18-071 West Valley Community Services of Santa Clara County, Inc., General Fund Human Service Grants Program cityNon-Profit Contract FIRST AMENDMENT
TO GENERAL FUND HUMAN SERVICE GRANTS PROGRAM
CITY/NON-PROFIT CONTRACT
(Services Only)
This First Amendment to Contract is entered into between WEST VALLEY COMMUNITY
SERVICES OF SANTA CLARA COUNTY INC. ("CORPORATION") and the CITY OF
CUPERTINO ("CITY") as of July 1, 2019 (the "Effective Date") to amend the General Fund
Human Services Grants Program City/Non-Profit Contract(the "Contract") dated July 1, 2018.
WITNESSETH
WHEREAS, CITY has reserved a portion of its Human Services Grants ("HSG") fiends to be
used on activities that benefit Cupertino's residents; and,
WHEREAS, CITY has agreed to the use by CORPORATION of a portion of CITY'S HSG
budget for the Program (as described below) to be operated within CITY for the benefit of low
and very low-income households;
THEREFORE, the parties agree as follows:
I. Section I, entitled "Program", is deleted in its entirety and replaced with the following:
For the period of July 1, 2018 to June 30, 2019, CITY agreed to allocate a portion of its HSG
funds to CORPORATION in the sum of Forty Thousand Dollars and No Cents ($40,000) for
the purpose of implementing the CORPORATION'S program, as more particularly described in
Exhibits A-D to the Contract (hereinafter "Program"), and said Exhibits set forth below, as they
may be amended or modified, are attached to this Contract and incorporated herein by reference.
Exhibit A: Program Description
Exhibit B: Program Work Plan
Exhibit C: Program Budget
Exhibit D: Basic Insurance and Bond Requirements For Non-Profit Contracts
For the period of July 1, 2019 to June 30, 2020 CITY agrees to allocate a portion of its current
HSG fiends to CORPORATION in the sum of Forty Thousand Dollars and No Cents
$4( 0,000) for the purpose of implementing the CORPORATION'S Program.
The total allocation for July 1, 2018 through June 30, 2020 shall not exceed Eighty Thousand
Dollars and No Cents ($80,000).
2. Section II, "Term," is deleted in its entirety and replaced with the following:
A. The purpose of this Contract is for the CITY to disburse the Grant for eligible
activities.
1
B. The term of this Contract (the "Term") will begin on July 1, 2018 and will end on
June 30, 2020, unless otherwise amended or terminated earlier pursuant to Section VII or
Section VIII of this Contract.
4. All terms, covenants and conditions stated in the CONTRACT, which are not herein amended,
remain in full force and effect.
[Signatures on following page.]
2
IN WITNESS WHEREOF, the parties have executed this First Amendment as of the
Effective Date.
CORPORATION: CITY:
[NAME], a California nonprofit public CITY OF CUPERTINO, a municipal
benefit corporation corporation
Josh Selo Date .ixnm Borden Date
Executive Director Interim City Manager
APPROVED AS TO FORM AND ATTEST:
LEGALITY:
Heather MinnerDate._ Gra..... _ce Schmidt Date
City Attorney City Clerk
EXPENDITURE DISTRIBUTION
PO# 2019-137 265-72-711-600-623
Original Contract: $40,000
Amendment#1: $40,000
Total: $80,000
Page 3 of 12
FY 2019-2020 General Fund Human Services Grants Program City/Non-Profit Contract Amendment
EXHIBIT A
PROGRAM DESCRIPTION
FY 2019/2020
Agency Name: DUNS:
West Valley Community Services Not Applicable(Only for CDBG)
Executive Director: Project Manager: Project# (For Office Use Only):
Josh Selo Su'atha Venkatraman 100-72-712 600-623
Street Address: City: State: Zip Code:
10104 Vista Drive Cupertino CA 95014
Telephone number: Fax Number: Manager E-mail
408-255-8033 sujathav@wvcommunityservices.org
Name of Project/Program:
Haven to Home
Project/Program Location:
10104 Vista Drive Cupertino, CA 95014
Program Description:
The goal of the Haven to Home (HTH) is to help currently un-housed Cupertino individuals and
families secure permanent housing,maintain employment, and enhance income opportunities and
financial stability. The supportive services critical to the success of this program are intensive
case management, housing search, landlord mediation, benefits clinic, and financial coaching.
HTH aims to end homelessness and prevent homelessness by coordinating multilevel services and
leveraging further resources in the community in order to build long-term stability and self-
sufficiency for participants.
Through this funding, WVCS will serve 50 homeless individuals and families whose last address
was in Cupertino by moving them into permanent housing. The target population for this grant
will be families or individuals who have become homeless in the City of Cupertino. HTH services
include:
Case Management: Case management is a key component that focuses on self-sufficiency rather
than dependency, and emphasizes sustainable solutions. WVCS' case managers work to assess a
family's needs by using a self-sufficiency matrix. Based on this assessment and the families' self-
sufficiency matrix score, the case manager will develop a family case plan with goals to address
critical needs and improve self-sufficiency.
Food Pantry: All qualified clients will have access to the food pantry in order to supplement their
needs and reduce grocery expenses. Every visit to the food pantry includes fresh fruit and
vegetables, fresh bread, eggs, a source of protein, and milk, sourced from Second Harvest Food
Bank and generous donations from local grocery stores such as Safeway and Whole Foods.
Clients will also have access to ready to eat meals.
Page 4 of 12
FY 2019-2020 General Fund Human Services Grants Program City/Non-Profit Contract Amendment
Emergency Financial Assistance: As part of this program, WVCS will provide Emergency
Financial Assistance for rapid rehousing and homelessness prevention. The deposit assistance
will be the families' first step in securing permanent housing and help rapidly re-house homeless
families. Case managed clients who may experience financial crisis will also get continued
support and emergency assistance to prevent homelessness.
Supportive Services: These include benefit assistance, financial coaching, free bus pass,housing
search assistance, and weekly laundry quarters. These supportive services help clients to save
money and increase their income.
Page 5 of 12
FY 2019-2020 General Fund Human Services Grants Program City/Non-Profit Contract Amendment
EXHIBIT B
PROGRAM WORK PLAN
FY 2019/2020
AGENCY NAME: West Valley Community Services
PROGRAM NAME: Haven to Home
Objectives Benchmarks for Each Quarter
1st I 2nd 3rd 4th TOTAL
Supportive services to help clients find housing and maintain 20 10 10 10 50
,housing
Page 6 of 12
FY 2019-2020 General Fund Human Services Grants Program City/Non-Profit Contract Amendment
EXHIBIT C
PROGRAM BUDGET
FY 2019/2020
AGENCY NAME: West Valley Community Services
PROGRAM NAME: Haven to Home
Proposed Program Expenses FY 2019-20
Salaries/Benefits/Payroll/Taxes $40,000
Office Su lies
Communication
Publications/Printin /Advertisin
Travel
Rent/Lease/Mort a e
Utilities
Insurance
Equipment Rental/Maintenance
Audit/Legal/Professional Services for CDBG portion only)
Direct Services (Funding fors ecific service such as a meal, ride
Contracted Services
Other
Total Expenses $40,000.00
Page 7 of 12
FY 20'19-2020 General Fund Human Services Grants Program City/Non-Profit Contract Amendment
EXHIBIT D
BASIC INSURANCE AND BOND REQUIREMENTS FOR
NON-PROFIT CONTRACTS
Definition of Contractor: The "Contractor" as the word is used in this Exhibit D is the party
contracting with the City of Cupertino for the direct distribution of BMR AHF funds.
Indemnity
The Contractor shall indemnify, defend, and hold harmless the City of Cupertino (hereinafter
"City"), its officers, agents and employees from any loss, liability, claim, injury or damage
arising out of, or in connection with performance of this Contract by Contractor and/or its
agents, employees or subcontractors, excepting only loss, injury or damage caused solely by the
acts or omissions of personnel employed by the City. It is the intent of the parties to this Contract
to provide the broadest possible coverage for the City. The Contractor shall reimburse the City
for all costs, attorneys' fees, expenses and liabilities incurred with respect to any litigation in
which the Contractor is obligated to indemnify, defend and hold harmless the City under this
Contract.
Insurance
Without limiting the Contractor's indemnification of the City, the Contractor shall provide and
maintain at its own expense, during the term of this Contract, or as may be further required
herein, the following insurance coverages and provisions:
A. Evidence of Coveraye
Prior to cominencement of this Contract, the Contractor shall provide on the City's own form or a
form approved by the City's Insurance Manager an original plus one copy of a Certificate of
Insurance certifying that coverage as required herein has been obtained and remains in force for
the period required by this Contract. The contract number and program name must be
stated on the Certificate of Insurance. The City's Special Endorsement form shall accompany
the certificate. Individual endorsements executed by the insurance carrier may be substituted for
the City's Special Endorsement form if they provide the coverage as required. In addition, a
certified copy of the policy or policies shall be provided by the Contractor upon request.
This verification of coverage shall be sent to the address as shown on the City's Certificate of
Insurance form and to the Community Development Department at the address set forth in this
Contract at Section VI. PROGRAM COORDINATION, Paragraph C., NOTICES. The
Contractor shall not issue a Notice to Proceed with the work under this Contract until it has
obtained all insurance required and such insurance has been approved by the City. This approval
of insurance shall neither relieve nor decrease the liability of the Contractor.
B. Notice of Cancellation of Reduction of Coverage
All policies shall contain a special provision for thirty (30) days prior written notice of any
cancellation or reduction in coverage to be sent to the Community Development Department,
10300 Torre Avenue, Cupertino, CA 95014.
Page 8 of 12
FY 2019-2020 General Fund Human Services Grants Program City/Non-Profit Contract Amendment
C. Qualifying Insurers
All policies shall be issued by companies which hold a current policy holder's alphabetic and
financial size category rating of not less than A VIII, according to the current Best's Key Rating
Guide, unless otherwise approved by the City's Insurance Manager.
D. Insurance Required
1. Comprehensive General Liability Insurance - for bodily injury (including death) and
property damage which provides limits of not less than one million dollars ($1,000,000)
combined single limit (CSL) per occurrence.
OR
2. Commercial General Liability Insurance - for bodily injury (including death) and
property damage which provides limits as follows:
a. General limit per occurrence - $1,000,000
b. General limit aggregate - $2,000,000
C. Products/Completed Operations- $1,000,000 aggregate
d. Personal Injury limit - $1,000,000
If coverage is provided under a Commercial General Liability Insurance form, the carrier shall
provide the City Insurance Manager with a quarterly report of the amount of aggregate limits
expended to that date. If over 50% of the aggregate limits have been paid or reserved, the City
may require additional coverage to be purchased by the Contractor to restore the required limits.
3. For either type of insurance, coverage shall include:
a. Premises and Operations
b. Products/Completed Operations with limits of one million dollars ($1,000,000)
per occurrence/ aggregate to be maintained for two (2) years following
acceptance of the work by the City.
C. Contractual Liability expressly including liability assumed under this Contract.
d. Personal Injury liability.
e. Independent Contractors' (Protective) liability.
f. Severability of Interest clause providing that the coverage applies separately to
each insured except with respect to the limits of liability.
Page 9 of 12
FY 2019-2020 General Fund Human Services Grants Program City/Non-Profit Contract Amendment
4. For either type of insurance, coverage shall include the following endorsements, copies
of which shall be provided to the City:
a. Additional Insured Endorsement:
Such insurance as is afforded by this policy shall also apply to the City of Cupertino, and
members of the City Council, and the officers, agents and employees of the City of
Cupertino, individually and collectively, as additional insureds.
b. Primary Insurance Endorsement:
Such insurance as is afforded by the additional insured endorsement shall apply as
primary insurance, and other insurance maintained by the City of Cupertino, its officers,
agents, and employees shall be excess only and not contributing with insurance provided
under this policy.
C. Notice of Cancellation or Change of Coverage Endorsement:
This policy may not be cancelled nor the coverage reduced by the Company without 30
days prior written notice of such cancellation or reduction in coverage to the City of
Cupertino at the address shown on the Certificate of Insurance.
d. Contractual Liability Endorsement:
This policy shall apply to liability assumed by the insured under written contract with the
City of Cupertino.
e. Personal Injury Endorsement:
The provisions of this policy shall provide Personal Injury coverage.
f. Severability of Interest Endorsement:
The insurance afforded by this policy shall apply separately to each insured that is
seeking coverage or against whom a claim is made or a suit is brought, except with
respect to the Company's limit of liability.
5. Comprehensive Automobile Liability Insurance for bodily injury (including death) and
property damage which provides total limits of not less than one million dollars
($1,000,000) combined single limit per occurrence applicable to all owned, non-owned
and hired vehicles.
6. Worker's Compensation and Employer's Liability Insurance for:
a. Statutory California Workers' Compensation coverage including a broad form all-
states endorsement.
Page 10 of 12
FY 2019-2020 Genera] Fund Human Services Grants Program City/Non-Profit Contract Amendment
b. Employer's Liability coverage for not less than one million dollars ($1,000,000)
per occurrence for all employees engaged in services or operations under this
Contract.
C. Inclusion of the City and its governing board(s), officers, representatives, agents,
and employees as additional insureds, or a waiver of subrogation.
7. Professional Errors and Omissions Liability Insurance
This type of insurance should be provided by persons/entities you contract with to provide you
with professional services.
a. Limits of not less than one million dollars ($1,000,000).
b. If this policy contains a self retention limit, it shall not be greater than ten
thousand dollars ($10,000) per occurrence/event.
C. This coverage shall be maintained for a minimum of two (2) years following
termination of this Contract.
The City must first approve any exceptions to the above requirements.
8. Bond Requirements
Fidelity Bond - Before receiving compensation under this Contract, Contractor will furnish City
with evidence that all officials, employees, and agents handling or having access to funds
received or disbursed under this Contract, or authorized to sign or countersign checks, are
covered by a BLANKET FIDELITY BOND in an amount of AT LEAST fifteen percent (15%)
of the maximum financial obligation of the City cited herein. If such bond is cancelled or
reduced, Contractor will notify City immediately, and City may withhold further payment to
Contractor until proper coverage has been obtained. Failure to give such notice may be cause for
termination of this Contract, at the option of the City.
9. Special Provisions
The following provisions shall apply to this Contract:
a. The foregoing requirements as to the types and limits of insurance coverage to be
maintained by the Contractor and any approval of said insurance by the City or its
insurance consultant(s) are not intended to and shall not in any manner limit or
qualify the liabilities and obligations otherwise assumed by the Contractor
pursuant to this Contract, including but not limited to the provisions concerning
indemnification.
b. The City acknowledges that some insurance requirements contained in this
Contract may be fulfilled by self-insurance on the part of the Contractor.
Page 11 of 12
FY 2019-2020 General Fund Human Services Grants Program City/Non-Profit Contract Amendment
However, this shall not in any way limit liabilities assumed by the Contractor
under this Contract. The City shall approve any self-insurance in writing.
C. The City reserves the right to withhold payments to the Contractor in the event of
material noncompliance with the insurance requirements outlined above.
d. If the Contractor fails to maintain such insurance as is called for herein, the City
must order the Contractor to immediately suspend work at Contractor's expense
until a new policy of insurance is in effect.
Page 12 of 12
FY 2019-2020 General Fund Human Services Grants Program City/Non-Profit Contract Amendment
WESTVAL-05 MARIAVELASQUEZ
C
DATE(MfVUDDNYYY)ERTIFICATE OF LIABILITY INSURANCE
6112/2019
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 have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME:
NFP Property&Casualty Services,Inc. PHONE FAX
160 West Santa Clara Street (A/C,No,Ext):(408)792-5400 I (X�8,No).(408)792-36M
Suite 576 E-MAIL
San Jose,CA 95113 ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIL_#
INSURER A:Philadelphia Indemnity Insurance Company 18058
INSURED INSURER B:New York Marine And General Insurance Company 16608
West Valley Community Services of Santa Clara County,Inc. NSURER C
10104 Vista Drive -INSURER D:
Cupertino,CA 95014
I 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.
INSR AWL SUB R POLICY NUMBER POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD (MMIDDIYYYY) (MWDD/YYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE— -i 1,000,000
CLAIMS-MADE F—X]OCCUR PHPK1991862 6/1/2019 61112020 DAMAGE TO RENTED --
x PREMISES(Ea oocurrengel $ 100,000
MEDEXP_(An y_oneRqr_§on)_ $ 5,
PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
POLICY JECT [::] LOC PRODUCTS-COMP/OPAGG $ 1,000,000
PRO-
OTHER
A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
-Lu accidentL— $ 1,000,000
ANY AUTO PHPK1991862 6/1/2019 6/112020 BODILY INJURY Per on
OWNED SCHEDULED ers
AUTOS ONLY AUTOS BODILY INJURY Per
accident)
HIRED AUTOS
ON VNED PROPERTY DAMAGE
AUTOS ONLY —I— AUT,5TONLY (Per accident) $
A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000
X EXCESS LIAR PHUB679137 6/1/2019 6/1/2020 AGGREGATE $ 2,000,000
DED I x I RETENTION$ 10,000 $
B WORKERS COMPENSATION X
PER OTH-
AND EMPLOYERS'LIABILITY STATUTE, I _]ER
Y/N WC201800007927 12/31/2018 12/31/2019 1,000,000
ANY PROPRIETOR/PARTNER/tAtuu 11vt [ E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes describe under
DESCRIPTION
RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 11060,000
A E&O PHPK1991862 6/1/2019 6/1/2020 Each Incident 1,000,000
A E&O PHPK1991862 611/2019 6/112020 Aggregate 3,000,000
DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
RE: Events underwritten contract
City of Cupertino,Its Officials&Employees named as an additional insured per form CG2026 attached. Primary wording applies. Blanket Work Comp waiver
endorsement WC 04 03 06 attached- (Form CIR attached)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Cupertino,Its Officials&Employees ACCORDANCE WITH THE POLICY PROVISIONS.
Attn:Recreation&Community Services/Facilities
10300 Torre Avenue
Cupertino,CA 95014 AUTHORIZED REPRESENTATIVE
-Zxa�
/ If
ACORD 25(2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID-WESTVAL-05 MARIAVELASQUEZ
LOC
ADDITIONAL REMARKS SCHEDULE Pagel of - 1
AGENCY NAMED INSURED
West Valley Community Services of Santa Clara County,Inc.
NFP Property &Casualty Services, Inc. 10104 Vista Drive
POLICY NU-MBER Cupertino,CA 95014
SEE PAGE 1
CARRIER NAIC CODE
�EE PAGE I �SEE P 1 EFFECTIVE DATE:SEE PAGE 1
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 25. FORM TITLE: Certificate of Liability Insurance
CIR
The attached Certificate of Insurance is provided as part of our service to our client,the Insured. If special endorsements have been
provided,they also are indicated attached.You may find that these documents do not comply with all the terms and conditions of
the underlying contract between the Certificate Holder and the Insured due to the insurance company's insuring conditions,
limitations,exclusions and other terms.
If you have any questions, please contact the undersigned.
NFP Property and Casualty Services,Inc.
160 West Santa Clara Street, Suite#575
CA License#OF1 5715
TELEPHONE:408.792.5400
FAX:408.792.3670
ACORD 101 (2008/01) @ 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
I
POLICY NUMBER: PHPK1991862 COMMERCIAL GENERAL LIABILITY
CG 20 26 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL IDESIGNATED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s);
City of Cupertino, Its Officials & Employees
Information re uired to com fete this Schedule, if not shown above,will be shown in the Declarations,
-d
A. Section 11 — Who Is An Insured is amended to B. With respect to the insurance afforded to these
include as an additional insured the person(s) or additional insureds, the following is added to
organization(s) shown in the Schedule, but only Section III—Limits Of Insurance:
with respect to liability for"bodily injury", "property If coverage provided to the additional insured is
damage or personal and advertising injury required by a contract or agreement, the most we
caused, in whole of in part, by your acts or will pay on behalf of the additional insured is the
omissions or the acts or omissions of those acting amount of insurance:
on your behalf:
1. Required by the contract or agreement; or
1. In the performance of your ongoing operations;
or 2. Available under the applicable Limits of
2. In connection with your premises owned by or
Insurance shown in the Declarations;
rented to you. whichever is less.
However: This endorsement shall not increase the
applicable Limits of Insurance shown in the
1. The insurance afforded to such additional Declarations.
insured only applies to the extent permitted by
law; and
2. If coverage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
CG 20 26 0413 O Insurance Services Office, Inc., 2012 Page10 of 18
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY VVC04O3O6
(Ed.O4-84)
WAIVER QFOUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA i
|
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce
our right against the person ororganization named in the Schedule. (This agreement applies only to the extent that you
perform work under a written contract that requires you io obtain this agreement from uoj
YOU m«oL maintain payroll records accurately segregating the remuneration of your employees vvhi|c engaged in No
work described in the Schedule. �
�
The additional premium for this endorsement shall be 2.0096 of the California workers' compensation premium �
otherwise due on such remuneration. �
Schedule �
�
�
Person orOrganization Job Description
Any Person or Organization ao Required By Written Contract All Operations of the Named Insured aa requested bv �
thauertho|dor. �
/
'
'
�
!
'
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. �
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.) �
Endorsement Effective 2O18-12-31 Policy No. Endorsement No. 1
Insured VVC201800007927 �
West Valley Community Services of Santa Clara
Insurance Company Countersigned By '
New York Marine and General Insurance
Company/2874G
wco4oaon �
(eu.cw-aw) �
@1998 by the Workers'Compensation Insurance Rating Bureau of California.All rights reserved,
�
Liberty CRIME PROTECTION POLICY
mutu'A Edition of April 1,2012 Policy No. 609202178
SURETY
The Ohio Casualty Insurance Company
(Herein called Company)
DECLARATIONS
Item 1. Name of Insured(herein called Insured):
West Valley Comi-nunity Services of Santa Clara County, Inc.
Principal Address:
10 104 Vista Drive, Cupertino,CA 95 014
Item 2. Policy Period:from 12:01 a.m.on August 1,2019 to12:01a.m,on Continuous
(MONTH,DAY,YEAR) (MONTH,DAY,YEAR)
Item3. INSURING AGREEMENTS,LIMITS OF INSURANCE AND DEDUCTIBLES
Limit of Insurance Deductible Amount
Insuring Agreement— Per Occurrence Per Occurrence
1. Employee Dishonesty $ 20,000.00 $ 1,000.00
2. Forgery or Alteration $ $
3. Inside the Premises $ $
4. Outside the Premises $ $
5. Computer Fraud $ $
6. Money Orders and Counterfeit Paper Currency $ $
If added by Endorsement Insuring Agreement(s):
If"Not Covered"is inserted above opposite any specified Insuring Agreement,or if no amount is inserted, such
Insuring Agreement and any other reference thereto in this Policy shall be deemed to be deleted,
Item 4. ENDORSEMENTS FORMING PART OF THIS POLICY WHEN ISSUED
SE 0145 02 06,SE 01 17 04 12,SE 0133 1104
Item 5. CANCELLATION OF PRIOR INSURANCE
By acceptance of this Policy you give us notice canceling prior policy Nos,
Issue Date 8/12/2019 At Scottsdale AZ
By Authorized Representative
SP 00 01 04 12
Printed in U.S.A. Copyright,The Surety&Fidelity Association of America,2012
CRIME PROTECTION POLICY
TABLE OF CONTENTS
yugo �
�
A. CONSIDERATION CLAUSE—.. ...... ................. .................... ........................................... .........................—..........»
B. INSURING AGREEMENTS �
l, Employee Dishonesty......................... ........ ...... ...... — .......................................................................................3 �
2. Forgery m Alteration................................. ................................ --........ ........................................ ...................... 3
IInside the Premises............ — .............................. ...................... .......... .........— .................................................... 3
4. Outside the Promises—...................................................... — ............ ....................... .......................................... 3
5. Computer Fraud.................-- ................................ .................... .................. ........ ........................ ................... «
6 Money Orders and Counterfeit Paper Currency..................—........ ............... ........... .......... ................................. 4
CDEBNITKIN8
4
L BaoWo&ymznmw--------------------------------------------------
2. Caab--...... ...... ........................................................... —.... ............................ ...................................—.... .......4
3� Counterfeit.......... .................................. ............. ..........—.................. _ ............ _ ............................................4
4. Custodian.................................. ......................................................... ..................................................... ...........*
5. Employee4
-----------'-----^~--------------------------^---------�
6, Forgery................---.................................................. ..... ........... ................... .......................................... ........*
7. Messenger----------------.---.............. ......... -- ......... ........................... .........................z !
8. Money.............. ... —........ --- .................................. ....... ........ ........................... ...........—..........................5
P. Occurrence...... .................................................................................. —........—..................... ................................5
10.0thv property.... ...... — .............. .....—......................................... .....— ... — ...... ............................. ...... ---' 5
lLPayment order........................................................................................................ ............. _ ...................... ___5
12.9ceuisc ........—........................... .............. ...................................................._ ................................... .............5
lIDobbory.......... .................... ...........-- ...................... ..................._ ............... ............................... ......._......... z
\4.Safe burglary............. ................................................. — ............................................................. ........... ...............5
15.8000d6os.---------.- 5
�
]6 BoondtyPmooduru------------------------------------------.------.
17.T6oft.------------------------------------------'------�5
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lO.\�u�bprmou.------------------------_--------.------------------
D. EXCIUGD}08
Applicable m All Insuring Agreements,Except as Indicated
l� Acts Committed by You............... .......................... ................................... ...... ........----................................v
3. Acts of Employees,Directors,Trustees m Representatives......................................—........--................... ......—h
lFire............................— ............... — ....—.............. ........................ ............... — ......... ............ ............... ......«
4. Governmental Action............. ................................ ............... ........... ...... ................................................ ............6
5. Indirect Loss........................... ........ ........... ............. ...................................---................................................. b
6
6. Logo fxpvoaou--.------------------------------------------------.
7. Nuclear Chemical m Biological---------------..-----.............. ............ .......................... ......o
& War and Similar Actions................ .............. ...... --_ ............................................................................... _ o
9� Confidential Information....—.............. ................................................................................... —....................... —.6
l0,Data Breach Costs..... ..................... ................................... .............. ................................................................— O
Applicable to Specific Insuring Agreements
l. Under Insuring Agreement
Employee Canceled Under Prior Insurance...................... ................................. ..............................................7
BondedEmployee..................................................— ........ .......... .....—............. ........................... ................/
Damages.................. ................ ................... ............... .................................................................. .............. ,
Treasurerm Tax Collector.............. ........ ........................... ............................................................... .........../
2. Under Insuring Agreements l and
?
�voomcy8bmougox----.-----------------------------------------�
3. Under Insuring Agreements 3 and
Accounting nr Arithmetical Errors or Omissions......... .................... ................ ............................................7
MoneyOperated Devices........................... ........................... ....—..... ............................ .........................— .../
Transfer or Surrender wf Property...................... —............. ...— ................................ ........... ......... .............. /
Vandalism............................. ........... ...... .................................................................. .............. _........... _ /
4. Under Insuring Agreement
5. Under Insuring Agreements 3'4 and 6
Exchangesm Purchases.............. — ....... ......... ......... ............................ .................... ..................................8
Voluntary Parting n[Title mor Possession of Property.........___......... —................ ----------- 8
6. Under Insuring Agreement
Failure m Follow Security Procedures............. ..................... ................................. ...................... ...........8
Debitand Credit Cards........ ............. ......... ............. .................................... —................. ....... ......... ........8
E, CO0D7TION8
Applicable k/All Insuring Agreements
l. Cancellation.........— ................... ..................' ......................................................... — ...........---..........
......
�u
2. C6aoOee .......................... ...... ................ ...... ............ ..................... ................................................................ '8 �
lConcealment,Misrepresentation orFmud------------.--.----...--.-------------�9
4. Consolidation and Merger..... ............................. ........... ....... ......... ......... ... ....... ........ ..............9
5. Dodnodhe........ ....................................... .............................. ............................... ......... .................................. v
6. Discovery ofLoss............. ......................... ...—............................ ...............— .............. ....... ....--- ...........p
7. Duties iu the Event of Loss ........... ..... ................................. ............... ........................................... ...... ...... �y
8. Extended Period m Discover Loss .......................................---...............—........ ................ ...........................Y
1 Joint Insured.......................................................................................................... ...... ............................ --- ]D �
lO �
l�L:gu Action Against Oo----.--.---_----------------------------- �
ll.Liberalization.............. ...... ................ ........................ ---....... — .......... ......... ................. .........................l0
llLimit oyluauzance--................................... ......---------........ ............................. ........ ......... ....... lO i
13.Loss Covered Under More Than One Coverage................... — ............ ------............—............--- .... l0
14, Limit ufIooumoco— ........... ....... ............................................ ..........—....................... ......... |O /
15.0thu Insurance.............. ............ .............. ...................................... ...................................----......— ........' 10 |
16 Ownership ny Property,Interests Co"erud ................—.................. ................. ............... --............. — ........ lV �
17.Records................................................ — ..................... ..................... ...... ...... ................................................l} |
|#.Recoveries.............. ......... ....... ...................... ............. — .......... ........... .............------ ..........
—� l1
19.Territory ........ ........--......... ....................................... --.----- ................................—........ ...... ....... I i
2i Transfer of Your Rights and Duties Under This Policy...--............ — ... ..................... .......... ......... ....... ll �
l}
%l.Trm��rof Your R�6t uf Recovery Agu�u 8�ominOo ------------------.--------.
22. —...... .................................... ............... ...... ........................................... ....... ........ ....... |l
Applicable toSpecifinInsuring Agreements
|. Insuring Agreement l
Cancellation uum Any Employee.................. .......................... ------- ..................... ...................--.l2
2. Insuring Agreement 2
Deductible........ ......... ---............ ----------............... ............ ....... .......... ....................... ......l2
FacsimileSignatures............. .................................. ....................... .......................................... ...... ...... ... .l2
Proofuf Loss.......... ....................................................... --.................................................. — ............. ' l%
Territory......... ............ .—....................................................... ---........ ...... ...................... --........—'l3
3. Insuring Agreements and
Special Limit o/Insurance for Specified Property......................................................................................� B �
Duties 6o the Event of Loss. --------------------.--------------------l3 �
4. Insuring Agreement 5
Special Limit of Insurance fhr3pmcdficdProDorty'-----------^----.---'—.----1--' 13
Duties in the Event ofLoss �
Territory.............. ............ ......—............ ........................ ............... ...................................... —............ —'l3 �
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CRIME PROTECTION Throughout this Policy the words"you"and"your"refer to the Insured(s)shown in the
POLICY Declarations.The words"we","us"and"our"refer to the Company providing this insurance.
Read the entire Policy carefully to determine rights,duties and what is or is not covered,
Words and phrases defined in the Policy are in boliltype.
A. CONSIDERATION In return for the payment of the premium,and subject to the Declarations,Insuring Agree-
CLAUSE ments,Definitions,Exclusions,Conditions and other terms of this Policy,we will pay for
loss covered by an Insuring Agreement of this Policy that you sustain resulting directly from
acts committed or events occurring at any time and discovered by you during the Policy
Period shown in the Declarations or during the period of time provided in the Extended
Period to Discover Loss,Condition E. 9.
B. INSURING 1. Employee Dishonesty
AGREEMENTS We will pay for loss resulting directly from dishonest acts committed by an employee,
whether identified or not,acting alone or in collusion with other persons,with the
manifest intent to:
a. Cause you to sustain loss;and
b. Obtain an improper financial benefit for:
(1) The employee;or
(2) Any person or organization intended by the employee to receive that benefit.
As used in this Insuring Agreement,an improper financial benefit does not include any
employee benefits received in the course of employment,including: salaries,
commissions,fees,bonuses,promotions,awards,profit sharing or pensions.
2. Forgery or Alteration
a. We will pay for loss resulting directly from forgery or alteration of checks,drafts,
promissory notes,or similar written promises,orders,or directions to pay a sum certain
in money that are:
(1) Made or drawn by or drawn upon you;
(2) Made or drawn by one acting as your agent;
or that purport to have been so made or drawn,
b. If you are sued for refusing to pay any instrument covered in paragraph 2 a.on the basis
that it has been forged or altered,and you have our written consent to defend against the
suit,we will pay for any reasonable legal expenses that you incur and pay in that defense.
The amount that we pay for such legal expenses is in addition to the Limit of Insurance
applicable to this Insuring Agreement.
3. Inside the Premises
a. We will pay for loss of cashand securities inside the prernisesor banking
premises resulting directly from theft,disappearance or destruction.Provided,
however,in the case of theft,the theft was committed by a person physically
present in the premisesor banking premises at the time of loss of such cashor
securities.
b. We will pay for loss of,and loss from damage to, other property:
(1) Inside the premises resulting directly from an actual or attempted robberyof
a custodian;or
(2) Inside the premises in a safe or vault,resulting directly from an actual or
attempted safe burglary,
c. We will pay:
(1) For loss from damage to the premises or its exterior;or
(2) For loss of,and loss from damage to,a locked safe,vault,cash register, cash
box or cash drawer located in the premises;
resulting directly from an actual or attempted theft,robbery or safe
burglary, if you are the owner of the premises or are liable for damage to it.
4. Outside the Premises
We will pay for loss of,and loss from damage to,cash,securities and other property
outside thepremises while in the care and custody of a messenger or armored motor
vehicle company:
a. For cash and securities resulting from theft,disappearance or destruction;and
b. For other property resulting from actual or attempted robbery.
3.
5. Computer Fraud
We will pay for loss resulting directly from the use of any computer to impersonate you,
or your authorized officer or employee,to gain direct access to your computer system,or
to the computer system of your financial institution,and thereby fraudulently cause the
transfer of money,securitiesor other property from yourpremises or banking
premises to a person,entity,place or account outside of your control.
6. Money Orders and Counterfeit Paper Currency
We will pay for loss resulting directly from your having accepted in good faith and in the
regular course of business,in exchange for merchandise,money or services:
a. Money orders issued by any post office,express company or bank in the United States
or Canada that are not paid upon presentation;or
b. Counterfeit United States or Canadian paper currency.
C. DEFINITIONS 1, Banking premises means the interior of that portion of any building occupied by a
financial institution with which you have an account or which has Custody of your money
or securities.
2. Cash means United States or Canadian bills and coins in current use and having a face
value that are accepted by the United States or by the government of Canada as legal
tender for the payment of debts.
3. Counterfeit means an imitation of an actual valid original which is intended to deceive
and to be taken as the original.
4. Custodian means you,any of your partners or any employee while having care and
custody of property inside the premises,excluding any person while acting as a
watchperson or janitor.
5. Eniployeemeans:
a. Any natural person:
(1) While in your service or for 30 days after termination of service;and
(2) Whom you compensate directly by salary,wages or commissions;and
(3) Whom you have the right to direct and control while performing services for you.
b. Any natural person who is furnished temporarily to you to:
(1) Substitute for a permanent employee as defined in(a)above who is on leave;or
(2) Meet seasonal or short-term workload conditions;
while that person is subject to your direction and control and performing services for
you excluding,however,any such person while having care and custody of property
outside the premises.
c. Any natural person who is:
(1) A trustee,officer,employee,administrator or manager,except an administrator or
manager who is an independent contractor,of any employee benefit plan(s)
insured under this insurance;and
(2) Your director or trustee while that person is handling fundsor other propertyof
any employee benefit plans(s)insured under this insurance.
d. Employee does not mean any:
(1) Agent,broker,person leased to you by a labor leasing firm,(except when furnished
on a temporary basis under the circumstances set forth in Definition 5.b),factor,
commission merchant,consignee,independent contractor or representative of the
same general character;or
(2) Director or trustee except while performing acts within the scope of the usual
duties of an employee,
6. Employee benefit plan(s)means any welfare or pension benefit plan listed in the
Declarations that is subject to the Employee Retirement Income Security Act of 1974
(ERISA).
7, Forgery means the signing of the name of another person or organization with intent to
deceive;it does not mean a signature which consists in whole or in part of one's own name
signed with or without authority,in any capacity,for any purpose,
4.
8. Messenger means you,any of your partners or employees while having care and custody of
property outside'the premises.
9. Moneymeans
a. Cash;
b. Demand and savings deposits at financial institutions;and
c. Travelers checks,register checks and money orders held for sale to the public.
10. Occurrencemeans:
a. As respects Insuring Agreement I.,all loss or losses caused by,or involving,any one
employee,acting alone or in collusion with others.
b. As respects Insuring Agreement 2.,all loss or losses caused by any person or in which
that person is involved,whether the loss involves one or more instruments.
c. As respects all other Insuring Agreements,all loss or losses caused by:
(1) Any number of acts,involving one person whether acting alone or in collusion with
others;
(2) Any number of acts involving a group of persons acting together;or
(3) An act or event,or any number of related acts or events,not involving any
identifiable person.
11.Other property means any tangible property other than moneyand securities that has
intrinsic value but does not include any property excluded under this insurance.
12.Payment order means an instruction of a sender to a receiving bank,transmitted orally,
electronically,or in writing,to pay,or to cause another bank to pay,a fixed or
determinable amount of money to a another person.
13.Premises means the interior of that portion of any building you occupy in conducting
your business.
14.Robbery means the taking of property from the care and custody of a person by one who
has:
a. Caused or threatened to cause that person bodily harm;or
b. In the presence of that person,caused or threaten to cause bodily harm to someone
else.
15.Safe burglary means the taking of.,
a. Property from within a looked safe or vault by a person unlawfully entering the safe
or vault as evidenced by marks of forcible entry upon its exterior;or
b. A safe or vault on the premises by a person without your permission.
16.Securities means negotiable and nonnegotiable instruments or contracts representing
either money or property and includes:
a. Tokens,tickets,revenue and other stamps(whether represented by actual stamps or
unused value in a meter)in current use;and
b. Evidences of debt issued in connection with credit or charge cards,which cards are
not issued by you,
but does not include money.
17.Security procedure means a procedure established by agreement of the Insured and its
customer or financial institution for the purpose of(i)verifying that a payment orderis
that of the Insured,or(ii)detecting error in the transmission or the content of the
payment order or communication,A security procedure may require the use of
algorithms or other codes,identifying words or numbers,encryption,callback procedures,
or similar security devices,
18.Theft means any act of stealing,
19.Watchperson means any person you retain specifically to have care and custody of
property on the premises and who has no other duties.
D. EXCLUSIONS Applicable to All Insuring Agreements,Except as Indicated
We will not pay for loss as specified below:
L Acts Committed by You or Your Partners
Loss resulting from any dishonest act committed by you or any of your partners whether
acting alone or in collusion with other persons.
2. Acts of Employees,Directors,Trustees or Representatives
We will not pay for loss resulting from any dishonest act committed by any of your
employees,directors,trustees or authorized representatives;
a. Acting alone or in collusion with other persons;or
b. While performing services for you or otherwise;
except when covered under Insuring Agreement 1.
3. Fire
Loss from damage to the premises resulting from fire,however caused.
4. Governmental Action
Loss resulting from seizure or destruction of property by order of governmental authority.
5. Indirect Loss
Loss that is an indirect result of any act or occurrence covered by this Policy including
but not limited to,loss resulting from:
(a) Your inability to realize income that you would have realized had there been no loss,
(b) Payment of damages of any type for which you are legally liable unless you establish
that the act or acts that gave rise to the damages involved conduct which caused a
loss of money,securitiesor other property which was in your custody and control
and for which you were responsible prior to the loss;or
(c) Payment of costs,fees or other expenses you incur in establishing either the existence
or the amount of loss under this insurance.
6. Legal Expenses
Expenses related to any legal action,except when covered under Insuring Agreement 2.
7. Nuclear Chemical or Biological
Loss resulting from nuclear reaction,nuclear radiation or radioactive chemical or
biological contamination,or any related act or incident.
8. War and Similar Actions
Loss resulting from war,whether or not declared,warlike action,insurrection,rebellion
or revolution,or any related act or incident,
9. Confidential Information
Loss resulting from the theft,disappearance,destruction or disclosure of confidential
information including,but not limited to,trade secrets,personal information,customer
lists and intellectual property.For purposes of Insuring Agreement 5,confidential
information cannot itself be the other property transferred,but a loss otherwise covered
under Insuring Agreement 5 shall not be excluded by the fact that confidential information
was used to gain access to your computer system or to the computer system of your
financial institution in order to cause the fraudulent transfer.
10.Data Breach Costs
Expenses related to your obligations to comply with federal and state pr►vacy laws and
Payment Card Industry Data Security Standards(if applicable)arising from a data security
breach,including,but not limited to,expenses related to notifying affected individuals
when the affected individuals'personally identifiable financial or medical information was
stolen,accessed,downloaded or misappropriated white in your care,custody or control,
forensic audit expenses and fines and penalties.
Applicable to Specific Insuring Agreements
We will not pay for loss as specified below:
1. Under Insuring Agreement 1
Employee Canceled Under Prior Insurance
Loss caused by any employee of yours,or predecessor in interest of yours,for whom
similar prior insurance has been canceled and not reinstated since the last such
cancellation.
6.
2. Under Insuring Agreements I and 5
Inventory Shortages
Loss,or that part of any loss,the proof of which as to its existence or amount is dependent
upon:
a. An inventory computation;or
b. A profit and loss computation,
3. Under Insuring Agreements 3 and 4
a, Accounting or Arithmetical Errors or Omissions
Loss resulting from accounting or arithmetical errors or omissions.
b. Money Operated Devices
Loss of property contained in anymoney operated device unless the amount of money
deposited in it is recorded by a continuous recording instrument in the device.
c. Transfer or Surrender of Property
(1) Loss of property after it has been transferred or surrendered to a person or place
outside the premisesor banking premises-
(i) On the basis of unauthorized instructions;or
(ii) As a result of a threat to do:
(a) Bodily harm to any person;or
(b) Damage to any property.
(2) But,this exclusion does not apply under Insuring Agreement 4.to loss of money,
securitiesand other property while outside the premisesor banking premises
in the care and custody of a messenger if you:
(i) Had no knowledge of any threat at the time the conveyance began;or
(ii) Had knowledge of a threat at the time the conveyance began.but the loss was
not related to the threat.
d, Vandalism
Loss from damage to any safe,vault,or other property,or to the premises or its
exterior,by vandalism or malicious mischief.
4. Under Insuring Agreement 4
Motor Vehicles or Equipment and Accessories
Loss of motor vehicles,trailers or semi-trailers or equipment and accessories
attached to them.
5. Under Insuring Agreements 3 and 4
a. Exchanges or Purchases
Loss resulting from the giving or surrendering of property in any exchange or
purchase.
b. Voluntary Parting of Title to or Possession of Property
Loss resulting from your,or anyone acting on your express or implied authority,
being induced by any dishonest act to part voluntarily with title to or possession of
any property.
6. Under Insuring Agreement 5
a. Failure to Follow Security Procedures
(1) Loss resulting from your failure to follow security procedures agreed to in writing
with your customer or your financial institution:
(2) Loss that would have been avoided if you had accepted and followed
commercially reasonable security procedures that your financial institution
made available for your account or accounts involved in the loss;or
(3) Loss resulting from your failure to comply with security procedures that you
represented to us you would follow.
b. Debit and Credit Cards
Loss resulting from the use or purported use of credit,debit,charge,access,
convenience,or other cards.
7.
Applicable to All Insuring Agreements
E. CONDITIONS 1. Cancellation
a, The first named Insured shown in the Declarations may cancel this Policy by mailing
or delivering to us advance written notice of cancellation.
b. We may cancel this Policy by mailing or delivering to the first named Insured written
notice of cancellation at least:
(1) 10 days before the effective date of cancellation if we cancel for nonpayment of
premium;or
(2) 30 days before the effective date of cancellation if we cancel for any other reason.
c. We will mail or deliver our notice to the first named Insured's last mailing address
known to us,
d. 'Notice of cancellation will state the effective date of cancellation,The Policy Period
will end on that date.
e. If this Policy is canceled,we will send the first named Insured any premium refund
due,If we cancel,the refund will be pro rata. If the first named Insured cancels,the
refund may be less than pro rata.The cancellation will be effective even if we have
not made or offered a refund.
f. If notice is mailed,proof of mailing will be sufficient proof of notice.
2. Changes
This Policy contains all the agreements between you and us concerning the insurance
afforded.The first named Insured shown in the Declarations is authorized on behalf of all
insureds to agree with us on changes in,the terms of this Policy.If the terms are changed,
the changes will be shown in an endorsement issued by us and made part of this Policy,
3. Concealment,Misrepresentation or Fraud
This Policy is void in any case of fraud by you as it relates to this Policy at any time,It is
also void if any insured,at any time,intentionally conceals or misrepresents a material
fact concerning:
a. This insurance;
b. The covered property;
c. Your interest in the covered property;or
d. A claim under this insurance.
4. Consolidation and Merger
If through consolidation or merger with,or purchase or acquisition of assets or liabilities
of,some other entity any additional persons become employees or you acquire the use
and control of any additional premises:
a. You must give us written notice and obtain our written consent to extend this Policy
to such additional employeesor premises.We may condition our consent upon
payment of an additional premium;but
b. For the first 60 days after the effective date of such consolidation,merger or purchase
or acquisition of assets or liabilities,any insurance afforded for employeesor
premises also applies to these additional employeesor premises for acts committed
or events occurring within said 60 day period.
5. Deductible
a. We will not pay for loss in any one occurrence unless the amount of loss exceeds the
Deductible Amount shown in the Declarations.We then will pay the amount of loss
in excess of the Deductible Amount,up to the Limit of Insurance.In the event more
than one Deductible Amount could apply to the loss,only the highest Deductible
Amount will be applied.
b. For losses covered under Insuring Agreement 1.you must:
(1) Give us notice as soon as possible even though the loss falls entirely within the
Deductible Amount;and
(2) Upon our request,give us a statement describing the loss.
c. The deductible does not apply to loss sustained by any employee benefit plan(s).
6. Discovery of Loss
Discovery of loss occurs when you first become aware of facts which would cause a
reasonable person to assume that a loss covered by this Policy has been or will be
incurred,even though the exact amount or details of the loss may not then be known.
Discovery also occurs when you receive notice of an actual or potential claim against
you alleging facts that if true would constitute a covered loss under this insurance.
8.
7. Ditties in the Event of Loss
After you discover a loss or a situation that may result in a loss you must:
a. Notify us as soon as possible;
b. Submit to examination under oath at our request and give us a signed statement of
your answers;
c. Give us a detailed,sworn proof of toss within 120 days;and
d. Cooperate with us in the investigation and settlement of any claim,
8. Employee Benefit Plan(s)
a. If any employee benefit plan(s)is insured jointly with any other entity under this
insurance,you or the plan administrator must select a Limit of Insurance for Insuring
Agreement 1.that is sufficient to provide a limit of insurance for each plan that is
at least equal to that required if each plan were separately insured.
b, If the first named Insured is an entity other than a plan,any payment we make to that
Insured for loss sustained by any plan will be held by that Insured for the use and
benefit of the plan(s)sustaining the loss.
c. If two or more plans are insured under this insurance,any payment we make for loss:
(1) Sustained by two or more plans;or
(2) Of commingled fundsor other property of two or more plans;
that arises out of one occurrence,is to be shared by each plan sustaining loss in the
proportion that the limit of insurance required for each such plan bears to the total of
those limits.
9. Extended Period to Discover Loss
a. We will pay for loss that you sustained prior to the effective date of termination or
cancellation of this insurance,which is discovered by you:
(1) Within 60 days following the date of termination or cancellation;and
(2) As respects any employee benefit plan(s),within one year following the date of
termination or cancellation.
b. However,this extended period to discover loss terminates immediately upon the
effective date of any other insurance obtained by you replacing in whole or in part the
insurance afforded by this Policy whether or not such insurance provides coverage
for loss sustained prior to its effective date.
10.Joint Insured
a. The first named Insured shown in the Declarations is responsible for the payment of
all premiums and will be the payee for any return premiums we pay.
b. If more than one Insured is named in the Declarations,the first named Insured will
act for itself and for every other Insured for all purposes related to this insurance.If
the first named Insured ceases to be covered,then the next named Insured will
become the first named Insured.
c. If any Insured or partner or officer of that Insured has knowledge of any information
relevant to this insurance,that knowledge is considered knowledge of every Insured.
d. An employee of any Insured is considered to be an employee of every Insured.
e. If this Policy or any of its coverage is canceled or terminated as to any Insured,
Condition E.9.Extended Period to Discover Loss applies separately to that Insured.
f. We will not pay more for loss sustained by more than one Insured than the amount
we would pay if all the loss had been sustained by one Insured.
11. Legal Action Against Us
You may not bring any legal action against us involving loss:
a. Unless you have complied with all the terms of this Policy;and
b. Until 90 days after you have filed proof of loss with us;and
c. Unless brought within 2 years from the date you discover the loss.
12. Liberalization
If we adopt any revision that would broaden the coverage under this Policy without
additional premium within 45 days prior to or during the Policy Period,the broadened
coverage will immediately apply to this insurance.
13. Limit of Insurance
The most we will pay for loss in any oneoccurrence is the applicable Limit of
Insurance shown in the Declarations.
9.
14. Loss Covered Under More Than One Coverage
If two or more coverages of this Policy apply to the same loss,we will pay the lesser of:
a. The actual amount of loss;or
b. The highest single Limit of Insurance applicable to those coverages,
15. Non-Cumulation of Limit of Insurance
Regardless of the number of years this Policy remains in force or the number of
premiums paid,no Limit of Insurance cumulates from year to year or Policy Period to
Policy Period.
16. Other Insurance
a. This Policy does not apply to loss recoverable or recovered under other insurance or
indemnity.However,if the limit of the other insurance or indemnity is insufficient to
cover the entire amount of the loss,this Policy will apply to that part of the loss,
other than that falling within any Deductible Amount,not recoverable or recovered
under the other insurance or indemnity.However,this Policy will not apply to the
amount of loss that is more than the applicable Limit of Insurance shown in the
Declarations.
b. Under Insuring Agreement 4.,we will pay only for the amount of loss that you
cannot recover:
(1) Under your contract with the armored motor vehicle company,and
(2) From any insurance or indemnity carried by,or for the benefit of customers of,
the armored motor vehicle company.
17. Ownership of Property,Interests Covered
The property covered under this Policy is limited to property:
a. That you own or hold;or
b. That is owned and held by someone else under circumstances that made you
responsible for the property prior to,and independent of,the loss.
However,this Policy is for your benefit only.It provides no rights or benefits to any
other person or organization.
18. Records
You must keep records of all covered property so we can verify the amount of any loss.
19. Recoveries
a. Recoveries,whether effected by you or us,shall be applied,net of the expense of
such recovery,in the following manner and order:
(1) To the satisfaction of your loss which would otherwise have been paid under this
Policy but for the fact that it is in excess of the Limit of Insurance and the
Deductible Amount,if any;
(2) Then to us,until we are reimbursed for the settlement made;
(3) Then to you,until you are reimbursed for that part of the loss equal to the
Deductible Amount,if any;
(4) Then to you for any loss not covered by this Policy.
b. Recoveries do not include any recovery from insurance,suretyship,reinsurance,
security or indemnity taken for our benefit. If original securities are recovered after
duplicates of such securities have been issued,the original securities shall be
surrendered to us.
20. Territory
This Policy covers only acts committed or events occurring within the United States of
America,U.S.Virgin Islands,Puerto Rico or Canada. In addition,under Insuring
Agreement I.,we will pay for loss caused by any employee while temporarily outside of
said territories for a period of not more than 90 days.
21. Transfer of Your Rights and Duties Under This Policy
Your rights and duties under this Policy may not be transferred without our written
consent except in the case of death of an individual named insured,If you die,your
rights and duties will be transferred to your legal representative but only while acting
within the scope of duties as your legal representative.Until your legal representative
is appointed,anyone having proper temporary custody of your property will have your
rights and duties but only with respect to that property,
22. Transfer of Your Rights of Recovery Against Others to Us
You must transfer to us all your rights of recovery against any person or organization for
any loss you sustained and for which we have paid or settled.You also must do
everything necessary to secure those rights and do nothing after loss to impair our actual
or potential rights of recovery.
10.
23,Valuation—Settlement
a. Subject to the applicable Limit of Insurance provision we will pay for:
(1) Loss of money but only up to and including its face value.We may,at our option,
pay for loss of money issued by any country other than the United States of
America:
(i) At face value in the money issued by that country;or
(ii) In the United States of America dollar equivalent determined by the rate of
exchange on the day the loss was discovered.
(2) Loss of securities but onlyup to and including their value at the close of business
on the day the loss was discovered.We may,at our option:
(i) Pay the value of such securities,or replace them in kind,in which event you
must assign to us all your rights,title and interest in and to those securities;
or
(ii) Pay the cost of any Lost Securities Bond required in connection with issuing
duplicates of the securities.However,we will be liable only for the payment
of so much of the cost of the bond as would be charged for a bond having a
penalty not exceeding the lesser of the:
(a) Value of the securities at the close of business on the day the loss was
discovered;or
(b) Limit of Insurance.
(3) Loss of,or loss from damage to,other property or loss from damage to the
premises or its exterior for the replacement cost of the property without deduction for
depreciation.However,we will not pay more than the least of the following:
(i) The Limit of Insurance applicable to the lost or damaged property;
(ii) The cost to replace the lost or damaged property with property:
(a) Of comparable material and quality;and
(b) Used for the same purpose;or
(iii)The amount you actually spend that is necessary to repair or replace the lost or
damaged property.
(4) We will not pay on a replacement cost basis for any loss or damage:
(i) Until the lost or damaged property actually is repaired or replaced;and
(ii) Unless the repairs or replacement are made as soon as reasonably possible
after the loss or damage.
If the lost or damaged property is not repaired or replaced,we will pay on an
actual cash value basis.
b. We may,at our option,pay for loss of,or loss from damage to,property other than
money:
(1) In the money of the country in which the loss occurred;or
(2) In the United States of America dollar equivalent of the money of the country in
which the loss occurred determined by the rate of exchange on the day the loss
was discovered,
c, Any property that we pay for or replace becomes our property.
Applicable to Specific Insuring Agreements
1. Insuring Agreement I
Cancellation as to Any Employee
Coverage under this Policy is canceled as to anyemployee:
a. Immediately upon discovery by:
(1) You;or
(2) Any of your partners,officers or directors not in collusion with the employee; or
(3) As to Employee benefit plan(s),any trustee,fiduciary or plan administrator not in
collusion with the employee;
of any dishonest act committed.by that employee whether before or after becoming
employed by you.Whether such discovery occurs prior to or after commencement of
this Policy,there is no coverage-tinder Insuring Agreement 1,for loss or losses resulting
from acts committed by that employee after the date of such discovery.
b. On the date specified in a notice mailed to you.That date will be at least 30 days after
the date of mailing.The mailing of notice to you at the last mailing address known to
us will be sufficient proof of notice,Delivery of notice is the same as mailing.
2. Insuring Agreement 2
a. Deductible
The deductible does not apply to legal expenses paid under Insuring Agreement 2,
b. Facsimile Signatures
We will treat reproduction of a handwritten signature the same as a handwritten
signature,An electronic or digital signature is not treated as a reproduction.of a
handwritten signature.
c. Proof of Loss
You must include with your proof of loss any instrument involved in that loss,or,if
that is not possible,an affidavit setting forth the amount and an explanation of the
absence of the instrument.
d. Territory
We will cover loss you sustain anywhere in the world.The Territory Condition 20 does
not apply to Insuring Agreement 2.
3. Insuring Agreements 3 and 4
a. Special Limit of Insurance for Specified Property
We only will pay up to$5,000 for any one occurrence of loss of,and loss from damage
to:
(1) Precious metals,precious or semi-precious stones,pearls,furs,or completed or
partially completed articles made of or containing such materials that constitute the
principal value of such articles;or
(2) Manuscripts,drawings,or records of any kind or the cost of reconstructing them
or reproducing any information contained in them.
b. Duties in the Event of Loss
If you have reason to believe that any loss of,or loss from damage to,money,securities
or other property involves a violation of law,you must notify the police.
4. Insuring Agreement 5
a. Special Limit of Insurance for Specified Property
We only will pay up to$5,000 for any one occurrence of loss of,and loss from damage
r to,manuscripts,drawings or records of any kind or the cost of reconstructing them or
reproducing any information contained in them.
b, Duties in the Event of Loss
If you have reason to believe that any loss of, or loss from damage to, money,securities
or other property involves a violation of law,you must notify the police,
c. Territory
We will cover loss you sustain anywhere in the world. The Territory Condition 20
does not apply to Insuring Agreement 5.
5. Insuring Agreement 6
a. Duties in the Event of Loss
You must notify the police if you have reason to believe you have accepted a
counterfeit money order or counterfeit paper currency.
IN WITNESS WEREOF,we have caused this Policy to be executed on the Declarations page.
Secretary President
12.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
OCCURRENCE ENDORSEMENT
This Endorsement modifies Crime Protection Policy No. 609202178
L Paragraph 10. Occurrence of the Definitions of this Policy is deleted and replaced by the following:
10. Occurrence means:
a. As respects Insuring Agreement L, all loss or losses caused by or involving any employee,
acting alone or in collusion with other persons, or any group of employees acting together,
even if in collusion with other persons,whether the result of a single act or multiple acts
and whether or not sustained only during the period of this Policy. All acts by one employee,
acting alone or in collusion with other persons, or by any group of employees acting together,
and whenever performed, can give rise to only one occurrence.
b.As respects Insuring Agreement 2., all loss or losses caused, or contributed to,by any one
person, acting alone or in collusion with others, or in which any such person is implicated,
whether the loss or losses involves one or more instruments,
c.As respects all other Insuring Agreements, all loss or losses caused by(1) a single act,or
series of related acts, (2) any act or acts involving one person, or a group of persons acting
together, or(3) an act or event, or a series of related acts or events, not involving any
identifiable person.
SE 0145 02 06 Copyright, The Surety Association of America,2005 Page 1 of 1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ [[ CAREFULLY.
CALIFORNIA ESCROW AGENT
This Endorsement modifies Crime Protection Policy No. 809202178 �
1. The definition of Employee |o amended bm also include any;
a. officer, director or employee of yours who is not compensated when performing acts coming within
the scope of the usual duties ofan officer or employee of yours; or
b. member of any of your committees duly elected or appointed to examine or auditor have custody
of your property.
The ownership of all or o pnd|un of the shares of the named Insured by an employee ahoU not be o �
defense to any suit, action or other legal proceeding against us. �
2. Exclusion 1. Acts Committed by You or Your Partners of the Exclusions Applicable to AH Insuring
Agreements is deleted if you are licensed as an escrow agent by the Commissioner of Corporations �
uf the State ofCalifornia. �
3. An additional Condition io added aafollows:
Notice of Cancellation: No manmd|ot|un of the Policy or any Insuring AQnaemerd, whether at your �
request or our request, shall bake effect prior to the expiration of3O days after written notice of such �
cancellation has been filed with the Commissioner ofCorporations. |
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8EU117O412 Copyright,The Surety Association of America, 1999 Page 1of1 �
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ [TCAREFULLY.
CALIFORNIA CHANGES - CANCELLATION
AND NONRENEWA[
This endorsement modifies Crime Protection Policy No.
6092()2178
For purposes of all Insuring Agreements except Insuring Agreements 1., 2. and 7.
1. Condition 1I.Cancellation of the Conditions Applicable to All Insuring Agreements is deleted and replaced
by the following:
a. The first named Insured shown in the Declarations may cancel this Policy by making or delivering tous
advance written notice o[cancellation.
b. All Policies in Effect For 80 Days orLess
If this Policy has been in effect for 60 days or less, and is not a renewal of a policy we have previously
issued, we may oonoe| this policy by mailing or delivering to the first named Insured at the mailing
address shown in the policy and to the producer cfrecord, advance written notice of cancellation,
stating the reason for cancellation, atleast:
(1) 1U days before the effective date of cancellation ifwo cancel for:
(a) Nonpayment of premium; or
(b) Discovery of fraud by:
(i) Any insured or his or her representative in obtaining this insurance; or
(h)You or your representative in pursuing o claim under this policy.
(2) 30 days before the effective date of cancellation if we cancel for any other reason.
o. All Policies |n Effect For More Than 0ODays
If this policy has been in effect for more than 60 daya, or is a nenovvo| of o policy we issued, we may
cancel this policy only upon the occurrence, after the effective date of the policy, of one or more of the
following:
(1) Nonpayment of premium, including payment due on a prior policy we issued and duo during the
current policy term covering the same risks.
(2) Discovery of fraud or material misrepresentation by:
(a) Any insured or his ur her representative in obtaining this insurance;or
(b) You or your representative in pursuing a claim under this po{icy� !
(3) A judgment by a court or an administrative tribunal that you have violated a California or Federal
|ew, having as one of its necessary elements an act which materially increases any ofthe risks !
insured against. �
(4) Discovery of willful or grossly negligent acts or omissions, or of any violations of state laws or !
regulations establishing safety standards, by you or your representative, which materially
increase any nf the risks insured against.
(5) Failure by you or your representative to implement reasonable|oae control requirements, agreed
to by you as a condition of policy isouanco, or which were conditions precedent to our use of o
particular rate orrating p|on, if that failure materially increases any ofthe risks insured against.
(0) A determination by the Commissioner of Insurance that the:
(a) Loss of, or changes in, our reinsurance covering all or part of the risk would threaten our
financial integrity or solvency; or
(b) Continuation of the policy coverage would:
(i) Place us in violation of California law or the laws of the state where we are domiciled; or
(i|) Threaten our solvency.
(7) A change by you or your representative in the activities or property of the commercial or
industrial enterprise, which results In a material added risk, or a materially increasedorchenged
risk, unless the added, increased or changed risk im included|n the policy.
We will mail mdeliver advance written notice of cancellation, stating the reason for cancellation, to the
first named Insured, at the mailing address shown in the policy, and to the producer of record, at least10
days before the effective date of cancellation, if we canonl for nonpayment of premium or discovery of
fraud, or 30 days before the effective date of cancellation if we cancel for any other reason listed in
pamgraphn. �
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2 The following is added and supersedes any provisions hz the contrary:
NONRENEVVAL |
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a. Subject to the provisions of Paragraph 2.b. behw, if we elect
(1) not to renew this policy, or
(2) to condition renewal upon reductions of limits, elimination of coverages, increase in deductibles, �
or increase of more than 25% in the rate upon which the premium |ebased, �
we will mail or deliver written notice, stating the reason for nonnanmwm|, to the first named Insured at
the mailing address shown in the policy, and to the producer of record, at least 60 days, but not more �
than 120 days, before the expiration or anniversary date,We will mail or deliver our notice to the first �
named Insured, and to the producer of record, at the mailing address shown in the policy,
b' We are not required to send notice of nonrenewal in the following situations:
(1) If the transfer or renewal of e policy, without any changes in tarmu, oondidons, or nstem. is
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between us and e member of our insurance group. �
(2) If the po|lcy has been extended for 90 days or less, provided that notice has been given in i
accordance with Paragraph 2.a.
(3) If you have obtained replacement ooveroge, or if the first named Insured has agmed, in writing, |
within 8D days of the termination of the policy,ho obtain that coverage. �
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(4) If this policy is for e period of no more than SO days and you are notified at the time of issuance
that|t will not berenewed. �
(5) If the first named insured requests o change in the terms or conditions or risks covered by the
policy within 8O days of the end nf the policy period,
(G) If we have made a written offer to the first named |nmurad, in accordance with the time hemoa
shown in Paragraph 2.a., to renew the policy under changed terms or conditions or at a changed
premium rate. As used in this paragraph, "terms orconditions" ino|udea, but im not limited to, a
reduction in limits,elimination of coverages, oran increase indeductibles.
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Page 2of2 Copyright,The Surety Association nf America,eoo4 GEO13311O4 |
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GENERAL FUND HUMAN SERVICE GRANTS PROGRAM
CITY/NON-PROFIT CONTRACT
(Services Only)
This General Fund Human Services Grants Program City/Non-Profit Contract (the
"Contract") is entered into between the CITY OF CUPERTINO, a political subdivision of the
State of California (hereinafter"CITY"), and WEST VALLEY COMMUNITY SERVICES
OF SANTA CLARA COUNTY INC., a non-profit public benefit corporation (the
"CORPORATION"). The allocation of funds pursuant to this Contract will be a grant. CITY
approved the allocation and disbursement of General Fund Human Service Grants ("HSG")
funds to CORPORATION on July 1,2018.
WITNESSETH
WHEREAS, CITY has reserved a portion of its HSG funds to be used on activities that
benefit Cupertino's residents; and,
WHEREAS, CITY has agreed to the use by CORPORATION of a portion of CITY'S
HSG budget for the Program (as described below) to be operated within CITY for the benefit of
low and very low-income households;
NOW, THEREFORE, the parties agree as follows:
I® Program
CITY agrees to allocate a portion of its current HSG funds to CORPORATION, in the
sum of Forty Thousand Dollars and No. Cents ($40,000) (the "Grant") for the purpose of
implementing the CORPORATION'S program, as more particularly described in Exhibits A-E to
the Contract (the "Prograrn"), and said Exhibits set forth below, as they may be amended or
modified, are attached to this Contract and incorporated herein by reference.
Exhibit A: Program Description
Exhibit 13: Program Work Plan
Exhibit C: Proposed Implementation Timeline Schedule
Exhibit D: Program Budget
Exhibit E: Basic Insurance and Bond Requirements For Non-Profit Contracts
11. TERM
A. The purpose of this Contract is for the CITY to disburse the Grant for eligible
activities,
B. The term ofthis Contract (the "Term") will begin on July 1, 2018 and will end on
June 30, 2019, unless otherwise amended or terminated earlier pursuant to Section V11 or
Section VIII of this Contract.
111. SECOND YEAR RENEWAL OPTIONS
The term of this Contract may be extended by an amendment to this Contract authorized by City
Council for the fiscal year Subsequent to the initial terra ofthis Contract, contingent on the
following requirements and process:
A. Authorization by CITY to expend funds for the put-poses of this Contract-,
B. CITY'S appropriation of I ISG funds for this Program;
C. CMPORATION'S satisfactory performance, as determined in the CITY's sole
discretion, of all its obligations as stated in this Contract;
D. Submission to CITY of current proof of insurance satisfying the reClUirements set
forth in Exhibit E.
IV. OBLIGATIONS OF CORPORATION
A. Organization of CORPORATION, CC M)OIZATION shall:
I. Provide CITY with copies of the following docurnents, evidencing filing
with the appropriate governmental agency:
a) Its Articles of Incorporation under the laws of the State of California;
b) A copy of the current Bylaws of CORPORATION;
C) Documentation of its Internal Revenue Service non-profit status;
d) Names and addresses of the Current Board of Directors of
CORPORATION; and,
e) An adopted copy of CORPORATION'S personnel policies and
procedures.
1 During the Contract Term, immediately report any changes, Subsequent to
the date of this Contract, in CORPORATION'S Articles of Incorporation, Bylaws, Board of
Directors, personnel policies and procedures, or tax exempt status to CITY.
1 Maintain no member of its Board of Directors as a paid en'lployee, agent,
independent contractor, or subcontractor under this Contract.
2
4� Open to the public meetings of"its Board of"Directors, if reClUired by
C,alif'ornia's open ineeting laws, except meetings, or portions thereof, dealing with personnel or
litigation matters or as otherwise provided by law.
5. Keel) minutes of all its regular and special meetings.
Cr. Comply with all provisions of California and Federal Non-Profit
Corporation Laws.
T Provide to the CITY a copy of a resolution authorizing the
CORPORATION's execution of this Contract. The CORPORATION hereby warrants to the
CITY that this Conti-act is a legal, valid, and binding obligation of the CORPORATION
enforceable in accordance with its terms, and that the execution and delivery of this Contract and
the performance of the CORPORATION's obligations have been duly authorized by the
CORPORATION.
B. Pro rain Performance by
CORPORATION shall:
I. Conduct the Program within the City of Cupertino, for the purpose of
benefiting low and very low-income households.
2. File quarterly reports on the type and number of services rendered
through the operation of the Program, and a description ofthe beneficiaries of these services, and
which reports will evaluate the manner in which the Program is achieving its objectives and
goals according to the standards established by CITY. The progress reports will be due ten (10)
days after the close of each reporting period and must cover the three (3) months immediately
preceding the date on which the report is f filed.
1 Coordinate its services with other existing organizations providing similar
services in order to foster community cooperation and to avoid unnecessary duplication of
services.
4. Seek out and apply for other sources of revenue in support of its operation
or services from local, state, federal and private Sources and, in the event of receipt of such
award, inform CITY within ten (10) days.
5 Include an acknowledgement of CITY Funding and support on
CORPORATION stationery and on all appropriate program-related publicity and publications
using words to the effect: "funded in whole or in part by the City of"Cupertino General Funds.
C. LFLiscall Responsibilities of CORPORATION. CORPORATION shall:
I. Appoint and Submit the name of a fiscal agent who will be responsible for
the financial and accounting activities of CORPORATION, including the receipt and
disbursement of CORPORATION funds. The CITY must immediately be notified in writing of
the appointment of any new fiscal agent and that agent's name.
3
1 If the Term of this Contract is extended by an arnendment for a second
fiscal year, Submit a satisfactory audit within one hundred fifty (150) days of CORPORATION's
fiscal year encompassed by the first year ofth is Conti-act,
3. Document all Program costs by maintaining records in accordance with
Section IV, Paragraph D below,
4. Submit to the CITY, based on an agreed upon schedule, a request for
payrrient, together with all Supporting documentation. Invoices requesting disbursements
submitted after the expiration of the Contract will be honored only for eligible charges incurred
during the Contract Term. All invoices must be Submitted by the Contract expiration date or
within Such other time period specified by the CITY for this Contract Term. Funds not disbursed
will be returned to the City for future reallocation.
5 Certify current and continuous insurance coverage, subject to CITY
approval and in accordance with requirements as Outlined in Exhibit E and provide a current
insurance certificate evidencing such coverage.
6. Deliver to the CITY a copy of the resolution authorizing
CORPORATION's execution of this Contract.
T Items 4 through 6 above are express conditions precedent to disbursement
o-fany CITY Funding and failure to comply with these conditions will, at discretion of CITY,
result in suspension of funding or termination of this Contract.
8. If CORPORATION does not use the Grant funds in accordance with the
requirements of this Contract, CORPORATION is liable for repayment of all disallowed costs,
Disallowed costs may be identified through audits, monitoring or other sources.
CORPORATION is required to respond to any adverse findings, which may lead to disallowed
costs subject to provisions of OMB Circular A-122, "Cost Principles for Non-Prol'it
Organizations."
D. Establishment and Maintenance of Records, CORPORATION shall:
I. Maintain complete and accurate records of all its transactions including,
but not limited to, contracts, invoices, time cards, cash receipts, vouchers, canceled checks, bank
statements, client statistical records, personnel, property and all other pertinent records sufficient
to reflect properly (a) all direct and indirect costs of whatever nature claimed to have been
incurred or anticipated to be incurred to perform this Contract or to operate the Program, and (b)
all other matters covered by this Contract.
2. Maintain client data demonstrating client eligibility for services provided
in connection with the Prograrn. Such data will include, but not be limited to, client name,
address, incorrie level or other basis for determining eligibility, and description of service
provided. Such information will be made available to CITY monitors for review upon request.
4
E Preservation of Records. CORPORATION will preserve and make available its
records:
I Until five (5) years f'ollowing date of final payment under this Contract, or
2. For such longer period, if any, as is required by applicable law; or
3, If this Contract is completely or partially terminated, the records relating
to the work terminated will be preserved and made available for a period of five (5) years from
the date of termination.
F. Examination ol"Records and Facilities. At any time during normal business
hours, and as often as may be deemed necessary, CORPORATION agrees that the CITY, and/or
any duly authorized representatives may until expiration of the later of- (a) five (5) years after
final payment under this Contract, (b) five (5) years from the date of termination of this Contract,
or (c) such longer period as may be described by applicable law, have access to and the right to
examine its plants, offices and facilities used in the performance of this Contract or the operation
of the Program, and all its records with respect to the Prograrn and all matters covered by this
Contract. CORPORATION also agrees that CITY or any duly authorized representatives will
have the right to audit, examine, and make excerpts or transactions of and from, Such records and
to make audits of Al contracts and subcontracts, invoices, payrolls, records of personnel,
conditions ofeiripioyrnent, rnaterials and all other data relating to the Program and matters
covered by this Contract, CORPORATION will be notified in advance that all audit will be
conducted, CORPORATION will be required to respond to any audit findings, and have the
responses included in the final audit report. 'Fhe cost of any such audit will be borne by CITY.
G. Qom pIjA v�✓Lth Law. CORPORATION will become familiar and comply with
and cause all its subcontractors, independent contractors, and employees, if any, to become
familiar and comply with all applicable federal, state and local laws, ordinances, codes,
regulations and decrees.
K Susvension and "I'ermination, If CORPORATION materially fails to comply with
any term of this Contract, CITY may suspend or terminate the Contract in whole or in part, In no
event shall any payment by CITY hereunder constitute a waiver by CITY of any breach of this
Contract or any default, which may then exist on the part of CORPORATION, nor shall such
payment impair or prejudice any remedy available to CITY with respect to the breach or default.
CITY expressly reserves the right to demand of CORPORATION the repayment to the CITY of
any funds disbursed to CORPORATION under this Contract, which were not expended in
accordance with the terms of this Contract, and CORPORATION agrees to promptly refund any
Such funds upon dernand.
Notwithstanding the above, CORPORATION shall not be relieved of liability to CITY for
damages sustained by CITY or others by virtue of any breach of the Contract by
CORPORATION, and CITY may withhold any payrnents to the CORPORATION for the
purpose of set off until such time as the exact amount of damages due CITY from
CORPORATION is determined.
5
I. Reversion of Assets, Upon expiration or termination of this Contract, the
CORPORATION will transfer to the CITY any Grant funds on hand at the tune of expiration and
any accounts receivable attributable to the use of such funds.
J. Conflict of Interest. In accordance with Government Code Section 1090 and the
Political Reform Act, Government Code Section 87100 g"se ., except for approved eligible
administrative or personnel costs, no person who is an employee, agent, consultant, officer, or
any immediate farnily member of such person, or any elected or appointed official of the CITY
who exercises or has exercised any functions or responsibilities with respect to the activities
funded by this Contract or who is in a position to participate in a decision-making process may
obtain a personal or financial interest or benefit from the activity, or have all interest in any
contract, subcontract, or agreement with respect thereto, or the proceeds thereunder, during, or at
arry time after, SLIC11 person's tenure. CORPORATION shall exercise due diligence to ensure that
the prohibition in this Section is followed.
Further, no person who is a director, officer, partner, trustee or employee or
Consultant of CORPORATION, or immediate family member of any of the preceding,, shall
snake or participate in a decision, made by the CITY or a CITY board, commission or
committee, if it is reasonably foreseeable that the decision will have a material effect on any
source of income, investment or interest in real property of that person or CORPORATION,
Interpretation of this section shall be governed by the definitions and provisions
used in the Political Reform Act, Government Code Section 87100 et,seq., its implementing
regulations manual and codes, and Government Code Section 1090.
V. OBLIGATIONS OF CITY
A. Methodgf_Pay ngit. During the Term of this Contract, CITY shall disburse the
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FISG Grant funds to CORPORATION on a reimbursement basis unless otherwise provided
herein for all allowable costs and expenses incurred in connection with the Program, riot to
exceed the total sum set forth in Article 1. CITY may, at any time in its absolute discretion, elect
to Suspend or terminate payment to CORPORATION, in whole or in part, pursuant to this
Contract based on CORPORATION'S non-compliance, including, but not limited to, incomplete
docurnentation of expenses, failure to substantially rneet goals and objectives as required in
Exhibit B ("Program Work Plan"), failure to Submit adequate progress reports as required herein
or other incidents of noncompliance as described in Section VII, Paragraph B of this Contract or
based on the refusal by CORPORATION to accept any additional conditions that may be
imposed by City at any time to ensure compliance with the terms of this Contract.
V1. PROGRAM COORDINATION
A. CITY. The CITY has designated the Senior 1-lousing Planner for CITY who will
render overall Supervision of the progress and performance of this Contract by CITY.
B. CORPORATION, As of the date hereof",
C ORPORA11ON has designated Josh
Selo to serve as EXECUTIVE DIRECTOR and to assume overall responsibility for the progress
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and execution of this Contract. The CITY will be immediately notified in writing of the
appointment of a new EXECUTIVE DIRECTOR.
C. NOTICES. All notices or other co rrespon(fence required or contemplated by this
Contract shall be sent to the parties at the following addresses:
C ITY: Attention: Senior Housing Planner
Community Development Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014
CORPORATION: West Valley Community Services
10104 Vista Drive
Cupertino, CA 95014
All notices will either be hand delivered or sent by United States mail, registered or certified,
postage prepaid, Notices given in such a manner will be deemed received when hand delivered
or seventy-two (72) hours after deposit in the United States mail. Any party may change his or
her address for the purpose of this section by giving five days written notice Of SUCh change to
the other party in the manner provided in this section.
VIL CONTRACT COMPLIANCE
A. M'onitorin T nand of Set-vices. Evaluation and monitoring of the
Program performance is the mutual responsibility of both CITY and CORPORATION,
CORPORATION must furnish all data, statements, records, information and reports necessary
for DIRECTOR to monitor, review and evaluate the performance of the Program and its
components. CITY will have the right to request the services of an outside agent to assist in any
such evaluation. Such services shall be paid for by CITY
13. Contract Noncompliance. If CORPORATION fails to comply with any provision
of this Contract; CITY will have the right to require corrective action to enforce compliance with
such provision as well as the right to suspend or terminate this Conti-act. Examples of
noncompliance include, but are not limited to:
1. If CORPORATION (with or without knowledge) has made any material
misrepresentation of any nature with respect to any information or data furnished to CITY in
connection with the Program,
2. If there is pending litigation with respect to the performance by
(-,',ORPORATION if any of its duties or obligations under this Contract, which may materially
Jeopardize or adversely affect the undertaking of or the carrying out of the Prograrn,
1 If CORPORATION has taken any action pertaining to the Prograrn, which
action required CITY approval, and Such approval was not obtained.
4. If CORPORATION is in default Under any provision of this Contract.
5. If CORPORATION makes illegal use of CITY funds.
6. If CORPORATION submits to CITY any report which is incorrect or
incomplete in any material respect.
7. If CORPORATION fails to meet the stated objectives in the Program
Work Plan attached as Exhibit B.
C. Corrective Action Procedure. CITY, in its absolute discretion and in lien Of
immediately terminating this Contract upon occurrence or discovery of noncompliance by
CORPORATION pursuant to this Contract, will have the right to give CORPORATION notice
of CITY'S intention to consider corrective action to enforce compliance. Such notice must
indicate the nature of the non-compliance and the procedure whereby CORPORATION will
have the opportunity to participate in formulating any corrective action recommendation, CITY
will have the right to require the presence of CORPORATION'S officer(s) and EXECuTIVE
DIRECTOR at any hearing or meeting called for the purpose of considering corrective action,
fit the event that CORPORATION does not implement the corrective action
recommendations in accordance with the corrective action timetable, CITY may Suspend
payments hereunder or terminate this Contract as set forth in Section VI 11 below.
V111. TERMINATION
A. Termination for Cause. CITY may terminate this Contract by providing written
notice to CORPORATION, for any of the following reasons: uncorrected Contract non-
compliance as defined in Section VII, Paragraph B; CORPORATION is insolvent or in
bankruptcy or receivership; a member of the CORPORATION'S Board of Directors or the
executive director is found to have committed fraud or; there is reliable evidence that
CORPORATION is unable to complete the Program as described in the attached I.-Ahibits. The
date of termination will be as specified in the notice.
B. Termination for Convenience. In addition to the CITY'S right to terminate for
cause set forth in Section VII, either CFFY or CORPORATION may suspend or terminate this
Contract for any reason by giving thirty (30) days prior written notice to the other party. Upon
receipt of such notice, performance of the set-vices hereunder will be immediately discontinued.
C. In the event that this Conti-act is terminated, CORPORATON may be required to
return funds to the CITY.
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D. I.Jpon termination of this Contract, CORPORATION must irriniediately provide
CITY access to all documents, records, payroll, minutes of meetings, correspondence and all
other data pertaining to Grant made to CORPORATION pursuant to this Contract.
IX. PROGRAM INCOME
Incorne generated by the Program, is considered Program Income. CORPORATION will
annually report all program income generated by activities carried out with Grant funds made
available under this Contract. By way of further limitations, CORPORATION may use such
income during the Contract period for activities permitted under this Contract and shall reduce
requests for additional funds by the amount of any such program income balance on hand. All
unused program income shall be returned to the CITY at the end of the Contract period,
X. INDEPENDENT CONTRACTOR
This is a Contract by and between independent contractors and is not intended and will not be
construed to create the relationship of agent, servant, employee, partnership,joint venture or
association between CORPORATION and CITY. CORPORATION, including its officers,
employees, agents or independent contractors or subcontractors, shall not have any claim Linder
this Contract or otherwise against CITY for any Social Security, Worker's Compensation, or
erriployee benefits extended to employees of CITY.
X1. ASSIGNABILay
CITY is entering into this Contract based on the experience, skill, and ability to perform of the
CORPORATION. The CORPORATION recognizes that its qualifications and identify are of
particular concern to the CITY in view of the CITY's interest in providing services to lower
income persons and the CITY's reliance on the unique qualifications of the CORPORATION,
Consequently, this Contract may not be assigned to another CORPORATION, person,
partnership or any other entity without the prior written approval of CITY. None of the work or
services to be performed hereunder may be assigned, delegated or Subcontracted to third parties
without the prior written approval of CITY, which the CITY may withhold in its sole discretion.
Copies of all third party contracts shall be submitted to CITY at least ten (10) days prior to the
proposed effective date. In the event CITY approves of any such assignment, delegation or
Subcontract, CORPORATION shall remain fully liable for all obligations and requirements
under this Contract including the performance and any liabilities attaching to the assignees'
actions or emissions,
X11. DISCLOSURE OF CONFIDENTIAL CLIENT INII;'ORMATION
CITY and CORPORATION agree to maintain the confidentiality of any information regarding
applicants for services offered by the Program pursuant to this Conti-act or their immediate
farnifies which may be obtained through application fbrrns, interviews, tests, reports fiom public
agencies or counselors, or any other Source. Without the written permission ofthe applicant,
such information will be diVLdged only as necessary for purposes related to the performance or
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evaluation of the services and work to be provided pursuant to this ontract, and then only to
persons having responsibilities under this Contract, including those furnishing services under the
Program through approved subcontracts,
X111. HOLD HARMLESS
In addition to the indemnity obligations set forth in Exhibit E, "Basic Insurance and Bond
Requirements for Non-Profit Contracts", CORPORATION will indemnify and hold harmless the
CITY, its employees, agents, and officials, members of boards and comn�iissions, frorn any and
all claims, actions, suits, charges and judgments whatsoever, with respect to any darnages,
including attorney's fees and court costs, arising Out of the failure of the CORPORATION's
Program to comply with applicable laws, ordinances, codes, regulations and decrees.
XIV. WAIVER OF RIGHTS AND REMEDIES
In no event will any payment by CITY constitute or be construed to be a waiver by CITY of any
breach of the covenants or conditions of this Contract or any default which may then exist on the
part of CORPORATION, and the making of any such payment while any such breach or default
will in no way impair or prejudice any right or remedy available to CITY with respect to such
breach or default. In no event will payment to CORPORATION by CITY in any way C01IStitUte
a waiver by CFFY of its rights to recover from CORPORATION the amount ofmoney paid to
CORPORATK)"N on any itein, which is riot eligible for payrnent under the Prograrn or this
Contract.
XV. NON-DISCRIMINATION
CORPORATION will comply with all applicable Federal, State and local laws and regulations
including the City of Cupertino's policies concerning nondiscrimination and equal opportunity in
contracting. Such laws include but are not limited to the following: Title VII of the Civil Rights
Act of 1964 as amended; Americans with Disabilities Act of 1990; The Rehabilitation Act of
1973 (Sections 503 and 504); California Fair Employment and Housing Act (Government Code
sections 12900 et seq.); and California 1-.,abor Code sections 1101 and 1102. CORPORATION
will not discriminate against any Subcontractor, employee, or applicant for employment because
of age, race, color, national origin, ancestry, religion, sex/gender, sexual orientation, mental
disability, physical disability, medical condition, political beliefs, organizational affiliations, or
marital status in the recruitment, selection for training including apprenticeship,.hiring,
employment, utilization, promotion, layoff, rates of pay or other forms of compensation. Nor
shall CORPORATION discriminate in provision of services provided in this Contract because of
age, race, color, national origin, ancestry, religion, sex/gender, seXUal orientation, mental
disability, physical disability, medical condition, political beliefs, organizational affiliations, or
marital status.
This non-discrirnination provision must be included in CORPORATION's contracts with sub-
contractors and vendors when utilizing the Grant funds disbursed for this program.
XV1. AMENDMEN,rs
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Other than the amendment related to a second year renewal option as stated in Section 111. above,
amendments to the terms or conditions of this Contract Must be requested in writing by a duly
authorized representative of the party desiring such amendments, and any such amendment shall
be effective Only upon the mutual agreement in writing of the parties hereto. Amendments will
not invalidate this Contract, nor relieve or release the CITY or the CORPORATION from its
obligations under this Contract.
XVIL INTEGRATED DOCUMENT
']"his Contract contains the entire agreement between CITY and CORPORATION with respect to
the subJect matter hereof. No written or oral agreements with any officer, agent or employee of
CITY prior to execution of this Contract shall affect or modify any of the terms of obligations
contained in any documents comprising this Contract.
XV111. MISCELLANEOUS
A. KLqption. The captions and section headings used in this Conti-act, are for
convenience ot'reference only, and the words contained herein will, in no way, be field to
explain, triodify, amplify or aid in the interpretation, construction or meaning of the provisions of
this Contract.
B. Discretion Retained By_LL I FY. CITY's execution of this Contract in no way limits
the discretion of'the CITY in the permit and approval process in connection with the Program,
C. Exhibits. All Exhibits attached hereto and referred to in this Contract are
incorporated herein by this reference as if set forth fully herein. Exhibits are as follows: Exhibit
A(Program Description), L,,xLiibjt B (Program Work Plan), Exhibit C (Proposed Implementation
Time Schedule), ExhibiLD (Program Budget),E2ihibitj-_`, (Basic Insurance and Bond
Requirements for Non-Profit Contracts).
D. Interpretation. Each party to this Contract has had an opportunity to review the
Contract, confer with legal counsel regarding the meaning of the Contract, and negotiate
revisions to the Contract. This Contract shall not be construed as if it had been prepared by one
of the parties, but rather as if both parties had prepared it, The parties have read and reviewed
this Contract and agree that any rule of construction to the effect that ambiguities are to be
resolved against the drafting party (including but not limited to Civil Code Section 1654 as may
be amended from time to time, or any other state law, or cornmon law principle) shall not apply
to the interpretation of this Contract.
E. Third-Part.y_ Bmefl,cLqr_Y,, There shall be no third party beneficiaries to this
Contract.
E Choice of 1,aw and Venue. 'T"his Conti-act shall be governed by and construed in
accordance with California law. Venue shall be Santa Clara County.
II
G. 'Par'ties Bound, Except as otherwise limited herein, the provisions of this Contract
shall be binding upon and inure to the benefit of the parties and then-heirs, executors,
administrators, legal representatives, successors, and assigns.
Ft. Attorneys orn F`ees, If any lawsuit is commenced to enforce any ofthe terms of this
J---
Contract, the prevailing party will have the right to recover its reasonable attorneys' fees and
costs of suit from the other party.
I. SeverabLlity. If any Term of this Contract is held by a Court of competent
jurisdiction to be invalid, void Or unenforceable, the remainder of the provisions shall continue in
full force and effect unless the rights and obligations of the parties have been materially altered
or abridged by such invalidation, voiding or Unenforceability.
.J, Authorization. The persons signing below are duly authorized to execute this
Contract.
K. MulfipLe CLrig:qjLi ty,(Lo Ltplpt. This Agreement
e� Ai: -it may be executed in multiple
_
originals, each of which is deemed to be an original, and may be signed in counterparts.
[Signatures oil following page.]
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IN WITNESS WHEREOF, the parties have executed this Contract the day and year above
written.
CORPORATION: CITY:
CITY OF CUPERTINO, a municipal
corporation
By: By:
fi
Josh Selo Afrti ShrivaWva
Executive Director Assistant City Manager
APPROVED AS TO FORM. ATTEST:
k.-i4-i oitph--Steveiiso-n--H-o-rn-- Date Grace Schmidt Date
City ttome City Clerk
Y/
13
EXHIBITA
PROGRAM DESCRIPTION
FY 2018-19
Agency Name, DUNS-
West Valley Community Services 141088968
Executive Director: Project Manager: Project# (For Of Use Only)
Josh Selo Sujafha Venkatrainan 100-72-712 600-623
Street Address: City: State: Zip Code:
10104 Vista Drive �fino, CA ..9 51014
Telephone nuiniber- Fax Number: Manager E-mail
408-255-8033 _[Au:�athav( wvcomm unit yservices.or Y;
.................
Name of Project/Program:
flaven to Home
Project/Prograin Location:
10104 Vista Drive Cupe�tipo.qA 95014
Program Description:
The goal of the Haven to Home (FITH) is to help currently Un-housed Cupertino individuals and
families secure permanent housing, maintain employment, and enhance income Opportunities and
financial stability, The supportive services critical to the success of this program are intensive
case management, housing search, landlord mediation, benefits clinic, and financial coaching,
flITI aims to end homelessness and prevent homelessness by coordinating multilevel services and
leveraging further resources in the Community in order to build long-terin stability and self-
sufficiency for participants.
"Through this funding, WVCS will serve 50 homeless individuals and families whose last address
was in Cupertino by moving them into permanent housing. The target population for this grant
will be families or individuals who have become homeless in the City of Cupertino. H'rH services
include:
Case Management: Case management is a key component that focuses on self-sufficiency rather
than dependency, and emphasizes sustainable solutions. WVCS' case managers work to assess a
family's needs by using a self-sufficiency matrix, Based on this assessment and the families' self-
sufficiency matrix score, the case manager will develop a family case plan with goals to address
critical needs and improve self sufficiency.
Food Pantry: All qualified clients will have access to the food pantry in order to Supplement their
needs and reduce grocery expenses. Every visit to the food pantry includes fresh fruit and
vegetables, fresh bread, eggs, a source of protein, and milk, sourced from Second I farvest Food
Ban]<. and generous donations from local grocery stores such as Safeway and Whole Foods.
Clients will also have access to ready to eat meals.
Emergency Financial Assistance: As pail of this program, WVCS will provide Emergency
Financial Assistance For rapid rehousing and homelessness prevention. The deposit assistance will
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be the families' first step in securing permanent housing and help rapidly re-hOUse homeless
families. Case managed clients who may experience financial crisis will also get continued
support and ernergency assistance to prevent homelessness,
Supportive Services: These include benefit assistance, financial coaching, free bus pass, housing
search assistance, and weekly laundry quarters, "These supportive services help clients to save
money and increase their income.
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HIBU
PROGRAM R PLAN
FY 201 -19
(,', T'gCY NAME. West Valley Community Services
PROGRAMNAME: Haven to donne
Benchmarks s for Each (uarten
Objectives
_ ]Est Ind rd w th TOTAL
services to help clients find housing; and nlaintarn 20� � 10 10 la � 50
hcntrsin
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EXHIBIT C
PROPOSED IMPLEMENTATION TIMELINE SCHEDULE
FY 201849
AGENCY NAME: West Valley Community Services
PROGRAM NAME: Haven to Home
Activity Number & Description:
Activity Jul Aug Sep Oct Nov Dee Jan Feb MajrA�pr May Jun
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PROGRAM BUDGET
FY 201 -19
AGENCY NAME: West Valley Community Services
PROGRAM NAME: Haven to Horne
1'ro osed Pro ram L i enses I~Y 2018-19
S Jades/Benefits/Payroll/Taxes 9i 0,000
C)ffice Sty
Communication _
00
F��P�I�cat�ons/1 r nt�n / fiver �srra .........w
l"r•aveI _
l�ent/f,ease/NZ-rT'ga e.... - .,_.-W........-w
Utilities
� suri;-t1'Ce .w...........
.w w..
a Maintenance
L11 Ynent.ee17tww � ���w� www�ww�
ndit/l,e�,� Professional Services (for C,DBG portion only)--I--,-
Direct
;e�°viee.� l trr�dirr ft7r �eclfic �ervice ,LICK as a rneal, ride)
wm' wpa � �mm�
c; ntracted Services
Gather
$40,000.00
EXHIBITE
BASIC INSURANCE AND BOND REQUIREMENTS FOR
NON.-PPROFIT COWRACTS
Definition of Contractor: The "Contractor" as the word is used in this Exhibit E is the party
contracting with the City of Cupertino for the direct distribution of HSG funds.
Indemnity
The Contractor shall indernnifY, defend, and hold harmless the City of Cupertino (hereinafter
"City"), its officers, agents and employees from any loss, liability, claim, injury or damage
arising out of, or in connection with performance of this Contract by Contractor and/or its agents,
employees or Subcontractors, excepting only loss, injury or damage caused solely by the acts or
omissions of personnel employed by the City. It is the intent of the pat-ties to this Contract to
provide the broadest possible coverage for the City. The Contractor shall reirriburse the City for
all costs, attorneys' fees, expenses and liabilities incurred with respect to any litigation in which
the Contractor is obligated to indemnify, defend and hold harmless the City under this Contract.
Insurance
Without limiting the Contractor's indemnification ofthe City, the Contractor shall provide and
maintain at its own expense, during the Term of' this Contract, or as may be further required
herein, the following insurance coverages and provisions:
A. Evidence of Covera e y—
Prior to commencement of this Contract, the Contractor shall provide on the City's own form or a
form approved by the City's Insurance Manager an original plus one copy of a Certificate of
Insurance certifying that covet-age as required herein has been obtained and remains in force for
the period required by this Contract. The contract number and project name must be stated
on the Certificate of Insurance. The City's Special Endorsement form shall accompany the
certificate. Individual endorsements executed by the insurance carrier may be Substituted for the
City's Special 1'ridorsement form if they provide the coverage as required. In addition, a certified
copy of the policy or policies shall be provided by the Contractor upon request.
This verification of coverage shall be sent to the address as shown on the City's Certificate of
Insurance form and to the Community Development Department at the address set forth in this
Contract at Section VI. Prograrn COORDINATION, Paragraph C., NOTICES. The Contractor
shall not issue a Notice to Proceed with the work under this Contract until it has obtained all
insurance required and Such insurance has been approved by the City. This approval of insurance
shall neither relieve nor decrease the liability of the Contractor.
13. 'Notice of Cancellation cif Of CO_VSLw�
All policies shall contain a special provision for thirty (30) days prior written notice of any
cancellation or reduction in coverage to be sent to the Community Development Department,
10300 Torre Avenue, Cupertino, CA 95014.
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C_ _QualifyLhjg_InsuEe s
L_
All policies shall be issued by companies which hold a current policy holder's alphabetic and
financial size category rating of`not less than A Mill. according to the current Best's Key Rating
Guide, unless otherwise approved by the City's Insurance Manager,
D. Insurance e uired
I Comprehensive Genet-at Liability Insurance for bodily m.jUry (including death) and
property damage which provides limits of not less than one million dollars ($1,000,000)
combined single limit (CSL) per Occurrence.
OR
2. Commercial General Liability Insurance - for bodily injury (including death) and
property damage which provides limits as follows:
a. General limit per occurrence $1,000,000
b. General limit aggregate $2,000,000
cl Prod UCtS/CO1_npleted Operations-- $1,000,000 aggregate
d. Personal Injury limit - $1,000,000
If coverage is provided tinder a Commercial General Liability Insurance form, the carrier
shall provide the City insurance Manager with a quarterly report Of the amount Of
aggregate limits expended to that date. If over 50%of the aggregate limits have been paid
or reserved, the City may require additional coverage to be purchased by the Contractor
to restore the required limits.
1 For either type of insurance, coverage shall include:
a. Premises and Operations
ll. Prod Ucts/Com pI eted Operations with limits of one million dollars ($1,000,000)
per occurrence/aggregate to be maintained for two (2) years following acceptance
of the work by the City.
C. Contractual Liability expressly including liability assurned under this Contract,
d. Personal Injury liability.
e. Independent Contractors' (Protective) liability.
f. Severability of Interest clause providing that the coverage applies separately to
each insured except with respect to the limits of liability.
20
4. For either type of insurance, coverage shall irlClUde the following endorsernents, copies of
which shall be provided to the City:
a. Additional Insured Endorsement:
Such insurance as is afforded by this policy shall also apply to the City of
Cupertino, and members of the City Council, and the officers, agents and
employees of the City of Cupertino, individually and collectively, as additional
insureds.
b. Primary Insurance Endorsement:
Such insurance as is afforded by the additional insured endorsement shall apply as
primary insurance, and other insurance rnaintained by the City of Cupertino, its
officers, agents, and employees shall be excess only and not contributing with
insurance provided under this policy.
c. Notice of Cancellation or Change of Coverage Endorsement:
This policy may not be cancelled nor the coverage reduced by the Company
Nvithout 30 days prior written notice of such cancellation or reduction in coverage
to the City of Cupertino at the address shown on the Certificate Of Insurance,
d. Contractual Liability Endorsement:
This policy shall apply to liability assumed by the insured Linder written contract
with the City of Cupertino.
e. Personal Injury Endorsement:
The provisions of this policy shall provide Personal Injury coverage,
f. Severability of Interest Endorsement:
The insurance afforded by this policy shall apply separately to each insured that is
seeking coverage or against whom a claim is made or a suit is brought, except
with respect to the Company's limit of liability.
5 Cot 11 Ury (including death) and
g=reh.ensive Automobile LiabitlUit Insurance for bodily i j
property damage which provides total lit-nits of' not less than one million dollars
($1,000,000) combined single limit per occurrence applicable to all owned, non-owned
and hired vehicles.
6. -Worker's Compensation and Employers Liability Insurance for:
a. Statutory California Workers' Compensation covet-age including a broad form all-
states endorsement.
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b. I"rriployer's Liability coverage for not less than one million dollars ($1,000,000)
per occurrence for all employees engaged in services or operations under this
Contract.
C. Inclusion of the City and its governing board(s), officers, representatives, agents,
and employees as additional insureds, or a waiver of subrogation,
7. Professional Errors and Omissions I-jabilijyjnsurance
This type of insurance should be provided by persons/entities you contract with to
provide you with professional set-vices.
a. Limits of not less than one million dollars ($1,000,000).
b. If this policy contains a self retention limit, it shall riot be greater than ten
thousand dollars ($10,000) per occurrence/event.
C. This coverage shall be maintained for a MinitnUm of two (2) years following
termination of this Contract.
The City must first approve any exceptions to the above requirements.
& Bond Requirements
Fidelity Bond - Before receiving compensation under this Contract, Contractor will
furnish City with evidence that all officials, employees, and agents handling or having
access to funds received or disbursed under this Contract, or authorized to sign or
countersign checks, are covered by a BLANKET FIDEL,rrY BOND in an amount of'
AT LEAST fifteen percent (15%) of the maximum financial obligation of the City cited
herein. if such bond is cancelled or reduced, Contractor will notify City immediately, and
City may withhold further payrnent to Contractor until proper covet-age has been
obtained. Failure to give such notice may be cause for termination of this Contract, at the
option of the City,
9, SpecialJ11,rovisions,
The following provisions shall apply to this Contract:
a. The foregoing requirements as to the types and limits of insurance covet-age to be
maintained by the Contractor and any approval of said insurance by the City or its
insurance consultant(s) are not intended to and shall not in any manner fit-nit or
qualify the liabilities and obligations otherwise assurned by the Contractor
pursuant to this Contract, including but not limited to the provisions concerning
inderrinification.
b. 'The City acknowledges that some insurance requirements contained in this
(."'ontract may be fulfilled by self-insurance on the part of the Contractor,
22
However, this shall not in any way firnit liabilities assumed by the, Conti-actor
under this Contract. The City shall approve any self-insurance in writing.
c. The City reserves the right to withhold payments to the Contractor in the event of
material noncompliance with the insurance requirements outlined above,
d. If the Contractor fails to maintain such insurance as is called for herein, the City
must order the Contractor to immediately SUspend work at Contractor's expense
until a new policy of insurance is in effect.
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