Attachment 1ATTACHMENT 1
Recording Requested by:
TOWN OF LOS GATOS
WHEN RECORDED MAIL TO:
CLERK ADMINISTRATOR
TOWN OF LOS GATOS
110 E MAIN ST
LOS GATOS, CA 95030
______________________________________________________________________________
(SPACE ABOVE BAR FOR RECORDER’S USE)
(RECORD WITHOUT FEE UNDER GOVERNMENT CODE SECTIONS 27383 AND 6103)
TYPE OF RECORDING
CERTIFICATE OF ACCEPTANCE AND NOTICE OF COMPLETION
PPW JOB NO. 15-811-9901 AND 15-811-9903 ANNUAL STREET REPAIR AND
RESURFACING AND PAVEMENT REHABILITATION – CRACK SEAL PROJECT
CERTIFICATE OF ACCEPTANCE AND NOTICE OF COMPLETION
PPW JOB NO. 15-811-9901 AND 15-811-9903 ANNUAL STREET REPAIR AND
RESURFACING AND PAVEMENT REHABILITATION – CRACK SEAL PROJECT
TO WHOM IT MAY CONCERN:
I do hereby certify that Intermountain Slurry Seal completed the work called for in the
agreement with the Town of Los Gatos dated October 31, 2016. The work is outlined in the
Town’s bid process prepared by the Town of Los Gatos and generally consisted of furnishing all
labor, materials, tools, equipment, and services required for completion of the PPW Job No. 15-
811-9901 and 15-811-9903 located in the TOWN OF LOS GATOS, County of Santa Clara, State
of California and was completed, approved and accepted January 17, 2017.
Bond No.: 82394965
Date: March 15, 2016
TOWN OF LOS GATOS
By: __________________________________
Laurel Prevetti, Town Manager
Acknowledgement Required
AFFIDAVIT
To Accompany Certificate of Acceptance and Notice of Completion
PPW JOB NO. 15-811-9901 AND 15-811-9903 ANNUAL STREET REPAIR AND
RESURFACING AND PAVEMENT REHABILITATION – CRACK SEAL PROJECT
I, LAUREL PREVETTI, the Town Manager of the Town of Los Gatos, have read the
foregoing CERTIFICATE OF ACCEPTANCE AND NOTICE OF COMPLETION and know
the contents thereof. The same is true of my own knowledge, except as to the matters which are
therein alleged on information or belief, and as to those matters I believe it to be true.
I declare under penalty of perjury that the foregoing is true and correct and that this declaration
was executed on _____________________, 2017 at Los Gatos, California.
__________________________________________
LAUREL PREVETTI, TOWN MANAGER
Town of Los Gatos
RECOMMENDED BY:
Date: ____________________________
Matt Morley
Director of Parks and Public Works
APPROVED AS TO FORM:
Date: ____________________________
Robert Schultz, Town Attorney
Notary Jurat Required