23-014 San Jose Conservation Corps Compost Site Attendants for 2023CITY OF
CuPERTINO
PROFESSIONAL/CONSULTING SERVICES AGREEMENT
1.PARTIES
This Agreement is made by and between the City of Cupertino, a municipal corporation ("City"),
and San Jose Conservation Corps ("Contractor"), a Non-Profit for Compost Site Attendants for
2023, and is effective 011 the last date signed below ("Effective Date").
2.SERVICES
Contractor agrees to provide the services and perform the tasks ("Services") set forth in detail in
Scope of Setavices, attached here and incorporated as Exhibit A. Contractor ftnther agrees to carry
out its work in compliance with any applicable local, State, or Federal order regarding COVID-19.
3.TIME OF PF,RFORMANCF,
3.1 Tis Agreement begins on the Effective Date and ends on November 25, 2023 ("Contract
Time"), unless terminated earlier as provided herein. Contractor's Services shall begin on the
effective date and shall be completed by November 25, 2023. The City's appropriate department
head or the City Manager may extend the Contract Time through a written amendment to tis
Agreement, provided such extension does not include additional contract funds. Extensions
requiring additional contract funds are subject to the City's purchasing policy.
3.2 Schedule of Performance. Contractor must deliver the Services in accordance with the
Schedule of Performance, attached and incorporated here Exhibit B.
3.3 Time is of the essence for the performance of all the Services. Contractor must have
sufficient time, resources, and qualified staff to deliver the Services on time.
4.COMPENSATION
4.2 Invoices and Payments. Montmy invoices must state a description of the deliverable
completed and the amount due for the preceding month. Wit thirty (30) days of completion of
Services, Contractormust submit arequisition for final and complete payment of costs and pending
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claims for City approval. Failure to timely submit a complete and accurate payment requisition
relieves City of any fuither payment or other obligations under the Agreement.
5.TNDEPENDENT CONTR ACTOR
511 Status. Contractor is an independent contractor and not an employee, partner, or joint
venture of City. Contractor is solely responsible for the means and methods of performing the
Services and for the persons hired to work under this Agreement. Contractor is not entitled to
health benefits, worker's compensation, or other benefits from the City.
52 Contractor's Qualifications. Contractor warrants on behalf of itself and its subcontractors
that theyhave the qualifications and skills to perform the Setavices in a competent and professional
manner and according to the highest standards and best practices in the industry.
53 Permits and Licenses. Contractor warrants on behalf of itself and its subcontractors that
they are properly licensed, registered, and/or certified to perform the Services as required by law
and have procured a City Business License, if required by the Cupertino Municipal Code.
54 Subcontractors. Only Contractor's employees are authorized to work under this
Agreement. Prior written approval from City is required for any subcontractor, and the terms and
conditions of this Agreement will apply to any approved subcontractor
55 Tools, Materials, and Equipment. Contractor will supply all tools, materials and
equipment required to perform the Services under this Agreement.
516 Payment of Benefits and Taxes. Contactor is solely responsible for the payment of
employmenttaxesincurredunderthisAgreementandanysimilarfederalorstatetaxes. Contractor
and any of its employees, agents, and subcontractors shall not have any claim underthis Agreement
or otherwise against City for seniority, vacation time, vacation pay, sick leave, personal time off,
overtime, health insurance, medical care, hospital care, insurance benefits, social security,
disability, unemployment, workers compensation or employee benefits of any kind. Contractor
shall be solely liable for and obligated to pay directly all applicable taxes, fees, contributions, or
charges applicable to Contractor's business including, but not limited to, federal and state income
taxes. City shall have no obligation whatsoever to pay or withhold any taxes or benefits on behalf
of Contractor. Should any court, arbitrator, or administrative authority, including but not limited
to the Califoria Public Employees Retirement System (PERS), the Internal Revenue Service or
the State Employment Development Division, determine that Contractor, or any of its employees,
agents, or subcontractors, is an employee for any purpose, then Contractor agrees to a reduction in
amounts payable under this Agreement, or to promptly remit to City any payments due by the City
as a result of such determination, so that the City's total expenses under this Agreement are not
greater than they would have beenhad the determination not been made.
6.PTiO}i<iE IARY/CONFmF,NTTAT,INFORMATTON
In performing this Agreement, Contractor may have access to piivate or confidential information
owned or controlled by the City, which may contain proprietary or confidential details the
disclosure of which to tmd parties may be damaging to City. Contractor shall hold in confidence
all City information provided by City to Contractor and use it only to perform this Agreement.
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Contractor shall exercise the same standard of care to protect City infornnation as a reasonably
piudent contractor would use to protect its own proprietary data.
7.OWNERSHIP OF MATERIALS
7.I Property Rights. Any interest (including copyright interests) of Contractor in any product,
memoranda, study, report, map, plan, drawing, specification, data, record, document, or other
information or work, in any medium (collectively, "Work Product"), prepared by Contractor in
connection with tis Agreement will be the exclusive propeity of the City upon completion of the
work to be perfoimed hereunder or upon teimination of this Agreement, to the extent requested by
City. In any case, no Work Product shall be shown to any third-partywithout piior written approval
ofCity.
72 Copyright. To the extent permitted by Title 17 of the U.S. Code, all Work Product arising
out of this Agreement is considered "works for hire" and all copyrights to the Work Product will
be the propeity of City. Alternatively, Contractor assigns to City all Work Product copyrights.
Contractor may use copies of the Work Product for promotion only with City's written approval.
73 PatentsandLicenses.Contractormustpayroyaltiesorlicensefeesrequiredforauthorized
use of any third party intellectual property, including but not limited to patented, trademarked, or
copyrighted intellectual property if incorporated into the Services or Work Product of this
Agreement.
7.4 Re-Use of Work Product. Unless prohibited by law and without waiving any rights, City
mayuse or modify the Work Product of Contractor or its sub-contractors prepared or created under
this Agreement, to execute or implement any of the following:
(a) The original Services for which Contractor was hired;
(b) Completion of the original Services by others;
(c) Subsequent additions to the original Services; and/or
(d) Other Cityprojects.
7.5 DeliverablesandFormat.ContractormustprovideelectronicandhardcopiesoftheWork
Product, on recycled paper and copied on both sides, except for one single-sided original.
8.RECORDS
Contractor must maintain complete and accurate accounting records relating to its performance in
accordance with generally accepted accounting principles. The records must include detailed
information of Contractor's performance, benchmarks and deliverables, which must be available
to City for review and audit. The records and supporting documents must be kept separate from
other records and must be maintained for four (4) years from the date of City's finalpayment.
Contractor acknowledges that certain documents generated or received by Contractor in
connection with the performance of this Agreement, including but not limited to correspondence
between Contractor and any third party, are public records under the California Public Records
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Act, Califoiia Government Code section 6250 et seq. Contractor shall comply with all laws
regarding the retention of public records and shall make such records available to the City upon
request by the City, or in such manner as the City reasonably directs that such records be provided.
9.ASSIGNMENT
Contractor shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest
therein, directly or indirectly, by operation of law or otherwise, without prior written consent of
City. Any attempt to do so will be null and void. Any changes related to the financial control or
business nahire of Contractor as a legal entity is considered an assignn'ient of the Agreement and
subject to City approval, which shall not be unreasonably witbheld. Control means fifty percent
(50%) or more of the voting power of the business entity.
10. PUBLICITY / S'IGNS
Any publicity generated by Contractor for the project under this Agreement, during the term of
this Agreement and for one year thereafter, will reference tlie City's coiitributions in making the
project possible. The words "City of Cupeitino" will be displayed in all pieces of publicity,
including flyers, press releases, posters, brochures, public setavice announcements, interviews and
newspaper aiticles. No signs may be posted, exhibited or displayed on or about City property,
except signage required by law or this Contract, without prior written approval from the City.
11. TNDEMNIFICATION
11.1 To the fullest extent allowed by law, and except for losses caused by the sole and active
negligence or willful tnisconduct of City personnel, Contractor shall indemnify, defend and hold
harmless City, its City Council, boards and commissions, officers, officials, employees, agents,
servants, volunteers, and consultants ("Indemnitees"), through legal counsel acceptable to City,
from and against any and all liability, damages, claims, actions, causes of action, demands,
charges, losses, costs, and expenses (including attorney fees, legal costs, and expenses related to
litigation and dispute resolution proceedings) of every nature, arising directly or indirectly from
this Agreement or in any manner relating to any of the following:
(a) Breach of contract, obligations, representations, orwarranties;
(b) Negligent or willful acts or omissions committed duig performance of the Services;
(c) Personalinjury,propertydamage,oreconorniclossresultingfromtheworkorperformance
of Contractor or its subcontractors or sub-subcontractors;
(d) Unarithorized use or disclosure of City's confidential and proprietary Information;
(e) Claim of inftingement or violation of a U.S. patent or copyright, trade secret, trademark,
or service mark or other proprietary or intellectual property rights of any thirdparty.
11.2 Contractor must pay the costs City incurs in enforcing this provision. Contractor must
accept a tender of defense uponreceiving notice from City of a third-party claim. At City's request,
Contractor will assist City in the defense of a claim, dispute, or lawsuit arising out of this
Agreement.
11.3 Contractor's duties under this section are not litnited to the Contract Price, workers'
compensation payments, or the insurance or bond amounts required in the Agreement. Nothingin
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the Agreement shall be constiued to give rise to an implied right of indemnity in favor of
Contractor against City or any Indemnitee
11.4. Contractor's payments may be deducted or offset to cover any money the City lost due to a
claim or counterclaim arising out of this Agreement, a purchase order, or othertransaction.
11.5. Contractor agrees to obtain executed indemnity agreements with provisions identical to
those set forth here in this Section 11 from each and every subcontractor, or any other person or
entity involved by, for, with, or on behalf of Contractor in the performance of tis Agreement.
Failure of City to monitor compliance with these requirements imposes no additional obligations
on City and will in no way act as a waiver of any rights hereunder.
11.6. Tis Section 11 shall survive termination of the Agreement.
12.INSURANCE
Contractor shall comply with the Insurance Requirements, attached and incorporated here as
Exhibit D, and must maintain the insurance for the duration of the Agreement, or longer as
required by City. City will not execute the Agreement until City approves receipt of satisfactory
certificates of insurance and endorsements evidencing the type, amount, class of operations
covered, and the effective and expiration dates of coverage. Failure to comply with this provision
may result in City, at its sole discretion and without notice, purchasing insurance for Contractor
and deducting the costs from Contractor's compensation or tetaminating the Agreement.
13.COMPLIANCE WITH LAWS
13.1 Genera} Laws. Contractor shall comply with all local, state, and federal laws and
regulations applicable to this Agreement. Contractor will promptly notify City of changes in the
law or other conditions that may affect the Project or Contractor's ability to perform. Contractor
is responsible for verifying the employment authorization of employees performing the Services,
as required by the Immigration Reform and Control Act.
13.2 Labor Laws. Contractor shall comply with all labor laws applicable to this Agreement. If
the Scope of Services includes a "public works" component, Contractor is required to complywith
prevailing wage laws under Labor Code Section 1720 and other labor laws.
13.3 Discriminahon Laws. Contractor shall not discriminate on the basis of race, religious
creed, color, ancestry, national origin, ethnicity, handicap, disability, marital status, pregnancy,
age, sex, gender, sexual orientation, gender identity, Acquired-Immune Deficiency Syndrome
(AIDS), or any other protected classification. Contractor shall comply with all anti-discrimination
laws, including Governrnent Code Sections 12900 and 11135, and Labor Code Sections 1735,
1777, and 3077.5. Consistent with City policy prohibiting harassment and discrimination,
Contractor understands that harassment and discination directed toward a job applicant, an
employee, a City employee, or any other person, by Contractor or its employees or sub-contractors
will not be tolerated. Contractor agrees to provide records and documentation to the City on
request necessary to monitor compliance with t's provision.
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13.4 Conflicts of Interest. Contractor shall comply with all conflict of interest laws applicable
to t's Agreement and must avoid any conflict of interest. Contractor warrants that no public
official, employee, or member of a City board or commission who might have been involved in
the making of this Agreement, has or will receive a direct or indirect financial interest in this
Agreement, in violation of California Goverent Code Section 1090 et seq. Contractor may be
required to file a conflict of interest form if Contractor makes certain governmental decisions or
serves in a staff capacity, as defined in Section 18700 of Title 2 of the California Code of
Regulations. Contractor agrees to abide by the City's rules governing gifts to public officials and
employees.
13.5 Remedies.AnyviolationofSectionl3constitutesamaterialbreachandmayresultinCity
suspending payments, requiring reimbursements or terminating this Agreement. City reserves all
other rights and remedies available under the law and this Agreement, including the tight to seek
indemnification under Section 11 of this Agreement.
14. PRO.TECT COORDINAT}ON
City ProjectManager. TheCityassigns Ursula Syrova as tlie City's representative for all purposes
under tis Agreement, with authority to oversee the progress and performance of the Scope of
Services. City reserves the right to substitute another Project manager at any time, and without
prior notice to Contractor.
Contractor Project Manager. Subject to City approval, Contractor assigns Monica Rosquillas as
its single Representative for all purposes under this Agreement, with authority to oversee the
progress and performance of the Scope of Services. Contractor's Project manager is responsible for
coordinating and scheduling the Services in accordance with the Scope of Services and the Schedule
of Performance. Contractor must regularly ripdate the City's Project Manager about the progress
with the work or any delays, as required under the Scope of Services. City written approval is
required prior to substituting a new Representative
15. ABANDONMENT OF PRO.TECT
City may abandon or postpone the Project or parts therefor at any time. Contractor will be
compensated for satisfactory Services performed through the date of abandonment, and will be
given reasonable time to assemble the work and close out the Services. With City's pre-approval
in writing, the time spent in closing out the Services will be compensated up to a maximum of ten
percent (10%) of the total time expended to date in the performance of the Services.
16. TERMINATION
City mayterminate this Agreement for cause or without cause at any time. Contractor will be paid
for satisfactory Services rendered tbrough the date of termination, but final payment will not be
made until Contractor closes out the Services and delivers the Work Product.
17,GOVF,RNTNG LAW, VF,'NUE, AND DTSPUTF, RESOLUTION
This Agreement is governed by the laws of the State of California. Any lawsuits filed related to
tis Agreement must be filed with the Superior Court for the County of Santa Clara, State of
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California. Contractor must comply with the claims filing requirements under the Government
Code prior to filing a civil action in couit. If a dispute arises, Contractor must continue to provide
the Services pending resolution of the dispute. If the Parties elect arbitration, the arbitrator's award
must be suppoited by law and substantial evidence and include detailed written findings of law
and fact.
18.ATTORNEY FEF,S
If City initiates legal action, files a complaint or cross-complaint, or pursues arbitration, appeal, or
other proceedings to enforce its rights or a judgment in connection with this Agreement, the
prevailing paity will be entitled to reasonable attorney fees and costs.
19.THIRD PARTY BENEFICIARIES
There are no intended third paity beneficiaiies of this Agreement.
20. WAIVER
Neither acceptance of the Services nor payment thereof shall constitute a waiver of any contract
provision. City's waiver of a breacli shall not constitute waiver of another provision or breach.
21.ENTIRE AGREEMENT
This Agreement represents the full and complete understanding of every kind or nature between
the Paities, and supersedes any other agreement(s) and understanding(s), either oral or written,
between the Parties. Any modification of this Agreement will be effective only if in writing and
signed by each Party's authorized representative. No verbal agreement or implied covenant will
be valid to amend or abridge this Agreement. If there is any inconsistency between any teim,
clause, or provision of the main Agreement and any term, clause, or provision of the attachments
or exhibits thereto, the terms of the main Agreement shall prevail and be controlling.
22.INSERTED PROVISIONS
Each provision and clause required by law for this Agreement is deemed to be included and will
be inferred herein. Either party may request an amendment to cure mistaken insertions or
omissions of required provisions. The Parties will collaborate to implement this Section, as
appropriate
23.HEADTNGS
The headings in this Agreement are for convenience only, are not a part of the Agreement and in
no way affect, limit, or amplify the terms or provisions of this Agreement.
24. SEVERABILITY/PARTIAL INVALIDITY
If any term or provision of this Agreement, or their application to a particular situation, is found
by the court to be void, invalid, illegal, or unenforceable, such term or provision shall remain in
force and effect to the extent allowed by such ruling. All other terms and provisions of this
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Agreement or their application to specific situations shall remain in full force and effect. The
Parties agree to work in good faith to amend this Agreement to carry out its intent.
25. SURVIVAL
All provisions which by their nature must continue after the Agreement expires or is terminated,
including the Indemnification, Ownership of Materials/Work Product, Records, Governing Law,
and Attorney Fees, shall sutavive the Agreement and remain in full force and effect.
26. NOTICES
All notices, requests and approvals must be sent in writing to the persons below, which will be
considered effective on the date of personal delivery or the date confirmed by areputable overnight
delivery scrvice, on the fifth calendar day after deposit in the United States Mail, postage prepaid,
registered or ceitified, or the next business day following electronic submission:
To City of Cupertino
Ofke of the City Manager
10300 Torre Ave.
Cupeitino, CA 95014
Attention: Ursula Syrova
Email: ursulas@cupertino.org
To Contractor:
San Jose Conservation Corps.
1560 Berger Dr.
San Jose, CA 95112
Attention: Monica Rosquillas
Email: mrosquillas@sjccs.org
27. EXECUTION
The person executing this Agreement on behalf of Contractor represents and warrants that
Contractor has full right, power, and authority to enter into and carry out all actions contemplated
by this Agreement and that he or she is authorized to execute this Agreement, which constitutes a
legally binding obligation of Contractor. Tis Agreement may be executed in counterpaits, each
one of which is deemed an original and all of which, taken together, constitute a single binding
instrument.
IN WITNESS WHEREOF, the parties have caused the Agreement to be executed.
CITY OF CUPF,RTINO
A Municipal Coiporation
CONTRACTOR
B V t!=-J' 57-'-=-BY
DorseyA Moore
Name Ursula Syrova (she/her)Name DorseyAMoore
1at1eEnValr0nmemalPr0gramSManager Title CEO
Date Feb 23, 2023 Date Feb 23, 2023
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APPROVED AS TO FORM:
rL z:;
CHRISTOPHER D. JENSEN
Cupertino City Attorney
ATTEST:
k-2%
KIRSTEN SQUARCIA
City Clerk
Date Feb 23, 2023
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EXHIBIT A- Scope of Services
SAN JOSE CONSERVATION CORPS
PROPOSAL FOR CITI OF CUPERTINO COMPOST SITE ATTENDANTS
DATE PREPARED: 1/10/2023
Thisprojectissubjectofthetermsandconditionsofthe"MasterAgreement" betweenCityofCupertino and
the San lose Conservation Corps (SjCCl which terms and conditions are incorporated by reference into this Special
Project Approval Form. The terms of the Agreement shall apply to the project described on this Project Services
Approval Form.
I Project/Event Name: City of Cupertino Compost Giveaway Site Attendant
2
Project/Event Address/Location:
12100 Stevens Canyon Road, Cupertino
Mailing Address:
10300 Torre Avenue, Cupertino, California, 95014
Project/Event Description:
The San lose Conservation Corps (SJCC) will provide the of City of Cupertino with * minimzrqqf Oyyq (24) (;qrp4
[%(nbersr woqj4rnq d:tfi to serve as Compost Site Attendants. Attendants will work at their Compost Facility where
free compost is available to Cupertino residents 7:30 am to 12:30 pm each Friday and Saturday morning between
mid-March and mid-November.
San Jose Conservation Corps Members will fulfill the following duties:
p) Provide excellent customer service to patrons.
(2) Communicate clearly with the public.
(3) Provide clear and concise directions.
(4) Lifts, carries, and places barricade signs and safety cones at the facility and adjacent to Stevens Creek Canyon
Road.
(5) Open and close the facility on time.
(6) Verify residency requirements through personal interaction with each customer.
(kl nintain a rt,cord ot vet)files miving at thg IRel
3
(s) Effectively manages the circulation of vehicle into and out of the site.
(g) Exercises sound judgement to apply the specified time limit to each resident so that all can be served.
(io) Provides City-supplied outreach and other approved materials to customers as needed.
(:i.+) Closes the site securely and reports on the estimated amount of compost and /or bags remaining at the closing
time each Saturday.
(i;_) Communicates clearly with City staff in person, by telephone, and by email.
(13) Provide proof of forma! training within two years from the start date of the agreement for each Corps member
working at the site the following: 1) Heat Illness Prevention, 2) Blood Born Pathogens.
(14) Participate in training as needed and deemed necessary by the City for effective operation of the site. Regular
compensation to be paid by the City to the SJCC for any training and training to be provided by the City.
0s) Performs other duties as assigned.
FORM J-1
EXHIBIT B- Schedule of Performance
4 Start Date: Friday, March 24, 2023 Estimated Completion Date: Saturday, November 25,
2023
5a Sponsor Finance/Administration
contact: Alex Wykoff
Phone: (408) 777-3255
5b Sponsor Project Supervisor Contact:Phone:
5c Corps Project/Event Supervisor Contact:
Monica Rosquillas
Phone: (408) 472-7093
6 Estimated number of crew members: 2
7 Estimated total hours worked by all crew members: 10 hours per week
8 Materials/equipment supplied by City of Cupertino and Corps:
City will supply safety vests, shade structure, folding chairs, dust masks and ear plugs as
needed. Corps will provide hats, sunscreen, water, sturdy closed toe footwear, and other
PPE as needed.
FORM J-1
EXHIBIT C Compensat on
Estimated Costs:
2 Attendants
FY 22-23 Hourly Rate for 2 Attendant(s)S96.00 from March 24,2023 to June 30,2023 (15 weeks)
FY 23-24 Hourly Rate for 2 Attendant(s)S112.00 from July 1,2023 to November 25,2023 (22 weeks)
Number of Hours per Week 10
Number of Weeks per Year 37
TOTAL S12,480 + 622,400= 534,880
ESTIMATED TOT AL COST FOR PROJECT : S34,880
EXHIBIT D
Imurance Requirements
Design Professionals & Consultants Contracts
Consultant shall procure prior to commencement of Services and maintain for tlie duration of tlie contract,
at its own cost and expense, the following insurance policies and coverage with companies doing business in
California and acceptable to City.
INS{JRANCE POLICIES AND MINIMUMS REQUIRED
1. Cotntnercia/GeneralIiabi/i/y(CGL)forbodilyinjury,propertydamage,personalinjuryliabilityfor
premises operations, products and completed operations, contractual liability, and personal and
adveitising injuiy with liinits no less than $2,000,000 per occurrence (ISO Form CG 00 01). If a
general aggregate limit applies, either the general aggregate limit sliall apply separately to tliis
project/location (ISO Form CG 25 03 or 25 04) or it shall be twice the required occurrence limit.
a It shall be a requirement tliat any available insurance proceeds broader than or in excess of the
specified minirmim insurance coverage requirements and/or limits shall be made available to the
Additional Insured and shall be (i) the minimum coverage/limits specified in this agreement; or (ii) tlie
broader coverage and maximum limits of coverage of any insurance policy, whichever is greater.
b. Additional Insured coverage under Consultant's policy sliall be "primaiy and non-contributory,"
will not seek contribution from City's insurance/self-insurance, and shall be at least as broad as ISO
Form CG 20 10 (04/13).
c. The limits of insurance required may be satisfied by a combination of primary and umbrella or
excess insurance, provided each policy complies with the requirements set forth in this Contract. Any
umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage
shall also apply on a primary basis for the benefit of City before the City's own insurance or self-
insurance shall be called upon to protect City as a namedinsured.
2. AutomobileLiabil%: ISO CA 00 01 covering any auto (including owned, hired, and non-owned
autos) with limits no less than $1,000,000 per accident for bodily injury and property damage.
3. Workers' Compensation: As required by the State of California, with Statutory Limits and
Employer's Liability Insurance of no less than $1,000,000 per occurrence for bodily injury ordisease.
D Not required. Consultant has provided written verification of no employees.
4. Professional LiabilUy for professional acts, errors and omissions, as appropriate to Consultant's
profession, with limits no less than $2,000,000 per occurrence or claim, $2,000,000 aggregate. If written
on a claims made form:
a TheRetroactiveDatemustbeshownandmustbebeforetheEffectiveDateoftheContract.
b . Insurancemustbemaintainedforatleastfive(5)yearsaftercompletionoftheServices.
c . Ifcoverageiscanceledornon-renewed,andnotreplacedwithanotherclaims-madepolicyform
with a Retroactive Date prior to the Contract Effective Date, the Consultant must purchase
"extended reporting" coverage for a minimum of five (5) years after completion of the Services.
Exh. D-Insurance Requirements for Design Professionals & Cons'tdtant Contracts Form UpdatedJan. 2022
1
OTHER INSURANCE PROVISIONS
The aforementioned insurance shall be endorsed and have all the following conditions and provisions:
Additional Insured Status
The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers
("Additional Insureds") are to be covered as additional insureds on Consultant's CGL and automobile
liability policies. General Liability coverage can be provided in the fori'n of an endorsement to Consultant's
insurance (at least as broad as ISO Forin CG 20 10 (11/ 85) or both CG 20 10 and CG 20 37 forms, if Later
editions are rised).
Primary Coverage
Coverage afforded to City/Additional Insureds shall be primaiy insurance. Any iiisurance or self-insurance
maintained by City, its officers, officials, employees, or volunteers shall be excess of Consultant's insurance
and shall not contribute to it.
Notice of Cancellation
Each insurance policy sliall state that coverage shall not be canceled or allowed to expire, except with written
notice to City 30 days in advance or 10 days in advance if due to non-payment of premiums.
Waiver of Subrogation
Consultant waives any right to sribrogation against City/Additional Insureds for recovery of damages to the
extent said losses are covered by the insurance policies required herein. Specifically, the Workers'
Compensation policy shall be endorsed with a waiver of subrogation in favor of City for all work perfori'ned
by Consultant, its employees, agents and subconsultants. Tl'iis provision applies regardless of whether or not
tlie City has received a waiver of subrogation endorsement fiaom tlie insurer.
Deductibles and Self-Insured Retentions
Any deductible or self-insured retention must be declared to and approved by the City. At City's option, either:
the insurer must reduce or eliminate the deductible or self-insured retentions as respects the City/Additional
Insureds; or Consultant must show proof of ability to pay losses and costs related investigations, claim
administration and defense expenses. The policy shall provide, or be endorsed to provide, that the self-insured
retention may be satisfied by either the insured or the City.
Acceptability of Insurers
Insurers must be licensed to do business in California with an A.M. Best Rating of A-VII, or better.
Verification of Coverage
Consultant mustfurnish acceptable insurance certificates and mandatory endorsements (or copies of the policies
effecting the coverage required by this Contract), and a copy of the Declarations and Endorseinent Page of the
CGL policy listing all policy endorsements prior to commencement of the Contract. City retains the right to
demand verification of compliance at any time during the Contractterin.
Subconsultants
Consultant shall require and verify that all subconsultants maintain insurance tliat meet the requirements of
this Contract, including naming tlie City as an additional insured on subconsultant's insurance policies.
Higher Imurance Limits
If Consultantmaintains broadercoverage and/orhigher limitsthan the minimums shown above, City shall be
entitled to coverage for the higher insurance liinits maintained by Consultant.
Adequacy of Coverage
City reserves the right to modify these insurance requirements/coverage based on the nature of the risk, prior
experience, insurer or other special circumstances, with not less than ninety (90) days prior written notice.
Exh. D-Insurance Requirements,for Design Professionals & Corrsvdtant Contracts Form UpdatedJan. 2022
2
DATE IMMIDD/YYYY)
03/30/2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOL[ER. 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 ISSulNG INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
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).
PRODUCER
Conservation United
Pa Box 759
Higley 4285236
coNTAcT Sandra NennaNAME:
I
I
Pl
'A
ION
IC, IEol=x, (855)570-2797 I.A,,o',"', (602)388-8110
E.
Al
HAI
IDR LEsS, sandta@insuranceunited.com
INSURER(S) AFFORDING COVERAGE NAIC #
INSURERA: Philadelphia Indemnity Ins Co 18058
INSURED
San Jose Conservation Corps & Charter School
1560 Berger Drive
SanJose CA95112
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSuRED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDINGANYREQUIREMENT,TERMORCONDITIONOFANYCONTRACTOROTHERDOCUMENTWITHRESPECTTOWHICHTHIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
E>:CLLlSIONS AND CONDITIONS OF SUCH POLICIE 3. LIMITS SHOWN MAY HAVE BEEN REDtJCED BY PAID CI_AIMS.
INSR
LTR TYPE OF INSURANCE
AUUL
INSD
SClk
WVD POLICY NUMBER
POLICY EFF
IMM/DD)
POLICY EXP
(MMIDD/YYYY)LIMITS
A
x
ThcoMMcEuRi:A:x::N;R[xAl'AoB:c'upYYPHPK239663204/01/2022 04/01/2023
EACH OCCURRENCE $ 1 ,000,000
[)AMAGE TO RENTED
PREMISES (Ea occurrence)$ 1,000,000
MED EXP (Any one person)$ 20,000
PERSONAL & M)V INJURY $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
2koP:L1=C;: a .... @ LOC
GENERAL AGGREGATE $ 2,000,000
PRODuCTS - COMPVOP AGG $ 2,000,000
Sexual Abuse Cov $ 1,000,000
A
AUTOMOBILE LIABILITY
gaxyquro
OWNED rlschtouceo auros ONLY LJ quros
HIRED l NON-OWNED at.nos ONLY LJ AUTOS ONLY
Y Y PHPK2396632 04/01/2022 04/01/2023
COMBINED SINGLE LIMIT
(Ea accident)$ 1,000,000
B(X)ILY INJURY (Per person)$
BODILY INJURY (Pet accident)$
PROPERTY DAMAGE
(Pet accldent)$
$
A
x UMBRELLA LIAB
EXCESS LIAR
x OCCUR
CLAIMS-MAnE PHuB808853 04/01/2022 04/01/2023
EACH OCCURRENCE $ 5,000,000
AGGREGATE $ 5,000,000
DED I X RETENTIJN $ 101000 $
WORKERS COMPENSATION
AND EMPLOYERSa LIABILITf y l N
":'i:Hg';:'o':S'x'c"u'A':g:EcuT"E @(Mandatory In NH)
If yes, descnbe under
DESCRIPTION OF OPERATIONS below
N {A Y
ISRAuTE I I ER"-
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
A
Crime
PHSD1694621 04/01/2022 04/01/2023
Per occurrence
Deductible
1 ,000,000
10,000
DES(;RIPTION OF OPERATICINS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be a tached if more syiace is required}
"This certificate represents coverage currently in effect and may or may not be in compliance with any written contract as this is limited to the information
provided by the insured.a'
The City, its City Council, boards and commissions, officers. employees, and volunteers are included as an additional insureds with respect to General
Liability & Auto Liability. Waiver of Subrogation is included on General Liability and Auto Liability
CERTIFICATE HOLDER
CERTIFICATE NUMBER: 22/23 Liabilit'}REVISION NUMBER:
CANCELLATION
City of Cuperfino Office of Parks and Recreation City Hall
10300 Torre Avenue
Cupertino CA95014
I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AuTHORIZED REPRESENTATIVE
_:-'t--=-f . ,r'-t- _,,
@1988-2015ACORDCORPORATION. Allrightsreserved.
ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: PHPK2396632 COMMERCIAL GENERAL LIABILITY
CG 20 26 0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERC)AL GENERAL LIABIL)TY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s):
AI status will be g'ranted if required by
contract and certificate of insurance
is filed with company.
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 your acts or
omissions or the acts or omissions of those acting
on your behalf:
1. In the performance of your ongoing operations;
or
2. In connection with your premises owned by or
rented to you.
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 Ill - 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:
4. Required by the contract or agreement; or
2. Available under the applicable Limits of
Insurance shown in the Declarations:
whichever is less.
This endorsement shaff not increase the
applicable Limits of Insurance shown in the
Declarations.
CG 20 26 0413 @ Insurance Services Office, Inc., 2012 Page I of I
POLICY NUMBER: PHPK2396632
PI-GL-005 (07/12)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED
PRIMARY AND NON-CONTRIBUTORY INSURANCE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Effective Date:
Name of Person or Organization (Additional Insured):
BLANKET PRIMARY & NON-CONTRIBUTORY STATUS APPLIES
WHEN REQUIRED BY CONTRACT AND CERTIFICATE OF INSURANCE
IS FILED WITH COMPANY.
SECTION II - WHO IS AN INSURED is amended to include as an additional insured the person(s) or
organization(s) shown in the endorsement Schedule, but only with respect to liability for "bodily injury,"
"property damage' or 'personal and advertising injury" arising out of or relating to your negligence in the
performance of "your work' for such person(s) or organization(s) that occurs on or after the effective date
shown in the endorsement Schedule.
This insurance is primary to and non-contributory with any other insurance maintained by the person or
organization (Additional Insured), except for loss resulting from the sole negligence of that person or
organization.
This condition applies even if other valid and collectible insurance is available to the Additional Insured
for a loss or 'occurrence" we cover for this Additional Insured.
The Additional Insured's limits of insurance do not increase our limits of insurance, as described in
SECTION Ill - LIMITS OF INSURANCE.
All other terms, conditions, and exclusions under the policy are applicable to this endorsement and
remain unchanged.
Page 5 of 5
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
POLICY NUMBER: PHPK2396632 COMMERCIAL GENERAL LIABILITY
CG 24 04 05 09
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
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:
WOS will be granted if required by
contract and certificate of insurance
is filed with company.
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 - Condltions:
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 @ Insurance Services Office, Inc., 2008 Page 1 of 1 0
POLICY NUMBER: PHPK2396632
PI-CA-001 (09/15)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL AUTOMOBILE ELITE ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE PART
Following is a summary of the Limits of Insurance and additional coverages provided by this
endorsement. For complete details on specific coverages, consult the policy contract wording.
Coverage Applicable Limit of Insurance
Page
#
Who is An Insured
Board Members
Newly Acquired Entities
Designated Insured
Lessor of Leased Autos
Included
Included
Included
Included
2
Cost of Bail Bonds $5,000 2
Reasonable Expenses - Loss of Earnings $500 per day 2
Fellow Employee Coverage Amended 3
Towing $100 per disablement 3
Glass Breakage (Windshields and Windows)No deductible applies 3
Transportation Expenses I 5100 per day/E 33,000 maximum 3
Hired Auto Physical Damage - Loss of Use I 5100 perday/S i1,000 maximum 3
Hired Auto Physical Damag-e ACV or repair or replacement of the
vehicle whichever is less
4
Personal Effects I 5500 4
Rental Reimbursement I ti100 per day/30 days 4
Accidental Discharge - Air Bag Amended - -4
Electronic Equipme-nt -$1000 5
Original Equipment Manufacturer Parts
Replacement
Included 5
Auto Loan / Lease Gap Coverage Amended 5
One Comprehensive Coverage Deductible Per
Occurrence
Amended 6
Notice of and Knowledge of Occurrence Amended 7
Blanket Waiver of Subr-ogation Amended (as required by written contract)7
Unintentional Errors or Omissions Amended - -7
Mental Anguish - Bodily Injury Redefined Amended 7
Coverage extensions under this endorsement only apply in the event that no other specific coverage for
these extensions is provided under this policy. If such specific coverage applies, the terms, conditions
and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless
otherwise noted in this endorsement.
Any deductible listed in the Auto Declarations Page will apply unless specific deductible provisions are set
forth under a coverage enhancement below.
Page 1 of 7
@ 20al5 Philadelphia Indemnity Insurance Company
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI-CA-001 (09/15)
€. LIABILITY COVERAGE EXTENSIONS
A. Who Is An Insured
SECTION II- LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured is amended by
adding the following:
The following are also "insureds":
"1. Board Members - Board members (or their spouses) while renting a vehicle while on
business for the named insured.
2. Newly Acquired Entities - Any business entity newly acquired or formed by you during
the policy period, provided you own 50% or more of the business entity and the business
entity is not separately insured for Business Auto Coverage. Coverage is extended up to
a maximum of 180 days following the acquisition or the formation of the business entity.
3. Designated Insured - Any person or organization designated by the 'insured' is an "insured"
for Liability Coverage, but only to the extent that person or organization qualifies as an
"insured" under the Who Is An Insured Provision contained in SECTION II of the Coverage
Form.
4. Lessor of Leased Autos - The lessor of a "leased auto" is an "insured" only for "bodily
injury" or "property damage" resulting from the acts or omissions by:
a. You;
b. Any of your 'employees" or agents; or
c. Any person, except the lessor or any 'employee' or agent of the lessor, operating
a "leased auto" with the permission of any of the above.
Any 'leased auto" in the.policy schedule will be considered a covered "auto" you own
and not a covered "auto" you hire or borrow.
The coverages provided under this endorsement apply to any "leased auto" in the policy
schedule until the expiration date of the lease, or when the lessor or his or her agent
takes possession of the "leased auto," whichever occurs first.
'Leased auto" means an "auto" leased or rented to you, including any substitute, replacement
or extra "auto" needed to meet seasonal or other needs, under a leasing or rental agreement
that requires you to provide direct primary insurance for the lessor.
B. Cost of Bail Bonds
SECTION II - LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a.
Supplementary Payments, Item (2) is deleted in its entirety and replaced with the following:
(2) Up to $5,000 for cost of bail bonds (including bonds for related traffic law violations)
required because of an "accident" we cover. We do not have to furnish these bonds.
C. Reasonable Expenses
SECTION If - LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a.
Supplementary Payments, Item (4) is deleted in its entirety and replaced with the following:
Page 2 of 7
@ 2015 Philadelphia Indemnity Insurance Company
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI-CA-001 (09/15)
(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.
D. Fellow Employee Coverage
SECTION El - LIABILITY COVERAGE, B. Exclusions, 5. Fellow Employee is deleted in its
entirety and replaced by the following:
"Bodily injury' to any fellow "employee" of the "insured" arising out of and in the course of the
fellow "employee's" employment or while performing duties related to the conduct of your
business.
However, this exclusion does not apply to any manager or officer of your company.
II, PHYSICAL DAMAGE COVERAGE EXTENSIONS
A. Towing
SECTION Ill - PHYSICAL DAMAGE COVERAGE, A. Coverage, 2. Towing is deleted in its
entirety and replaced with the following:
2. Towing
We will pay up to $100 for towing and labor costs incurred each time a covered "auto" is
disabled. However, the labor must be performed at the place of disablement. No deductible
applies to this enhancement.
B. Glass Breakage
SECTION Ill - PHY81CAL DAMAGE COVERAGE, A. Coverage, 3. Glass Breakage - Hitting
A Bird Or Animal - Falling Objects Or Missiles is amended by adding the following:
No deductible applies to "loss" to glass used in the windshield or windows.
C. Transportation Expenses
SECTION Ill- PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a.
Transportatlon Expenses is deleted in its entirety and replaced with the following:
a. Transportation Expenses
We will pay up to $100 per day to a maximum of $3,000 for temporary transportation
expenses incurred by you because of a "loss' to a covered "auto." We will pay for
temporary transportation expenses incurred during the period beginning 48 hours after
the 'loss" and ending, regardless of the policy's expiration, when the covered 'auto" is
retumed to use or we pay for its "loss.'
D. Hired Auto Physlcal Damage - Loss of Use
The last sentence of SECTION Ill- PHYSICAL DAMAGE COVERAGE, A. Coverage, 4.
Coverage Extensions, b. Loss of Use Expenses is deleted in its entirety and replaced with the
followlng:
However, the most we will pay for any expenses for loss of use is $100 per day, to a
maximum of $1,000.
Page 3 of 7
@ 2015 Philadelphia Indemnity Insurance Company
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI-CA-001 (09/15)
E. Hired Auto Physical Damage
SECTION Ill - PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions is
amended by adding the following extension:
Hired Auto Physical Damage
Any "auto" you lease, hire, rent or borrow from someone other than your "employees" or partners,
or members of their household is a covered "auto" for each of your physical damage coverages.
The most we will pay for any "loss" in any one "accident" is the ACV or the cost for repair or
replacement of the vehicle, whichever is less.
For each covered 'auto" our obligation to pay will be reduced by a deductible of $500 for
Comprehensive Coverage and $1000 for Collision Coverage,
F. Personal Effects Coverage
SECTION Ill- PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions is
amended by adding the following extension:
Personal Effects Coverage
We will pay up to $500 for "loss' to personal effects, which are:
t Owned by an "insured"; and
2. In or on your covered "auto."
This coverage applies only in the event of the total theft of your covered 'auto-" No deductible
applies to this coverage.
G. Rental Reimbursement
SECTION Ill- PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions is
amended by adding the following extension:
Rental Reimbursement Coverage
We will pay up to $100 per day, for up to 30 days, for rental reimbursement expenses
incurred by you for the rental of an 'auto" because of "loss' to a covered "auto."
We will also pay up to $300 for reasonable and necessary expenses incurred by you to
remove and replace your materials and equipment from the covered "auto."
If "loss" results from the total theff of a covered "auto," we will pay under this coverage only that
amount of your rental reimbursement expenses which is not already provided under Item Ill. C.
Transportation Expenses of this endorsement.
H. Accidental Discharge - Airbag Coverage
SECTION Ill - PHYSICAL DAMAGE COVERAGE, B. Exclusions, Paragraph 3. is amended by
adding the following exception:
Page 4 of 7
@ 2015 Philadelphia Indemnity Insurance Company
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI-CA-001 (09/al5)
This exclusion does not apply to the accidental discharge of an airbag. This coverage is
excess of any other collectible insurance or warranty. No deductible applies to this
COVerage.
1. Electromc Equipment Coverage
The following supersedes anything to the contrary in SECTION Ill - PHYSICAL DAMAGE
COVERAGE, B. Exclusions, Paragraph 4.
Exclusions 4.c. and 4.d. do not apply to:
Any risk management or monitoring equipment and electronic equipment that receives or
transmits audio, visual or data signals and that Is not designed solely for the reproduction of
sound. This coverage applies only if the equipment is permanently installed in the covered
"auto' at the time of the 'loss" or the equipment is removable from a housing unit which is
permanently installed in the covered 'auto" at the time of the "loss," and such equipment is
designed to be solely operated by use of the power from the "auto's" electrical system, in or
upon the covered "auto.'
The most we will pay for all "loss" to risk management or monitoring equipment, audio, visual
or data electronic equipment that is not designed solely for the reproduction of sound and any
accessories used with this equipment as a result of any one 'accident" is the least of:
a, The actual cash value of the damaged or stolen property at the time of the "loss";
b. The cost of repairing or replacing the damaged or stolen property with other property of
like kind and quality; or
C. $1,000.
This coverage will not apply if there is other insurance provided by this policy for the above-
described electronic equipment. We will, however, pay any deductible, up to $500, that is
applicable under the provisions of the other insurance.
J. Original Equipment Manufacturer (OEM) Parts Replacement
SECTION Ill - PHYSICAL DAMAGE COVERAGE, C. Limit of Insurance, Paragraph 1. is
amended to include:
However, if the covered "auto' has less than 20,000 miles on its odometer, then the following
condition will apply:
We will pay the cost to replace the damaged parts (excluding glass and mechanical parts)
with new Original Equipment Manufacturer replacement parts if the damaged parts cannot be
repaired.
K. Auto Loan / Lease Gap Protection
SECTION ill- PHYSICAL DAMAGE COVERAGE, C. Limit of Insurance is amended to include
the following:
4. In the event of "loss' to a covered "auto" that is loaned or leased to an 'insured":
a. The most we will pay for "loss" in any one 'accident' is the lesser of:
Page 5 of 7
@ 2015 Philadelphia Indemnity Insurance Company
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI-CA-001 (09/15)
(1 ) The actual cash value of the damaged or stolen property as of the time of the "loss';
or
(2) The cost of repairing or replacing the damaged or stolen property with other property
of like, kind and quality.
b. Our Limit of Insurance for "total loss" will be the greater of:
(1 ) The balance due under the terms of the lease or (oan, to which your "auto" is subject
but not including:
(a) Past due payments;
(b) Financial penalties imposed under the lease;
(c) Security deposits not refunded;
(d) Costs for extended warranties or insurance; or
(e) Final payment due under a 'balloon loan"; or
(2) Actual cash vaJue of the stolen or damaged property.
An adjustment for depreciation and physical condition will be made in determlning actual
cash value at the time of "loss.'
c. Additional Definitions
(1 ) "Total loss" for the purpose of this coverage, means a loss in which the estimated
cost of repairs, plus the salvage value, exceeds the actual cash value.
(2) "Balloon loan" is one with pertodic payments that are insufficient to repay the balance
over the term of the loan, thereby requiring a large final payment,
d. Additional Conditions
This coverage will apply only to the original lease or loan written on your covered "auto."
In order for this coverage to apply, leased "autos" must be leased or rented to you under
a leasing or rental agreement, for a period of not less than six months, which requires
you to provide direct primary insurance for the benefit of the lessor.
L. One Comprehensive Coverage Deductible
SECTION Ill - PHYSICAL DAMAGE COVERAGE, D. Deductible is amended by adding the
following:
Only one Comprehensive Coverage Deductible per occurrence will apply to any "loss"
resulting from a covered peril.
For the purpose of this extension, occurrence means a single incident, including continuous
or repeated exposure to substantially the same general harmful conditions within a 24-hour
period.
Page 6 of 7
@ 2015 Philadelphia Indemnity Insurance Company
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI-CA-001 (09/15)
Ill. BUSINESS AUTO CONDITIONS
A. Notice and Knowledge of Occurrence
SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event
Of Accident, Claim, Suit Or Loss, Paragraph a. is deleted in its entirety and replaced with the
following:
a. In the event of "accident," claim, 'suit" or "loss,' you must give us, or our authorized
representative, prompt notice of the 'accident" or "loss." Include:
(1) How, when and where the 'accident" or "loss" occurred;
(2) The "insured's" name and address; and
(3) To the extent possible, the names and addresses of any injured persons and
witnesses.
Your duty to give us or our authorized representative prompt notice of the "accident" or
'loss" applies only when the "accident" or "loss' is known to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership; or
(3) An executive officer or insurance manager, if you are a corporation.
B. Blanket Waiver Of 8ubrogation
SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer Of Rights Of
Recovery Against Others To Us, is amended by.adding the following exception:
However, we waive any right of recovery we may have against any person or organization
because of payments we make for "bodily injury" or "property damage" arising out of the
operation of a covered 'auto" when you have assumed liability for such "bodily injury" or
'property damage" under an "insured contract.'
C. Unintentional Errors or Omissions
SECTION IV - BUSINESS AUTO CONDITIONS, B. General Conditions, 2. Concealment,
Misrepresentation, Or Fraud is amended by adding the following:
The unintentional omission of, or unintentional error in, any information given by you shall not
prejudice your rights under this insurance. However, this provision does not affect our right to
collect additional premium or exercise our right of cancellation or non-renewal.
IV. DEFINITIONS
A. Mental Anguish
SECTION V - DEF1NIT10N8, C. "Bodily injury" is amended by adding the following:
'Bodily injury' also includes mental anguish but only when the mental anguish arises from
other bodily injury, sickness, or disease.
Page 7 of 7
@ 2015 Philadelphia Indemnity Insurance Company
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DATE (MMIDD/'maY)
4/1/2022
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
REPRESENT ATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
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).
PRODLICER
(WC) Heffernan Insurance Brokers
1350 Carlback Avenue
Walnut Creek CA 94596
License#: 05B4249
CONT ACT
NAME:
Pi
(A :8,"5o, EXtl: 925-934-8500 i (6:, Noj: 925-934-8278
€:i
A[
jAiL-' - '=
IDRESS:
INSLIRER(S} AFFORDING COVERAGE NAIC#
issuhen A : Cypress Insurance Company 10855
INSuRED SANJOSE-37
San Jose Conservation Corps and Charter School
4 560 Berger Drive
San Jose CA 95'l12
INSURER El :
INSURER C :
INSURER D :
INSLIRER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 598680329 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSuRED NAME[) ABOVE FOR THE POLICY PERIOD
IN[)ICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCLIMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSLIRANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SLIBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCE[) BY PAID CLAIMS.
INSR
LTR TfPE OF INSIIRANCE
ADDL
INSD
SuElR
WVD POLICY NLIMBER
POLICY EFF
iMMIDD/YYYY)
POLICY EXP
(MM{DD/'mtY)LIMITS
COMMERCIAL GENERAL LIABILITY
ICLAIMS-MADE € OCCUR
EACH OCCURRENCE $
DAMAGE TO RENTED
PREMISES (Ea occunence)$
MED EXP (Any one person)$
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO- I
4 'o'c' LJ JECT n LOC
10THER:
GENERAL AGGREGATE $
PRODUCTS-COMP/OP AGG $
$
AuTOMOBiLE LIABILITY
- ANY AtJTO
OWNED SCHEDULE[)_ AUTOS ONLY LJ AUTOS
HIRED n NON-OWNED_ AUTOS ONLY l_J AtlTOS ONLY
COMBINED SINGLE LIMIT
(Ea accident)$
BODILY INJURY (Pet person)$
BODILY INJURY (Per accident)$
PROPERTY DAMAGE
(Per accident)$
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CIAIMS-MADE
EACH OCCURRENCE $
AGGREGATE $
DED I I RETENT.ON $$
A WORKERS COMPENSATION
AND EMPLOYERS! LIABILITY Y , N
ANYPROPRIETOFUPARTNERIEXECtlTIVE rl
OFFICERIMEMBEREXCLUDED? §
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
Y SAWC351652 4/i/2022 4/1/2023 " I S'B'TUTE I I ER"-
E.L. EACH ACCIDENT $1,000,000
E.L. DISEASE-EAEMPLOYEE $1 ,000,000
E.L. DISEASE-POLICY LIMIT $1 ,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101 Additional Remarks Schedule, may b Th attached If mori space Is required)
Re: As Per Contract or Agreement on File with Insured. Waivers of Subrogation is included on Workers Compensation policy per the attached endorsements, if
required.
CERTIFICATE HOLDER CANCELLATION
City of Cupertino Office of Parks and Recreation City Hall
10300 Torre Avenue
Cupertino, CA 95014
I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
M)THORIZED REPRESENT ATIVE
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY wc 99 0410 C
(Ed. 01-1 9)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA
BLANKET BASIS
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce
our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you
perform work under a written contract that requires you to obtain this agreement from us.)
The additional premium for this endorsement shall be calculated by applying a factor of 2% to the total manual
premium, with a minimum initial charge of $350, then applying all other pricing factors for the policy to this calculated
charge to derive the final cost of this endorsement.
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
Blanket Waiver
Person/Organization Blanket Waiver - Any person or organization for whom the Named Insured has
agreed by written contract to furnish this waiver.
Job Description
All CA Operations
Waiver Premium (prior to adjustments)
13652.00
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective: 04/0'l/2022 PolicyNo.: SAWC351652 Endorsement No.:
Insured:Premium $
Insurance Company: Cypress Insurance Company
Countersigned by
WC 99 0410 C
(Ed. 01-19)
San Jose Conservation Corps Compost Site
Attendants for 2023
Final Audit Report 2023-02-24
Created:
By:
Status:
. Transaction ID:
2023-02-23
City of Cupertino (webmaster@cupertino.org)
Signed
CBJCHBCAABAARqXrfi5VQv9ZuCSA-7LADgkTEql mrlg
"San Jose Conservation Corps Compost Site Attendants for 202
3" History
'6 Document created by City of Cupertino (webmaster@cupertino.org)
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P-> Document emailed to Julia Kinst 0uliak@cupertino.org) for approval
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i@ Document approved by Julia Kinst (juliak@cupertino.org)
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@ Document e-signed by Christopher D. Jensen (christopherj@cupertino.org)
Signature Date: 2023-02-23 - 11 :23:31 PM GMT - Time Source: server- IP address: 136.24.22.194
[?-+ Document emailed to Ursula Syrova (she/her) (ursulas@cupertino.org) for signature
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4 Document e-signed by Ursula Syrova (she/her) (ursulas@cupertino.org)
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[?-> Document emailed to Kirsten Squarcia (kirstens@cupertino.org) for signature
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'6 Email viewed by Kirsten Squarcia (kirstens@cupertino.org)
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4 Document e-signed by Kirsten Squarcia (kirstens@cupertino.org)
Signature Date: 2023-02-24 - 0:30:17 AM GMT - Time Source: server- IP address: 67.'l88.176.248
@ Agreement completed.
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