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PW Sanitary Sewer Lateral Replacement:1 Rnq F ' DEPARTMENT OF i PUBLIC WORKS Contact Public Works: 415-485-3355 EIA%Nv.cityofsanrafael.orgicontactDP'P1 t��,w», cityofsan rafael. orgisidewalk s Agreement for Sanitary Sewer Lateral Replacement This Agreement is entered into on L�5 ,?,—(u -2011 by and between the City of San Rafael, a municipal corporation ("City"), Ghilotti Construction Company (-Contractor), and Mikol Davis and Carolyn Rosenblatt, the owner(s) of the real property located at 54 McNear Drive San Rafael, California ("Owner"). Whereas, the City has offered to replace the sanitary sewer lateral connecting Owner's property to the public sanitary sewer system, and cost share with the owners of the real property. and Whereas, Owner agreed to contribute to the cost-sharing for the work at the rate of Fifty percent (50`Yo) of the total cost but in no event to exceed S12,500 00; Now, therefore, City, Contractor and Owner agree as follows Owner hereby requests the Contractor to replace the sanitary sewer lateral at 54 McNear Drive. and will provide Contractor with all access needed for such work Owner acknowledges that the Contractor will invoice the City for such work on Owner's property, and that City will bill Owner for those costs following completion of the work Owner agrees to pay 50 percent of the cost for the work (not to exceed S12,500.00) within 30 days of receipt of the City's invoice. Owner acknowledges and agrees that installation, maintenance and care of the sanitary sewer lateral is solely the responsibility of Owner, and nothing in this Agreement is intended to or shall be deemed to alter Owner's responsibilities and liabilities for such installation, maintenance of care in the future or to create any duty on the part of City to assume or perform such obligations other than as set forth herein. Acceptance of Proposal and Agreement: Owner specifically agrees the specifications and conditions of this Agreement are satisfactory and are hereby accepted. The Contractor is authorized to do the work as specified, and Owner will make payment to City as outlined above. The undersigned Owners represent that helshelthey are the only owners of the property referenced above. or if not that helshelthey is/are duly authorized to execute this Agreement on behalf of all property owners. Contractor Signature, by Property Owner Signature Property Owner Name Date: [signature and titiel �r. r'T �471 , Date: Property Owner Phone/Email: Ct G'<<Cf1'� (r� GZ bt •L�� Y►�1, LLQ C:E- l v Y second property owner (optIn Property Owner Signature. Date Property Owner Name: ML -(c0 L L�11, LS Page Z of 2 %--I -3 - S03 b is r" ;, � k.1 .7 t n4F�F 8 DEPARTMENT OF PUBLIC WORKS Contact Public Works 415-485-3355 www cityofsanrafael.oralcontactDP��' vo,vw cityofsanrafael orgisidewalks SN77V greement is received by the City City of San Rafael, by: Date: Jim chutz, Ci Manager Copy of frrta d agreement (with 'ty signature) will be sent to the property owner. Page 2 of 2 .a far lS� SIA* DEPARTMENT OF PUBLIC WORKS Contact Public Works 415-485-3355 %10,%,:dr-l!yofsanrafael.org/contactDFI,',-' vrY1rv.cit ofsanrafaei or isidewaiks Agreement for Sanitary Sewer Lateral Replacement This Agreement is entered into on 5L_ D 12_& , 2011 , by and between the City of San Rafael, a municipal corporation ("City"), Ghilotti Construction Company (`Contractor'), and Mikol Davis and Carolyn Rosenblatt, the owner(s) of the real property located at 54 McNear Drive, San Rafael, California ("Owner"). Whereas, the City has offered to replace the sanitary sewer lateral connecting Owner's property to the public sanitary sewer system, and cost share with the owners of the real property; and Whereas, Owner agreed to contribute to the cost-sharing for the work. at the rate of Fifty percent (50%) of the total cost but in no event to exceed S12,500.00; Now, therefore, City, Contractor and Owner agree as follows Owner hereby requests the Contractor to replace the sanitary sewer lateral at 54 McNear Drive, and will provide Contractor with all access needed for such work. Owner acknowledges that the Contractor will invoice the City for such work on Owner's property, and that City will bill Owner for those costs following completion of the work. Owner agrees to pay 50 percent of the cost for the work (not to exceed S12,500.00) within 30 days of receipt of the City s invoice. Owner acknowledges and agrees that installation maintenance and care of the sanitary sewer lateral is solely the responsibility of Owner, and nothing in this Agreement is intended to or shall be deemed to alter Owner's responsibilities and liabilities for such installation, maintenance of care in the future or to create any duty on the part of City to assume or perform such obligations other than as set forth herein. Acceptance of Proposal and Agreement: Owner specifically agrees the specifications and conditions of this Agreement are satisfactory and are hereby accepted. The Contractor is authorized to do the work as specified, and Owner will make payment to City as outlined above. The undersigned Owners represent that he/shelthey are the only owners of the property referenced above, or if not that he/shelthey is/are duly authorized to execute this Agreement on behalf of all property owners Contractor Signature. by Date - [signature and frtlej Property Owner Signature t i' '.. ICE : iT %�C Date: Property Owner Name L' ! 'Lj_ J (��Cn��,vG�y�^-2� t ,mkDe_ 1JA�� Property Owner Phone/Email: C (al' es%oa ����1_l1yyLLt, C E V► V If second property owner (oph n Property Owner Signature. Date_ � Property Owner Name: AA L-(( O 1�1L iS Page 1 of 2 R4f�41f'. DEPARTMENT OF PUBLIC WORKS Contact Public Works: 415-485-3355 wane eityofsanrafael.orcfcontactDPW vomv cityofsanrafael.orcisid-awalks Seal n bet nr Tete after agreement is received by the City City of San Rafael: by: Date: Ji Sc utz, Ci Manager Copy of final sig greement (withAfty signature) will be sent to the property owner. Page 2 of 2 4v hn/S.. DEPARTMENT OF = PUBLIC WORKS Contact Public Works 415.485.3355 �w_CII oFsanrafael orq/contactDF'• -,- v41rw cnYofsanrafaat orq; sidewalks Agreement for Sanitary Sewer Lateral Replacement This Agreement is entered into on FP_b 20117 . by and between the City of San Rafael, a municipal corporation ("City"), Ghilotti Construction Company (`Contractor'), and Mikol Davis and Carolyn Rosenblatt, the owner(s) of the real property located at 54 McNear Drive, San Rafael, California ("Owner"). Whereas, the City has offered to replace the sanitary sewer lateral connecting Owner's property to the public sanitary sewer system, and cost share with the owners of the real property: and Whereas, Owner agreed to contribute to the cost-sharing for the work. at the rate of Fifty percent 15014,) of the total cost but in no event to exceed S12.500.00: Now, therefore, City, Contractor and Owner agree as follows Owner hereby requests the Contractor to replace the sanitary sewer lateral at 54 McNear Drive, and will provide Contractor with all access needed for such work Owner acknowledges that the Contractor will Invoice the City for such work on Owner's property, and that City will bill Owner for those costs following completion of the work Owner agrees to pay 50 percent of the cost for the work (not to exceed S12,500.00) within 30 days of receipt of the City's invoice Owner acknowledges and agrees that Installation, maintenance and care of the sanitary sewer lateral is solely the responsibility of Owner, and nothing in this Agreement is intended to or shall be deemed to alter Owner's responsibilities and liabilities For such installation, maintenance of care in the future or to create any duty on the part of City to assume or perform such obligations other than as set forth herein. Acceptance of Proposal and Agreement: Owner specifically agrees the specifications and conditions of this Agreement are satisfactory and are hereby acct pled. The Contractor Is authorized to do the work as specified, and Owner will make payment to City as outlined above. The undersigned Owners represent that he/she/they are the only owners of the property referenced above, or if not. that helshe/they is/are duly authorized to execute this Agreement on behalf of all property owners. Contractor Signature, by P27o r' -'e f 04gWate- Z,CS T Cit, [sign a ura`and Title] Property Owner Signature: Date:Cj Property Owner Name: 6iWziM.N��� Property Owner Phone/Email: t Yyllftt! . (&V-p�/ Ij If second property owner (opti n Property Owner Signature: Date. �- _ Property Owner Name: PIA L C"OL L, , DAV Lta / Page i of 2 4rT. nvt�( r1 '• DEPARTMENT OF PUBLIC WORKS Contact Public Works. 415-485-3355 +a om atyufsanraFael.oie/contactDPW mrw ablofsanrafael arclsidewalks sect'All bel m tete after agreement Is received by the City r City of San Rafael, by: Date: A Sc Utz, C1 Manager Copy of final sig agreement (wit ' y signature) will be sent to the property owner Page 2 of 2 CONTRACT CONTRACT ROUTING FORM INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown below. TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER: Contracting Department: Public Works Project Manager: Shawn Graf Extension: 5347 Contractor Name: Dr. Mikol Davis Contractor's Contact: 415-250-7380 Contact's Email: drmikol@comcast.net ❑ FPPC: Check if Contractor/Consultant must file Form 700 Step RESPONSIBLE DESCRIPTION COMPLETED REVIEWER DEPARTMENT a. Email PINS Introductory Notice to Contractor DATE Check/Initial 1 Project Manager Click here to ❑ enter a date. b. Email contract (in Word) & attachments to City 1/7/2019 SG Atty c/o Laraine.Gittens@cityofsanrafael.org 2 City Attorney a. Review, revise, and comment on draft agreement 2/7/2019 ® LG and return to Project Manager 2/7/2019 ® N/A b. Confirm insurance requirements, create Job on PINS, send PINS insurance notice to contractor Forward three (3) originals of final agreement to 2/8/2019 3 Project Manager Project Manager contractor for their signature When necessary, * contractor -signed agreement ® N/A 4 agendized for Council approval *PSA > $75,000; or Purchase > $75,000; or Or Public Works Contract > $175,000 Click here to SG Date of Council approval enter a date. PRINT CONTINUE ROUTING PROCESS WITH HARD COPY 5 Project Manager Forward signed original agreements to City 2/26/2019 SG City Attorney Attorney with printed copy of this routing form 6 Review and approve hard copy of signed agreement Review and approve insurance in PINS, and bonds 7 City Attorney 11A (for Public Works Contracts) 8 City Manager/ Mayor City Clerk Agreement executed by Council authorized official 3 l 9 Attest signatures, retains original agreement and forwards copies to Project Manager 3