Cities Index.
Item 7e

Lomita City Council
February 7, 2023

Document
Item 7e
Meeting
February 7, 2023
Body
Lomita City Council
Pages
5
Original file
682 KB
Text extracted from the city's file for reading and search. Open the original on lomitacity.primegov.com. That file is the official record.

1 TO: City Council
FROM: Ryan Smoot, City Manager
PREPARED BY: Carla Dillon, P.E., Public Works Director
MEETING DATE: February 7, 2023
SUBJECT: Agreement with the City of Lomita and Metropolitan Water District for Access and Permitting of Temporary Lane Use

RECOMMENDATION
Approve the Access and Permitting Agreement and authorize the City Manager and City Clerk to execute the agreement.

Background
On September 6, 2022, staff from the Metropolitan Water District (Metropolitan), presented to the City Council about their Second Lower Feeder Rehabilitation project (“Project”). This project is expected to be completed by the second quarter of 2025.

During the construction period, usage of lanes in certain areas within the City of Lomita may be required at various times for construction related activities; those locations are described in more detail below. As the City has done in the past with other larger scale and lengthy projects, this agreement enables an extended permit period and allows for an expedited permitting process specifically for this usage while also maintaining the City’s ability to require separate permits for other work in the public right of way.

As described by Metropolitan on Sept. 6, 2022, the Project consists of relining approximately 25,000 feet of pipe with new 95-inch diameter steel liner, replacing or upgrading ancillary components (valves, flow meters). The overall project duration will be approximately 18 months, from November 2023 through May 2025. Pipe access shafts will be used on 262nd Street between Cayuga Avenue and Western Avenue and another at the west end of 262nd Street. This will block the westbound lane and private property driveways. There will also be a pipe access shaft on Western Ave, just outside Lomita boundaries; however, traffic control may have impacts within the City boundaries.

During the beginning and end of each shutdown, dewatering will be necessary, which can be a 24/7 operation located at a manhole at 262nd and Eshelman Ave for up to 7 days, though shorter time frames are often seen. This activity may include an above-ground Item No. 7e

CITY OF LOMITA

CITY COUNCIL REPORT
2 blower for ventilation and whisper generators; however, sound levels will be required to be in compliance with the City Municipal Code.

While much of the work is below ground, the project will impact Lomita city streets, including, Western Avenue, 262nd Street and Cayuga Ave, Eshelman Ave, and Oak Street. Due to the impact on its water customers, Metropolitan plans to conduct the work during two consecutive water years during periods of lowest water demand. In order to complete the work within the expected window of time and minimize the duration of impacts to residents, Metropolitan has requested to work beyond the normal construction hours and work 24 hours per day for 7 days per week. It is expected that active Project work will occur from November 2023 to May 2024 then again from November 2024 to May 2025. The activities within Lomita will be during only one of the two water years, at the discretion of their contractor.

Metropolitan have requested a variance from the City’s standard requirements and a longer duration permit prior to awarding their contract for construction. The proposed agreement provides early assurance of conditions to Metropolitan and allows the City to adequately plan for construction related activities while reducing the City’s administrative burden by reissuing permits for each phase of the project in 6-month increments.

OPTIONS:

1. Approve the Agreement

2. Do not approve the License Agreement

3. Provide further direction

FISCAL IMPACT
The fee associated with this permit is $235,850.47 for the twenty-month term of the Agreement. Additional fees would be incurred should an optional extension be required, as well as for any work outside the scope of this agreement.

ATTACHMENTS:

1. Agreement
Reviewed by: Approved by:

Gary Y. Sugano Ryan Smoot
Assistant City Manager City Manager
Prepared by:
______________________
Carla Dillon, P.E.

Public Works Director / City Engineer

Page 1 of 5 ends

ACCESS AND PERMITTING AGREEMENT
This Access and Permitting Agreement ("Agreement") is effective as of February 7, 2023 (“Effective Date”) and is made between The Metropolitan Water District of Southern California ("Metropolitan"), on the one hand, and the City of Lomita ("Lomita" or “City”), on the other hand.

Both Metropolitan and Lomita are also referred to herein individually as "Party" and collectively as "Parties."

BACKGROUND
A. Metropolitan is undertaking a large pipe rehabilitation project (“Project”) that spans several cities. Within the City, the work below ground will take place within Western Avenue, 262nd Street, and Oak Street. Above ground activity, with access points, will be located along Western Avenue, 262nd Street, and Oak Street. In addition, Metro Park (owned by Metropolitan and licensed to the City) will be utilized for a laydown area and unavailable for City use. The Project work in Lomita is anticipated to take approximately eighteen (18) months for completion.

B. Due to the Project duration and work hours, the Parties desire to enter into an agreement to help increase the efficiency and efficacy of the construction of the Project—specifically as it relates to an encroachment permit allowing Metropolitan to utilize the public right of way on Western Avenue, 262nd Street, and Oak Street so as to minimize impacts on the public.

C. To expedite the encroachment permitting process over the course of the Project, Metropolitan has requested this comprehensive permitting agreement, rather than submission of a series of individual encroachment permit applications for six (6) months each, and to provide advance assurance to its contractor on work hours for construction activities. Separate permits will be required for activities outside the scope of the Encroachment Permit (as defined below) and this Agreement that require an encroachment permit.

D. The City allows construction activity from 7 AM to 6 PM Monday through Friday. Due to the Project scope and potential impacts on regional water supply, Metropolitan is requesting to work outside those days and times due to the time-sensitive nature of the rehabilitation work and to protect persons and property from potential exposure to danger.

E. Generally, the City’s encroachment permits are valid for six months with a maximum number of days for certain activities (i.e. lane closures). Therefore, Metropolitan seeks various entitlements herein, including an extension of the term of the encroachment permit and permitted construction work hours and lane closures, and an expediting of the permitting process.

F. In return, the City obtains the benefit of a reduction in administrative processing and costs, reduction in construction delays, water reliability, and a more efficient and effective construction project, which will benefit the community at large.

Attachment 1

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AGREEMENT
In consideration of the mutual promises and covenants contained in this Agreement, and in reliance upon the representations and covenants made by Metropolitan and the City hereunder, the sufficiency of which are acknowledged, the parties covenant and agree as follows:

1. Permitting Process. The Parties acknowledge that the kind of work proposed in the Agreement would typically require a six-month Public Works permit approval by the City with fees for each day of usage of the lane/right-of-way for the Project. Instead of this process Metropolitan shall complete the City’s Public Works permit application in the form attached hereto as Exhibit “A” and submit all required documents, including traffic control plans and site plan with laydown areas for each site location, but instead of being valid for a six month term, the permit issued pursuant to this Agreement shall be valid for a period of eighteen (18) months from November 16, 2023 through May 23, 2025 (“Encroachment Permit”), and may be renewed for an additional term of up to one year.

Additional conditions may be required for the permit as determined by the Director of Public Works.

2. Term. This Agreement will remain in effect until May 23, 2025 unless otherwise expressly extended and agreed to by both parties or terminated by either party as provided herein.

All noise level requirements in the City’s Municipal Code remain in effect.

3. Extensions. The Public Works Director, in her discretion, may extend the termination date of the Encroachment Permit issued pursuant to this Agreement for an additional period of at least six months and up to one year upon Metropolitan’s submission of a request in writing, which request may be subject to approval by Metropolitan's Board of Directors, to the Public Works Director in advance of the expiration of the Encroachment Permit.

Metropolitan shall provide any information requested by the Public Works Director as part of her standard review process and detail the proposed work to be done. The Public Works Director may include additional conditions to any permit whose termination date is extended as a condition of the extension of the termination date. No permit issued under this Agreement shall be valid after May 23, 2025 without an extension of this Agreement.

Upon expiration of any permit (including any extensions thereof), Metropolitan must complete and submit a new permit application in accordance with the terms of this Agreement and pay any fees due.

4. Permit Fees. All relevant encroachment permit fees are required to be fully paid within 90 days of the Effective Date for this Agreement to be in effect. Metropolitan shall be responsible for paying a fee of $235,850.47, (“Fee”) for the Encroachment Permit issued pursuant to this Agreement. After the initial term ( eighteen months) of this Agreement, if Metropolitan requests an extension pursuant to Paragraph 3 above, Metropolitan shall deposit a fee of $11,609.00 per month (“Extension Fee”) for the extended term with the request for the extension; provided, however that such Extension Fee deposit shall be refunded by the City within 30 days of its denial of any extension request. Such extension shall be for a minimum of six months. Payment shall be due with submittal of an application for such permit, or for a request for an extension as applicable. No refunds shall

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be issued if work is completed before the expiration of such permit. In the event the Project is delayed or postponed due to Acts of God, war, civil commotion, fire, flood, drought or other casualty, or other causes beyond Metropolitan’s reasonable control, Metropolitan may request an extension without the payment of an Extension Fee, and such request is subject to the approval of the Public Works Director, not to be unreasonably withheld.

Delay or postponement due to issues related to COVID-19, the coronavirus, or any similar virus shall not qualify for a no fee extension.

5. Early Termination. If any substantial portion of the Project is cancelled or the start date significantly delayed, Metropolitan may terminate this Agreement by written notice to City. In the event of any early termination of this Agreement, City will refund to Metropolitan, within 60 days of termination, all fees paid by Metropolitan pursuant to this Agreement or the Encroachment Permit except for $20,000 which the Parties agree reflects the current costs to the City of work related to this matter.

6. Coordination During Implementation. Metropolitan representatives will coordinate with appropriate City personnel to ensure that construction activities related to the Project are conducted in a manner to the extent practicable that minimizes disruption to the citizens of the City.

7. Compliance With Law. During the term of this Agreement and the Encroachment Permit, Metropolitan agrees that it shall not violate any applicable City or County ordinance or federal or state law. Noncompliance with any such laws or regulations shall be grounds for the City to terminate this Agreement.

8. Non-Liability of the City. The City shall not be liable for any injury of any kind whatsoever to any person caused by the actions of Metropolitan or their representatives, employees, contractors, or agents under this Agreement arising from any cause whatsoever except to the extent arising from the City’s negligence or willful misconduct.

9. Insurance. Metropolitan shall, during the term of the Encroachment Permit and at all times during which access is available to it, require all contractors and subcontractors performing the Activities work to maintain insurance with the following minimum coverage levels:
(i) Workers Compensation with statutory limits;
(ii) Automobile Liability with $1,000,000 single limit or equivalent; and, (iii) Commercial General Liability, with $2,000,000 aggregate limit/$1,000,000 per occurrence ($4,000,000 excess) limits.

Metropolitan confirms that it is a local government entity created under the laws of the State of California and is self-insured for $25 million dollars against any third-party loss and maintains $75 million dollars of commercial liability insurance in excess of the selfinsurance retention, as set forth in the letter attached as Exhibit “B”. Metropolitan must maintain its self-insurance program in full force during the term of this Agreement.

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10. Notification for Commencement of Work. Metropolitan shall notify the City at least 24- hours prior to each mobilization effort providing information on type of work, duration, and field contact information.

11. Restoration of City Property. After completion of activities, disturbed areas, if any, will be restored by Metropolitan to the conditions existing at the beginning of the work, and will comply with the Encroachment Permit, as determined by the Director of Public Works in her reasonable discretion.

12. Substitute Contractors. In the event that Metropolitan is required to retain a substitute contractor for the work governed by an Encroachment permit issued pursuant to this Agreement, Metropolitan shall inform the City, in writing, prior to commencement or continuation of the work, and the substitute contractor shall be considered one of Metropolitan’s agents for the purposes of this Agreement and shall also be responsible for maintaining all insurance coverage set forth herein.

13. Choice of Law. The terms of this Agreement shall be construed pursuant to the laws of the State of California.

14. Venue. Venue for any action involving this Agreement will be exclusively in Los Angeles County.

15. Further Acts. For the duration of this Agreement, the Parties will, whenever requested to do so by another party to this Agreement, execute, acknowledge and deliver, or cause to be executed, acknowledged or delivered, any and all such further instruments, documents and do any and all other acts as may be reasonably necessary to accomplish the intent of this Agreement.

16. Entire Agreement. This Agreement, including any exhibits attached hereto, and the Encroachment Permit constitute the entire agreement and understanding between the Parties pertaining to this subject matter and supersede all prior agreements and understanding, both written and oral, pertaining to the subject matter hereof.

17. Interpretation. This Agreement will be interpreted according to the fair meaning of its terms and not strictly for or against any particular Party.

18. Modification. The provisions of this Agreement may only be amended, modified or waived by written agreement executed by all Parties.

19. Severability. If any provision of this Agreement is held to be invalid or unenforceable for any reason, the remaining provisions shall continue in full force and effect without being impaired or invalidated in any way.

20. Notice. All notices or other documents (collectively "Notices") given hereunder shall be in writing and shall be addressed to the recipient and sent by electronic mail, personal delivery

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or United States certified mail, postage prepaid. Unless and until otherwise notified, the address of each of the parties for the giving of Notices shall be:

TO CITY OF LOMITA:

City of Lomita
24300 Narbonne Ave.

Lomita, CA 90717
Attention: Public Works Director
Email: [email protected]
TO Metropolitan:

The Metropolitan Water District of Southern California
P.O. Box 54153
Los Angeles, CA 90054-0153
Attention: Cristian A. Ovalle, Pipeline Rehabilitation PM Team Manager
Email: [email protected]
Notices will be deemed given as of the date when emailed (provided a copy thereof is concurrently sent by nationally recognized overnight courier), personally delivered to the addressee, or upon the third day after being deposited in the United States mail in accordance with the foregoing.

21. Electronic Signatures; Counterparts. This Agreement may be executed in one or more counterparts, each of which shall be deemed an original and all of which taken together will constitute the same instrument. Electronic signatures will be deemed original signatures for the purposes of this Agreement.

IT IS SO AGREED

CITY OF LOMITA
Dated: _________________ by:________________________________ its:_________________________________
The Metropolitan Water District of Southern California
Dated: __________________ by:________________________________ John Bednarski
its: Chief Engineer and Manager of Engineering Services

CITY OF LOMITA

PUBLIC WORKS DEPARTMENT

ENGINEERING DIVISION
1 24300 Narbonne Avenue
Lomita, CA 90717
Phone: (310) 325-7110
Email: [email protected]
Revised October 5, 2022

PUBLIC WORKS PERMIT APPLICATION
Site Address: __________________________________________________________________________________________ Owner/Applicant Information
Name: _____________________________________
Address: ___________________________________
City: _______________________________________
State/Zip: ____________________________________
Telephone: ___________________________________
Email: _______________________________________
Contractor Information
Name: ______________________________________
Company: ___________________________________
Street: ______________________________________
City: ________________________________________
State/Zip: ____________________________________
Telephone: ___________________________________
Email: _______________________________________
CA Contractor License No.: ______________________
City Business License No.: _______________________
Email: _______________________________________
Description of Work
______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ U.S.A. (1-800-422-4133) Reference No.:
____________________________________________
Estimated Construction Cost: $ __________________
Work Order Number (for utility companies):
____________________________________________
Construction Duration: _________________________
Additional Notes: _____________________________________________________________________________________ _______________________________________________________________________________________________________

FOR CITY USE ONLY
Encroachment Permit No.: Date of Issuance:

Permit Extension No.: Date of Issuance:

Approvals
APPROVED BY: ______________________________ EXPIRATION DATE: _____________________________ (Not valid unless approved by Department)
EXTENSION EXPIRATION DATE: ____________________________ INSPECTION:

INSPECTOR: ____________________________ DATE PROJECT COMPLETED: _____________________________ SIGN OFF: (DEPOSIT REFUND)
______ ISSUE REFUND ______ HOLD DEPOSIT
Exhibit A

CITY OF LOMITA

PUBLIC WORKS DEPARTMENT

ENGINEERING DIVISION
2 24300 Narbonne Avenue
Lomita, CA 90717
Phone: (310) 325-7110
Email: [email protected]
Revised October 5, 2022
Detailed Description of Work

DESCRIPTION LENGTH
(FT)
AREA
(SQ. FT)
NO. OF

SEGMENTS/
PHASES

QUANTITY OTHER

INFORMATION
Water
Connection
Water Meter
Sewer
Connection
Sidewalk
Replacement
Driveway
Apron
Replacement
Curb and/or
Gutter
Replacement
Trenching
Paving
Pole
Replacement
Aerial Cable
Work
Other

CITY OF LOMITA

PUBLIC WORKS DEPARTMENT

ENGINEERING DIVISION
3 24300 Narbonne Avenue
Lomita, CA 90717
Phone: (310) 325-7110
Email: [email protected]
Revised October 5, 2022

STANDARD REQUIREMENTS
Anyone working in the City of Lomita right-of-way, such as streets, alleys, sidewalks, parkways, public easements, and utility easements, is required to obtain an Encroachment Permit from the Public Works Department prior to starting work.

1. The Encroachment Permit, regardless of when dated shall not be in effect until the fees are paid, Commercial Liability Insurance and a copy of contractor license are submitted along with the permit application and applicant has obtained all appropriate licenses including City Business License and other permits required by law.

2. A current City of Lomita Business License is required.

3. Permit should be present on construction site at all times.

4. All changes in the Scope of Work must have prior approval by the City Engineer.

5. This permit is declared null and void if work has not commenced and completed within six (6) months from the date of permit issuance.

6. Alternate hours will be permitted for work under this permit to allow expeditious restoration of public water supply through the pipeline. The allowable hours of operation shall be 24 hours per day, seven days per week. All work must comply with the City noise standards in the Lomita Municipal Code.

7. All work done within the public right-of-way shall be done by a licensed contractor possessing a Class A, C-12 or C-34 License for all trenching and paving, a Class C-08 License for all concrete work, and a Class B License for minor curb, gutter, and sidewalk. (See Table on page 5)

8. Applicant must carry adequate insurance to work in the public right of way and name the City of Lomita as additional insured.

Applicant agrees to keep insurance active for the duration of the project in the amount of one million dollars ($1,000,000) minimum.

9. Any damages to existing facilities and improvements above ground or below ground, shall be promptly repaired or replaced at the permittee’s expense, and claims for damage to City property must be promptly paid.

10. All Construction, unless otherwise specified shall be done in accordance with the latest Standard Specifications for Public Works Construction latest edition and/or LA County Standards and “Highway Permit Ordinance Division 1 Title 16”.

11. NOTIFICATION REQUIREMENT: The contractor shall notify the adjacent property owners and all affected residents of any work that will impact them. This includes all street or lane closures and any work that will generate extreme noise (i.e., demolition).

12. Permittee shall notify the Public Works Office at least 24 hours prior to commencement of work. The number and type of inspections required, and any tests that may be required will be as directed by the Public Works Engineer. The Public Works Engineering staff may be contacted by email at [email protected]

13. Applicant is responsible for determining exact locations and or depths of existing utilities or other facilities. Call Underground Service Alert (USA) at 1-800-422-4133 a minimum of 72 hours or as early as 14 days prior to performing work.

14. Pedestrian walkway must be maintained with safety fencing or barrier separation from adjacent excavation when left unattended.

All trench plates used in the public right of way must have a non-skid surface.

15. Excavations over five (5) feet in depth shall conform to Occupational Safety & Health Administration (OSHA) requirements and regulations.

16. Where excavation tunnels under curb and gutter or sidewalk, or other improvements, which are to remain in place, or crosses an intersection, backfill shall be cement slurry consisting of one (1) sack of cement per cubic yard of slurry. The slurry shall be placed in a method satisfactory to the inspector to assure the elimination of any cavities.

17. Utility mainline projects are required to slurry seal the full street width where excavation is made in street less than five (5) years old. Permittee is responsible for replacing all traffic stripping and pavement markings.

18. Permanent pavement repairs shall be made within fourteen (14) days but no less than 10 days after excavation work is completed or as directed by the City Engineer. Inspector’s approval is required before permanent repairs are made.

19. Sewer Lateral: When installing a new sewer lateral, existing lateral must be plugged at the property line, sewer lateral connection to the City sewer must be done with a wye connection or a mechanical saddle.

CITY OF LOMITA

PUBLIC WORKS DEPARTMENT

ENGINEERING DIVISION
4 24300 Narbonne Avenue
Lomita, CA 90717
Phone: (310) 325-7110
Email: [email protected]
Revised October 5, 2022

20. Traffic Control plans must be submitted for approval prior to issuance of an encroachment permit.

21. A Traffic Control Plan is required for work on arterial streets. Traffic control for work on local and residential streets shall comply with Manual on Uniform Traffic Control Devices (MUTCD) or “Work Area Traffic Control Handbook” (WATCH); permittee shall provide and maintain all such signs lights and devices.

22. The Traffic Control Plan as attached must be adhered to at all times. Note that the Traffic Control Plan may have restricted working hours for working in the public right of way, which supersedes the standard encroachment permit working hours.

23. One lane of traffic in each direction shall be maintained at all times on all major and secondary streets and highways.

24. The use of City property by permittee shall be limited to the purposes set forth by this permit and no structures of any kind, except those expressly permitted shall be erected or placed thereon.

25. Dumpsters (Debris boxes)/pods, storage containers shall have reflectors so that they can be seen at night. The permit must be taped to the outside of these boxes in a visible location.

26. All graffiti must be removed within 24 hours of notification including utility markings (USA).

27. All erosion control measures, stormwater BMPs (Stormwater Pollution Prevention Plans-SWPPP) must be in place or as directed by the Public Works Engineer or Inspector.

28. A faithful performance bond or a cash deposit for restoration of the streets is required. The City Engineer shall determine the bond amount based on the estimated cost of restoring the streets.

29. Bond(s) will be refunded in full after the Public Works Inspector has signed off on the permit as being complete.

30. BACKFILL: The material used for backfill shall have a sand equivalent of not less than 30% as determined by tests from a qualified soils laboratory. Material encountered in excavation that will meet this requirement may be used for backfill. If excavated materials fail to meet this requirement the contractor shall use sand or crushed aggregate as backfill. If cement slurry used, no compaction tests will be required. Compaction shall be done by mechanical means. Jetting is not allowed. The maximum lift shall be 0.64’ when handheld compaction equipment is used. Free falling weight compaction equipment shall not be allowed. Relative compaction required shall be 90% except for the final 0.5’, which shall be 95%. Costs of the compaction test to be borne by the permittee. The frequency of such testing will be determined by the inspector and will be sufficient to ensure that requirements have been met. Determination of frequency will be based on variables such as the nature of the material or the efficiency of the contractor’s method.

31. All Survey Monuments destroyed as a result of the contractor’s work shall be reset “in kind” at the contractor’s expense by a licensed Surveyor and recorded with the County Recorder’s Office. Copies of all ties to reset monuments will be supplied to the City prior to release of work guarantee deposit or sign off by the City.

32. This grant of permission does not constitute a deed or grant of easement by the City, is not transferable or assignable and is revocable at any time upon violations of the Permit.

33. Additional conditions if any, are attached to this permit and shall be followed accordingly.

CITY OF LOMITA

PUBLIC WORKS DEPARTMENT

ENGINEERING DIVISION
5 24300 Narbonne Avenue
Lomita, CA 90717
Phone: (310) 325-7110
Email: [email protected]
Revised October 5, 2022

APPLICATION FOR BOND RELEASE
I hereby acknowledge that I have read this permit and the attached conditions that the information given by me is correct, that I am the owner or the duly authorized agent of the owner, and that I agree to comply with the conditions and all applicable provisions of state laws, city ordinances, and the rules of any governmental agency involved.

PRINT NAME: ___________________________ E-MAIL ADDRESS: ________________________________ CONTACT NO.: __________________________
SIGNATURE: __________________________________________ DATE: _____________________________ Contractor License Requirements
Curb/Gutter A (General Engineering)
C8 (Concrete Contractor)
Under Ground Utilities
(Water, Gas, or Oil)
A (General Engineering)
C34 (Pipeline Contractor)
Driveways A (General Engineering)
C8 (Concrete Contractor)
Under Ground
Electrical
A (General Engineering)
C8 (Concrete Contractor)
C12 (Earth and Paving
Contractor)
Sidewalks A (General Engineering)
B (General Building)
C8 (Concrete Contractor)
Sewer Later/ Mainline A (General Engineering)
C34 (Pipeline Contractor)
C42 (Sanitation Contractor)
Street/ Alley A (General Engineering)
C8 (Concrete Contractor)
C12 (Earth and Paving
Contractor)
Storm Drain Lateral/
Mainline
A (General Engineering)
C34 (Pipeline Contractor)
C42 (Sanitation Contractor)

CITY OF LOMITA

PUBLIC WORKS DEPARTMENT

ENGINEERING DIVISION
6 24300 Narbonne Avenue
Lomita, CA 90717
Phone: (310) 325-7110
Email: [email protected]
Revised October 5, 2022
PROJECT ADDRESS: PERMIT # DATE:

COMPANY NAME: CONTACT PERSON: PHONE #
MAILING ADDRESS: ORIGINAL RECEIPT ATTACHED:
□ Yes □ No*
*IF NO, ATTACH ALTERNATE PROOF OF PAYMENT
REASON FOR REFUND: (CHECK ONE)
□ COMPLETION BOND □ STREET OPENING BOND
BOND RELEASE REQUEST AMOUNT:

APPLICANT SIGNATURE:

NOTE: ALL REFUNDS WILL BE REFUNDED TO THE ORIGINAL FEE PAYEE.

REFUND REVIEWED AND APPROVED BY: DATE:

REFUND PROCESSED BY: DATE STATUS LETTER MAILED:

FOR CITY USE ONLY

CHECKLIST / SUBMITTAL DATE
1 Permit Application Form
2 Plans (Construction, Site Lay-out, Sections)
3 Traffic Control Plan (Stamped for Arterial Streets)
4 Contractor’s License
5 Business License
6 Liability Insurance
7 Other:

THE METROPOLITAN WATER DISTRICT

OF SOUTHERN CALIFORNIA
Office of the General Manager
October 12, 2022
City of Lomita
24300 Narbonne A venue
Lomita, CA 90717
Metropolitan Water District of Southern California Letter of Self-Insurance The Metropolitan Water District of Southern California (Metropolitan) is self-insured for General Liability up to $25 million, which includes Automobile Liability, and Workers' Compensation up to $5 million with excess statutory limits. Metropolitan is completely self-insured for its property. This is for the coverage period of July 1, 2022 to June 30, 2023.

Our insurance broker has provided the attached insurance certificate identifying our selfinsured limits. Please note that endorsements are not available for self-insurance. If your requirements exceed our self-insured limits, we will request our insurance broker to provide the necessary documentation.

If there is any damage or loss, please contact Risk Management at (213) 217-7715 to report the incident and receive instructions regarding filing your claim. If you have further questions or require additional information, please contact me at [email protected] or (213) 217-7735.

Very truly yours,
Barbara McGrane
Risk Management
Attachment (1)
cc: Certificate file
700 N. Alameda Street, Los Angeles, California 90012 • Mailing Address: Box 54153, Los Angeles, California 90054-0153 • Telephone (213) 217-6000 Exhibit B

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