Attachment A
Name
Street
Address
City &
State
SPACE ABOVE THIS LINE FOR RECORDERS USE
NOTICE OF COMPLETION
(CA Civil Code §§ 8180-8190, 8100-8118, 9200-9208)
NOTICE IS HEREBY GIVEN THAT:
1. The undersigned is an owner of an interest of estate in the hereinafter described real property, the nature of which interest or estate is:
_________________________________________________________________________________ (e.g. fee, leasehold, joint tenancy , etc.)
2. The full name and address of the undersigned owner or reputed owner and of all co -owners or reputed co -owners are:
Name Street and No. City State
__________________________________________________________________________________________________________
3. The name and address of the direct contractor for the work of improvement as a whole is:
__________________________________________________________________________________________________________
4. This notice is given for (check one):
Completion of the work of improvement as a whole.
Completion of a contract for a particular portion of the work of improvement (per CA Civ. Code § 8186).
5. If this notice is given only of completion of a contract for a particular portion of the work of improvement (as provided in CA Civ. Code § 8186), the name and address of the direct contractor under that contract is:
___________________________________________________________________________________________________________
6. The name and address of the construction lender, if any, is:
___________________________________________________________________________________________________________
7. On the ____________ day of ___________, 20___, there was completed upon the herei n described property a work of improvement as a whole (or a particular portion of the work of improvement as provided in CA Civ. Code § 8186) a general description of the work provided:
___________________________________________________________________________________________________________
8. The real property herein referred to is situated in the City of __________________________, County of _______________________ _ State of California, and is described as follows:
___________________________________________________________________________________________________________
9. The street address of said property is:
___________________________________________________________________________________________________________
10. If this Notice of Completion is signed by the owner’s successor in interest, the name and address of the successor’s transferor is:
___________________________________________________________________________________________________________ I certify (or declare) under pe nalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date: _______________________________________ By: ________________________________________________________ Signature of Owner or Owner’s Authorized Agent
City of Palm Springs
Recording Requested By:
When Recorded Mail To:
City of Palm Springs
Brenda Pree, City Clerk
3200 E. Tahquitz Canyon Way
Palm Springs, CA 92262
Fee
City of Palm Springs 3200 E. Tahquitz Canyon Way Palm Springs CA 92262 Matich Corporation, 1596 Harry Sheppard Blvd, San Bernardino, CA 92408 ✔
Not Applicable
Not Applicable
19th
December
25 Pavement rehabilitation at various streets throughout the City of CP No. 25-01 Palm Springs
Riverside
Various - See street list attached
Various - See street list attached
Not applicable
Joel Montalvo/City Engineer
VERIFICATION
I, _______________________________________________, state: I am the ________________________________ __ (“Owner”, “President”, “Authorized A
gent”, “Partner”, etc.) of the Owner identified in the foregoing Notice of Completion. I have read said Notice of Completion and know the contents thereof; the same is true of my own knowledge.
I de
clare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on _______________________, _______ (da te), at _______________________________________________ ______ (City), ________ (State). ______________________________________________________
Signature of Owner or Owner’s Authorized Agen
Joel Montalvo/City Engineer
City of Palm Springs
PROOF OF SERVICE DECLARATION
a.
b.
c.
_____________________________________________________________ (Signature of Person Making Service)
STATE OF CALIFORNIA
COUNTY OF ______________________________________
On _____________________________ ____________, ________ (date), before me, ________________________________ ____________, Notary Public (name and title of officer) personally appeared __________________________________________who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorize d capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PURJURY under the laws of the State of California that the foregoing paragraph is true and correct.
Witness my hand and official seal.
_____________________________________________
Signature
A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
Joel Montalvo
City Engineer
Palm Springs
CA
2025 Citywide Pavement Rehabilitation, City Project 25‐01 1 11200 AVENIDA CABALLEROS ALEJO ROAD TAMARISK ROAD
2 11210 AVENIDA CABALLEROS TAMARISK ROAD TACHEVAH DRIVE 3 11220 AVENIDA CABALLEROS TACHEVAH DRIVE PASEO EL MIRADOR 4 11230 AVENIDA CABALLEROS PASEO EL MIRADOR VISTA CHINO 5 11240 AVENIDA CABALLEROS VISTA CHINO VIA ESCUELA
6 11250 AVENIDA CABALLEROS VIA ESCUELA RACQUET CLUB ROAD 7 11270 AVENIDA CABALLEROS RACQUET CLUB ROAD FRANCIS DRIVE 8 11280 AVENIDA CABALLEROS FRANCIS DRIVE SAN RAFAEL ROAD 9 11290 AVENIDA CABALLEROS SAN RAFAEL ROAD END OF STREET 10 12240 BOLERO ROAD LAWRENCE CROSSLEY ROAD 1732 FT. E/O LAWRENCE CROSSLEY RD 11 13770 CARILLO ROAD DELGADO ROAD VIA ESCUELA
12 14250 CHIA ROAD VIA MIRALESTE AVENIDA CABALLEROS
13 14320 CHINO CANYON ROAD VIA NORTE PANORAMA ROAD
14 14330 CHINO CANYON ROAD PANORAMA ROAD LEONARD ROAD
15 14430 CHUPEROSA DEL LAGO ROAD FRANCIS DRIVE
16 14910 DELGADO ROAD HERMOSA DRIVE CARILLO ROAD
17 14920 DEL LAGO ROAD FARRELL DRIVE E/S CERRITOS ROAD
18 14930 DEL LAGO ROAD CERRITOS ROAD BISKRA ROAD
19 15090 DINAH SHORE DRIVE CROSSLEY ROAD WEST END OF BRIDGE 20 15920 FARRELL DRIVE END OF STREET VERONA ROAD
21 16050 FIESTA ROAD CHUCKWALLA ROAD END OF STREET
22 16110 FRANCIS DRIVE SUNRISE WAY FARRELL DRIVE
23 16120 FRANCIS DRIVE FARRELL DRIVE END OF STREET
24 18490 MILBEN CIRCLE VIA ESCUELA END OF CUL-DE-SAC
25 18830 NAVAJO CIRCLE NAVAJO ROAD END OF CUL-DE-SAC
26 19040 OPUNTIA ROAD CHUCKWALLA ROAD END OF STREET
27 20360 RODEO ROAD CHIA ROAD CUL-DE-SAC
28 20370 RODEO ROAD CHUCKWALLA ROAD END OF STREET
29 20460 ROXBURY DRIVE SUNNY DUNES ROAD THERESA DRIVE
30 22000 SUNNY DUNES ROAD 440 FT. E/O GENE AUTRY TRAIL SAN LUIS REY ROAD 31 22010 SUNNY DUNES ROAD SAN LUIS REY DRIVE CROSSLEY ROAD 32 22300 TACHEVAH DRIVE INDIAN CANYON DRIVE VIA MIRALESTE 33 22310 TACHEVAH DRIVE VIA MIRALESTE AVENIDA CABALLEROS 34 22320 TACHEVAH DRIVE AVENIDA CABALLEROS PASEO DE ANZA 35 22340 TACHEVAH DRIVE SUNRISE WAY CERRITOS ROAD
36 22910 VAQUERO ROAD CHUCKWALLA ROAD END OF STREET
37 22920 VAQUERO ROAD CHIA ROAD CUL-DE-SAC
38 23030 VERBENA DRIVE SUNRISE WAY PASEO DE ANZA
39 23070 VERONA ROAD FARRELL DRIVE 115 FT. E/O WHITEWATER CLUB DRIVE 40 20070 RAMON ROAD E/S BELARDO ROAD W/S S PALM CANYON DRIVE 41 20080 RAMON ROAD E/S PALM CANYON DRIVE W/S S INDIAN CANYON DRIVE # Section ID Street Name Start Section End Section
Updated 01/08/2026 Page 1 of 1