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HomeMy WebLinkAboutB-2019-036013 V Bond No. 107015412 Premium: $100.00 per year BOND FOR TEMPORARY CERTIFICATE OF OCCUPANCY KNOW ALL PERSONS BY THESE PRESENTS, That we, Hathaway Dinwiddle Construction Company, hereinafter referred to as Principal, and, Tra,vellers Casuallty and Surety Company of Amerilcai a corporation organized and existing under the laws of the State of Connecticut and authorized to do business in the State of Cali , fornia, as Surety, are held and firmly bound unto the City of Cupertino, hereinafter referred to as Obligee,-in,the sum of Te'n, Thousand and no/100 DoIllars ($10,000.00.), lawful money of the United States of America, to the payment of which sum, well and truly to be made, we bind ourselves, our executors, administrators, successors and assigns, firmly by these presents. WHEREAS, the said Principal, Hathaway Dinwiddie Construction Company, has made application to the said Obligee, City of Cupertino, for the issuance of a Temporary Certificate of Occupancy for the premises located at 20230. Stevens Creek Blvd., Cupertino, CA. I NOW, THEREFORE, if the Principal shall complete the improvements and - faithfully i6mply with all City of Cupertino building codes, ordinances and -.- regulations, and shall save and keep harmless the Obligee from all loss or damage which the Ob,ligee may ay, incur arising out of the issuance of said Temporary Certificate of Occupancy to the Principal, then this obligation shall be void; otherwise to remain in full force and effect. SIGNED, SEALED AND DATED this 14th day of June, 2019. Hathaway Dinwiddie Construction Company Principal By: /4 Travelers Casualty and Surety Company of America Suret yi` 0, 'A I By: I Nancy L. Oamilton,- Attorney -in -Fact f"a CALIFORNIA } F 6 _Pf 7l iC, OL E A? 0W._H ne'QEt o e 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 San Francisco ) Nerissa S. Bartolome, (Votary Public Ong_// before me, Date Here Insert`Nam-e and Title of the Officer m personally appeared Nancy L. Hamilton -------------------------------------------------------------------------------------------- Names) of Signer(s) ----------------------------------------------------------------------------------------------------------------------------------------------------- who proved to me on the basis of satisfactory evidence to be the persono whose name(s) is/" subscribed y -to the within instrument and acknowledged to me that be/she/tb executed the same in Ks/her7tfadr authorized capacity, and that by i slher/ti it signature(s)'an the.`instrumenttpe person, or the entity upon behalf of which the personKacted, 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. NERISSA S. WITNESS my hand and official seal. Commission # 2113190 t� Notary Public - California z a San Francisco County" �' Signature - � ExpirQs Jun 24, 2019;` 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 Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: Nancy L. Hamilton --------------- -------er's Name: _. ❑ Corporate Officer - Titie(s): 74--p,, Corto Officer — Title(6):❑ Partner — ❑ Limited ❑ General artner 'imited ❑ Gen ❑ Individual C2 Attorney in Fact ❑ Individual ttor in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Trustee a W' 1 or Conservator ❑ Other: ❑ Other: Signer Is Representing: Signer l epresenting: 02014 National Notary Association o www.NationalNotary.org ^ 1-800-US NOTARY (1-800-876-6827) ` Item #5907 Travegers Casua0ty and Surety Company ®f America Ora ve0ers Cas uafty and Surety Company TRAVELERSTRAVELERSJ St. l auP Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Nancy L Hamilton of San Francisco California ;'their true and lawful Attomey-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 3rd day of February, 2017. z ta�ts�rtsa lip, i State of Connecticutr�_ City of Hartford ss. Robert L. Raney, Senior Vice President On this the 3rd day of February, 2017, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. In Witness Whereof, I hereunto set my hand and official seal. My Commission expires the 30th day of June, 2021 YAR qo Marie C. Tetreault, Notary Public This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, which` resolutions are now in full force and effect, reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys=in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her; and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part.of the foregoing authority to one or more officers or employees of this Company, provided'thateach such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance,, or conditional undertaking shall be valid and binding upon`the Company when (a),signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President,any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's 'seal by Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attomeys-in-Fact and Agents pursuant to the powerprescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant' Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attomeys-in-Fact for purposes only of.executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney oreertificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such'"facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to'which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, do hereby certify that the above and foregoing is a true and correct,copy of the Power of Attorney executed by said Companies, which remains in full force and effect. Dated this 14th day of June 12019 t�,ir •`''rev 44` 9F ,� CR46L j CONN _ Kevin E. Hughes, Assistant Secretary 7'® verify the authe,7 cif of this Power ofAfforney� Please call us at 1-909-421 3,9,90 Please refer to the above-namedAtbarney4n-Fact and the details of the bond to which the power is attached, CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2019-0360 20230 STEVENS CREEK BLVD CUPERTINO, CA 95014-2210 (369 02 031) HATHAWAY DINWIDDIE CONSTRUCTION COMPANY SAN FRANCISCO, CA 94111-3330 OWNER'S NAME: DATE ISSUED: 04/26/2019 OWNER'S PHONE: PHONE NO: (415) 986-2718 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #729664 Contractor HATHAWAY DINWIDDIE CONSTRUCTION COMPANY Date X BLDG —ELECT —PLUMB 11 /30/2020 MECH _ RESIDENTIAL X COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my JOB DESCRIPTION: license is in full force and effect. APPLE SC-04 T.I. - (43,953 SF) I hereby affirm under penalty of perjury one of the following two declarations: REV #1 - REVISE EXTERIOR SIDEWALK TO ACCOUNT FOR (E) Compensation, as provided for by Section 3 700 of the Labor Code, for the FIRE RATING -ISSUED 6/12/19 performance of the work for which this permit is issued. REV #2 - MODIFY CONCRETE WALK TO ACCOMMODATE (E) ve and will maintain Worker's Compensation Insurance, as provided for by TREE; ADD FURRING WALL AT 2ND FLOOR BREAK ROOM -ISSUE Section 3700 of the Labor Code, for the performance of the work for which this 6-6-2019 permit is issued. APPLICANT CERTIFICATION Sq. Ft Floor Area: Valuation: $7750000.00 I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for APN Number: Occupancy Type: inspection purposes. (We) agree to save indemnify and keep harmless the 369 02 031 A (Tenant Improvements),B (Tenant Improvements) City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point PERMIT EXPIRES IF WORK IS NOT STARTED source 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 6/12/19 OWNER -BUILDER DECLARATION : Issued b Hal McKee 3' Haley I Date: 04/26/2019 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. I, as owner of the property, or my employees with wages as their sole RE -ROOFS: compensation, will do the work, and the structure is not intended or offered for All roofs shall be inspected prior to any roofing material being installed. If a roof is sale (Sec.7044, Business & Professions Code) installed without first obtaining an inspection, I agree to remove all new materials for 2. I, as owner of the property, am exclusively contracting with licensed inspection. contractors to construct the project (Sec.7044, Business & Professions Code). Signature of Applicant: I hereby affirm under penalty of perjury one of the following three declarations: Date: 6/12/19 1. I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this HAZARDOUS MATERIALS DISCLOSURE permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 3. I certify that in the performance of the work for which this permit is issued I California Health & Safety Code, Sections 25505, 25533, and 25534. I will shall not employ any person in any manner so as to become subject to the maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Worker's Compensation laws of California. If, after making this certificate of Health &Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous exemption, I become subject to the Worker's Compensation provisions of the air contaminants as defined by the Bay Area Air Quality Management District I Labor Code, I must forthwith comply with such provisions or this permit shall will maintain compliance with the Cupp tino Municipal Code, Chapter 9.12 and be deemed revoked. the Health & Safety correct. I agree to comply with all city and county ordinances and state laws Date: 6/12/19 relating to building construction, and hereby authorize representatives of this city CONSTRU TION LENDING AGENCY to enter upon the above mentioned property for inspection purposes. (We) agree I hereby affirm that there is a construction lending agency for the performance to save indemnify and keep harmless the City of Cupertino against liabilities, of work's for which this permit is issued (Sec. 3097, Civ C.) judgments, costs, and expenses which may accrue against said City in Lender's Name consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Lender's Address Code, Section 9.18. ARCHITECT'S DECLARATION CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2019-0360 20230 STEVENS CREEK BLVD CUPERTINO, CA 95014-2210 (369 02 031) HATHAWAY DINWIDDIE CONSTRUCTION COMPANY SAN FRANCISCO, CA 94111-3330 OWNER'S NAME: DATE ISSUED: 04/26/2019 OWNER'S PHONE: PHONE NO: (415) 986-2718 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #729664 Contractor HATHAWAY DINWIDDIE CONSTRUCTION COMPANY Date X BLDG _ELECT _PLUMB 11 /30/2020 MECH _ RESIDENTIAL X COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my JOB DESCRIPTION: license is in full force and effect. APPLE SC-04 T.I. - (43,953 SF) I hereby affirm under penalty of perjury one of the following two declarations: REV #1 - REVISE EXTERIOR SIDEWALK TO ACCOUNT FOR (E) 1. I have and will maintain a certificate of consent to self -insure for Worker's TREE; UPGRADE (E) ROOM #1150 TO SHOW AND DETAIL 1 HOUR Compensation, as provided for by Section 3700 of the Labor Code, for the FIRE RATING. performance of the work for which this permit is issued. REV #2 - MODIFY CONCRETE WALK TO ACCOMMODATE (E) I have and will maintain Worker's Compensation Insurance, as provided for by TREE; ADD FURRING WALL AT 2ND FLOOR BREAK ROOM -ISSUE Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 6-6-2019 APPLICANT CERTIFICATION Sq. Ft Floor Area: Valuation: $7750000.00 I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize APN Number: Occupancy Type: representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the 369 02 031 A (Tenant Improvements),B (Tenant Improvements) City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against sa' City in consequence of the granting of this permit. Additionally, Municipal Code, Section 9.18. WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Signature °` Date 6-6-2019 QWNER- reasons: 1. I, as owner of the property, or my employees with wages as their sole RE -ROOFS: compensation, will do the work, and the structure is not intended or offered for All roofs shall be inspected prior to any roofing material being installed. If a roof is sale (Sec.7044, Business & Professions Code) installed without first obtaining an inspection, I agree to remove all new materials for 2. I, as owner of the property, am exclusively contracting with licensed inspection. contractors to construct the project (Sec.7044, Business & Professions Code). Signature of Applicant: I hereby affirm under penalty of perjury one of the following three declarations: Date: 6-6-2019 1. I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this HAZARDOUS MATERIALS DISCLOSURE permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 3. I certify that in the performance of the work for which this permit is issued I California Health & Safety Code, Sections 25505, 25533, and 25534. I will shall not employ any person in any manner so as to become subject to the maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Worker's Compensation laws of California. If, after making this certificate of Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall air contaminants as defined by the Bay Aroma Air Quality Management District I will maintain compliance with APPLICANT CERTIFICATION 1 certify that I have read this application and state that the above information is Owner or authorized agent: correct. I agree to comply with all city and county ordinances and state laws Date: 6-6-2019 relating to building construction, and hereby authorize representatives of this city CONSTRU TION LENDING AGENCY to enter upon the above mentioned property for inspection purposes. (We) agree I hereby affirm that there is a onstruction lending agency for the performance to save indemnify and keep harmless the City of Cupertino against liabilities, of work's for which this permit is issued (Sec. 3097, Civ C.) judgments, costs, and expenses which may accrue against said City in Lender's Name consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Lender's Address Code, Section 9.18. ARCHITECT'S DECLARATION CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2019-0360 20230 STEVENS CREEK BLVD CUPERTINO, CA 95014-2210 (369 02 031) HATHAWAY DINWIDDIE CONSTRUCTION COMPANY SAN FRANCISCO, CA 94111-3330 OWNER'S NAME: DATE ISSUED: 04/26/2019 PHONE NO: (415) 986-2718 OWNER'S PHONE: LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class a, b Lic. #729664 Contractor HATHAWAY DINWIDDIE CONSTRUCTION COMPANY Date X BLDG —ELECT —PLUMB MECH _ RESIDENTIAL X COMMERCIAL 11/30/2020 I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing 3 the Business & Professions Code and that my JOB DESCRIPTION: with Section 7000) of Division of license is in full force and effect. APPLE SC-04 T.I. - (43,953 SF) [ hereby affirm under penalty of perjury one of the following two declarations: 1. I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. have and will maintain Worker's Compensation Insurance, as provided for by Sq. Ft Floor Area: Valuation: $7750000.00 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above 369 02 031 B (Tenant Improvements) information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for (We) agree to save indemnify and keep harmless the EXPIRES IF WORK IS NOT STARTED PERMIT E inspection purposes. City of Cupertino against liabilities, judgments, costs, and expenses which WITHIN 180 DAYS OF PERMIT ISSUANCE OR may accrue against said Cityin consequence of the granting of this permit. 180 DAYS FROM LAST CALLED INSPECTION. Additionally, he applicant . understands and will comply with all non -point source regulations l6er the Cupertino Municipal Code, Section 9.18. Issued by: Haley McKee Signature Date 4/26/19 Date: 04/26/2019 _ DECLARATION OWNER -BUILDER RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is [ hereby affirm that I am exempt from the Contractor's License Law for one of the installed without first obtaining an inspection, I agree to remove all new materials for following fivo reasons: 1. I, as owner of the property, or my employees with wages as their sole inspection. compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business &Professions Code) Signature of Applicant: 2. I, as owner of the property, am exclusively contracting with licensed Date: 4/26/19 contractors to construct the project (Sec.7044, Business &Professions Code). ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I herebv affirm under penalty of perjury one of the following three declarations: 1. I have and will maintain a Certificate of Consent to self -insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation, as provided for by Section 3700 of the Labor Code, for the p I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. Worker's Compensation Insurance, as provided for by California Health & Safety Code, Sections 25505, 25533, and 25534. I will 2. I Have and will maintain Section �700 of the Labor Code, for the performance of the work for which this Chapter 9.12 and the maintain compliance with the Cupertino Municipal Code, p Health & Safety Code, Section 25532(a) should I store or handle hazardous permit is issued. material. Additionally, should I use equipment or devices which emit hazardous 3. I certify that in the performance of the work for which this permit is issued, I air contaminants as defined by the Bay Area Air Quality Management District I shall not employ any person in any manner so as to become subject to the will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and Worker's Compensation laws of California. If, after making this certificate of the Health &Safety Code ,ctions 25505, 25533, and 25534. exemption, I become subject to the Worker's Compensation provisions of the forthwith comply with such provisions or this permit shall Labor Code, I must P Y authorized agent: - Owner or autho be deemed revoked. Date: 4/26/19 CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that there is a onstruction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) correct. I agree to comply with all city and county ordinances and state laws and hereby authorize representatives of this city Lender's Name relating to building construction, to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Address to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in ARCHITECT'S DECLARATION consequence of the granting of this permit. Additionally, the applicant understands I understand my plans shall be used as public records. and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18.