21-116 Encroachment Agreement, GTE Mobilnet of California Limited Partnership, dba Verizon Wireless, R.O.W, 10335 North Tantau Avenue1.Encroachment Agreement. This is an Encroachment Agreement as referenced in that
certain Small Cell License Agreement between Licensor and Licensee dated May 16, 2017
("Agreement"). This Encroachment Agreement shall serve as an encroachment license. All of the
terms and conditions of the Agreement are incorporated hereby by reference and made a part hereof
without the necessity of repeating or attaching the Agreement. In the event of a contradiction,
modification or inconsistency between the terms of the Agreement and this Encroachment
Agreement, the terms of the Encroachment Agreement shall govern. Capitalized terms used in this
Encroachment Agreement shall have the same meaning described for them in the Agreement unless
otherwise indicated herein.
2.Project Description and Locations. Licensee shall have the right to use the ROW for a
Small Cell at the designated areas in the ROW as further described in Attachment 1 attached hereto
(the “Licensed Area”).
3. Equipment. The Small Cell to be installed at the Licensed Area is described in Attachment
1 attached hereto.
4.Term. The term of this Encroachment Agreement shall be as set forth in Section 2 of the
Agreement.
5.Fees. The initial Rent for the term of this Encroachment Agreement shall be $1,500.00, as
determined in accordance with Paragraph 5.1 of the Agreement, as adjusted by Paragraph 5.2.
6.Commencement Date. The first day of the month following the date Licensee has
Commenced Installation of its Equipment at the Licensed Area.
7. Approvals/Fiber. It is understood and agreed that Licensee's ability to use the Licensed
Area is contingent upon its obtaining all of the certificates, permits and other approvals
(collectively the "Governmental Approvals") that may be required by any Federal, State or Local
authorities, as well as a satisfactory fiber and electrical connection which will permit Licensee use
of the Licensed Area as set forth above. In the event that (i) any of such applications for such
Governmental Approvals should be finally rejected; (ii) any Governmental Approval issued to
Licensee is canceled, expires, lapses, or is otherwise withdrawn or terminated by governmental
authority; (iii) Licensee determines that such Governmental Approvals may not be obtained in a
timely manner; (iv) Licensee determines that it will be unable to obtain in a satisfactory manner,
or maintain any fiber or power connection; or (v) Licensee determines that the Licensed Area is no
CA_SJ_CUPERTINO_316
10335 N Tantau Ave, Cupertino, CA 95014
ENCROACHMENT AGREEMENT
This Encroachment Agreement (“Encroachment Agreement”), made as of the last date signed
below (“Effective Date”) between the City of Cupertino, a political subdivision of the State of
California, hereinafter designated “Licensor” and GTE Mobilnet of California Limited
Partnership, d/b/a Verizon Wireless, with its principal offices at c/o Verizon Wireless, 180
Washington Valley Road, Bedminster, New Jersey 07921, hereinafter designated “Licensee”:
545461
DocuSign Envelope ID: 2AF402F9-E4FE-49CE-A224-F23EE644947BDocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54
longer technically compatible for its use, Licensee shall have the right to terminate this
Encroachment Agreement. Notice of Licensee's exercise of its right to terminate shall be given to
Licensee in writing by certified mail, return receipt requested, and shall be effective upon the
mailing of such notice by Licensee, or upon such later date as designated by Licensee. All rentals
paid to said termination date shall be retained by Licensor. Upon such termination, this
Encroachment Agreement shall be of no further force or effect except to the extent of the
representations, warranties and indemnities made by each party to the other hereunder. Otherwise,
Licensee shall have no further obligations for the payment of Rent to Licensor.
8.Miscellaneous. N/A
[Signature page follows]
DocuSign Envelope ID: 2AF402F9-E4FE-49CE-A224-F23EE644947BDocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54
EXECUTED to be effective as of the last date shown below.
LICENSOR:
City of Cupertino, a political subdivision
of the State of California
By: ___________________________
Name: _________________________
Title: __________________________
Date: ___________________________
ATTEST:
Date: ___________________________
APPROVED AS TO FORM CITY
ATTORNEY’S OFFICE
BY: __________________________
Print Name: _____________________
Date: __________________________
City Attorney
LICENSEE:
GTE MOBILNET OF CALIFORNIA
LIMITED PARTNERSHIP, D/B/A
VERIZON WIRELESS
by Cellco Partnership, its
General Partner
By:
Date: ______________________________
Name: Alba Barber
Title: Senior Real Estate Manager
Exhibits:
Attachment 1
, Clerk
DocuSign Envelope ID: 2AF402F9-E4FE-49CE-A224-F23EE644947BDocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54
Mar 25, 2021
Heather Minner
Apr 5, 2021
Chad Mosley
City Engineer
Apr 5, 2021
Apr 5, 2021
Attachment 1
Licensed Area
See attached.
DocuSign Envelope ID: 2AF402F9-E4FE-49CE-A224-F23EE644947BDocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54
T-1
TITLE SHEET
DRAWN BY:
CHECKED BY:BM
APE
IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS
THEY ARE ACTING UNDER THE DIRECTION OF A LICENSED
PROFESSIONAL ENGINEER, TO ALTER THIS DOCUMENT
0 08/13/20 100% CD
REV DATE DESCRIPTION
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA
94108
APPROVED BY:LJB
CA_SJ_CUPERTINO_316
VERIZON WIRELESS
2785 MITCHELL DRIVE, SUITE 9
WALNUT CREEK, CA
94598
(NEAR) 10335 N TANTAU AVE,
CUPERTINO, CA 95014
1 12/17/20 100% CD PLAN CHECK
SITE INFORMATION
SITE ADDRESS:
OWNER:
APPLICANT:
LATITUDE:
LONGITUDE:
COUNTY:
ASSESSORS PARCEL NUMBER:
ZONING:
ELEVATION:
CITY OF CUPERTINO
10300 TORRE AVE
CUPERTINO, CA 95014
VERIZON WIRELESS
2785 MITCHELL DRIVE, SUITE 9
WALNUT CREEK, CA 94598
37° 19' 46.58 N NAD83
122° 0' 21.58" W NAD83
SANTA CLARA
PUBLIC RIGHT OF WAY
NEAR 316-06-064
CITY OF CUPERTINO
162.30' AMSL
VICINITY MAPPOLE PHOTO
N
DRAWING INDEX
T-1
SHEET NO.
TITLE SHEET
T-2 GENERAL NOTES
A-1 SITE PLAN & ENLARGED SITE PLAN
A-2
A-4
ELEVATIONS
CIRCUIT DIAGRAM
D-1 DETAILS
CODE COMPLIANCE
ALL WORK AND MATERIALS SHALL BE PERFORMED AND INSTALLED IN ACCORDANCE WITH THE CURRENT
EDITIONS OF THE FOLLOWING CODES AS ADOPTED BY THE LOCAL GOVERNING AUTHORITIES. NOTHING
IN THESE PLANS IS TO BE CONSTRUCTED TO PERMIT WORK NOT CONFORMING TO THESE CODES.
·2019 CALIFORNIA CODE
·2019 CALIFORNIA BUILDING CODE (CBC), BASED ON THE 2018 IBC
·2019 CALIFORNIA RESIDENTIAL CODE (CRC), BASED ON THE 2018 IRC
·2019 CALIFORNIA ELECTRICAL CODE (CEC), BASED ON THE 2017 NEC
·2019 CALIFORNIA MECHANICAL CODE (CMC), BASED ON THE 2018 UMC
·2019 CALIFORNIA PLUMBING CODE (CPC), BASED ON THE 2018 UPC
·2019 CALIFORNIA GREEN BUILDINGS STANDARDS CODE (CALGREEN)
·2019 CALIFORNIA FIRE CODES WITH ALL LOCAL AMENDMENTS
·ANY LOCAL BUILDING CODE AMENDMENTS TO THE ABOVE
·CITY / COUNTY ORDINANCES
SHEET TITLE
E-1 ELECTRICAL GENERAL NOTES
E-2 ONE-LINE DIAGRAM & GROUNDING SCHEMATIC
E-3 ELECTRICAL DETAILS
ACCESSIBILITY REQUIREMENTS FOR PERSONS WITH DISABILITIES:
FACILITY IS UNMANNED AND NOT FOR HUMAN HABITATION. ACCESSIBILITY IS
NOT REQUIRED IN ACCORDANCE WITH CALIFORNIA ADMINISTRATIVE STATE
CODE PART 2, TITLE 24, CHAPTER 11B, SECTION 1103B.
10335 N TANTAU AVE
SURVEY
PROJECT TEAM PROJECT DESCRIPTION
D-2 DETAILS
THE UTILITIES SHOWN HEREIN ARE FOR THE CONTRACTORS CONVENIENCE
ONLY. THERE MAY BE OTHER UTILITIES NOT SHOWN ON THESE PLANS. THE
ENGINEER/SURVEYOR ASSUMES NO RESPONSIBILITY FOR THE LOCATIONS
SHOWN AND IT SHALL BE THE CONTRACTOR'S RESPONSIBILITY TO VERIFY
ALL THE UTILITIES WITHIN THE LIMITS OF THE WORK. ALL DAMAGE MADE TO
THE (E) UTILITIES BY THE CONTRACTOR SHALL BE THE SOLE RESPONSIBILITY
OF THE CONTRACTOR.
CALL 811 BEFORE YOU DIG
IT'S THE LAW
MODUS PROJECT MANAGER:
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA 94108
PHONE: (415) 989.1102
EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM
CONSTRUCTION/IMPLEMENTATION MANAGER:
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA 94108
PHONE: (415) 989.1102
EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM
A&E PROJECT MANAGER:
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA 94108
PHONE: (415) 989.1102
EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM
APPLICANT:
VERIZON WIRELESS
2785 MITCHELL DRIVE, SUITE 9
WALNUT CREEK, CA 94598
CONTACT: CHRIS MOLLER
PHONE: (925) 339.2778
EMAIL: CHRIS.MOLLER@VERIZONWIRELESS.COM
LAND USE PLANNER:
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA 94108
PHONE: (415) 989.1102
EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM
SITE ACQUISITION:
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA 94108
PHONE: (415) 989.1102
EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM
SITE
C-1
A-3 ELEVATIONS
VERIZON WIRELESS PROPOSES TO INSTALL A NEW WIRELESS COMMUNICATION SITE ON A LIGHT POLE IN THE PUBLIC RIGHT-OF-WAY.
SCOPE:
·INSTALL (2) 5G ANTENNA/RADIOS INSIDE NEW FRP CONCEALMENT SHROUD ON TOP OF POLE
·INSTALL (1) NEW DISCONNECT / SMART METER ON SIDE OF POLE
·INSTALL NEW POLE AND FOUNDATION TO REPLACE EXISTING
D-3 POLE SPECS
(NEAR) 10335 N TANTAU AVE
CUPERTINO, CA 95014
(NEAR) 10335 N TANTAU AVE
CUPERTINO, CA 95014
CA_SJ_CUPERTINO_316
SITE ID:
SITE TYPE:
POLE #:
CX PROJECT ID:
COUNTY:
PSLC:
CA_SJ_CUPERTINO_316
LIGHT POLE
7208
20191962640
SANTA CLARA
545461
A-4A CIRCUIT DIAGRAM
D-4 CITY STANDARD DETAILS
A-4B CIRCUIT DIAGRAM
A-4C CIRCUIT DIAGRAM
DocuSign Envelope ID: 2AF402F9-E4FE-49CE-A224-F23EE644947BDocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54
FI
B
E
R
S/
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S/
L
S
/
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F
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F
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DRAWN BY:
CHECKED BY:BM
APE
IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS
THEY ARE ACTING UNDER THE DIRECTION OF A LICENSED
PROFESSIONAL ENGINEER, TO ALTER THIS DOCUMENT
0 08/13/20 100% CD
REV DATE DESCRIPTION
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA
94108
APPROVED BY:LJB
CA_SJ_CUPERTINO_316
VERIZON WIRELESS
2785 MITCHELL DRIVE, SUITE 9
WALNUT CREEK, CA
94598
(NEAR) 10335 N TANTAU AVE,
CUPERTINO, CA 95014
1 12/17/20 100% CD PLAN CHECK
A-1
SITE PLAN
1ENLARGED SITE PLAN
N
SITE PLAN2
N
2
A-1
ENLARGED
SITE PLAN
1&2
A-3
1&2
A-2
(E
)
LA
N
D
S
C
A
P
E
1/16"=1'-0"
SCALE
1/2"=1'-0"
SCALE
(E) LIGHT POLE & FOUNDATION TO BE REMOVED. (N)
LIGHT POLE & FOUNDATION TO BE INSTALLED IN PLACE
(N) LOCATION OF VERIZON
WIRELESS ANTENNA IN FRP SHROUD
MOUNTED ON LIGHT POLE
PR
O
P
E
R
T
Y
L
I
N
E
(E) FACE OF THE CURB
2'-7"± BACK OF
POLE TO ROW LINE
(N) LOCATION OF VERIZON WIRELESS
ANTENNA AND EQUIPMENT
N
T
A
N
T
A
U
A
V
E
A.P.N.:
316-06-065
ELECTRICAL LINE
STREET LIGHT LINE
E
S/L
FIBER LINE(S)FIBER
LEGEND
NC
1
(N) STEEL MAST ARM
(N) LUMINAIRE
N1
EC
2
N
C
2
NC
3
(E) INLET
PR
O
P
E
R
T
Y
L
I
N
E
(E
)
LA
N
D
S
C
A
P
E
(E) FACE OF
THE CURB
FENC
E
N
T
A
N
T
A
U
A
V
E
2'-7"± BACK OF POLE
TO ROW LINE
EC1
10300
N TANTAU AVE
CUPERTINO,
CA 95014
SE
C
T
O
R
AZ
I
M
U
T
H
1
8
0
5G
B
SE
C
T
O
R
AZ
I
M
U
T
H
0
5G
A
E1
(N) 2'-6" x 4'-0" x 6" THICK CONCRETE
CAP PER CITY STANDARDS TO
REPLACE EXISTING
6
"
M
I
N
.
(E) MANHOLE
(E) PULLBOX
(E
)
LA
N
D
S
C
A
P
E
PR
O
P
E
R
T
Y
L
I
N
E
(E) WATER
VALVE TYP.
(E) MANHOLE
PROP
E
R
T
Y
L
I
N
E
(E) FIRE
HYDRANT
(E) DRIVEWAY
A.P.N.:
316-06-064
10335
N TANTAU AVE
CUPERTINO,
CA 95014
EC
2
CO
N
C
R
E
T
E
S
I
D
E
W
A
L
K
(E
)
LA
N
D
S
C
A
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(E
)
LA
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D
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C
A
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CO
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S
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A
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NOTE:
1. FIBER PULLBOX EXACT LOCATION TO BE VERIFIED IN FIELD
2. UPON COMPLETION OF CONSTRUCTION, RESTORE
LANDSCAPE AND IRRIGATION TO LIKE OR BETTER
CONDITION, TEST IRRIGATION.
3. UPON COMPLETION OF CONSTRUCTION, NOTIFY THE
CITY OF NEW STREETLIGHT INSTALLATION SO THAT NEW
BADGE ID NUMBER CAN BE PLACED BY THE CITY ONTO
THE NEW STREETLIGHT POLE.
NOTE:
CARRIER GROUND WIRE TO BE LABELED IN FIELD
Label carrier gnd line in City box
Repl inductive with (N) LED
DocuSign Envelope ID: 2AF402F9-E4FE-49CE-A224-F23EE644947BDocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54
SHUTDOWN
DRAWN BY:
CHECKED BY:BM
APE
IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS
THEY ARE ACTING UNDER THE DIRECTION OF A LICENSED
PROFESSIONAL ENGINEER, TO ALTER THIS DOCUMENT
0 08/13/20 100% CD
REV DATE DESCRIPTION
MODUS, LLC
240 STOCKTON ST., 3RD FLOOR
SAN FRANCISCO, CA
94108
APPROVED BY:LJB
CA_SJ_CUPERTINO_316
VERIZON WIRELESS
2785 MITCHELL DRIVE, SUITE 9
WALNUT CREEK, CA
94598
(NEAR) 10335 N TANTAU AVE,
CUPERTINO, CA 95014
1 12/17/20 100% CD PLAN CHECK
A-2
EXISTING & PROPOSED
ELEVATIONS
12PROPOSED ELEVATIONEXISTING ELEVATION 1/2"=1'-0"
SCALE
1/2"=1'-0"
SCALE
EXISTING SURFACE
0'-0" AGL
EXISTING SURFACE
0'-0" AGL
(E) FOUNDATION
(E) LIGHT POLE TO BE REPLACED
(E) LUMINAIRE
(E) ROAD SIGNS
2'-7" BACK OF POLE TO ROW LINE
4
D-2
(N) FOUNDATION
(N) 10'-0" MAST ARM
NOTES:
1. ALL NEW ANTENNAS, BRACKETS, AND OTHER EQUIPMENT WILL BE PAINTED TO MATCH LIGHT POLE.
2. ALL EXISTING SIGNAGE TO BE RELOCATED SHALL BE FASTENED USING 1/2" STEEL BANDING
B.O. (E) SIGNS
9'-5" AGL
B.O. (E) SIGNS
7'-0" AGL
T.O. (E) LIGHT SENSOR
31'-6" AGL
(E) LIGHT ARM
28'-4" AGL
T.O. (E) STEEL LIGHT POLE
28'-8" AGL
T.O. (E) SIGNS
8'-6" AGL
(N) LIGHT POLE
(N) (2) 5G ANTENNAS
IN FRP SHROUD
6
D-1
(N) FRP CONCEALMENT
SHROUD
1
D-1
T.O. (N) STEEL LIGHT POLE
29'-11" AGL
RAD CENTER OF (N) 5G ANTENNA
31'-7" AGL
T.O. (N) CONCEALMENT SHROUD
35'-6" AGL
8
D-1
3
E-3
B.O. (N) DISCONNECT/B.O. (E) SIGNS
7'-0" AGL
T.O. (N) DISCONNECT
8'-9" AGL
(N) SMART METER / DISCONNECT
w/ SHUTDOWN SIGNAGE
4
D-1
5
D-1
PORT HOLE LOCATION
FOR DISCONNECT
1
D-2
(E) ROAD SIGNS
(N) LUMINAIRE
1
D-3
7
E-3
2'-7" BACK OF POLE TO ROW LINE
T.O. (E) LIGHT SENSOR
31'-8" AGL
(N) NOTICE SIGNAGE, TYP. OF (1)
FACING STREETSIDE
9
D-1
T.O. (N) NOTICE SIGNAGE
25'-2" AGL
T.O. (E) SIGNS
11'-11" AGL
B.O. (E) SIGNS
9'-5" AGL
T.O. (E) SIGNS
8'-6" AGL
T.O. (E) SIGNS
11'-11" AGL
DocuSign Envelope ID: 2AF402F9-E4FE-49CE-A224-F23EE644947BDocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54
Certificate Of Completion
Envelope Id: 2AF402F9E4FE49CEA224F23EE644947B Status: Completed
Subject: Please DocuSign: CA_SJ_CUPERTINO_316_Encroachment Agreement.pdf
Source Envelope:
Document Pages: 7 Signatures: 0 Envelope Originator:
Certificate Pages: 5 Initials: 14 BRYAN MCCAFFERY
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
92 Bay Street
Glens Falls, NY 12801
modusdocusign@modusllc.com
IP Address: 24.7.112.21
Record Tracking
Status: Original
3/3/2021 8:31:22 PM
Holder: BRYAN MCCAFFERY
modusdocusign@modusllc.com
Location: DocuSign
Signer Events Signature Timestamp
Chad Mosley
chadm@cupertino.org
Security Level: Email, Account Authentication
(None)
Signature Adoption: Drawn on Device
Using IP Address: 67.164.60.110
Sent: 3/3/2021 8:33:42 PM
Viewed: 3/9/2021 11:31:35 AM
Signed: 3/9/2021 11:31:49 AM
Electronic Record and Signature Disclosure:
Accepted: 1/8/2021 11:03:58 AM
ID: cf965389-d53e-4e7e-9e57-3e9c6593663d
Marlene Dehlinger
Dehlinger@smwlaw.com
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 52.39.49.65
Sent: 3/3/2021 8:33:42 PM
Viewed: 3/10/2021 10:27:29 AM
Signed: 3/10/2021 10:37:44 AM
Electronic Record and Signature Disclosure:
Accepted: 3/10/2021 10:27:29 AM
ID: 01f257ae-9025-4fd2-a53b-b4f49a3aae78
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Steve Pagan
stevep@cupertino.org
Security Level: Email, Account Authentication
(None)
Sent: 3/3/2021 8:33:42 PM
Viewed: 3/4/2021 8:06:19 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events Signature Timestamp
DocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 3/3/2021 8:33:43 PM
Certified Delivered Security Checked 3/10/2021 10:27:29 AM
Signing Complete Security Checked 3/10/2021 10:37:44 AM
Completed Security Checked 3/10/2021 10:37:44 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
DocuSign Envelope ID: 5765FCAC-8609-4499-ACCB-FF0B34A60B54