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HomeMy WebLinkAbout22 Chorro - SLO Encroachment App - SeaBay BuilG:Reference-Library\Forms-Templates\DevRevForms\Inspections and Management\Encroachment Permit Checklist Encroachment Permit Checklist: This checklist was created as a guide to help applicants with submittals. Additional information may be required prior to permit approval. City of San Luis Obispo Encroachment Permits: 805-781-7015 Matt LaFreniere mlafreniere@slocity.org Contractor Information: Company Name/Contractor Name Mailing address of business Names of persons authorized to sign for permits Phone number of business Cell phone numbers Fax Email Contractors State License Number Insurance for private encroachment permit projects: The City of San Luis Obispo requires: A certificate of liability insurance with at least $1 million in general liability coverage AND a CG 2012 additional insured endorsement attached to it. Please email a current liability insurance certificate to Matt LaFreniere, mlafreniere@slocity.org, with a CG 2012 additional insured endorsement attached. An example form is available online at: http://www.slocity.org/encroachment. Please provide this example form to your insurance provider so the endorsement can be issued under your policy. CIP Insurance: This requirement only applies to CIP projects or job contracts with the City of San Luis Obispo. This is not for private developments. City CIP (Capital Improvement Plan) projects require a liability insurance certificate and a CG 2010 endorsement. CIP insurance documents are coordinated through Public Works Administration at 805-781-7200. Contractors State License: A valid Contractors State License is required. The contractor must be licensed for the type of work to be performed. City Business License: A current City business license must be maintained. For information on obtaining a City business license, please contact the Finance Department. Water Pollution Control Plan Forms: Both forms must be filled out for all encroachment permits. Forms are located here: http://www.slocity.org/encroachment Traffic and Pedestrian Control Plan: Please submit the application, located here: http://www.slocity.org/encroachment with your traffic and/or pedestrian control plan. Traffic and pedestrian control plans are generally reviewed within five working days of their submittal date. Construction Plans: These include building plans, engineering plans, miscellaneous project plans, public improvement plans, and subdivision plans. Necessary construction plans must be submitted and approved prior to permit issuance. Engineering Standards: Encroachment permit work must conform to City Engineering Standards and Standard Specifications, unless alternate plans are approved. Applicants should reference specific standards in their plan submittals, as they apply. Night Work Permit: Work between the hours of 7:00pm and 7:00am is called “night work.” A separate permit must be obtained through the Community Development Department if night work is necessary. Please contact the Planning Division at 805-781-7170 to apply for a night work permit. To allow adequate time for processing, please submit night work applications at least four weeks prior to the proposed start date of the work. Night work applications require a separate fee. Payment of Encroachment Permit Fees: Current fee schedule at: http://www.slocity.org/encroachment N/A N/A N/A N/A Company Name SeaBay Building Group Address 1011 Pacific St.,San Luis Obispo,CA,93401 Phone 206 775 5004 Authorized Persons Nate Buchman 206 775 5004 Randy Johnson 510 427 3337 Armando Martinez 415 515 1375 Email nbuchman@seabay group.com rjohnson@seabay group.com amartinez@seabay group.com CA Licence 1005237 CG 20120798 Copyright, Insurance Services Office, Inc ‘1997 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20120798 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED STATE OR POLITICAL SUBDIVISIONS - PERMITS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Section II — Who Is An Insured is amended to include as an insured any state or political subdivision shown in the Schedule. Subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. 2. This insurance does not apply to: a. “Bodily injury,” “property damage” or “personal and advertising injury” arising out of operations performed for the state or municipality; or b. “Bodily injury” or “property damage” included within the “products-completed operations hazard”. State or Political Subdivision: City of San Luis Obispo, A Municipal Corporation Public Works Department 919 Palm Street San Luis Obispo, CA 93401 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT A/C, No): FAX E-MAILADDRESS: PRODUCER A/C, No, Ext): PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. 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). 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. OTHER: Per accident) Ea accident) N / A SUBR WVD ADDL INSD 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 CLAIMS. PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOSONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY) POLICY EXP( MM/DD/YYYY) POLICYEFFPOLICYNUMBERTYPEOFINSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE AGGREGATE OCCUR CLAIMS-MADE DED RETENTION $ PRODUCTS - COMP/OP AGG GENERAL AGGREGATE PERSONAL & ADV INJURY MED EXP (Any one person) EACH OCCURRENCE DAMAGE TO RENTED $ PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 1/20/2021 Arthur J.Gallagher Risk Management Services,Inc. 777 108th Ave NE,#200 Bellevue WA 98004 Colin Dooley Colin_Dooley@ajg.com Ohio Security Insurance Company 24082 SEABBUI-02 State CompensationFundSeaBayBuildingGroup,LLC 205 S Clark Drive Tempe AZ 85281 Travelers Casualty and Surety Co of America 31194 Mt Hawley Insurance Company 37974 Charter Oak Fire Insurance Company 25615 1625994886 D X 1,000,000 X 100,000 5,000 1,000,000 2,000,000 X MGL0192953 11/23/2020 11/23/2021 2,000,000 A 1,000,000 X X X BAS2162114300 11/23/2020 11/23/2021 D X 10,000,000 X MXL0431404 11/23/2020 11/23/2021 10,000,000 B X91578664/26/2020 4/26/2021 CA WC 1,000,000 1,000,000 1,000,000 C E E Crime Property Installation Floater 106833779 QT6606P930236TIL-20 QT6606P930236TIL-20 11/23/2020 11/23/2020 11/23/2020 11/23/2021 11/23/2021 11/23/2021 Limit Limit Limit 500,000 The Certificate Holder is an additional insured per the attached Endorsements only as respects the operations of the Named Insured where a contract exists. City of San Luis Opispo,A Municipal Corporation Public Works Department 919 Palm Street San Luis Opispo CA 93401 COMMERCIAL AUTO AC 85 4306 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement! the provisions of the policy apply unless modified by the endorsement. If the policy to which this endorsement is attached also contains a Business Auto Coverage Enhancement Endorsement with a specific state named in the title, this endorsement does not apply to vehicles garaged in that specified state. COVERAGE INDEX SUBJECT PROVISION NUMBER ACCIDENTAL AIRBAG DEPLOYMENT 12 ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT 3 AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 20 AMENDED FELLOW EMPLOYEE EXCLUSION 5 AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 14 BODILY INJURY REDEFINED 24 EMPLOYEES AS INSUREDS (including Employee Hired Auto) 2 EXTRA EXPENSE -BROADENED COVERAGE '10 GLASS REPAIR -WAIVER OF DEDUCTIBLE 16 HIRED AUTO COVERAGE TERRITORY 22 HIRED AUTO PHYSICAL DAMAGE (including Employee Hired Auto) 6 LOAN / LEASE GAP (Coverage Not Available In New York) 15 NEWLY FORMED OR ACQUIRED SUBSIDIARIES 1 PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) 17 PERSONAL EFFECTS COVERAGE 11 PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 8 PHYSICAL DAMAGE DEDUCTIBLE -VEHICLE TRACKING SYSTEM '13 PRIMARY AND NON-CONTRIBUTORY -WRITTEN CONTRACT OR WRITTEN AGREEMENT 23 RENTAL REIMBURSEMENT 9 SUPPLEMENTARY PAYMENTS 4 TOWING AND LABOR 7 TWO OR MORE DEDUCTIBLES 18 UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 19 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 21 SECTION 11 -LIABILITY COVERAGE is amended as follows: 1. NEWLY FORMED OR ACQUIRED SUBSIDIARIES SECTION 11 -LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured is amended to include the following as an "insured": di. Any legally incorporated subsidiary of which you own more than 50 percent interest during the policy period. Coverage is afforded only for 90 days from the date of acquisition or formation, However, "insured" does not include any organization that: 1) Is a partnership or joint venture; or 2) Is an "insured" under any other automobile policy except a policy written specifically to apply in excess of this policy; or 3) Has exhausted its Limit of Insurance or had its policy terminated under any other automobile policy. 2018 Liberty Mutual Insurance AC 85 43 06 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 7 Coverage under this provision d. does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 2. EMPLOYEES AS INSUREDS SECTION II -LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured is amended to include the following as an "insured": e. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow but only for acts within the scope of their employment by you. Insurance provided by this endorsement is excess over any other insurance available to any "employee". f. Any "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the "employee". 3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION II -LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured is amended to include the following as an "insured": g. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed in a written contract, written agreement, or permit issued to you by governmental or public authority, to add such person, or organization, or governmental or public authority to this policy as an "insured". However, such person or organization is an "insured": 1) Only with respect to the operation, maintenance or use of a covered "auto"; 2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or written agreement, or the permit has been issued to you; and 3) Only for the duration of that contract, agreement or permit. The "insured" is required to submit a claim to any other insurer to which coverage could apply for defense and indemnity. Unless the "insured" has agreed in writing to primary noncontributory wording per enhancement number 24, this policy is excess over any other collectible insurance. 4. SUPPLEMENTARY PAYMENTS SECTION II -LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, Paragraphs 2) and (4) are replaced by the following: 2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations) required because of an "accident" we cover. We do not have to furnish these bonds. 4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law, fellow "employees" are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule, or similar protection, the following provi- sion is added: SECTION II -LIABILITY, Exclusion B.5. Fellow Employee does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire if you have workers compensation insurance in force for all of your "employees" at the time of "loss". This coverage is excess over any other collectible insurance. SECTION III -PHYSICAL DAMAGE COVERAGE is amended as follows: 6. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4. Coverage Extensions of SECTION III -PHYSICAL DAMAGE COVERAGE, is amended by adding the following: If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any "auto" you own, then the Physical Damage coverages provided are extended to "autos": 1 2018 Liberty Mutual Insurance AC 85 43 06 18 Includes copyrighted material of insurance Services Office, Inc., with its permission. Page 2 of 7 a. You hire, rent or borrow; or b. Your "employee" hires or rents under a written contract or agreement in that "employee's" name, but only if the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: a. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of: 1) $50,000; or 2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or 3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality, minus a deductible. b. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. c. Subject to the limit, deductible and excess provisions described in this provision, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. d. Subject to a maximum of $1,000 per "accident", we will also cover the actual loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss. e. This coverage extension does not apply to; 1) Any "auto" that is hired, rented or borrowed with a driver; or 2) Any "auto" that is hired, rented or borrowed from your "employee" or any member of your employee's" household. Coverage provided under this extension is excess over any other collectible insurance available at the time of "loss". 7. TOWING AND LABOR SECTION III -PHYSICAL DAMAGE COVERAGE, Paragraph A.2. Towing, is amended by the addition of the following: We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type, "light truck" or "medium truck" is disabled: a. For private passenger type vehicles, we will pay up to $75 per disablement. b. For "light trucks", we will pay up to $75 per disablement. "Light trucks" are trucks that have a gross vehicle weight (GVW) of 10,000 pounds or less. c. For "medium trucks", we will pay up to $150 per disablement. "Medium trucks" are trucks that have a gross vehicle weight (GVW) of 10,001 -20,000 pounds. However, the labor must be performed at the place of disablement. 8. PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a. Coverage Extensions, Transportation Expenses of SECTION III -PHYSICAL DAMAGE COVERAGE, is amended to provide a limit of $50 per day and a maximum limit of $1,500. 9. RENTAL REIMBURSEMENT SECTION III -PHYSICAL DAMAGE COVERAGE, A. Coverage, is amended by adding the following: a. We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "accident" or "loss", to an "auto" for which we also pay a "loss" under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for those ex- penses incurred after the first 24 hours following the "accident" or "loss" to the covered "auto." b. Rental Reimbursement requires the rental of a comparable or lesser vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered "auto". This limit is excess over any other collectible insurance. 2018 Liberty Mutual Insurance AC 85 43 06 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7 d. This coverage does not apply unless you have a business necessity that other "autos" available for your use and operation cannot fill. e. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4. Coverage Extension. f. No deductible applies to this coverage. g. The insurance provided under this extension is excess over any other collectible insurance. If this policy also provides Rental Reimbursement Coverage you purchased, the coverage provided by this Enhancement Endorsement is in addition to the coverage you purchased. For the purposes of this endorsement provision, materials and equipment do not include "personal effects" as defined in provision 11.B. 10. EXTRA EXPENSE -BROADENED COVERAGE Under SECTION III -PHYSICAL DAMAGE COVERAGE, A. Coverage, we will pay for the expense of returning a stolen covered "auto" to you. The maximum amount we will pay is $1,000. 11. PERSONAL EFFECTS COVERAGE A. SECTION III -PHYSICAL DAMAGE COVERAGE, A. Coverage, is amended by adding the following: If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that auto" is stolen, we will pay, without application of a deductible, up to $600 for "personal effects" stolen with the "auto." The insurance provided under this provision is excess over any other collectible insurance. B. SECTION V -DEFINITIONS is amended by adding the following: For the purposes of this provision, "personal effects" mean tangible property that is worn or carried by an "insured." "Personal effects" does not include tools, equipment, jewelry, money or securi- ties. 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION III -PHYSICAL DAMAGE COVERAGE, B. Exclusions is amended by adding the following: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for "loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other coverage or warranty. 13. PHYSICAL DAMAGE DEDUCTIBLE -VEHICLE TRACKING SYSTEM SECTION III -PHYSICAL DAMAGE COVERAGE, D. Deductible, is amended by adding the following: Any Comprehensive Deductible shown in the Declarations will be reduced by 50% for any "loss" caused by theft if the vehicle is equipped with a vehicle tracking device such as a radio tracking device or a global position device and that device was the method of recovery of the vehicle. 14. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III -PHYSICAL DAMAGE COVERAGE, B. Exclusions, Paragraph a. of the exception to exclu- sions 4.c. and 4.d. is deleted and replaced with the following: Exclusions 4.c. and 4.d. do not apply to: a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not de- signed solely for the reproduction of sound, if the equipment is: 1) Permanently installed in the covered "auto" at the time of the "loss" or removable from a housing unit that is permanently installed in the covered "auto"; and 2) Designed to be solely operated by use from the power from the "auto's" electrical system; and 3) Physical damage coverages are provided for the covered "auto". If the "loss" occurs solely to audio, visual or data electronic equipment or accessories used with this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a $100 deductible. @ 2018 Liberty Mutual insurance AC 85 43 06 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 7 15. LOAN / LEASE GAP COVERAGE (Not Applicable In New York) A. Paragraph C. Limit Of Insurance of SECTION III -PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any one accident" is the greater of the: 1. Balance due under the terms of the loan or lease to which the damaged covered "auto" is subject at the time of the "loss" less the amount of: a. Overdue payments and financial penalties associated with those payments as of the date of the "loss"; b. Financial penalties imposed under a lease due to high mileage, excessive use or abnormal wear and tear; c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insur- ance purchased with the loan or lease; d. Transfer or rollover balances from previous loans or leases; e. Final payment due under a "Balloon Loan"; f. The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a covered "auto"; g. Security deposits not refunded by a lessor; h. All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto"; i. Any amount representing taxes; j. Loan or lease termination fees; or 2. The actual cash value of the damage or stolen property as of the time of the "loss". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the "loss". This adjustment is not applicable in Texas. B. Additional Conditions This coverage applies only to the original loan for which the covered "auto" that incurred the loss" serves as collateral, or lease written on the covered "auto" that incurred the "loss". C. SECTION V -DEFINITIONS is changed by adding the following: As used in this endorsement provision, the following definitions apply: Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. A "balloon loan" is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment. 16. GLASS REPAIR -WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION III -PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: No deductible applies to glass damage if the glass is repaired rather than replaced. 17. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION liI -PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: The deductible does not apply to "loss" caused by collision to such covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as maximum loaded weight the "auto" is designed to carry while it is: a. In the charge of an "insured"; b. Legally parked; and c. Unoccupied. 2018 Liberty Mutual Insurance AC 85 43 06 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 7 The "loss" must be reported to the police authorities within 24 hours of known damage. The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations. This provision does not apply to any "loss" if the covered "auto" is in the charge of any person or organization engaged in the automobile business. 18. TWO OR MORE DEDUCTIBLES Under SECTION III -PHYSICAL DAMAGE COVERAGE, if two or more company policies or coverage forms apply to the same "accident", the following applies to Paragraph D. Deductible: a. If the applicable Business Auto deductible is the smaller (or smallest) deductible, it will be waived; or b. If the applicable Business Auto deductible is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible; or c. If the "loss" involves two or more Business Auto coverage forms or policies, the smaller (or smallest) deductible will be waived. For the purpose of this endorsement, company means any company that is part of the Liberty Mutual Group. SECTION IV -BUSINESS AUTO CONDITIONS is amended as follows: 19. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV- BUSINESS AUTO CONDITIONS, Paragraph B.2. is amended by adding the following: If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the incep- tion date or renewal date of the Business Auto Coverage Form, the coverage afforded by this policy will not be prejudiced. However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery, and we have the right to collect additional premium for any such hazard or exposure. 20. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS SECTION IV -BUSINESS AUTO CONDITIONS, Paragraph A.2.a. is replaced in its entirety by the follow- ing: a. In the event of "accident", claim, "suit" or "loss", you must promptly notify us when it is known to: 1) You, if you are an individual; 2) A partner, if you are a partnership; 3) Member, if you are a limited liability company; 4) An executive officer or the "employee" designated by the Named Insured to give such notice, if you are a corporation. To the extent possible, notice to us should include: a) How, when and where the "accident" or "loss" took place; b) The "insured's" name and address; and c) The names and addresses of any injured persons and witnesses. 21. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV -BUSINESS AUTO CONDITIONS, Paragraph A.5. Transfer Of Rights Of Recovery Against Others To Us, is amended by the addition of the following: If the person or organization has in a written agreement waived those rights before an "accident" or loss", our rights are waived also. 22. HIRED AUTO COVERAGE TERRITORY SECTION IV -BUSINESS AUTO CONDITIONS, Paragraph B.7. Policy Period, Coverage Territory, is amended by the addition of the following: f. For "autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that the insured's" responsibility to pay for damages is determined in a "suit", on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. @ 2018 Liberty Mutual Insurance AC 85 43 06 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 7 This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. 23. PRIMARY AND NON-CONTRIBUTING IF REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREE- MENT The following is added to SECTION IV -BUSINESS AUTO CONDITIONS, General Conditions, B.5. Other Insurance and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". SECTION V -DEFINITIONS is amended as follows: 24. BODILY INJURY REDEFINED Under SECTION V -DEFINITIONS, Definition C. is replaced by the following: Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. Q 2018 Liberty Mutual Insurance AC 85 43 06 18 Includes copyrighted material of insurance Services Office, Inc., with its permission. Page 7 of 7 ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – SCHEDULED PERSON OR ORGANIZATION Policy Number: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 2.If coverage provided to the additional insured is required by a contract or agreement,the insur- ance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B.With respect to the insurance afforded to these addi- tional insureds,the following additional exclusions apply: This insurance does not apply to "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 re- pairs)to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed;or A.Section II –Who Is An Insured is amended to in- clude as an additional insured the person(s)or organization(s)shown in the Schedule,but only with respect to liability for "bodily injury","property dam- age"or "personal and advertising injury"caused by: 1.Your negligence;or 2.The negligence of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s)at the location(s)designated above. However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law;and CGL 20 10 08 15 Page 1 of2ContainscopyrightedmaterialofInsuranceServicesOffice, Inc. with its permission. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Location(s) Of Covered Operations SCHEDULE Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Name Of Additional Insured Person(s) Or Organization(s) Additional Insured - Owners, Lessees Or Contractors - Scheduled Person Or Organi All persons or organizations where required by a written contract executed prior to the commencement of your work. Mt. Hawley InsuranceCompanyMGL0192953 Insured 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. C.With respect to the insurance afforded to these addi- tional insureds,the following is added to Section III – Limits Of Insurance: CGL 20 10 08 15 Page 2 of2ContainscopyrightedmaterialofInsuranceServicesOffice, Inc. with its permission. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. The most we will pay on behalf of the additional insured is: 1.The minimum amount required by any contract or agreement you have entered into to provide additional insured coverage;or 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Insured ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – COMPLETED OPERATIONS Policy Number: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A.Section II –Who Is An Insured is amended to in- clude as an additional insured the person(s)or organi- zation(s)shown in the Schedule,but only with respect to liability for "bodily injury"or "property damage" caused by your negligence at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law;and 2.If coverage provided to the additional insured is required by a contract or agreement,the insur- ance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CGL 20 37 08 16 Page 1 of1ContainscopyrightedmaterialofInsuranceServicesOffice, Inc. with its permission. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Information required to complete this Schedule, if not shown above, will be shown in the Declarations. SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) (Vendor)Location And Description Of Completed Operations B.With respect to the insurance afforded to these additional insureds,the following is added to Section III –Limits Of Insurance: The most we will pay on behalf of the additional in- sured is: 1.The minimum amount required by any contract or agreement you have entered into to provide addi- tional insured coverage;or 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Additional Insured - Owners, Lessees Or Contractors - Completed Operations All persons or organizations where required by a written contract executed prior to the commencement of your work. All "Commercial Construction Projects". For the purpose of this Endorsement, "Commercial Construction Projects" are defined as buildings or structures constructed for commercial use and also include apartments, hotels, homes for the aged, dormitories or barracks. However, "Commercial Construction Projects" shall not include any building or structure which, in whole or in part,contains individual owner occupied units or dwellings. MGL0192953 Mt. Hawley Insurance Company Insured The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek con- tribution from any other insurance available to an additional insured under your policy provided that: 1)The additional insured is a Named Insured under such other insurance;and 2)You have agreed in writing in a contract or agree- ment that this insurance would be primary and would not seek contribution from any other in- surance available to the additional insured. PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy Number: CG 20 01 04 13 Page 1 of 1© Insurance Services Office, Inc., 2012 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Primary And Noncontributory - Other Insurance Condition MGL0192953 Mt. Hawley Insurance Company Insured WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Policy Number: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. The following is added to Paragraph 8.Transfer Of Rights Of Recovery Against Others To Us of Section IV –Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work"done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 Page 1 of 1© Insurance Services Office, Inc., 2008 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Name of Person or Organization: SCHEDULE Waiver of Transfer of Rights of Recovery Against Others To Us All persons or organizations where required by a written contract executed prior to the commencement of your work. Mt. Hawley InsuranceCompanyMGL0192953 Insured Policy Number: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ADDITIONAL INSURED – STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION – PERMITS OR AUTHORIZATIONS SCHEDULE a."Bodily injury","property damage"or "person- al and advertising injury"arising out of opera- tions performed for the federal government, state or municipality;or b."Bodily injury"or "property damage"included within the "products-completed operations hazard". B.With respect to the insurance afforded to these addi- tional insureds,the following is added to Section III – Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement,the most we will pay on behalf of the additional insured is the amount of insurance: 1.Required by the contract or agreement;or 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. A.Section II –Who Is An Insured is amended to in- clude as an additional insured any state or govern- mental agency or subdivision or political subdivision shown in the Schedule,subject to the following provisions: 1.This insurance applies only with respect to oper- ations performed by you or on your behalf for which the state or governmental agency or subdi- vision or political subdivision has issued a permit or authorization. However: a.The insurance afforded to such additional insured only applies to the extent permitted by law;and b.If coverage provided to the additional insured is required by a contract or agreement,the insurance afforded to such additional insured will not be broader than that which you are re- quired by the contract or agreement to provide for such additional insured. 2.This insurance does not apply to: Insurance Services Office, Inc., 2012CG20120413 Page 1 of 1 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. State Or Governmental Agency Or Subdivision Or Political Subdivision: Addl Insured - State Or Governmental Agency All persons or organizations where required by a written contract executed prior to the commencement of your work. MGL0192953 Mt. Hawley Insurance Company Insured POLICY NUMBER:COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: 1) The additional insured is a Named Insured under such other insurance; and 2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. MGL0192953 POLICY NUMBER:COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s)Location(s) Of Covered Operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2.The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "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 location 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. MGL0192953 Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. POLICY NUMBER:COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 ADDITIONAL INSURED – OWNERS, LESSEESORCONTRACTORS – COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s)Location And Description Of Completed Operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or property damage" caused, in whole or in part, by your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1.Required by the contract or agreement; or 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. MGL0192953 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 WAIVER OF TRANSFER OF RIGHTS OFRECOVERYAGAINSTOTHERSTOUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. MGL0192953 Water Pollution Control Plan for Minor Projects Best Management Practices BMP) BMP to be Implemented Standard Specification BMP Description Good Housekeeping BMPs Equipment Maintenance 13 4.03C Maintain,repair,fuel,storage location,inspect vehicles Stockpile Management 13 4.03C(3)Cover Stockpile,Place Waddles Sweeping 13 4.03F Sweep work area daily and prior to rain events Spill Management 13 4.03 Plan and materials for mitigating spills onsite Waste Management BMPs Saw cut Slurry 13 4.03E(7)Vacuum slurry and contain Washout 13 9 Plastic lined washout areas for concrete and tools Portable toilets 13 4.03D(4)Provide and ensure secondary containment Solid waste 5 1.31 Contain and remove trash from site daily Work Specific BMPs check and add all that apply) Creek Protection Controls 13 10 BMPs and Controls to protect adjacent waterways Storm Drain Inlet Protection 13 6 Gravel bags and entrance Construction Entrance 13 7 BMPs to eliminate tracking from construction site BMP Maintenance Inspect,Document,Clean Repair 13 1.03 Daily maintenance of required BMPs Acknowledgment I have read,understood,and agree to the requirements of: 1. This WPCP 2. City of San Luis Obispo’s Engineering Standard and Specifications 3. State of California’s General Construction Permit I understand and agree that: 1. Additional BMPs may be required during the course of the work to ensure the protection of local water quality 2. You must take corrective actions to protect local water quality 3. Failure to comply with all requirements could cause: a. All construction work to be stopped until compliance is achieved b. Permit to be revoked c. Lose the privilege to work within the City right of way for 2 years Water Pollution Control Manager Signature Date Water Pollution Control Manager Printed Name Nathaniel Buchman 1/21/2021 Public Works / Community Development T 805.781.7015 919 Palm Street, San Luis Obispo, CA 93401 F 805.783.7751 ALL FIELDS MUST BE COMPLETED FOR APPROVAL General Info: Project Location: _______________________________________________________________________________________ Description of Work: ____________________________________________________________________________________ Agency / Company: _____________________________________________________________________________________ Contact Person: _________________________________________ Phone: _____________________________________ Check One Permit Project…………………… City Inspector: ______________________________ Capital Improvement Project…… City Inspector/Spec. No. ______________________ Special Event Street Closure……. City Event Supervisor: ______________________________ Schedule: Requested Schedule (Dates & Hours): Dates ___________________________________________ Hours: (From)_________(To)__________ Number of Days Required to complete work (list for each location):_____________________________________________________ Night Work Requests (7pm – 7am) must receive night work permit from Community Development Department. Night work application: Date Submitted __________ Date Approved __________ Permit Number _____________ Traffic Control: All temporary traffic control shall be per the most current version of the California Manual on Uniform Traffic Control Devices (MUTCD), City of San Luis Obispo Engineering Standards & Specifications (Engr. Std. Appendix G), and CalTrans Standard Plans & Specifications. Work Zone / Event Closure Area: STREET: _____________________________________________________________________________________________ FROM: ________ (Dist. Ft.) ______(Direction N,S,E,W) Of ________________________________________________(Street) TO: ________ (Dist. Ft.) ______(Direction N,S,E,W) Of ___________________________________________________(Street) Work Zone Description __________________________________________________________________________________ Work affects City Transit Stop or Route. Yes No Transit Division approved work: Yes No Date: __________ If yes, contractor must advise Transit Division 7 days prior to work. Contact SLO Transit at 781-7 City Staff Name) Work requires closure of parking lane or parking meters Yes No Parking Division approved work: Yes No Date: __________ If yes, contractor must receive approval from Parking Division 7 days prior to work. Contact Parking Division at 781-7230. Work requires traffic control to be set up on Caltrans Right of Way. Yes No . If yes, attach copy of permit. Permit No.______________ SLO City Engineering Standard Appendix G. Check applicable standards AND indicate location of work zone on applicable standard. Fig. A Fig. B Fig. C Fig. D Fig. E Fig. F Fig. G Fig. H Fig. I Fig. J Fig. K Fig. L Fig. M Fig. N Fig. O Fig. P Custom Traffic Control Plan (TCP) Required and Attached. Traffic Control Plan Requirements for each phase of work: Accurate Depiction of Street (St. Names, Striping, Traffic Signals, Stop Signs, etc….) Depiction of work zone area (Approx. Dimension) Depiction of temporary delineation & signing (Taper Lengths Dimensioned) Traffic control plans should be submitted to the City Inspector assigned to your job; if the work is by permit then the plan should be submitted along with the encroachment permit. Please refer to the links below for typical applications, sign codes, use of flashing arrow panels, and taper lengths. Accepted Accepted With Comments See Additional Comments on TCP __________________________________________________ Denied (By: __________________ Date ______ ) Resubmittals shall include original application and traffic control plan with City comments CA MUTCD: http://www.dot.ca.gov/hq/traffops/signtech/mutcdsupp/ca_mutcd2012.htm SLO City Std. Plans: http://www.slocity.org/publicworks/stds/appx-g.pdf OFFICE USE ONLY Rec. By: _______ Date: _____ App. By: _______ Date: _____ TEMPORARY TRAFFIC CONTROL APPLICATION CHOOSE ONE 22 Chorro St, San Luis Obispo Wood Siding Repair/Refinish SeaBay Building Group Nate Buchman 206- 775-5004 4/5/2021 - 4/8/2021 0730 1530 4 Chorro St East Sidewalk Rougeot Pl.Foothill East side side walk on Chorro St from Rougeot Pl. to Foothill. Pedestrian traffic to be redirected to West side sidewalk on