24-109 Bruce Hildenbrand for Bike Fest Master of CeremoniesBruce Hildenbrand Entertainment Agreement for Bike Fest Master of Ceremonies
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Services Agreement ($5,000) / April 2024
SERVICES AGREEMENT
($5,000 OR LESS)
1. Parties. This Agreement (“Agreement”) is made by and between the City of Cupertino, a municipal
corporation (“City”) and Bruce Hildenbrand (“Contractor”), a Sole Proprietorship/Individual, and is
effective on the last date signed below (“Effective Date”).
2. Services. Contractor agrees to provide the programs, classes or activities (“Services”) set forth in detail
in the Scope of Services, attached and incorporated here as Exhibit A. Contractor further agrees to carry
out its work in compliance with any applicable local, State, or Federal order regarding COVID-19.
3. Time of Performance. This Agreement begins on the Effective Date and ends on September 28, 2024
(“Contract Time”), unless terminated earlier as provided herein. Contractor must deliver the Services in
accordance with the Schedule of Performance included or attached to Exhibit A. 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. The City’s designated supervisor for this Agreement may extend
the Contract Time by up to six (6) months through a written amendment to this Agreement, provided
such extension does not include additional contract funds.
4. Compensation. City will pay Contractor for satisfactory performance of the Services an amount that
will based upon actual costs but that will be capped so as not to exceed $350.00 (“Contract Price”),
based upon the Scope of Services and the budget and rates included in Exhibit A. The maximum
compensation includes all expenses and reimbursements and will remain in place even if Contractor’s
actual costs exceed the capped amount. Upon City approval of written invoices, Contractor will be paid
as follows: (check one; cross out others):
☒ A lump sum amount of $350.00 which shall not exceed the
Contract Price.
☐ At the rate of $_______ per hour for a total not to exceed the Contract
Price.
☐ Based on the payment schedule included or attached to Exhibit A which shall not
exceed the Contract Price.
5. Independent Contractor. 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, workers compensation or other benefits from the City. Contractor must have the skills and
qualifications to perform the Services in a competent and professional manner, and must be licensed,
registered, and/or certified and have a City Business License. Contractor will supply all tools, materials
and equipment required to perform the Services under this Agreement.
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6. Payment of Benefits and Taxes. Contractor is solely responsible for the payment of employment
taxes incurred under this Agreement and any similar federal or state taxes. Contractor and any of its
employees, agents, and subcontractors shall not have any claim under this 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. In the event that
Contractor or any employee, agent, or subcontractor of Contractor providing services under this
Agreement is determined by a court of competent jurisdiction, arbitrator, or administrative authority,
including but not limited to the California Public Employees Retirement System (PERS) to be eligible
for enrollment in PERS as an employee of City, Contractor shall indemnify, defend, and hold harmless
City for the payment of any employee and/or employer contributions for PERS benefits on behalf of
Contractor or its employees, agents, or subcontractors, as well as for the payment of any penalties and
interest on such contributions, which would otherwise be the responsibility of City, and actual
attorney’s fees incurred by City in connection with the above.
7. Assignment. This Agreement is not assignable. Contractor may not substitute another or transfer any
rights or obligations under this Agreement without prior written approval of City. Only those persons
whose names are included in Exhibit A may perform the Services.
8. Indemnification. To the fullest extent allowed by law and except for losses caused by the sole and
active negligence or willful misconduct 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 or warranties;
(b) Negligent or willful acts or omissions committed during performance of the Services;
(c) Personal injury, property damage, or economic loss resulting from the work or performance of
Contractor or its subcontractors or sub-subcontractors;
Contractor must pay any costs City may incur in enforcing this provision and must accept a tender of
defense upon receiving notice from City. 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.
9. Insurance. Contractor shall comply with the Insurance Requirements, attached and incorporated here
as Exhibit B, 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
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discretion and without notice, purchasing insurance for Contractor and deducting the costs from
Contractor’s compensation or terminating the Agreement.
10. Compliance with Laws. Contractor shall comply with all laws and regulations applicable to this
Agreement, included without limitation the following laws:
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 comply with prevailing wage
laws under Labor Code Section 1720 and other labor laws.
☒ Sole Proprietor. If Contractor is a sole proprietorship/individual, it must sign
the Affidavit of No Employees included in this Agreement.
Discrimination 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
Government Code Sections 12900 and 11135, and Labor Code Sections 1735, 1777 and 3077.5.
Consistent with City policy, Contractor understands that harassment and discrimination directed
toward a job applicant, an employee, a City employee, or any other person, by Contractor or
Contractor's 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 this
provision.
Conflicts of Interest. Contractor shall comply with all conflict of interest laws applicable to this
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 Government 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 the California Code of Regulations. Contractor agrees to abide by the
City’s rules governing gifts to public officials and employees.
11. Abandonment. City may abandon or postpone the Project at any time. Contractor will be compensated
for satisfactory Services performed through the date of abandonment.
12. Termination. City may terminate this Agreement for cause or without cause at any time. City reserves
the right to terminate the Agreement and the remainder of the Services offered by Consultant without
notice based upon Contractor’s cancellation of a Service (i.e., program, class or activity) without
giving advance notice or obtaining written approval from City.
13. Governing Law. This Agreement is governed by the laws of the State of California. Any lawsuits filed
related to this Agreement must be filed with the Superior Court for the County of Santa Clara, State of
California. Contractor must comply with the claims filing requirements under the Government Code
prior to filing a civil action in court. 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
supported by law and substantial evidence and include detailed written findings of law and fact.
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14. Entire Agreement. This Agreement represents the full and complete understanding of every kind or
nature between the Parties, and supersedes any other agreement or understanding, either oral or
written, between the Parties. Any changes to 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 term, 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. Each provision and clause
required by law for this Agreement is deemed to be inserted and will be inferred herein.
15. Services Coordinator. The Parties designate the following persons as Services Coordinators for this
Agreement. Contractor’s designation and any substitution are subject to City approval.
For City: For Contractor:
Birgit Werner Bruce Hildenbrand
Safe Route to School Coordinator Owner
bwerner@cupertino.gov bruce@brucehildenbrand.com
16. Contract Interpretation. There are no intended third party beneficiaries of this Agreement. Neither
acceptance of the Services nor payment therefor shall constitute a waiver of any contract provision.
City’s waiver of a breach shall not constitute waiver of another provision or breach. The headings in
this Agreement are for convenience only. The Indemnification and Governing Law sections expressly
survive this Agreement.
17. Severability. If a term or provision of the Agreement or its application to a particular situation is found
by the court to be void, invalid, illegal, or unenforceable, such term or provision shall remain in effect
to the extent allowed by such ruling. All other terms and provisions of this Agreement or their
application to specific situations shall remain in full force and effect.
18. Notices. All notices, demands, requests, and approvals must be sent to the persons below in writing,
and will be considered effective on the date of personal delivery, upon confirmation of delivery by a
reputable overnight delivery service, on the fifth calendar day after deposit thereof in the United States
Mail, postage prepaid, registered or certified, or the next business day following electronic submission:
To City of Cupertino:
Office of the City Manager
10300 Torre Ave.
Cupertino, CA 95014
Attention: Birgit Werner
Email: bwerner@cupertino.gov
To Contractor:
Bruce Hildenbrand
2034 San Luis Ave #2
Mountain View, CA 94043
Attention: Bruce Hildenbrand
Email: bruce@brucehildenbrand.com
19. Execution. Contractor’s signatory warrants that he or she is authorized to execute the Agreement and
to legally bind Contractor. This Agreement may be executed in counterparts, each one of which is
deemed an original and all of which, taken together, constitute a single binding instrument.
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IN WITNESS WHEREOF, the Parties have caused the Agreement to be executed as of the
Effective Date written above.
CITY OF CUPERTINO
A Municipal Corporation
BRUCE HILDENBRAND
By:
By:
Name: Name:
Title:
Date:
Title:
Date:
APPROVED AS TO FORM:
By:
CHRISTOPHER D. JENSEN
City Attorney
ATTEST:
By:
KIRSTEN SQUARCIA
City Clerk
Date:
Bruce E Hildenbrand
Bruce E Hildenbrand
Mr
Aug 26, 2024
Christopher D. Jensen
Director of Public Works
Chad Mosley
Aug 26, 2024
Aug 26, 2024
EXHIBIT A
Bruce Hildenbrand
Master of Ceremonies and Announcer for Fall Bike fest
$350
Cupertino Fall Bike Fest
September 28, 2024
Cupertino Civic Plaza
Event is 9am – 1pm
Setup starts at 7:30am
Insurance Requirements for Services Agreement ($5,000 or less) Version: August 2024
1
EXHIBIT B
INSURANCE REQUIREMENTS
For Services and Activities Involving Children
Services Agreement ($5,000 or less)
Contractor shall procure and maintain for the duration of the contract insurance against claims for injuries
to persons or damages to property which may arise from or in connection with the performance of the
work hereunder and the results of that work by the Contractor, his agents, representatives, employees,
or subcontractors.
MINIMUM SCOPE AND LIMIT OF INSURANCE
Coverage shall be at least as broad as:
1. Commercial General Liability (“CGL”): Insurance Services Office (“ISO”) Form CG 00 01
covering CGL on an “occurrence” basis, including property damage, bodily injury and personal &
advertising injury with limits no less than $2,000,000 per occurrence. If a general aggregate limit
applies, either the general aggregate limit shall apply separately to this project/location (ISO CG 25
03 or 25 04) or the general aggregate limit shall be twice the required occurrence limit.
a) It shall be a requirement under this agreement that any available insurance proceeds broader
than or in excess of the specified minimum insurance coverage requirements and/or limits
shall be made available to the Additional Insured and shall be (1) the minimum coverage/limits
specified in this agreement; or (2) the broader coverage and maximum limits of coverage of
any insurance policy, whichever is greater.
b) Additional Insured coverage under Contractor's policy shall be "primary and non-
contributory," will not seek contribution from City’s insurance/self-insurance, and shall be at
least as broad as ISO CG 20 01 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 named insured.
2. Sexual Abuse/ Molestation insurance or the equivalent are required for contracts involving children
in after school activities, recreational programs, athletics, studies, transportation of students. Covers
potential claims of abuse or child molestation. Sexual Abuse/Molestation coverage must be included
under General Liability or obtained in separate policies in an amount of not less than $1,000,000 per
occurrence ($2,000,000 aggregate) and $3,000,000 excess/umbrella coverage.
3. Automobile Liability: ISO Form Number CA 0001 covering Code 1 (any auto), or if Contractor
has no owned autos, Code 8 (hired) and 9 (non-owned), with limits no less than $1,000,000 per
accident for bodily injury and property damage. (Note – required only if auto is used in performance
of work; otherwise proof of personal auto liability policy may suffice)
Insurance Requirements for Services Agreement ($5,000 or less) Version: August 2024
2
4. Workers’ Compensation insurance as required by the State of California, with Statutory Limits,
and Employer’s Liability Insurance with limit of no less than $1,000,000 per accident for bodily
injury or disease. (Not required if Contractor provides written verification it has no employees).
If the Contractor maintains broader coverage and/or higher limits than the minimums shown above, City
requires and shall be entitled to the broader coverage and/or higher limits maintained by the contractor.
Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage
shall be available to City.
OTHER INSURANCE PROVISIONS
The insurance policies are to contain, or be endorsed to contain, the following provisions:
Additional Insured Status
The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers are
to be covered as additional insureds on the CGL and automobile liability policies with respect to liability
arising out of the Services performed by or on behalf of Contractor including materials, parts, or
equipment furnished. Endorsement of CGL coverage shall be at least as broad as ISO Form CG 20 10 11 85
or if not available, through the addition of both CG 20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 20
37 if a later edition is used.
Primary Coverage
For any claims related to this Contract, the Contractor’s insurance coverage shall be primary coverage at
least as broad as ISO CG 20 01 04 13 as respects the City, its officers, officials, employees and volunteers.
Any insurance or self-insurance maintained by the City, its officers, officials, employees, or volunteers
shall be excess of Contractor’s insurance and shall not contribute to it.
Notice of Cancellation
Each insurance policy shall 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
Contractor grants to City a waiver of any right to subrogation which any insurer of said Contractor may
acquire against City by virtue of the payment of any loss under such insurance. Contractor agrees to obtain
any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies
regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer.
Self-Insured Retentions
City may approve self-insured retentions and require proof of Contractor’s ability to pay losses and related
investigations, claim administration and defense expenses within the retention. The policy shall provide,
or be endorsed to provide, that the self-insured retention may be satisfied by either the named insured or
City.
Insurance Requirements for Services Agreement ($5,000 or less) Version: August 2024
3
Acceptability of Insurers
Insurance shall be placed with insurers admitted in the State of California and with an AM Best rating of
A- VII or higher.
Verification of Coverage
Contractor shall furnish the City with acceptable original certificates and mandatory endorsements (or
copies of the policies effecting the coverage required by this Contract), and a copy of the Declarations
and Endorsement Page of the CGL policy listing all policy endorsements to City prior to commencing the
Services. City retains the right to demand verification of compliance at any time during the Contract.
Subcontractors
Contractor shall require and verify that all subcontractors maintain insurance meeting all the requirements
stated herein, and Contractor shall ensure that City is an additional insured on insurance required from
subcontractors.
Insurance coverage shall not limit Contractor’s duties to indemnify, defend and hold City harmless. City
reserves the right to modify these requirements based on the nature of the risk, prior experience, insurer,
coverage or other special circumstances.
EXHIBIT C
AFFIDAVIT OF NO EMPLOYEES
State of California
County of Santa Clara
City of Cupertino
I, the undersigned, declare as follows:
I am an independent contractor and the owner of Bruce Hildenbrand.
I wish to enter into a services contract with the City of Cupertino. I am fully aware of the
provisions of section 3700 of the California Labor Code, which requires every employer to
provide Workers' Compensation coverage for employees in accordance with the provisions
of that Code. I am also aware that I must provide proof of workers’ compensation insurance
to the City of Cupertino for any and all employees I may have, pursuant to Section 12 of the
City of Cupertino’s contract.
I hereby certify that I do not have any employees nor will I have any employees working for
me or my business during the term of any service contract with the City of Cupertino. I am
not required to have Workers’ Compensation insurance.
I declare under penalty of perjury under the laws of the State of California that the foregoing
is true and correct.
Executed on this ____day of ____________, 2024, at , California.
______________________________
PRINT NAME
______________________________
SIGNATURE
Bruce E Hildenbrand
Bruce E Hildenbrand
Mountain ViewAugust25
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.: -
CERTIFICATE OF INSURANCE
SPECIAL EVENT LIABILITY PROGRAM
PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED)
Alliant Insurance Services, Inc. in conjunction with
Apex Insurance Services
P O Box 744963
Los Angeles, CA 90074-4963
License No: OC 36861
NAMED INSURED (EVENT HOLDER):
City of Cupertino, its City Council, Boards and Commissions
Officers, Officials, Employees, Agents, Servants, Volunteers
and Consultants
10300 Torre Avenue
Cupertino, CA 95014
EVENT INFORMATION:
TYPE: 2024 Fall Bike Fest
DATE(S): September 28, 2024
LOCATION: Cupertino Civic Center, 10350 Torre Ave
Cupertino, CA 95014
*Liquor Liability Yes No
**Liquor Liability after 12 am ends before 2 am
This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy
period indicated. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ies) unless
amended as described in Special Conditions.
INSURANCE CARRIER: Evanston Insurance Company
MASTER POLICY NUMBER MKLV7PBC001712
MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2024 EXPIRATION: JANUARY 1, 2025
COMMERCIAL GENERAL LIABILITY
General Aggregate Limit
Products & Completed Operations
Personal & Advertising Injury
Each Occurrence Limit
Damage To Premises Rented To You (Any One Premises)
Medical Payments (Any One Person)
Liquor Liability (If purchased)
Optional Limits Purchased
$1,000,000/$3,000,000
$2,000,000/$2,000,000
Damage To Property (If purchased)
$ 2,000,000
1,000,000
1,000,000
1,000,000
100,000
5,000
1,000,000
OCCURRENCE FORM
DEDUCTIBLE: NONE
SPECIAL CONDITIONS:
The following endorsements attached to
the Master Policy do not apply to this
Certificate Of Insurance:
The limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event.
OTHER ADDITIONAL INSUREDS
Bruce Hildebrand
Black Mountain Composite Mountain Bike Team
Bicycle Solutions
Jeff Clark
CANCELLATION: Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy
provisions.
AUTHORIZED REPRESENTATIVE:
DATE ISSUED: 8/15/24
MPIL 1039-CA 01 20 Page 1 of 2
EVANSTON INSURANCE COMPANY
IMPORTANT NOTICE
CALIFORNIA SURPLUS LINES NOTICE (D-2)
1. The insurance policy that you have purchased is being issued by an
insurer that is not licensed by the State of California. These companies
are called “nonadmitted” or “surplus lines” insurers.
2. The insurer is not subject to the financial solvency regulation and
enforcement that apply to California licensed insurers.
3. The insurer does not participate in any of the insurance guarantee
funds created by California law. Therefore, these funds will not pay
your claims or protect your assets if the insurer becomes insolvent
and is unable to make payments as promised.
4. The insurer should be licensed either as a foreign insurer in another
state in the United States or as a non-United States (alien) insurer. You
should ask questions of your insurance agent, broker, or “surplus
line” broker or contact the California Department of Insurance at the
toll-free number 1-800-927-4357 or internet website
www.insurance.ca.gov. Ask whether or not the insurer is licensed as a
foreign or non-United States (alien) insurer and for additional
information about the insurer. You may also visit the NAIC’s internet
website at www.naic.org. The NAIC – the National Association of
Insurance Commissioners – is the regulatory support organization
created and governed by the chief insurance regulators in the United
States.
5. Foreign insurers should be licensed by a state in the United States
and you may contact that state’s department of insurance to obtain
MPIL 1039-CA 01 20 Page 2 of 2
more information about that insurer. You can find a link to each state
from this NAIC internet website: https://naic.org/state_web_map.htm.
6. For non-United States (alien) insurers, the insurer should be
licensed by a country outside of the United States and should be on
the NAIC’s International Insurers Department (IID) listing of approved
nonadmitted non-United States insurers. Ask your agent, broker, or
“surplus line” broker to obtain more information about that insurer.
7. California maintains a “List of Approved Surplus Line Insurers
(LASLI).” Ask your agent or broker if the insurer is on that list, or view
that list at the internet website of the California Department of
Insurance: www.insurance.ca.gov./01-consumers/120-company/07-
lasli/lasli.cfm.
8. If you, as the applicant, required that the insurance policy you have
purchased be effective immediately, either because existing coverage
was going to lapse within two business days or because you were
required to have coverage within two business days, and you did not
receive this disclosure form and a request for your signature until after
coverage became effective, you have the right to cancel this policy
within five days of receiving this disclosure. If you cancel coverage,
the premium will be prorated and any broker’s fee charged for this
insurance will be returned to you.
Confirmation of Coverage
Dear: Laura Kalert, Bolton Insurance Services, LLC Date: Jul 02, 2024
Thank you for the bind order for the below Insured. We are pleased to present the RPS Confirmation of Coverage and
invoice along with the attached Tysers Insurance Brokers Ltd binder. Please review the attached and below carefully as
coverage described herein may be different from the original application submitted, or prior policy if applicable.
Insured: City of Cupertino DBA: Department of Recreation and Community
Services, Public Works Department
RPS Reference #: 6496584A
Mailing Address: 10300 Torre Avenue Cupertino, CA 95014
Physical Address: 10300 Torre Avenue, Cupertino, CA 95014
Carrier: Underwriters at Lloyd's, London
Carrier Status: Non-Admitted / AM Best Rating: A XV
Policy Number: MR244153 Expiring Policy Number: MR234153
Policy Period: 7/1/2024 to 7/1/2025
Coverage: Special Casualty - Sexual Misconduct
Limit of Liability:
a)USD 5,000,000 in the aggregate during the policy period for all claims brought
by or on behalf of each victim, and
b)USD 5,000,000 in the aggregate during the policy period for all claims brought by or
on behalf of all victims
and separately:
c)USD 75,000 in the aggregate during the policy period for all safeguard costs
resulting from all circumstances
Retention:
USD 35,000 each Victim
Policy Premium:$34,650.00
Fees (fully earned):
Taxes:
Surplus Lines Tax $1,039.50
Stamping Office Fee $62.37
Email:
Phone: (630) 285-4079
Risk Placement Services, Inc. - PNP
Shawn McCall
Sincerely,
If you have any questions, please feel free to call or email me. We look forward to our next opportunity to work with you.
that are overdue and are not received within this time frame are subject to cancellation.
· All premiums and any fees are due to RPS within 20 days of binding unless otherwise stipulated. Accounts with payments
· In the event of a claim please report immediately and visit the RPS Claims website: https://my.rpsins.com/claimsfnol
provided herein.
· You are responsible for the issuance and review of Certificates of Insurance (COI). COIs cannot amend or alter the terms
coverage to which the request applies.
· When requesting a policy change, addition, cancellation, endorsement, etc. you must provide every policy number/
cancellations allowed.
· By binding you commit to any provisions contained hereon, such as Minimum Earned Premiums. There are no flat
provisions and regulations of your state.
this policy is subject to the surplus lines laws in your state, you should make every effort to comply with any special
required surplus lines forms, taxes and fees from the insured. RPS will remit the applicable taxes and forms to the state. If
· If this policy is issued on a non-admitted basis, your office is responsible for completing, collecting and delivery to RPS any
terms and provisions of such policy(ies) shall prevail.
subject to all terms and conditions of policy(ies) which will be issued and that in the event of any inconsistency herewith, the
· This document is intended for use as evidence that the insurance, as described herein, has been effected and shall be
insurer, nor of us. This policy cannot be assigned to another without the written consent of the insurer or their Agent.
· You are not an Agent of the insurer, and as such, cannot bind coverage nor make any commitments on behalf of the
the risk to the client.
office. The terms hereon are not fully described and no assumption should be made as to the adequacy of the coverage of
· You are responsible for reviewing and explaining the coverage to the client, including any options, available or not from our
Please note:
Please see attched company quote for complete limits, terms, conditions, and exclusions.
Conditions/ Subjectivities: per Carrier terms attached
Information Section.
The State Surplus Lines Notice applies only if Insurance Carrier is shown as Non-Admitted in the Binder
Home State: CA
Minimum Earned Premium:
TOTAL: $35,751.87
TRIA: Status:
Bruce Hildenbrand for Bike Fest Master of
Ceremonies
Final Audit Report 2024-08-26
Created:2024-08-23
By:Webmaster Admin (webmaster@cupertino.org)
Status:Signed
Transaction ID:CBJCHBCAABAAYAkm241OYTEFFd3b2pPNrcDN8OtY0e_R
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2024-08-23 - 8:32:14 PM GMT
Email viewed by Araceli Alejandre (aracelia@cupertino.org)
2024-08-23 - 8:33:08 PM GMT- IP address: 3.232.50.116
Document approved by Araceli Alejandre (aracelia@cupertino.org)
Approval Date: 2024-08-23 - 8:39:21 PM GMT - Time Source: server- IP address: 71.204.144.228
Document emailed to bruce@brucehildenbrand.com for signature
2024-08-23 - 8:39:23 PM GMT
Email viewed by bruce@brucehildenbrand.com
2024-08-26 - 6:58:29 AM GMT- IP address: 99.59.182.78
Signer bruce@brucehildenbrand.com entered name at signing as Bruce E Hildenbrand
2024-08-26 - 7:00:17 AM GMT- IP address: 99.59.182.78
Document e-signed by Bruce E Hildenbrand (bruce@brucehildenbrand.com)
Signature Date: 2024-08-26 - 7:00:19 AM GMT - Time Source: server- IP address: 99.59.182.78
Document emailed to Christopher Jensen (christopherj@cupertino.org) for signature
2024-08-26 - 7:00:22 AM GMT
Email viewed by Christopher Jensen (christopherj@cupertino.org)
2024-08-26 - 7:00:50 AM GMT- IP address: 3.232.50.116
Signer Christopher Jensen (christopherj@cupertino.org) entered name at signing as Christopher D. Jensen
2024-08-26 - 11:41:19 AM GMT- IP address: 24.125.240.208
Document e-signed by Christopher D. Jensen (christopherj@cupertino.org)
Signature Date: 2024-08-26 - 11:41:21 AM GMT - Time Source: server- IP address: 24.125.240.208
Document emailed to Chad Mosley (chadm@cupertino.org) for signature
2024-08-26 - 11:41:23 AM GMT
Email viewed by Chad Mosley (chadm@cupertino.org)
2024-08-26 - 11:41:32 AM GMT- IP address: 3.232.50.116
Document e-signed by Chad Mosley (chadm@cupertino.org)
Signature Date: 2024-08-26 - 4:48:15 PM GMT - Time Source: server- IP address: 64.165.34.3
Document emailed to Kirsten Squarcia (kirstens@cupertino.org) for signature
2024-08-26 - 4:48:17 PM GMT
Email viewed by Kirsten Squarcia (kirstens@cupertino.org)
2024-08-26 - 4:49:17 PM GMT- IP address: 3.232.50.116
Document e-signed by Kirsten Squarcia (kirstens@cupertino.org)
Signature Date: 2024-08-26 - 4:52:46 PM GMT - Time Source: server- IP address: 162.245.20.145
Agreement completed.
2024-08-26 - 4:52:46 PM GMT