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19-070 Silicon Valley Bicycle Coalition, Non-Profit Services AgreementCITY OF II SERVICES AGREEMENT ($5,000 OR LESS) CUPERTINO 1.Parties. This Agreement ("Agreement") is made a n d entered into as of"---'A=p..c...ri=l..c...3..c...O'---', 2=--0'---'1'-"-9 _____ _ ("Effective Date") by and between the City of Cupe11ino, a municipal corporation ("City") and Silicon Valley Bicycle Coalition ("Contractor"), a--"-N---'---o""'ncc...-=P..c...ro"---'fi=1t'---------- 2.Services. Contractor agrees to provide the programs, classes or activities ("Services") set fo11h in detail in the Scope of Services, attached and incorporated here as Exhibit A. 3.Time of Performance. This Agreemen t begins on the Effective Date and ends on June 30, 2020 ("Contract Time"), unless terminated earlier as provided herein. Contractor must deliver the Services in accorda n ce with the Schedule of Perfmmance included or attached to Exhibit A. Time is of the essence for the pe1formance of all the Services. Contractor must have sufficien t time, resources, and qualified staff to deliver the Services on time. 4.Compensation. City will pay Contractor for satisfactory performance of the Services an amount that will based upon actual costs but that will be capped so as not to exceed $_5�0_0_0 ______ _ ("Contract Price"), based upon the Scope of Services and the budget a n d rates included i n Exhibit A. The maximum compen sation includes all expenses and reimbursements and will remain in place even if Con tractor's actual costs exceed the capped amou n t. Upon City approval of written invoices, Contractor will be paid as follows: (check one; cross out others): D A lump sum amou n t of$ which shall not exceed the Contract Price. D At the rate of$ per hour for a total not to exceed the Contract Price. 0 Based on the payment schedule included or attached to Exhibit A which shall not exceed the Contract Price. 5.Independent Contractor. Contractor is an independent contractor and not an employee, partner, or j oint venture of City. Contractor is solely responsible for the means and methods of performing the Services and for the persons hired to work u n der this Agreeme n t. Contractor is not entitled to health be n efits, workers compensation or other benefits from the City. Contractor must have the skills and qualifications to perform the Services in a competent and professional manner, and must be licensed, registered, and/or ce11ified and have a City Business License. Contractor will supply all tools, materials and equipment required to perform the Services under this Agreemen t. 6.Assignment. This Agreement is not assignable. Contractor may not substitute another or tran sfer any rights or obligations under this Agreement without prior written approval of City. Only those persons whose names are included i n Exhibit A may perfo1m the Services. Program Bicycle Education for City of Cupertino Safe Routes To School Program Services Agreement ($5,000)/Rev. May 22, 2018 Page 1 of 6 7.Indemnification. To the fullest extent allowed by law and except for losses caused by the sole and active negligence or willful misconduct of City personnel, Contractor shall indemnify, defend, and hold harmless City, its City Council, boards and commissions, officers, officials, employees, agents, servants, volunteers and consultants ("Indemnitees"), through legal counsel acceptable to City, from and against any and all liability, damages, claims, actions, causes of action, demands, charges, losses, costs and expenses (including attorney fees, legal costs and expenses related to litigation and dispute resolution proceedings), of every nature, aiising directly or indirectly from this Agreement or in any manner relating to any of the following: (a)Breach of contract, obligations, representations or warranties; (b)Negligent or willful acts or omissions committed during perfonnance of the Services; ( c)Personal injury, prope1iy damage, or economic loss resulting from the work or perfo1mance of Contractor or its subcontractors or sub-subcontractors; Contractor must pay any costs City may incur in enforcing this provision and must accept a tender of defense upon receiving notice from City. Contractor's payments may be deducted or offset to cover any money the City lost due to a claim or counterclaim arising out of this Agreement. 8.Insurance. Contractor shall comply with the Insurance Requirements, attached and incorporated here as Exhibit B, and must maintain the insurance for the duration of the Agreement, or longer as required by City. City will not execute the Agreement until City approves receipt of satisfactory ce1iificates of insurance and endorsements evidencing the type, amount, class of operations covered, and the effective and expiration dates of coverage. Failure to comply with this provision may result in City, at its sole discretion and without notice, purchasing insurance for Contractor and deducting the costs from Contractor's compensation or terminating the Agreement. 9.Compliance with Laws. Contractor shall comply with all laws and regulations applicable to this Agreement, included without limitation the following laws: Labor Laws. Contractor shall comply with all labor laws applicable to this Agreement. If the Scope of Services includes a "public works" component, Contractor is required to comply with prevailing wage laws under Labor Code Section 1720 and other labor laws. D Sole Proprietor. If Contractor is a sole proprietorship/individual, it must sign the Affidavit of No Employees included in this Agreement. Discrimination Laws. Contractor shall not discriminate on the basis of race, religious creed, color, ancestry, national 01igin, ethnicity, handicap, disability, marital status, pregnancy, age, sex, gender, sexual orientation, gender identity, Acquired-Immune Deficiency Syndrome (AIDS) or any other protected classification. Contractor shall comply with all anti-disc1imination laws, including Government Code Sections 12900 and 11135, and Labor Code Sections 1735, 1777 and 3077.5. Consistent with City policy, Contractor understands that harassment and discrimination directed toward a job applicant, an employee, a City employee, or any other person, by Contractor or Contractor's employees or sub-contractors will not be tolerated. Program Bicycle Education for City of Cupertino Safe Routes To School Program Services Agreement ($5,000)/Rev. May 22, 2018 Page 2 of6 Conflicts of Interest. Contractor shall comply with all conflict of interest laws applicable to this Agreement and must avoid any conflict of interest. Contractor wanants that no public official, employee, or member of a City board or commission who might have been involved in the making of this Agreement, has or will receive a direct or indirect financial interest in this Agreement, in violation of California Government Code Section 1090 et seq. Contractor may be required to file a conflict of interest f01m if Contractor makes certain governmental decisions or serves in a staff capacity, as defined in Section 18700 of the California Code of Regulations. Contractor agrees to abide by the City's rules governing gifts to public officials and employees. 10.Abandonment. City may abandon or postpone the Project at any time. Contractor will be compensated for satisfactory Services perfo1med through the date of abandonment. 11.Termination. City may te1minate this Agreement for cause or without cause at any time. City reserves the right to telTilinate the Agreement and the remainder of the Services offered by Consultant without notice based upon Contractor's cancellation of a Service (i.e., program, class or activity) without giving advance notice or obtaining written approval from City. 12.Governing Law. This Agreement is governed by the laws of the State of California. Any lawsuits filed related to this Agreement must be filed with the Superior Comt for the County of Santa Clara, State of California. Contractor must comply with the claims filing requirements under the Government Code prior to filing a civil action in comt. If a dispute arises, Contractor must continue to provide the Services pending resolution of the dispute. If the Parties elect arbitration, the arbitrator's award must be supported by law and substantial evidence and include detailed written findings of law and fact. 13.Entire Agreement. This Agreement represents the full and complete understanding of every kind or nature between the Parties, and supersedes any other agreement or understanding, either oral or written, between the Patties. Any changes to this Agreement will be effective only if in writing and signed by each Party's authorized representative. No verbal agreement or implied covenant will be valid to amend or abridge this Agreement. If there is any inconsistency between the main Agreement and the attachments or exhibits thereto, the text of the main Agreement shall prevail. Each provision and clause required by law for this Agreement is deemed to be inserted and will be infened herein. 14.Services Coordinator. The Parties designate the following persons as Services Coordinators for this Agreement. Contractor's designation and any substitution are subject to City approval. For Contractor: Silicon Valley Bicycle Coalition Ann Jasper Naine Programs Director Position ann@bikesiliconvalley.org Contact For City: City of Cupertino Cherie Walkowiak Name SRTS Coordinator Position 408.777.7609 I CherieW@Cupertino.org Contact Program Bicycle Education for City of Cupertino Safe Routes To School Program Services Agreement ($5,000)/Rev. May 22, 2018 Page 3 of 6 15.Contract Interpretation. There are no intended third patty beneficiaries of this Agreement. Neither acceptance of the Services nor payment therefor shall constitute a waiver of any contract provision. City's waiver of a breach shall not constitute waiver of another provision or breach.The headings in this Agreement are for convenience only. The Indemnification and Governing Law sections expressly survive this Agreement. 16.Severability. If a term or provision of the Agreement or its application to a paiiicular situation is found by the court to be void, invalid, illegal or unenforceable, such tenn/ provision shall remain in effect to the extent allowed by such rnling. All other te1ms and provisions of this Agreement or their application to specific situations shall remain in full force and effect. 17.Notices. All notices, demands, requests and approvals must be sent to the persons below in writing, and will be considered effective on the date of personal delivery, upon confirmation of delivery by a reputable overnight delivery service, on the fifth calendar day after deposit thereof in the United States Mail, postage prepaid, registered or certified, or the next business day following electronic submission: To City of Cupertino: 10300 Torre Ave., Cupertino, CA 95014 Attention: Cherie Walkowiak Email: Cherie W@Cupertino.org To Contractor: Silicon Valley BicycleCoalition PO Box 1927, San Jose, CA 95109 Attention: Ann Jasper, Programs Director Email: ann@bikesiliconvalley.org / 408.287.7259 18.Validity of Contract. This Agreement is valid and enforceable only if (a) it complies with the contract provisions of Cupe11ino Municipal Code Sections 3.22 and 3.23, (b) is signed by the City Manager or an autho1ized designee, and ( c) is approved for f 01m by the City Attorney's Office. 19.Execution. Contractor's signatory waii-ants that he or she is authmized to execute the Agreement and to legally bind Contractor. This Agreement may be executed in counterparts, each one of which is deemed an original and all of which, taken together, constitute a single binding instiument. Program Bicycle Education for City of Cupertino Safe Routes To School Program Services Agreement ($5,000)/Rev. May 22, 2018 Page 4 of 6 IN WITNESS WHEREOF, the Parties have caused the Agreement to be executed as of the Effective Date written above. CONTRACTOR Silicon Valley Bicycle Coalition PO Box 1927 r;?rnl ��� Jo �.� Name: Shiloh Ballard Title:President & Executive Director Tax I.D. No.: 77-0338658 -------- APPROVED AS TO FORM: By: �U\A_�� HEATHER M. MINNER Cupertino City Attorney ATTEST: CITY OF CUPERTINO A Municipal Corporation By: Name: Roger Lee Title: Acting Director of Public Works By:�.'Jt�(?�/9 GRACE SCHMID T, City Clerk Program Bicycle Education for City of Cupertino Safe Routes To School Program Services Agreement ($5,000)/Rev. May 22, 2018 Page 5 of 6 Scope of Work Silicon Valley Bicycle Coalition for the City of Cupertino Safe Routes to School Program May 1, 2019-June 30, 2020 Task: Bicycle Education Workshops and Bike Rodeos Exhibit A Silicon Valley Bicycle Coalition (SVBC) will provide bicycle and pedestrian safety education and on-bike sills training for schools during Bike Rodeos. SVBC may provide in-class education, on-bike skills training, and group rides. The City of Cupertino will: 1.Provide adequate facilities to host activities provided by SVBC SVBC will: 1.Provide staff and equipment required to conduct educational presentations, bicycle skills courses and group rides 2.Work with City of Cupertino to schedule Bike Rodeos 3.Work with City of Cupertino to schedule Workshops Task Schedule: •The bike rodeo and workshop dates are to be scheduled •SVBC will arrive one hour prior to each bike rodeo and workshop to set up the bike skills course Task Payment: •Cost for each Bike Rodeo is $750 and each workshop is $1000. Payment will be made to Silicon Valley Bicycle Coalition within 30 days flowing completion of contracted service. Maximum Fee for services provided to the City of Cupertino -not to exceed $5,000 (FIVE -THOUSAND DOLLARS). EXHIBIT B INSURANCE REQUIREMENTS For Services and Activities Involving Children Instructor shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages to prope1ty which may arise from or in connection with the performance of the work hereunder and the results of that work by the Instructor, his agents, representatives, employees or subcontractors. MINIMUM SCOPE AND LIMIT OF INSURANCE Coverage shall be at least as broad as: 1.Commercial General Liability (CGL): Insurance Services Office F01m CG 00 01 covering CGL on an "occmTence" basis, including prope1ty damage, bodily injury and personal & adve1tising injury with limits no less than $1,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO CG 25 03 or 25 04) or the general aggregate limit shall be twice the required occmTence limit. 2.Sexual Abuse/ Molestation insurance or the equivalent are required for contracts involving children in after school activities, recreational programs, athletics, studies, transp01tation of students. Covers potential claims of abuse or child molestation. Sexual Abuse/Molestation coverage must be included under General Liability or obtained in separate policies in an amount of not less than $1,000,000 per occurrence ($2,000,000 aggregate) and $3 ,000,000 excess/umbrella coverage. 3.Automobile Liability: Insurance Services Office Fo1m Number CA 0001 covering, Code 1 (any auto), or if Instructor has no owned autos, Code 8 (hired) and 9 (non-owned), with limits no less than $1,000,000 per accident for bodily injury and prope1ty damage. (Note -required only if auto is used in performance of work) 4.Workers' Compensation insurance as required by the State of California, with Statutory Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident for bodily injury or disease. (Note-required only if Instructor has employees). If the contractor maintains broader coverage and/or higher limits than the minimums shown above, the Entity requires and shall be entitled to the broader coverage and/or higher limits maintained by the contractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the Entity. Self-Insured Retentions Self-insured retentions must be declared to and approved by the Entity. The Entity may require the Instructor to provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. The policy language shall provide, or be endorsed to provide, that the self-insured retention may be satisfied by either the named insured or Entity. Other Insurance Provisions The general liability policy is to contain, or be endorsed to contain, the following provisions: 1.The Entity, its officers, official s, employees, agents, and volunteers are to be covered as additional insureds with respect to liability arising out of work or operations perfo1med by or on behalf of the Instmctor including materials, parts or equipment furnished in connection with such work or operations. 2.For any claims related to this contract, the Instructor's insurance coverage shall be primary insurance coverage at least as broad as ISO CG 20 01 04 13 as respects the Entity, its officers, officials, employees, agents, and volunteers. 3.The Insurance Company agrees to waive all rights of subrogation against the Entity, its elected or appointed officers, officials, agents, and employees for losses paid under the terms of any policy which arise from work performed by the Instructor for the Entity. This provision also applies to the Instructor's Workers' Compensation policy. 4.Each insurance policy required above shall provide that coverage shall not be canceled, except with notice to the Entity. Acceptability of Insurers Insurance is to be placed with insurers with a current AM. Best's rating of no less than A: VII, unless otherwise acceptable to the Entity. Verification of Coverage Instructor shall furnish the Entity with original certificates and amendatory endorsements effecting coverage required by this clause. All certificates and endorsements are to be received and approved by the Entity before work commences. The Entity reserves the right to require complete, certified copies of all required insurance policies, including endorsements affecting the coverage required by these specifications, at any time. We strongly recommend obtaining a copy of the policy declarations and endorsement page (make this a requirement in your Contract) to facilitate verification of coverages and spot any undesirable policy limitations or exclusions. Homeowner's Insurance In some cases the Instructor's homeowner's liability insurance may provide coverage sufficient to meet these requirements. Instructor should provide these requirements to his or her agent to confirm and provide verification to the Entity. Special Events Coverage for Instructors Special events coverage is available for an additional fee to provide the liability insurance required by this agreement. Instmctor can obtain additional information and cost from the Entity. Special or Low Risk Activities Entity reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. The Entity reserves the right to modify or waive insurance requirements for certain low risk recreational activities. ACORi:f CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) � 05/01/2019 THIS CERTIFICATE IS ISSUED AS A MATIER 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: American Specialty Insurance & Risk Services, Inc. PHONE I FAX lb.IC 1.1- c � n , CA/C Nol: dba A.S.I.R.S.I. Insurance Agency E-MAILADDRESS: 7609 W. Jefferson Blvd., Suite 100 INSURER(S) AFFORDING COVERAGE NAIC# Fort Wayne IN 46804 INSURER A: Arch Insurance Company 11150 INSURED INSURER B: League of American Wheelmen dba League of American Bicyclists INSURER C: 1612 K Street NW, Suite 1102 INSURER D: INSURER E: Washington DC 20006 INSURER F: COVERAGES CERTIFICATE NUMBER: 1001648896 REVISION NUMBER· THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE X COMMERCIAL GENERAL LIABILITY I-� CLAIMS-MADE [X] OCCUR I- I-GEN'L AGGREGATE LIMIT APPLIES PER: Fx1 D PRO-POLICY JECT OTHER: CLUB AUTOMOBILE LIABILITY I-ANY AUTO - DLOC I-OWNED SCHEDULED I-AUTOS ONLY -AUTOS HIRED NON-OWNED -AUTOS ONLY -AUTOS ONLY UMBRELLA LIAB H OCCUR EXCESS LIAB CLAIMS-MADE DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE D OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below ADDL SUBR POLICY EFF POLICY EXP , .. en lwun POLICY NUMBER CMM/DD/YYYYl CMMIDD/YYYYl y SBCGL0054502 02/01/2019 02/01/2020 N/A LIMITS EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES !Ea occurrence\ $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS -COMP/OP AGG $ $ COMBINED SINGLE LIMIT $ /Ea accidenll BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ /Per accidenll $ EACH OCCURRENCE $ AGGREGATE $ $ I �ffrnTE I I OTH-ER E.L. EACH ACCIDENT $ E.L. DISEASE· EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) - Coverage applies to SILICON VALLEY BICYCLE COALITION, 96 N. 3RD ST., SUITE 375, SAN JOSE, CA 95112. 1,000,000 1,000,000 Excluded 1,000,000 5,000,000 5,000,000 -The certificateholder shall be an additional insured, but only with respect to the operations of the Named Insured, and subject to the provisions and limitations of Form CG 2026 -Additional Insured -Designated Person or Organization, but only with respect to IN-CLASS EDUCATION AND AFTER-SCHOOL BIKESKILLS COURSE 050719 on May 07, 2019. CERTIFICATE HOLDER CANCELLATION City of Cupertino CE Dept of Recreation & Community Services SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10185 N Stelling Road AUTHORIZED REPRESENTATIVE D�/� Cupertino CA 95014 I © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: -------------------- LO C #: -------- -�ACORu ADDITIONAL REMARKS SCHEDULE Page 1 of 1 ----AGENCY NAMED INSURED American Specialty Insurance & Risk Services, Inc. League of American Wheelmen dba League of American Bicyclists POLICY NUMBER 1612 K Street NW, Suite 1102 SBCGL0054502 CARRIER I NAIC CODE Washington, DC 20006 Arch Insurance Company 11150 EFFECTIVE DATE: 02/01/2019 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE -Certificate #1001648896 -The general liability policy includes Sexual Abuse or Molestation Coverage -Defense Cost included within limit, $25,000 each occurrence/$25,000 aggregate ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORc:f CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) �..,,. 05/01/2019 THIS CERTIFICATE 15 ISSUED AS A MATIER 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 15 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: American Specialty Insurance & Risk Services, Inc. PHONE I FAX 'll.lC No Ext I· fA/C Nol: dba A.S.I.R.S.I. Insurance Agency E-MAIL ADDRESS: 7609 W. Jefferson Blvd., Suite 100 INSURER(Sl AFFORDING COVERAGE NAIC# Fort Wayne IN 46804 INSURER A: Arch Insurance Company 11150 INSURED INSURER B: Silicon Valley Bicycle Coalition INSURER C: 96 North Third Street, Suite 375 INSURER D: P.O. Box 1927 INSURER E: San Jose CA 95109 INSURER F: COVERAGES CERTIFICATE NUMBER: 1001648899 REVISION NUMBER· THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR A TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY �� CLAIMS-MADE D OCCUR e-- e-- e--GEN'L AGGREGATE LIMIT APPLIES PER: =i D PRO-POLICY JECT OTHER: AUTOMOBILE LIABILITY -ANY AUTO -- DLOC OWNED SCHEDULED -AUTOS ONLY -AUTOS X HIRED X NON-OWNED AUTOS ONLY AUTOS ONLY - UMBRELLA LIAB H OCCUR EXCESS LIAB CLAIMS-MADE OED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE D OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below ADDL SUBR POLICY EFF POLICY EXP ,.,�n W\ln POLICY NUMBER (MM/DD/YYYYl (MM/DD/YYYYl SBAUT0044601 02/01/2019 02/01/2020 N/A LIMITS EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence\ $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS -COMP/OP AGG $ $ COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ f Per accident\ NON-OWNED/HIRED AUTO $ EACH OCCURRENCE AGGREGATE $ $ I ��fTuTE I I OTH-ER E.L. EACH ACCIDENT $ E.L. DISEASE • EA EMPLOYEE $ E.L. DISEASE· POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) -Evidence of coverage as respects to the IN-CLASS EDUCATION AND AFTER-SCHOOL BIKE SKILLS COURSE on May 07, 2019. 1,000,000 -The following physical damage deductibles apply to the Automobile Liability policy: HIRED AUTOS -Collision $1,000 For Each Covered Auto; Comprehensive $1,000 For Each Covered Auto. CERTIFICATE HOLDER CANCELLATION City of Cupertino -Department of Recreation & Community Services SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10185 N. Stelling Road AUTHORIZED REPRESENTATIVE �Cupertino CA 95014 D.;\J.)fl--� I © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: SBCGL0054502 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION WRITTEN CONTRACT OR WRITTEN AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A.SECTION II -WHO IS AN INSURED is amended to include as an additional insured, any person or organization you are required to add as an additional insured to this policy by written contract or written agreement which is: 1.Currently in effect or coming into effect during the term of this policy; and 2.Executed prior to the occurrence of any "property damage", "bodily injury", or "personal and advertising injury". It is further understood and agreed that SECTION II -WHO IS AN INSURED is amended to also include as an additional insured, any person or organization designated in the Schedule below. SCHEDULE Additional Insured: Any Certificate Holder identified as an additional insured on a Certificate of Insurance issued by American Specialty Insurance & Risk Services, Inc. dba A.S.I.R.S.I. Insurance Agency, American Specialty Insurance & Risk Services Agency, and A S Insurance & Risk Services Agency Coverage provided to any additional insured designated in the Schedule applies as follows: That person or organization is an additional insured, but only with respect to liability for "bodily injury", "property damage'' or "personal and advertising injury" caused in whole or in part;-by your acts or omissions or the acts or omissions of those acting on your behalf: 1.In the performance of your ongoing operations; or 2.In connection with your premises owned by or rented to you. However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B.With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: 00 SGL0029 00 10 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1.Required by the contract or agreement; or 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions remain unchanged. 00 SGL0029 00 10 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2 CLAIMS MADE SEXUAL MISCONDUCT AND MOLESTATION INSURANCE Fonn: Policy Number: Renewal of: Named Insured: Principal Address: SML Safeguard Wording -623AFB00213 TBA NIA City of Cupertino -Dept of Recreation & Community Services 10185 N Stelling Road, Cupertino, CA, 95014 Policy Period: From: pt July 2018 To: pt July 2019 Both dates at 12:01 a.m. Local Time at the Principal Address stated in Item 1. Limit of Liability: a)USD 5,000,000 b)USD 5,000,000 c)USD 50,000 for all Claims for Wrongful Acts against any one Victim for all Claims for Wrongful Acts against all Victims, but sub-limited to: for all Safeguard Costs resulting from all Circumstances Such Sub-limit of Liability shall be part of, and not in addition to, the overall Limit of Liability stated in 3.b) above. Retention: USD 35,000 any one Victim Premium: USD 27,000 to be paid within 25 days of attachment Notification pursuant to Clause IX. shall be given to: Claims Department Beazley 30 Batterson Park Road, Fannington, CT 06032. claims@beazley.com (860)677 3765 (phone) (860)679 0247 (fax) Retroactive Date: pt July 2018 Pending or Prior Litigation Date: p t July 2018 Service of Suit: Eileen Ridley, FLWA Service Corp., c/o Foley & Lardner LLP, 555 California Street, Suite 1700, San Francisco, CA 94104-1520 Choice of Law: New York Conditions: Application Dated: TBA California Surplus Lines Notice 1-LMA9098A Small Additional or Return Premiums Clause (U.S.A.)-NMA 1168 Nuclear Incident Exclusion Clause-Liability-Direct -NMA 1256 Radioactive Contamination Exclusion Clause-Liability -NMA 1477 War and Terrorism Exclusion-NMA 2918 Sanctions Limits Clause -LMA 3100 Beazley Safeguard Education Document Arch Safeguard Enhancement Endorsement U.S Classification: Surplus Lines Broker and State filed in: TBA License Number: TBA Subject to: 1)Satisfactory re-signed and dated SML application within 30 days of inception 2)Confinnation of the Surplus Lines Broker. Including name of individual, company name, address and license number All subjectivities to be received within 7 working days of binding otherwise Underwriters reserve the right to amend tenns or cancel ab initio. Brokerage: Information: Underwriting Security: 22.5% or same net equivalent downwards, plus taxes as applicable Employees -36 full time+ 250 part time+ 63 IC's Exposure Units -97,000 Nature of Business -Municipality Cancellation by an Insured may result in a short rate calculation to detennine the return premium, subject to 5% minimum earned of the total premium. 100% Lloyd's (Infonnation about Lloyds) ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDD/YYYY) � 4/30/2019 THIS CERTIFICATE 15 ISSUED AS A MATIER 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: ;f,gNJo CvH· (800) 533-7215 I FAX fA/C Nol: (866) 828-2424 HUB INTERNATIONAL INS SERVICES INC E-MAIL Certificate@Hanover.com ADDRESS: PO BOX4047 INSURER(Sl AFFORDING COVERAGE NAIC# CONCORD CA 94524 I N SURER A: Citizens Ins Co of America 31534 INSURED I N SURER B: SILICON VALLEY BICYCLE I N SURER C: COALITION INSURER D: PO BOX 1927 INSURER E: SAN JOSE CA 95109 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I NSR LTR A TYPE OF I NSURANCE COMMERCIAL GEN ERAL LIABILITY -D CLAIMS-MADE D OCCUR ,--- -GEN"L AGGREGATE LIMIT APPLIES PER: � DPRO-POLICY JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO D LOC OWNED -SCHEDULED -AUTOS ONLY ,--AUTOS HIRED NON-OWNED -AUTOS ONLY ,--AUTOS ONLY UMB RELLA LIAB HOCCUR -EXCESS LIAB CLAIMS-MADE DED I I RETENTION$ WORKERS COMPENSATION AND EMPLOYERS" LIABILITY YIN ANYPROPRIETOR/PA RTNER/EXECUTIVE 0 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below ADDL SUBR POLICY EFF POLICY EXP ,.,en '""'" POLICY NUMBER fMMIDD/YYYYl fMMIDD/YYYYl NIA y WBF A848500 04 05/01/2019 05/01/2020 LIMITS EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES fEa occurrencel $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS -COMP/OP AGG $ $ COMBINED SINGLE LIMIT (Ea accidentl $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ f Per accidentl $ EACH OCCURRENCE $ AGGREGATE $ $ ./I �.\'tuTE I I OTH-ER E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Waiver of Subrogation as provided by form WC040306. CERTIFICATE HOLDER CANCELLATION 1,000,000 1,000,000 1,000,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF CUPERTINO 10300 TORRE AVENUE CUPERTINO I ACORD 25 (2016/03) CA 95014 THE EXPIRATION DATE THEREOF, NOTICE ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE <-. I (..---·; 7\ '/HtLt1-�>{\f=, lee� (._... ....... .. --" WILL BE DELIVERED IN © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA in % Person or Organization BLANKET -ONLY WHERE Job Description REQUIRED BY CONTRACT (The information below is required only when this endorsement is issued subsequent to preparation of the policy.)