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13-183 COBE Construction, Agreement for Replacement of Sports Center Patio OFFICE OF THE CITY CLERK CITY HALL 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 TELEPHONE: (408) 777-3223• FAX: (408) 777-3366 WEBSITE:www.cup(.-rtino.org CUPERTINO November 26, 2013 COBE Construction 2470 S. Winchester Blvd., Suite D Campbell, CA 95008 RE: Agreement Enclosed for your records is a fully executed original copy of your agreement with the City of Cupertino. If you have any questions, please contact the Public Works Department at (408) 777-3354. Sincerely, Dckc�s >6 Dorothy Steenfott Senior Office Assistant cc: Public Works Enclosure AGREEMENT BETWEEN THE CITY OF C'UPERTINO AND COBS CONSTRUCTION THIS AGREEMENT, for reference dated SEPTEMBER 19`h 2013, is by and between CITY OF CUPERTINO, a municipal corporation (hereinafter referred to as "City"), and "LOBE CONSTRUCTION", a California corporation whose address is 2470 S. Winchester Blvd. Suite D, Campbell, CA. 95008 hereinafter called the Contractor, and is made with reference to the following: RECITALS: A. City is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to calTy on its business as it is now being conducted under the Constitution and the statutes of the State of California and the Cupertino Municipal Code. B. City and Contractor desire to enter into an agreement for SPORT CENTER PATIO REPLACEMENT in accordance with the proposal dated September 12` , 2013 NOW, THEREFORE, it is mutually ag-eed by and between the undersigned parties as follows: 1. TERM: The Contractor shall begin work within thirty (30) calendar days after receiving notice from the Facilities Supervisor to commence the work, and shall diligently prosecute the work to completion before the expiration of thirty (30) consecutive working days from the date of receipt of notice to begin work. 2. SERVICES TO BE PERFORMED: Contractor agrees, at its own cost and expense, to furnish all labor, tools, equipment, materials, except as otherwise specified, and to do all work strictly in accordance with the proposal(Exhibit A) dated September 12`h, 2013 hereby referred to and expressly made a part hereof with the same force and effect as if the same were fully incorporated herein. 3. COMPENSATION TO CONTRACTOR: Contractor shall be compensated for services performed pursuant to this agreement in an amount not to exceed twenty four thousand five hundred ninety eight dollars ($24,598.00) based on the rates of payment set forth in Exhibit A, attached and incorporated herein by this reference. Payment will be made in the same manner that claims of a like character are paid by the City, with checks drawn on the treasury of the City, to be taken from the general fund. 4. TIME IS OF THE ESSENCE: Contractor and City agree that time is of the essence regarding the performance of this Agreement. 5. STANDARD OF CARE: Contractor agrees to perform all services hereunder in a manner commensurate with the prevailing standards of like professionals in the San Francisco Bay Area and agrees that all services shall be performed by qualified and experienced personnel who are not employed by the City nor have any contractual relationship with (7ty. 6. INDEPENDENT PARTIES: City and Contractor intend that the relationship between them created by this Agreement is that of employer-independent contractor. The manner and means of conducting the work are under the control of Contractor, except to the extent they are limited by statute, rule or regulation and the express terms of this Agreement. No civil service status or other right of employment will be acquired by virtue of Contractor's services. None of the benefits provided by City to its employees, including but not limited to unemployment insurance, workers' compensation plans, vacation and sick leave are available from City to Contractor, its employees or agents. Deductions shall not be made for any state or federal taxes, FICA payments, PERS payments, or other purposes normally associated with an employer-employee relationship from any fees due Contractor. Payments of the above items, if required, are the responsibility of Contractor. 7. IMMIGRATION REFORM AND CONTROL ACT (IRCA): Contractor assumes any and all responsibility for verifying the identity and employment authorization of all of its employees performing work hereunder, pursuant to all applicable IRCA or other federal or state rules and regulations. Contractor shall indemnify and hold City harmless from and against any loss, damage, liability, costs or expenses arising from any noncompliance of this provision by Contractor. 8. NON-DISCRIMINATION: Consistent with City's policy that harassment and discrimination are unacceptable employer/employee conduct, Contractor agrees that harassment or discrimination directed toward a job applicant, a City employee, or a citizen by Contractor or Contractor's employee on the basis of race, religious creed, color, national origin, ancestry, handicap, disability, marital status, pregnancy, sex, age, or sexual orientation will not be tolerated. Contractor agrees that any and all violations of this provision shall constitute a material breach of this Agreement. 9. HOLD HARMLESS: Contractor shall, to the fullest extent allowed by law, indemnify, defend, and hold harmless the City and its officers, officials, agents, employees and volunteers against any and all liability, claims, stop notices, actions, causes of action or demands whatsoever from and against any of them, including any injury to or death of any person or damage to property or other liability of any nature, arising out of, pertaining to, or related to the performance of this Agreement by Contractor or Contractor's employees, officers, officials, agents or independent contractors. Contractor shall not be obligated under this Agreement to indemnify City to the extent that the damage is caused by the sole negligence or willful misconduct of City, its agents or employees. Such costs and expenses shall include reasonable attorneys' fees of counsel of City's choice, expert fees and all other costs and fees of litigation. Contractor agrees to obtain executed indemnity agreements with provisions identical to those set forth here in these sections from each and every subcontractor or any other person or entity involved by, for, with, or on behalf of Contractor in the performance of this agreement. If Contractor fails to obtain such indemnity obligations from others as required here, Contractor agrees to be fully responsible according to the te-:ins of this section. 10. INSURANCE: On or before the commencement of the terms of this Agreement, Contractor shall furnish City with certificates showing the type, amount, class of operations covered, effective dates and dates of expiration of insurance coverage in compliance with paragraphs 10A, B, C and D. Such certificates, which do not limit Contractor's indemnification, shall also contain substantially the following statement: "Should any of the above insurance covered by this certificate be canceled or coverage reduced before the expiration date thereof, the insurer affording coverage shall provide thirty (30) days' advance written notice to the City of Cupertino by certified mail, "Attention: City Manager." It is agreed that Contractor shall maintain in force at all times during the performance of this Agreement all appropriate coverage of insurance required by this Agreement with an insurance company that is acceptable to City and licensed to do insurance business in the State of California. Endorsements naming the City as additional insured shall be submitted with the insurance certificates. A. COVERAGE: Contractor shall maintain the following insurance coverage: (1) Workers' Compensation: Statutory coverage as required by the State of California. (2) Liabili Commercial general liability coverage in the following minimum limits: Bodily Injury: $1,()00,000 each occurrence $2,000,000 agg.-egate - all other Property Damage: $500,000 each occurrence $1,000,000 aggregate If submitted, combined single limit policy with aggregate limits in the amounts of $2,000,000 Nill be considered equivalent to the required minimum limits shown above. (3) Automotive: Comprehensive automobile liability coverage in the following minimum limits: Bodily injury: $500,000 each occurrence Property Damage: $500,000 each occurrence or Combined Single Limit: $1,000,000 each occurrence B. SUBROGATION WAIVER: Contractor agrees that in the event of loss due to any of the perils for which it has agreed to provide comprehensive general and automotive liability insurance, Contractor shall look solely to its insurance for recovery. Contractor hereby grants to City, on behalf of any insurer providing comprehensive general and automotive liability insurance to either Contractor or City with respect to the services of Contractor herein., a waiver of any right to subrogation which any such insurer of said Contractor may acquire against City by virtue of the payment of any loss under such insurance. C. FAILURE TO SECURE: If Contractor at any time during the term hereof should fail to secure or maintain the foregoing insurance, City shall be permitted to obtain such insurance in the Contractor's name or as an agent of the Contractor and shall be compensated by the Contractor for the costs of the insurance premiums at the maximum rate permitted by law and computed from the date written notice is received that the premiums have not been paid. D. ADDITIONAL INSURED: City, its City Council, boards and comm)ssions, officers, employees, and volunteers shall be named as an additional insured under all insurance coverages, except worker' s compensation insurance. The naming of an additional insuri;d shall not affect any recovery to which such additional insured would be entitled under this policy if not named as such additional insured. An additional insured named herein shall not be held liable for any premium, deductible portion of any loss, or expense of any nature on this policy or any extension thereof. Any other insurance held by an additional insured shall not be required to contribute anything toward any loss or expense covered by the insurance provided by this policy. E. SUFFICIENCY OF INSURANCE: The insurance limits required by City are not represented as being sufficient to protect Contractor. Contractor is advised to consult Contractor's insurance broker to determine adequate coverage for Contractor. 11. BONDS: Contractor is not required to provide bonds. 12. PROHIBITION AGAINST TRANSFERS: 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 without said consent shall be null and void, and any assignee, sublessee, hypothecate or transferee shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. However, claims for money by Contractor from City under this Agreement may be assigned to a bank, trust company or other financial institution without prior written consent. Written notice of such assignment shall be promptly furnished to City by Contractor. The sale, assignment, transfer or other disposition of any of the issued and outstanding capital stock of Contractor, or of the interest of any general partner or joint venturer or syndicate member or cotenant, if Contractor is a partnership or joint venture or syndicate or cotenancy, which shall result in changing the control of Contractor, shall be construed as an assignment of this Agreement. Control means fifty percent (50%) or more of the voting power of the corporation. 13. SUBCONTRACTOR APPROVAL: Unless prior written consent from City is obtained, only those people and subcontractors whose names are listed in Contractor's bid shall be used in the performance of this Agreement. Requests for additional subcontracting shall be submitted in writing, describing the scope of work to be subcontracted and the name of the proposed subcontractor. Such request shall set forth the total price or hourly rates used in preparing estimated costs for the subcontractor's services. Approval of the subcontractor may, at the option of City, be issued in the form of a Work Order. In the event that Contractor employs subcontractors, such subcontractors shall be required to furnish proof of workers' compensation insurance and shall also be required to carry general and automobile liability insurance in reasonable conformity to the insurance carried by Contractor. In addition, any work or services subcontracted hereunder shall be subject to each provision of this Agreement. 14. PERMITS AND LICENSES: Contractor, at its sole expense, shall obtain and maintain during the term of this Agreement, all appropriate permits, certificates and licenses, including a City Business License, that may be required in connection with the performance of services hereunder. 15. REPORTS: Each and every report, draft, work product, map, record and other document reproduced, prepared or caused to be prepared by Contractor pursuant to or in connection with this Agreement shall be the exclusive property of City. Consultant may retain a copy of any report furnished to the City pursuant to this Agreement No report, information nor other data given to or prepared or assembled by Contractor pursuant to this Agreement shall be made available to any individual or organization by Contractor without prior approval by City. Contractor shall, at such time and in such form as City may require, furnish reports concerning the status of services required under This Agreement. 16. RECORDS: Contractor shall maintain complete and accurate records with respect to sales, costs, expenses, receipts and other such information required by City that relate to the performance of services under this Agreement. Contractor shall maintain adequate records of services provided in sufficient detail to permit an evaluation of services. All such records shall be maintained in accordance with generally accepted accounting principles and shall be clearly identified and readily accessible. Contractor shall provide free access to such books and records to the representatives of City or its designees at all proper times, and gives City the right to examine and audit same, and to make transcripts there from as necessary, and to allow inspection of all work, data, documents, proceedings and activities related to this Agreement. Such records, together with supporting documents, shall be kept separate from other documents and records and shall be maintained for a period of three(3) years after receipt of final payment. If supplemental examination or audit of the records is necessary due to concerns raised by City's preliminary examination or audit of records, and the City's supplemental examination or audit of the records discloses a failure to adhere to appropriate internal financial controls, or other breach of contract or failure to act in good faith, then Contractor shall reimburse City for all reasonable costs and expenses associated with the supplemental examination or audit. 17. NOTICES: All notices, demands, requests or approvals to be given under this Agreement shall be given in writing and conclusively shall be deemed served when delivered personally or on the second business day after the deposit thereof in the United States Mail, postage prepaid, registered or certified, addressed as hereinafter provided. All notices, demands, requests, or approvals from Contractor to City shall be addressed to City at: City of Cupertino 10555 Mary Avenue Cupertino CA 95014 Attention: Chris Orr All notices, demands, requests, or approvals from City to Contractor shall be addressed to Contractor at: COBE Construction 2470 S. Winchester Blvd. Suite D Campbell, CA. 95008 Attention: Dan Piber 18. URBAN RUNOFF MANAGEMENT: The Contractor shall avoid creating excess dust when breaking asphalt or concrete and during excavation and grading. If water is used for dust control, contractor shall use as little as necessary. Contractor shall take all steps necessary to keep wash water out of the streets, gutters and storm drains. The Contractor shall develop and implement erosion and sediment control to prevent pollution of storm drains. Such control includes but is not limited to: A. Use storm drain inlet protection devices such as sand bag barriers, filter fabric fences, block and gravel filters. (Block storm drain inlets prior to the start of the rainy season (October 15), in site de-watering activities and saw-cutting activities; shovel or vacuum saw-cut slurry and remove from the site). B. Cover exposed piles of soil or construction material with plastic sheeting. All construction materials must be stored in containers. C. Sweep and remove all materials f=rom paved surfaces that drain to streets, gutters and storm drains prior to rain as well as at the end of the each work day. At the completion of the project, the street shall be washed and the wash water shall be collected and disposed of 6 offsite in an appropriate location. D. After breaking old pavement, Contractor shall remove all debris to avoid contact with rainfall or runoff. E. Contractor shall maintain a clean work area by removing trash, litter, and debris at the end of each work day. Contractor shall also --lean up any leaks, drips, and other spills as they occur. The objective is to ensure that the City and County of Santa Clara County-Wide Clean Water Program is adequately enforced. These controls should be implemented prior to the start of construction, up-graded as required, maintained during construction phases to provide adequate protection, and removed at the end of construction. These recommendations are intended to be used in conjunction with the States Best Management Practices Municipal and Construction Handbooks, local program guidance materials from municipalities, Section 7.1.01 of the Standard Specifications and any other appropriate documents on storm water quality controls for construction. Failure to comply with this program will result in the issuance of noncompliance notices, citations, project stop orders or fines. The fine for noncompliance of the above program is two hundred and fifty dollars ($250.00) per occurrence per day. The State under the Federal Clean Water Act can also impose a fine on the contractor, pursuant to Cal. Water Code ' 13385. 19. TERMINATION: In the event Contractor fails or refuses to perform any of the provisions hereof at the time and in the manner required hereunder, Contractor shall be deemed in default in the performance of this Agreement. If such default is not cured within a period of two (2) days after receipt by Contractor from City of written notice of default, specifying the nature of such default and the steps necessary to cure such default, City may terminate the Agreement forthwith by giving to the Contractor written notice thereof. City shall have the option, at its sole discretion and without cause, of terminating this Agreement by giving seven (7) days' prior written notice to Contractor as provided herein. Upon termination of this Agreement, each party :;hall pay to the other party that portion of compensation specified in this Agreement that is earned and unpaid prior to the effective date of termination. 20. COMPLIANCES: Contractor shall comply with all laws, state or federal and all ordinances, rules and regulations enacted or issued by City. 21. CONFLICT OF LAW: This Agreement shall be interpreted under, and enforced by the laws of the State of California excepting any choice of law rules which may direct the application of laws of another jurisdiction. The Agreement and obligations of the parties are subject to all valid laws, orders, rules, and regulations of the authorities ha,,ing jurisdiction over this Agreement (or the successors of those authorities.) Any suits brought pursuant to this Agreement shall be filed with the courts of the County of Santa Clara, State of California. 22. ADVERTISEMENT: Contractor shall not post, exhibit, display or allow to be posted, exhibited, displayed any signs, advertising, show bills, lithographs, posters or cards of any kind pertaining to the services performed under this Agreement unless prior written approval has been secured from City to do otherwise. 23. WAIVER: A waiver by City of any breach of any term, covenant, or condition contained herein, shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant, or condition contained herein, whether of the same or a different character. 24. INTEGRATED CONTRACT: This Agreement represents the full and complete understanding of every kind or nature whatsoever between the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or nature are merged herein. No verbal agreement or implied covenant shall be held to vary the provisions hereof. Any modification of this Agreement will be effective only by written execution signed by both City and Contractor. 25. SAFETY REQUIREMENT All work performed under this Agreement shall be performed in such a manner as to provide safety to the public and to meet or exceed the safety standards outlined by CAL-OSHA. City reserves the right to issue restraints or cease and desist orders to Contractor when unsafe or harmful acts or conditions are observed or reported relative to the performance of the work under this Agreement. Contractor shall maintain the work sites free of hazards to persons and/or property resulting from his or her operations. Any hazardous condition noted by Contractor, which is not a result of his or her operations, shall immediately be reported to City. 26. HOURS OF OPERATION Contractor shall be allowed to operate only for the hours of 7:00 a.m. to 3:30 p.m. unless prior written approval has been secured from City to do otherwise. 27. REQUIREMENT TO PAY PREVAILING WAGES Consistent with the City's policy to pay prevailing wage rates, Contractor shall comply with the City's Labor Compliance Program and all other requirements set forth in Labor Code section 1770 et seq. The City shall require payment of the general rate of per diem wages or the general rate of per diem wages for holiday and overtime work. Contractor will submit (monthly or biweekly) certified payroll records to the City for all employees and subcontractors in a preapproved format or a City provided form.. Any delay in remitting certified payroll reports to the City upon request from the City will result in either delay and/or forfeit of outstanding payment to Contractor. 28. INSERTED PROVISIONS: 8 Each provision and clause required by law to be inserted into the Agreement shall be deemed to be enacted herein, and the Agreement shall be read and enforced as though each were included herein. If through mistake or otherwise, any such provision is not inserted or is not correctly inserted, the Agreement shall be amended to make such insertion on application by either party. 29. CAPTIONS: The captions 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. IN WITNESS WHEREOF, the parties have caused the Agreement to be executed on the day and year first above written. CONTRACTOR CITY OF CUPERTINTO "COBE Construction" A :Municipal Corporation By By Title 110 ' r Title Gih� Date ?—l6 _--�0/ Date Soc. Sec. # or Tax I.D73 – RECOM MD FOR APPROVAL By ..� Title . r. r -444,"" �/ vSCI'- APPROVED AS TO FORM: By YtQAA)/k, C , City Attorney ATTEST: Cit,✓Clerk Contract Amount: aq Account Number: Alle, PURCHASE ORDER NO. 00058216 PURCHASE ORDER 10300 Torre Avenue Cupertino, CA 95014-3255 PAGE NO. 1 (408) 777-3219 CUPERTINO V f-3855 —1 s F H CITY OF CUPERTINO E COBE CONSTRUCTION I N 2470 S. WINCHESTER BLVD P SERVICE CENTER D 10555 MARY AVENUE 0 SUITE D T CUPERTINO CA 95014 R LCAMPBELL CA 95008 —1 0 L ATTN: CHRIS ORR ORDER DATE:09/16/13 BUYER: CHRIS ORR I REG. NO.: 00000987 REG. DATE: TERMS: NET 3 0 DAYS IF.0-B-: DESTINATION DESC.: TEM#j QUANTITY I UOM I DESCRIPTION UNIT PRICE EXTENSION X.M. k Znzs�IN .. .............. ........ ...... Xe- ""K 8-111 ................ ON .------------ -20 ............... . ............... -------------------- ...... -------------------------------------------------------- ..... ffl . .......... ..... . x -all - - - -- ----------------- ------ .......... ME - ---------------------- ..... -------------------- ------------- - ----------- ... .. .. .. ....... Xm, em aflill a ------- ...--------...... . ............... ...................... .................--a --------------------------------mg g g ................ --- ... m -W- 1.7 tmv o. R g g -I z .. . ....... z .................... RE X, -?flg.Im .. ............... �rU .... ---------- --K ..............................- ........... .......................... 13. i-iA.":,�? n: .ffi K Z W6gg N ........... ........... ow- ......... ------------------- g, ............... W ITEM# ACCOUNT AMOUNT PROJECT CODE PAGE TOTAL $ 24,598.00 1 TOTAL $ 24,598.00 01 4209268 9300 24,598.00 APPROVED BY *61RErTOR CHASING 04PIM C013E CONSTRUCTION September 25, 2013 City of Cupertino 10555 Mary Avenue Cupertino CA 95014 Attention: Chris Orr Sub: Sports Center Patio Re: Proposal Dear Chris, We are pleased to offer this proposal for the work at the Sp[orts Center. Following is a detailed proposal with a scope of work and a list of proposal qualifications. SCOPE OF WORK Mobilization • Pick up & deliver materials. • Keep the work area safe during construction. • Provide and install safety barricades and caution tape around work area. Demolition • Remove existing concrete on patio. • Concrete will be saw cut and removed by hand. • No jack hammering will be done. Some light chipping will be done only if it is necessary. • We will take care to minimize impact to existing stucco below patio. • Dispose of all debris created by the demolition. Water Proofing • Provide and install new water proofir c coating on to existing patio sub surface. Cast in Place Concrete • Pour new light weight concrete on existing patio. • No special inspection will be done. Rouqh Carpentry • No rough carpentry is included in this quote. • We are assuming that the ply wood sub-strait will be able to accept the water proofing material. • If the existing plywood needs repairs it will have to be addressed in the field. COBE Construction Incorporated 2470 S. Winchester Blvd., Suite D, Campbell, CA 95008 Phone (408) 371-3400 Fax (408) 371-3401 License#835122 COBE Construction Inc. - Budget Proposal Sports Center Patio Stucco • No stucco work is included in this prcposal. We will be as careful as possible to not damage the existing stucco on the underside of the patio. If there is damage it will have to be addressed in the field. Daily and Final Construction Clean-up • Provide labor to keep the project clee r and safe during construction. At the end of the project, provide a final construction clean up. Cost: $24,598.00 We appreciate this opportunity to quote your work. Please call if there are any questions. Dan can be reached anytime at(408)410-3889. Daniel W Piber Project Manager COBE Construction Inc. LOBE C0NST1_,PI,ICT1ON Standard Qualificati ins and Exclusions 1.We will ensure that all subcontractors will be given sL bcontracts to protect the property owner, client and COBE Construction Inc., maintain current insurance (Liability and Workers' Compensation ), provide proper lien releases, and have proper licenses and bonds regi,ired by the State of California. 2.Schedule: a.We have not included any overtime to make up for unforeseen scheduling delays that are not the fault of COBE Construction, Inc. or other Subcontractors. b. We have not included any weather protectiDn costs that are required because of scheduling delays that are not the fault of COBE Construction, Inc. or other Subcontractors. c. We have not included any costs for scheduling delays due to"Acts of God" or weather. 3.Insurance: a.COBE Construction Inc maintains general liability, workers compensation and automobile insurance. b.We have NOT included the following insurance: builder's risk, pollution liability, labor and performance bonds, and other project specific insurance. c. COBE Construction Inc does not provide design errors and omissions insurance. Page 2 COBE Construction Inc. - Budget Proposal Sports Center Patio 4.After Project Completion expenses: a.We have not included the cost of re-keying lacks. b.Final clean-up(including VCT waxing) beyond our standard construction clean-up c. Sealing of ceramic tile grout. 5.All water, power, toilet facilities, other utilities and parking will be provided by others during construction at no cost to COBE Construction, Inc. 6.Floor moisture testing: We recommend floor moisture testing on all slab on grades. We can have the test performed and if there is a moisture issue, we will prepare a proposal for that work. 7.We have NOT included any hazardous material removal. Including, but not limited to, asbestos and lead removal. 8.ADA Upgrades: a.We have included the ADA upgrades as noted in the proposal. We have not included additional ADA upgrades required by the Building Department, including fixing ADA upgrades that don't meet current code. 9.Proposal is valid for 30 days. After 30 days there may be an increase in material and/or labor costs. 10. Our standard terms of payment are Net 10. 11. We have not included the following: a.Overtime b.Expedited shipping c.Cubicles, tables, indoor plants, refrigerators, microwave, TV's, washer/dryer units and/or furniture. d.Relocating crates, equipment and other items in the way of our work. e.Building permits, planning permits, MEP permits, utility fees, public works fees and other building department Fees. f. Liquidated damages clauses. g.Repairs or upgrades to existing building systems not detailed in the above proposal. 12. Any scope of work for the following trades are not included: a.Communications (telephone or data/computer network cabling &speakers) b.Security Alarms c.Third Party Qualifying or Testing d.Fire Alarms or Life Safety Alarms e.Fire Sprinklers f. Signage g.Electrical h.Painting i. HVAC j. Plumbing 13. Additional work from final plan check comments or Tii:le-24 upgrades. Page 3 COBEC-1 OP ID:SL CERTIFICATE OF LIABILITY INSURANCE L T ".'r"1 aro8113rl3 IYY, 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 AMENCI, 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 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, th<: policy(ies) must 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). IACI PRODUCER 800-989-871 NAM_ _ BOZZuto & Associates Insurance PHONE FAX 34 S. Second St 408-429-8460 Arc No. (AJC No): _ Campbell, CA 95008 ADDRESS;_ _ Linda Ellis _ INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Mt. Hawley Insurance Co. 37974 INSURED Cobe Construction, Inc. INSURERB:Golden Eagle Insurance Corp. 10836 2470 S.Winchester Blvd Ste D INSURERC: Campbell,CA 95008 -- INSURER U INSURER E: INSURER0 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: FTHIS O CERTIFY THAT THE POLICIES OF INSUR ANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD D. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. NS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY RAVE BEEN REDUCED BY PAID CLAIMS.TYPE OF INSURANCE POUCYN MBER �ULtCY rF POLICY EX LIMITS L LIABILITY E.L:i->,CC URR.'-IJCE 1x000,00 A X X X MGLO178069 04101/13 04/01/14 r �t F + `rar i 4 50,00 1-71 A., I,H:,�r;c,.,' 3 _ 5,00( X OwnerlCont Prot. 1,000,00 2,000,00 F�.•r,TC L,.. .1. r r F;, s 2,000,00 X AUTOMOBILE LIABILITY a - �I�t, B X -r-_ X TF29i30112 03113/13 03113/14 ` I F "- ! ` UMBRELLAUAB X cl_JP crltl'.:�___�__���.:��.:_ � 5,000,00 A )( EXCESS LIAB ._Lilt;,•,;-NIALE MXL04170t33 04/01113 04/01/14 }:r;F;Pr,;err 5,000,00 _ 17-7r,47 7,t1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY YIN A,I'r�f'!t?PGIET�11p 4f'Tr�.-F F-C-'JR'L ❑ �- . (Mandatory in NHI -- Il.e'. il. Jrll- i I DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (Attach ACORD 101.Additional Remarks Schedule,If more space is required) ,... . Cupertino Sports Center Patio, 21111 Stevens Creek Bl•sd., Cupertino, Coll 95050. City of G�uper.tino, its City Council, boards and commissions, officers, employees, a-rid volunteers are named as additional insured per attached endorsement. General liability and auto liability waiver of s+.zbrogation applies. ( F (,- AI.F,HOLDER CITYCUP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Cupertino ACCORDANCE WITH THE POLICY PROVISIONS. 10300 Torre Avenue Cupertino, CA 95014 AUTHORIZED REPRESENTATIVE Y v 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Policy Number. MGLO178069 Mt. Hawley insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM C) This endorsement modifies insurance provided tinder the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART (If no entry appears below, information required to complete this endorsement will be shown in the Declarations as appli- cable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Sched- ule, but only with respect to liability arising out of"your work" for that Ensured by or for you. To the extent required under contract, this policy will apply as primary insurance to additional insureds scheduled below and other insurance which may be available to such additional insureds will be non-contributory Section IV., Condition 4.,of this policy is amended accerdir,gly. SCFEDULE Name of Person or Organization. All persons or organizations where required by written contract. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. CGI_216 (04/98) Page 1 of 1 Insured Poiicy Number: MGL0178069 Mt. Haw,ey insurance Co!rrpa.ny THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: All persons or organizations where required by written contract. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as appli- cable to this endorsement.) The Transfer Of Rights Of Recovery Against Others To Us Condition (SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: 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 10 93 Copyright, Insurance Services Office: Inc., 1992 Page 1 of 1 Insured _ Policy Number: BA 2913012 COMMERCIAL AUTO, G70! [l ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ |T CAREFUL[ Y. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SECTION U—LIABILITY COVERAGE A. COVERAGE Y. WHO I3AM INSURED The foUowingioadded: d. Any organization, other than a partnership or joint venture,. Over which you maintain ownership ur a majority interest on the effective date of this Coverage Form. if there is no oiffliiarinsunanoo available to that organization, 0. Any organization you newly acquire or form other then e partnership or joint venture, and over which yau maintain ownership ofa mujo/i!yinterest. However, coverage under this provision does not apply: (1) If there is similar insurance or a self-insured retention plan available to that organization: or (2) To 'bodily injury' or ^properlty damage" that occurred before you acquired or formed the organization. f� Any volunteer ur employee of yours while using a covered '`auto'`you do not own, hire orborrow in your business or your personal affairs. Insurance provided by this endorsement is excess over any other-insurance available hz any volunteer oremployee. g Any person, organization, trustee, ostafe or governmental entity with respect to the opo/obon, maintenance or use of covered "auto" by at)insured, it (1) You are obligated to add that pe/aon, orgunizahon, tmntae, estate or governmental entity as on additional insured io this policy by: (u) an expressed provision of an "insured contract", or written agreement; or (b) on expressed condition of written permit issued to you by a governmental or public authority. (2) The "bodily injury"or"property damagD'is caused by an "accident"which takes place after: (a) You executed the "insured cnntroc\`or written agreement: or (b) the permit has been issued teYou 2. COVERAGE EXTENSIONS m. Supplementary Payments. Subparagraphs (2)and (4) arc amended axfollows: (2) Up to $2500 for cost ofbail bonds (including bonds for related traffic law violations) required because ofan ''aooidont^we cover. VVodo not hoveto furnish these bonds. (4) All reasonable expenses incurred by the "Insured" at our requeo1, including actual loss of earning LIP to$5OOu day because o[time off from work. momuoxuvpx,|omeummor/r|v//nsuwncoeymoes Offices, |no.wm its porminsion (SECA 701 (01/07) Page I of INSURED COPY SECTION III—PHYSICAL DAMAGE COVERAGE A. COVERAGE The following is added: 5. Hired Auto Physical Damage a. 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. b. The most we will pay for"loss"in any on(,"accident"is the smallest of: (1) $50,000 (2) The actual cash value of the darnacied or stolen property as of the time of the"loss or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. If you are liable for the "accident",we will also pay up to $500 per"accident' for the actual loss of use to the owner of the covered "auto". c. Our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by an amount that is equal to the amount of the largest deductible shown for any owned "auto' for that coverage. However, any Comprehensive Coverage deductible shown in the Declarations does not apply to"loss"caused by fire or lightning. d. For this coverage, the insurance provided is primary for any covered "auto" you hire without a driver and excess over any other collectible insurance for any covered "auto' that you hire with a driver. 6. Rental Reimbursement Coverage We will pay up to $75 per day for up to 30 'rays, for rental reimbursement expenses incurred by you for the rental of an "auto' because of"loss" to a covered "auto". Rental Reirribursernt nt will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for a period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up tQ a maximum of 30 days. We will also pay up to $500 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 theft of a covered "auto"of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under paragraph Q. Coverage Extension. 7. Lease Gasp Coverage If a long-term [eased "auto" is a covered "auto' and the lessor is named as an Additional Insured — Lessor, In the event of a total loss, we will pay your additional legal obligation to the lessor for any difference between the actual cash value of the "auto" at the time of the foss and the 'outstanding balance"of the lease. "Outstanding balance" means the amount you owe on the lease at the time of loss less any amounts representing taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage charges; excess wear and tear charges; and lease termination fees. B. EXCLUSIONS The following is added to Paragraph 3 The exclusion for "loss" caused by or resulting from mechanical or electrical breakdown does not apply to the accidental discharge of an airbag. Includes copyrighted material of Insurance Services 0HIces, Inc,with its perm'ssion GECA 701 (01;07) Page 2 of 3 INSURED C::PY Paragraph 4 is replaced with the following: 4:. We,will not pay for"loss"to any of the following: a. Tapes, records, disks or other similar audio, visual or data electronic devices designed for use with audio,visual or data electronic equipment. b. Equipment designed or used for the det3ction or location of radar. c. Any electronic equipment that receives or transmits audio, visual or data signals. Exclusion 4.c does not apply to: (1) Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment is permanently installed in the covered "auto" at the time of the"toss" 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"; or (2) Any other electronic equipment that is: (a) Necessary for the normal operation of the covered "auto"or the monitoring of the covered "auto's"operating system; or (b) An integral part of the same unit housing any sound reproducing equipment described in (1) above and permanently installed ,n the opening of the dash or console of the covered`auto" normally used by the manufacturer for installation of a radio. D. DEDUCTIBLE The following is added: No deductible applies to glass dar'nage if the glass is repaired rather than replaced. SECTION IV. BUSINESS AUTO CONDITIONS A. LOSS CONDITIONS Item 2.a. and b. are replaced with: 2. Duties in The Event of Accident, Claim, Suit, or Lass a. You must promptly notify us. Your dut), to promptly notify us is effective when any of your executive officers, partners, members, o- legal representatives is aware of the accident, claim, "suit", or loss. Knowledge of an accident, claim, "suit", or loss, by other employee(s) does not Imply you also have such knowledge. b. To the extent possible, notice to us should include: (1) How, when and where the accident or loss took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the accident or loss. The following is added to 5. We waive any right of recovery we may have against any additional insured under Coverage A. 1. Who Is An Insured g., but only as respects loss arising out of the operation, maintenance or use of a covered "auto"pursuant to the provisions of thE!"insured contract", written agreement, or permit_ B. GENERAL CONDITIONS 9. is added 9. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Your unintentional failure to disclose any hazards existing at the effective date of your policy will not prejudice the coverage afforded. However, we have the right to collect additional premium for any such hazard. COMMON POLICY CONDITIONS 2.b.is replaced by the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. In copyrighted material of Insurance Services Offices, Inc.with its permission GECA 701 {01107) Page 3 of 3 iNSURED COPY —� COBEC-1 OP ID:JV DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 04/02/14 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 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holden is an ADDITIONAL INSURED,the policy(ies) must 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). INTACT PRODUCER 800-989-8712 NAME: Bozzuto&Associates Insurance 40.8-429-8460 PHONE FAX 34 S.Second St _[A/C,No,Exq: (AIC,No): Campbell,CA 95008 i DRIESS: Linda Ellis INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Mt.Hawley Insurance Co. 37974 INSURED Cobe Construction,.Inc. INSURER B:Golden Eagle Insurance Corp. 10836 498 Salmar Ave Campbell,CA 95008 INSURER C INSURER D INSURER E INSURER F: .COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE'LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED-ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER _ MM/DDIYYYY MMIDDIYYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED' A X COMMERCIALGENERAL LIABILITY X X MXL0417648 04101/14 04/01/15 PREMISES 50,000 a e_ CLAIMS-MADE I—XI OCCUR MED EXP(Anyone person) $ 5,000 X Owner/cont Prot. PERSONAL&ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GEN•L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 ' POLICY n.PE LOC $ AUTOMOBILE LIABILITY COM BINEDSINGLE LIMIT 1,000,000 accid Ea ent) $ _ B X ANY AUTO X BA2913012 03/13/14 03/13115 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS' AUTOS HIRED AUTOS NONNOSWNED PROPERTY DAMAGE $ Per accident) $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,009 A X EXCESS LIAB CLAIMS-MADE MXL0417648 04/01/14 04/01/15 AGGREGATE $ 5,000,000 DED X I RETENTION'$ $ WORKERS COMPENSATION WC STATU- 0TH- AND EMPLOYERS'LIABILITY Y 1 N TORY LIMITS ER ANY,PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? F—] NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $_ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) - RE: City Hall Office, 10300 Torre Ave. , Cupertino, CA 95014. City of Cupertino, its City Council, boards and commissions, officers, employees, and volunteers are named as additional insured per attached endorsement. General liability and auto liability waiver of subrogation applies. CERTIFICATE HOLDER CANCELLATION CITYCUP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Cupertino ACCORDANCE WITH THE POLICY PROVISIONS. 10300 Torre Avenue Cupertino,CA 95014 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) TheACORD name,and logo are registered marks of ACORD I COBEC-1 OP ID-JV AC��!U° DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE F 04/02/14 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 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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). INTACT PRODUCER 800-989-8712 NAME: Bozzuto&Associates Insurance 34 S.Second St 408-429-8460 (.vX_,NNo, E:t). Campbell,CA 95008 ADDRESS: Linda Ellis _ INSURER(S)AFFORDING COVERAGE NAIC# IIVSURER A:Mt.Hawley Insurance Co. 37974 INSURED Cobe Construction,Inc. INSURER B:Golden Eagle,Insurance Corp. 10836 498 Salmar Ave Campbell,CA 95008 INSURER C INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT-THE-POLICIES OF INSURANCE-LISTED BELOW HAVE: BEEN ISSUED TO THE,INSURED NAMED-ABOVE FOR-THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR PIN RIS D POLICY NUMBER MM DDIIYYYY MM DDIYYYY LIMITS LTR TYPE OF INSURANCE - GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED _ A X COMMERCIAL GENERAL.LIABILITY X MXL0417648 04/01/14 04101/15 PREMISES Ea occurrence) $ 50,000 CLAIMS-MADE OCCUR MED EXP(Any one,persoh) $ 5,000 X- Owner/Cont Prot. PERSONAL&ADV INJURY $ 190009000 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY n PRO LOC _ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Eaaccident) $ B JX ANY AUTO X BA2913012 03/13/14 03/13/15 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY.(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident) UMBRELLA LIAB X OCCUR EACH OCCURRENCE l$ 5,000,000 A X EXCESS LIAB CLAIMS-MADE MXL0417648 04/01/14 04/01/15 AGGREGATE $ 59000,000 DED I X I RETENTION$ _ $ WORKERS COMPENSATION TORY LAM U-,l T JOIR AND.EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT '$ OFFICER/MEMBER EXCLUDED? N/A (Mandatory.in NH) E.L.DISEASE-.EA EMPLOYEE $ If yes,describe unifier DESCRIPTION,OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS PVEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE,: Cupertino Mezzanine, 10555 Mary Ave. , Cupertino, Ck 95014 City of Cupertino, its City Council, boards and commissions, officers, employees, and volunteers are named as additional insured per attached endorsement. General liability and auto liability waiver of subrogation applies. CERTIFICATE HOLDER CANCELLATION CITYCUP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED,BEFORE City of Cupertino THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y p ACCORDANCE WITH THE POLICY PROVISIONS. 10300 Torre Avenue Cupertino,CA 95014 AUTHORIZED REPRESENTATIVE 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD I COBEC-1 OP ID:JV DATE(MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 04102/14 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 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pulicy(ies) must 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 800-989-8712 CONTACT . Bozzuto&Associates Insurance 408 419 $46D PHONE FAX - 34 S.Second St _(vC,No,Ext): (A/C,No): Campbell,CA 95008 ii DRIESS: Linda Ellis _ INSURER(S)AFFORDING COVERAGE NAIC k IIVSURER A:Mt.Hawley Insurance Co. 37974 INSURED Cobe Construction,Inc. INSURER B;Golden Eagle Insurance Corp. 10836 498 Salmar Ave Campbell,CA 95008 INSURER C INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO-CERTIFY'THAT'THE'POLICIES OF INSURANCE LISTED BELOW HAVE:_BEEN ISSUED TO THE INSURED NAMED ABOVE-FOR-THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN ADDL�SUBR POLICY EFF POLICY EXP N TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X X MXL0417648 04/01/14 04/01/15 DAMAGE TO RENTED 50,000 PREMISES,Ea occurrence $ CLAIMS-MADE OCCUR MED EXP(Any'oneperson) $ 5,000 X Owner/Copt Prot. PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE. $ 2,000,000 GEN'L AGGREGATE LIMIT.APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY 71 PE LOC _ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accid ccident) $ B X ANY AUTO X X BA2913012 03/:13/14 03/13/15 BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY'DAMAGE $ HIRED AUTOS AUTOS Per accident) I$ UMBRELLA LIAB X OCCUR EACHOCCURRENCE I $ 5,000,000 A X EXCESS LIAB CLAIMS-MADE MXL0417648 04/01/14 04/01/15 AGGREGATE $ 5,000,000 DED X RETENTION$ _ $ WORKERS COMPENSATION TORY LIMITS OT AND EMPLOYERS'LIABILITY ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.,EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA.EMPLOYEE, $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS LOCATIONS IVEHICLES (Attach ACORD 101,Additional Remarks Scinedule,if more space is required) RE: Cupertino Sports Center Patio, 21111 Stevens Creek Blvd. , Cupertino, CA 95050. City of Cupertino, its City Council, boards and commissions, officers, employees, and volunteers are named as additional insured per attached endorsement. General liability and auto liability waiver of subrogation applies. CERTIFICATE HOLDER (CANCELLATION CITYCUP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE' WILL BE DELIVERED IN City of Cupertino ACCORDANCE WITH THE POLICY PROVISIONS. 10300 Torre Avenue Cupertino,CA 95014 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD i COBEC-1 OP ID:JV DATE(MM/DDIYYYY) ,aco�rv• CERTIFICATE OF LIABILITY INSURANCE �—" 04102/14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRM_ATIVELY 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 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an enclorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). ACT PRODUCER 800-989-8712 pIAME: Bozzuto&Associates Insurance PHONE FAX 34 S.Second St 408-429-8460 (A/C No E:t). (A/C,No): Campbell CA 95008 [iDDRE p e ADDRESS: Linda Ellis INSURER(S)AFFORDING COVERAGE NAIC# INSURER A.:Mt.Hawley insurance Co. 379.74 INSURED Cobe Construction,Inc. INSURER B:Golden Eagle Insurance Corp. 10836 498 Salmar Ave Campbell,CA 95008 INSURER C INSURER INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: _ REVISION NUMBER: THIS-IS-TO-CERTIFY THAT-THE-POLICIES'OF-INSURANCE LISTED-BELOW HAVI BEEN ISSUED TO THE INSURED-NAMED ABOVE-FOR—THE-POLICY-PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CERTIFICATE CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP ` LTR POLICY NUMBER MM/DD/YYYY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 .> DAMAGE T6RENTED A X COMMERCIAL GENERAL LIABILITY X X MXL0417648 04/01/14 04/01/15 PREMISES(Ea occurrence) $ 50,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $ 5,000 X Ownencont Prot. PERSONAL&,ADV INJURY $ 1,000,000 c GENERALAGGREGATE $ 2,000,000 . GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PE O F LOC _ $ AUTOMOBILE LIABILITY a a COMBINED SINGLE LIMIT 1,000,000 (Eccident) $ B X ANY AUTO X X BA2913012 03/13/14 03/13115 BODILY INJURY(Per person) $ ALL.OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON70WNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident) Is UMBRELLA LIAB. X OCCUR EACH OCCURRENCE $ 5,000,000 A X EXCESS LIAB CLAIMS-MADE M 04/01/14 04/01/15 AGGREGATE $ 5,000,000 DIED I X I RETENTION$ $ WORKERS COMPENSATION YIN WC STATU- DER EMPLOYERS'LIABILITY TORY I IMITS'I ER ANY PROPRIETORlPARTNER/EXECUTIVE E.L.EACH ACCIDENT � $ ' OFFICER/MEMBER,EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEEI $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I'LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE: Cupertino Historical Society Tile Repair (Quinlan Community Center) , i0185 N. Stelling Rd. , Cupertino, CA 95014. City of Cupertino, its City Council, boards and commissions, officers, employees, and volunteers are named as additional insured per attached endorsement. General liability and auto liability waiver of subrogation applies. r CERTIFICATE HOLDER CANCELLATION CITYCLIP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Cupertino ACCORDANCE WITH THE POLICY'PROVISIONS. 10300 Torre Avenue Cupertino, CA 95014 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD