114691812
April 17, 2024
Customer Payment
Coupon
References
Notification # 114691812
Contract # 50101217 V1
E20C-PM # 35523045
Customer # 2122604
City of San Mateo
330 W 20th Avenue
SAN MATEO, CA 94403
Customer Cost Summary
BERMUDA DR BY FIESTA DR & ANNAPOLIS DR, SAN MATEO
Amounts Due Total Due
Rule 20C Non-Refundable Payment $186,685.48
Minus the following credit
Advance Credit ($10,000.00)
$176,685.48
Important Payment Information
To complete your contract ONLINE
Follow the instructions provided with your electronic contract Submit payment at https://www.pge.com/contractpayments
To complete your contract BY MAIL
Please make check payable to: PG&E or Pacific Gas and Electric Complete, sign and return the enclosed agreement(s), the SACAC form and the customer payment coupon with your payment
Remit payment and SACAC form to:
PG&E CFM/PPC Department
PO BOX 997340
Sacramento, CA 95899-7340
IMPORTANT MESSAGE
Please review the enclosed information
and total due. This document needs
to be returned with the enclosed
agreements.
If you complete your contract ONLINE,
a copy will be saved to your Customer
Connections Online (CCO) account at
pge.com/cco.
To learn more about PG&E's gas and
electric safety initiatives and resources
please visit pge.com/safety.
Have Questions?
Please Call 1-800-422-0436
* Automated document, Preliminary Statement, Part A
114691812
62-4527 (Rev 1/91)
Service Planning
Advice No. 1633-G/1342-E
Effective 4/02/91
Pacific Gas and Electric Company
Agreement to Perform
Tariff Schedule Related Work
DISTRIBUTION:
Applicant (Original)
Division (Original)
ACCTG. SVCS.
REFERENCES:
114691812Notification #
35523045R20-PM #
50101217Contract # 1V
April 17, 2024
City of San Mateo, A GOVERNMENT AGENCY (Applicant) has requested PACIFIC GAS AND ELECTRIC COMPANY, a California corporation (PG&E), to perform the tariff schedule related work as located and described in paragragh 3 herein. PG&E agrees to perform the requested work and furnish all necessary labor, equipment, materials and related facilities required therefore, subject to the following conditions:
1. Whenever part or all of the requested work is to be furnished or performed upon property other than that of Applicant, Applicant shall first procure from such owners all necessary rights-of-way and/or permits in a form satisfactory to PG&E and without cost to it.
2. Applicant shall indemnify and hold harmless PG&E, its officers, agents and employees, against all loss, damage, expense and liability resulting from injury to or death of any person, including but not limited to, employees of PG&E, Applicant or any third party, or for the loss, destruction or damage to property, including, but not limited to property of PG&E, Applicant or any third party, arising out of or in any way connected with the performance of this agreement, however caused, except to the extent caused by the active negligence or willful misconduct of PG&E, its officers, agents and employees. Applicant will, on PG&E's request, defend any suit asserting a claim covered by this indemnity. Applicant will pay all costs that may be incurred by PG&E in enforcing this indemnity, including reasonable attorneys' fees.
3. The location and requested work are described as follows: (Describe in detail the materials and facilities to be furnished and/or work to be performed by PG&E. If more space is required, use other side and attach any necessary drawings as Exhibits A, B, C, etc):
BERMUDA DR BY FIESTA DR & ANNAPOLIS DR, SAN MATEOLOCATION:
Rule 20C - Underground existing overhead electric facilitiesDESCRIPTION OF WORK:
$54,538.90 Engineering & Administrative Costs
Including Applicant Design Value of $0.00
Cost of Additional Applicant Design Plan Checks $0.00 (+) Value of 20C Underground System $10,242.18 (+)
Tie-In of 20C by PG&E $88,043.05 (+)
PG&E Land Rights Costs $813.84 (+)
Inspection Fees $1,661.11 (+)
Value of 20C Trench & Excavation $21,701.93 (+)
Value of 20C Conduits & Substructures $21,776.06 (+)
Rule 20C Trench Permits Obtained by PG&E $1,102.00 (+) less Salvage & Depreciation for Overhead Facilities $0.00 (-) SUB TOTAL $185,615.69 (=)
Including Net Joint Pole Credit Value of ($14,263.37)
24%plus ITCC @ $44,547.76 (+)
plus Cost to Remove Overhead Line by PG&E $0.00
Value of 20C Trench, Excavation & Conduit for Others (no ITCC) $0.00 (+) SUB TOTAL $230,163.46 (=)
less 20C Underground System Installed by Applicant $0.00 (-) less 20C Trench & Excavation Provided by Applicant $21,701.93 (-) less 20C Conduits & Substructures Installed by Applicant $21,776.06 (-) less Value of Applicant Design Work $0.00 (-)
Electric Rule 20C Cash Payment $186,685.47 (=)
#Form 62-4527#
* Automated document, Preliminary Statement, Part A
114691812
62-4527 (Rev 1/91)
Service Planning
Advice No. 1633-G/1342-E
Effective 4/02/91
4. Applicant shall pay to PG&E, promptly upon demand by PG&E, as the complete contract price hereunder, the sum of One hundred eighty-six thousand six hundred eighty-five dollars and forty-eight cents $186,685.47 Upon completion of requested work, ownership shall vest in: PG&E Applicant Executed this #signDayWPA# day of #signMonWPA# #signYrWPA# City of San Mateo, A
GOVERNMENT AGENCY
Applicant
PACIFIC GAS & ELECTRIC COMPANY
By: #sigWPA# By: Jay Min
Matt Fabry
Print/Type/Name
Title: Director Title: Service Planning Supervisor
#titleWPA#
Mailing Address: 330 W 20th Avenue
SAN MATEO, CA 94403