to = written contract or written agreement you for a period of 7 or fewer specifically requires that this insurance be consecutive days. either primary or primary and A separate limit of insurance applies to noncontributing. Damage To Premises Rented To You as 4. LEGAL LIABILITY— DAMAGE TO PREMISES described in Section D — Liability and Medical Expenses Limits of Insurance. A. Under B. Exclusions, 1. Applicable to Business Liability Coverage, Exclusion k. SB -146932-E (Ed. 06111) Page 3 of 5 Paragraphs 3, 4, 5, and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to "property damage" included in the "products -completed operations hazard." B. Under B. Exclusions, 1. Applicable to Business Liability Coverage, the last paragraph of 2. Exclusions is deleted and replaced by the following: Exclusions c, tl, e, f, g, h, i, k, I, an, n, and o, do not apply todamage by fire to premises while rented to you or temporarily occupied by you with permission of the owner or to the contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section D. Liability And Medical Expenses Limits Of Insurance. C. The first Paragraph under item 5. Damage To Premises Rented To You Limit of Section D. Liability And Medical Expenses Limits Of Insurance is replaced by the following: The most we will pay under Business Liability for damages because of"property damage" to any one premises; while rented to you, or temporarily occupied by you, with the permission of the owner, including contents of such premises rented to you for a period of 7 or fewer consecutive days, is the Damage to Premises Rented to You limit shown in the Declaration. 5. Blanket Waiver of Subrogation We waive any rightof recovery we may have against: a. Any person or organization with whom you have a written contract that requires such a waiver. 6. Broad Knowledge of Occurrence The following items are added to E. Businessowners General Liability Conditions in the. Businessowners Liability Coverage Form: a. Paragraphs a. and b. apply to you or to any additional insured only when such "occurrence," offense, claim or "suit" is known to: (1) You or any additional insured that is an individual; SB -146932-E (Ed- 06111) SB -146932-E (Ed. 06111) (2) Any partner, if you or an additional insured is a partnership; (3) Any manager, if you or an additional insured is a limited liability company; (4) Any "executive officer" or insurance manager, if you or an additional insured is a corporation; (5) Any trustee, if you or an additional insured is a trust; or (6) Any elected or appointed official, if you or an additional insured is a political subdivision or public entity. This paragraph e. applies separately to you and any additional insured. 7. Bodily Injury Section F. Liability and Medical Expenses Definitions, item 3. "Bodily Injury' is deleted and replaced with the following: "Bodily. injury" means bodily injury, sickness or disease sustained by a person; including death, humiliation, shock, mental anguish or mental injury by that person at any time which results as a consequence of the bodily injury, sickness or disease. 8. Expanded Personal and Advertising Injury Definition a. The following is added to Section F. Liability and Medical Expenses Definitions, item 14. Personal and Advertising Injury,. in the Businessowners General Liability Coverage Form: h. Discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but only if such discrimination or humiliation is: 1. Not done intentionally by or at the direction of. a. The insured; or b. Any "executive officer," director, stockholder, partner, member or manager (if you are a limited liability company) of the insured; and 2. Not directly or indirectly related to the. employment, prospective employment, past employment or termination of employment of any person or person by any insured. b. The following is added to Exclusions, Section B.: Page 4 of 5 P� It 6) Discrimination Relating to Room, Dwelling or Premises Caused by discrimination directly or indirectly related to the sale, rental, lease or sublease or prospective sale, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured. (16)Fines or Penalties Fines or penalties levied or imposed by a governmental entity because of discrimination. c. This provision (Expanded Personal and Advertising Injury) does not apply if SB -146932-E (Ed. 06/11) SB -146932-E (Ed. 06/11) Personal and Advertising Injury Liability is excluded either by the provisions of the Policy or by endorsement. 9. Personal. and Advertising Injury Re -defined Section F. Liability and Medical .Expenses Definitions, item 14, Personal Advertising Injury, Paragraph c. is replaced by the following: c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room dwelling or premises that a person or organization occupies committed by or on behalf of it's owner, landlord or lessor. Page 5 of 5 B A h E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager FROM: Bob Wilson, Supervisor II, Subdivisions DATE: November 26, 2014 SUBJECT: Encroachment Permit Application for: 1018 18" Street Name of Applicant: Blacktop Cyclery Description of Encroachment: Place 3 bike racks in front of bike shop. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S:\PERMITS\ENCROACH\INSURANCE\101818th Stdoc • R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer III FROM: Bob Wilson, Supervisor II, Subdivisions DATE: November 26, 2014 SUBJECT: Encroachment Permit Application for: 1018 18" Street Name of Applicant: Blacktop Cyclery Description of Encroachment Place 3 bike racks in front of bike shop. Please review the attached encroachment permit and return to me at your earliest convenience PC -C- 41 Z414 rizoV196 0 # uNo0s?Rucrc-V'5'rn&WnLr- Or 1,045;7',t' t14 wfp76f �tfA �� MifIv rft(NEO, CNO hwoo- po-r1w-F Deg �E SkGTL M S. PERMITS\ENCROACH\TR FFICM1818th St. a.