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19-001 Pyro Spectaculars North, Inc. CITY OF No. 12 FY2019-20 CUPERTINO RECREATION SERVICES AGREEMENT 1. Parties. This contract is made and entered into as of 6/7/2019 ("Effective Date"), by and between the City of Cupertino, a municipal corporation ("City"), and with PYRO SPECTACULARS NORTH, INC., 5301 LANG AVENUE, MCCLELLAN CA 95652 ("Contractor"), a CALIFORNIA CORPORATION for PUBLIC FIREWORKS DISPLAYS. 2. Services. Contractor agrees to provide the Services included in the Scope of Work and in accordance with the Schedule of Performance attached in Exhibit A. 3. Term.This contract begins on the Effective Date and ends on 7/5/2019("Contract Time"), unless extended or terminated as provided herein. Time is of the essence and Contractor must have sufficient time, resources, and qualified staff to deliver the Services as required. Contractor must promptly notify City of any actual or potential delays to afford the Parties adequate opportunity to address or mitigate such delays. 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$32,500("Contract Price"),based upon the Scope of Services,budget,performance schedule,and rates included in Exhibit A. The maximum compensation includes all costs, expenses and reimbursements and will remain in place even if Contractor's actual costs exceed the capped amount.Contractor must submit invoices and the information required in Exhibit A in order to receive payment. City will compensate Contractor within 30 days after approval of written invoices. Invoices are subject to review and audit by City during regular business hours upon 24-hours' notice. Contractor must maintain complete and accurate records of payrolls, expenditures, disbursements and other cost items charged to City or establishing the basis for an invoice, for a minimum of four(4)years from the date of final payment. 5. Independent Contractor.Contractor is an independent Contractor and not an employee, partner, or joint venture of City. Contractor is solely responsible for the means and methods of performing the Services and for the persons hired to work under this Agreement. No civil service status or other right of employment will be acquired by virtue of Contractor's performance of the Services. Contractor is not entitled to City's health benefits, worker's compensation or any other benefit. Contractor must have the skills and qualifications to perform the Services in a competent and professional manner. Contractor will supply all tools, materials and equipment required to perform the Services under this Contract. Contractor is responsible for obtaining permits and licenses required by law and must obtain a City business license. Recreation Services Agreement/Rev. 3-14-2018 Page I of 10 6. Proprietary/Confidential Information.To the extent Contractor may have access to private or confidential information owned or controlled by the City, Contractor agrees to treat it confidential and use it solely to perform this Agreement. Contractor must exercise the same standard i of care to protect City information as a reasonably prudent Contractor would use to protect its own proprietary data. i 7. Proprietary Rights. CONTRACTOR represents and warrants that it owns all copyrights,including performance rights,to this Production,except that CONTRACTOR does not own CITY-owned material or third-party-owned material that has been included in the Production,and as to such CITY-owned and third-party-owned material,CITY assumes full responsibility therefore. CITY agrees that CONTRACTOR shall retain ownership of, and all copyrights and other rights to, the Production,except that CONTRACTOR shall not acquire or retain any ownership or other rights in or to CITY-owned material and third-party-owned material and shall not be responsible in any way for such material. CONTRACTOR reserves the ownership rights in its trade names that are used in or are a product of the Production. Contractor grants to City the non-exclusive right to make and use recordings and photographs of the Production and to create and use pictures,and other reproductions of the Production in all media known and unknown throughout the uuuverse in perpetuity without any additional compensation to Contractor. 8. Records.Contractor must maintain complete,accurate,and detailed accounting records relating to its performance in accordance with generally accepted accounting principles and procedures. The records must include detailed information about Contractor's services,benchmarks, deliverables and costs/fees,and must be made reasonably available to City.The records and supporting documents must be kept separate from other files and maintained for four years from the date of City's final payment. 9. Assignment.This Contract is not assignable.Contractor may not substitute another or transfer any rights or obligations under this Contract without prior written approval of City.Only those persons whose names are included in Exhibit A may perform the Services. 10. Publicity and Signs.Any publicity generated by Contractor related to this contract or the Services during the Contract Time and for one year thereafter must reference City contributions. The words "City of Cupertino' shall be displayed in all pieces of publicity, including flyers, press releases, posters, brochures, public service announcements, interviews and newspaper articles. No signs may be posted,exhibited or displayed on or about City property,except signage required by law or under this Agreement without prior written approval from City. 11. Indemnification. CONTRACTOR represents and warrants that it is capable of furnishing the necessary experience, personnel, equipment, materials, providers, and expertise to produce the Production in a safe and professional manner. Notwithstanding anything in this Agreement to the contrary, CONTRACTOR shall indemnify,hold harmless,and defend CITY and the additional insureds from and against any and all claims, actions, damages, liabilities and expenses, including but not limited to, attorney and other professional fees and court costs, in connection with the loss of life, personal injury, and/or damage to property, arising from or out of the Production and the presentation thereof to the extent such are occasioned by any act or omission of CONTRACTOR, Recreation Services Agreement/Rev.3-14-2018 Page 2 of 10 their officers, agents, contractors, providers, or employees. CITY shall indemnify, hold harmless, and defend CONTRACTOR from and against any and all claims, actions, damages,liability and expenses, including but not limited to,attorney and other professional fees and court costs in connection with the loss of life, personal injury, and/or damage to property, arising from or out of the Production and the presentation thereof to the extent such are occasioned by any act or omission of CITY, its officers, agents, contractors, providers, or employees. In no event shall either party be liable for the consequential damages of the other party. 1 12. Insurance.Contractor shall comply with the insurance requirements in Exhibit B.City will not execute the Agreement until it has received and approved satisfactory certificates of insurance and endorsements evidencing the type,amount,and dates of coverage. 13. Compliance with Laws and Other City Requirements. i Requirements for all Contracts. This contract is subject to local, state and federal laws and regulations prohibiting discrimination,including Title VII of the Civil Rights Act of 1964,the California j Fair Employment Practices Act,the Americans with Disabilities Act of 1990,and other laws that pertain to fair employment and anti-discrimination practices. Contractor must comply with labor laws pertaining to prevailing wages, working hours, overtime, payroll records, and other requirements imposed by the Department of Industrial Relations.If Contractor does not have employees,it must sign the Affidavit of NoEmployees, att ached as Exhibit C. Contractor is responsible for verifying employment eligibility of employees pursuant to the Immigration Reform and Control Act of 1986. Contractor must comply with conflict of interest laws and regulations applicable to this Agreement and avoid conflicts of interest. Contractor may be required to file a conflict of interest form for engaging in governmental decisions or serving in a staff capacity,and is hereby advised to review the requirements of California Political Reform Act and the California Code of Regulations. Services may only be performed by persons who are not employed by City and who do not have a contractual relationship with City other than this contract. Contractor agrees to abide by City policies and administrative rules prohibiting gifts to City officials and employees. i Additional Requirements for Services Provided to Minors: Contractor and its employees who provide services under this Agreement must comply with these additional requirements: i A. Undergo fingerprinting and a criminal background check and verify all employees providing services under this contract have met this requirement. B. Complete a Tuberculosis screening test as required by law and as set forth in Exhibit D. C. Comply with the Mandatory Reporting under California Penal Code 11164-11174.3 and with the protocols, reporting, and training required under California Health and Safety Code Section 124235,AB2007, and other laws pertaining to concussion evaluation, removal from play, and return to play protocols. (Refer to Center. for Disease Control & Prevention, littps://www.ccic.6,ov/heruhuk)%index htmi). D. Submit required forms and acknowledgments included in Exhibit D, and ensure its each participant is provided with a concussion information sheet, signs and returns the forms to the City as required by Health and Safety Code Section 124235. Require coaches and administrators to successfully complete the concussion and head injury Recreation Services Agreement/Rev. 3-14-2018 Page 3 of 10 education at least once either online or in person, before supervising a participant. Contractor shall offer training, educational materials, or both to each Contractor administrator on a yearly basis. (Training resources are available at the Center for Disease Control&Prevention(link cited above). E. If providing instruction, Contractor must acknowledge and comply with all requirements set forth in the Recreation&Community Services Instructor Manual. 14. Coordination of Services. The Parties designate the following persons as Services Coordinators with the responsibility to oversee the delivery of Services in accordance with the terms of this Agreement.Contractor's designation and any substitution are subject to City approval. For City: For Contractor: Name:Kelsey Hayes Name:Pat Dyas Position:Recreation Coordinator Position:Show Producer Contact:KelseyH@cupertino.org,408-777-3126 Contact: pdyas@pyrospec.coin, 909-355-8120 16. Termination. City may terminate this contract for cause or without cause at any time and will notify Contractor as soon as possible. If CITY chooses to terminate this Agreement, CITY agrees to pay to CONTRACTOR, as liquidated damages, the following percentages of the Fee as set forth in paragraph 4 and Exhibit A. 1)50%if cancellation occurs 30 to 90 days prior to the scheduled date,2)75%if cancellation occurs 15 to 29 days prior to the scheduled date,3) 100%thereafter. In the event CITY cancels the Production,it will be impractical or extremely difficult to fix actual amount of CONTRACTOR's damages. The foregoing represents a reasonable estimate of the damages CONTRACTOR will suffer if CITY cancels the Production. . 17. Governing Law,Venue and Dispute Resolution.This contract is governed by the laws of the State of California. Any legal actions or proceedings filed against City in connection with this contract must comply with the government claims filing requirements and must be filed with the Superior Court for the County of Santa Clara, State of California. At City's request, Contractor is required to continue to provide Services pending resolution of any 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. 18. Attorney Fees. If City is required to pursue litigation,arbitration or other administrative or regulatory proceeding to enforce its rights or the terms of this Agreement, the prevailing party will be entitled to reasonable attorney fees and costs.This Section survives this Agreement. 19. Third Party Beneficiaries.There are no third party beneficiaries under tlus Contract. 20. Waiver.Neither acceptance of Services nor payment thereof constitutes a waiver of any contract provision. City waiver of a breach shall not constitute waiver of another term, provision, covenant or condition, or a subsequent breach,whether of the same or a different character. Recreation Services Agreement/Rev. 3-14-2018 Page 4 of 10 21. Entire Agreement.This Agreement and all referenced Exhibits are hereby attached and incorporated into the Agreement by this reference and represent the full and complete understanding as to those matters contained herein,and supersede any other contract or understanding,either oral or written,between the Parties.This Agreement may not be modified or amended except in writing signed by both Parties.If there is any inconsistency between the main contract and any attachments or exhibits thereto,the main contract shall prevail. 22. Inserted Provisions.Each provision or clause required by law or this contract is deemed to be included and will be inferred herein. Either party may request an amendment to cure any mistaken insertion or omission of a required provision. 23. Headings.The headings are for convenience only and are not a part of the contract or intended to affect,limit or amplify the terms or provisions of this Agreement. 24. Severability/Partial Invalidity.If any contract term or provision,or their application to a particular situation, is found by the court to be void, invalid, illegal or unenforceable, such term or provision shall remain in force and effect to the extent allowed by such ruling.All other contract terms and provisions and their application to specific situations will remain in full force and effect. 25. Survival.All provisions which by their nature must continue after the Agreement ends, including without limitation Indemnification, Insurance,Ownership of Materials,Records,Governing Law and Attorney Fees,will survive the expiration or termination of this Agreement. 26. Notices.All notices and instruments pertaining to material provisions of this contract or significant disputes which are required by law or under this contract to be in writing must be sent to the persons listed below. The notices will be deemed effective on the date of personal delivery or the date confirmed by a reputable overnight delivery service,on the fifth calendar day after deposit in the United States Mail, postage prepaid, registered or certified, or the next business day following electronic submission. To City of Cupertino: To Contractor: Office of the City Manager Pyro Spectaculars North,Inc. 10300 Torre Ave., Cupertino CA 95014 5301 Lang Ave,McClellan,CA 95652 cc:Representative/Coordinator: cc:General Counsel Kelsey Hayes Gary E.Brown Email:KelseyH@Cupertino.org Email:gbrown@pyrospec.com 27. Validity of Contract. This contract is valid and enforceable only if it complies with the provisions of Cupertino Municipal Code Chapters 3.22 and 3.23, is signed by the City Manager or authorized designee,and is approved for form by the City Attorney's Office. Recreation Services Agreement/Rev. 3-14-2018 Page 5 of 10 28. Execution. The person executing this contract on behalf of Contractor represents and warrants that Contractor has full right, power, and authority to execute this contract and to carry out all actions and services required. This contract constitutes a legally binding obligation of Contractor, and may be executed in counterparts,each one of which is deemed an original and all of which, taken together, constitute a single binding instrument. IN WITNESS WHEREOF,the parties have caused this contract to be executed. CONTRACTOR CITY OF CUPERTINO Pyr Spectaculars N_ o th,Inc. A Municipal Corporation Y By: ;me Tames R.SOuza Name: Christine Hanel Title President Title: Assistant Director Date: — T Date 05/12/19 Tax I.D.No.:20-8788339 APPROVED AS TO FORM: ATTEST: HEATHER MINER GRACE SCHMIDT Cupertino City Attorney City Clerk ContractlEncunibered Amount:$32,500 Account No.:100-61-605 700-702 Recreation Services Agreement/Rev. 3-14-2018 Page 6 of 10 EXHIBIT A SCOPE OF WORK,PERFORMANCE AND PAYMENT SCHEDULES The CONTRACTOR will provide FIREWORKS DISPLAY in, but not limited to, the following: 4TH OF JULY FIREWORKS DISPLAY AND COORDINATION MEETINGS PRIOR TO EVENT Location and Time of CONTRACTOR Services: (1) Attend coordination meetings as required by the City at the Quinlan Community Center, 10185 North Stelling Road, Cupertino, CA 95014; (2) Provide Fireworks display at Hyde Middle School, 19325 Bollinger Road,Cupertino, CA 95014 on July 4, 2019 at approximately 9:30 pm. Compensation for CONTRACTOR Services: Contractor shall be compensated for services performed pursuant to this Agreement. Compensation shall consist of the following: The City will pay Pyro Spectaculars North,Inc. a total of$32,500.00 (Thirty-Two Thousand Five Hundred Dollars), $15,000 (Fifteen Thousand Dollars) of the fee plus estimated permit and standby fees, specified production costs, and other regulatory costs approximated at$1,100 OR an amount to be determined,for a total of$16,100 as a deposit upon the execution of this agreement by both parties but no later than June 14, 2019.The balance shall be paid no later than July 15th, 2019. List of all Contractor Employees working for the City of Cupertino(if no Employees,identify"self"): Don Groshart Matthew Roseman Laury Smith Brad Wetmore Laura Richarson Alan Koczorowski Shawn Carr Amy Greever Zachary Carr Kenneth Finnegan Paul Hand Larry Yang Walter Yukinari Jon Krutz Bob Kraker Catherine Smith Brian Kraker Performance of CONTRACTOR Services: The CONTRACTOR will provide all pyrotechnic equipment, trained pyro technicians, shipping, pyrotechnic products,application for specific pyrotechnic permits(the cost of which,including standby fees,shall be paid by City)relating to the production,insurance covering the production(limits below) and the other things on its part to be performed as more specifically set forth below in this agreement and in this scope of work ("SCOPE OF WORK"), herein by this reference, and made a part of this agreement as though set forth fully herein. Recreation Services Agreement/Rev. 3-14-2018 Page 7 of 10 • One Pyro Spectaculars North, Inc., production on July 4, 2019, at approximately 9:30 p.m. at Hyde Middle School, 19325 Bollinger Road, Cupertino, CA 95014 • All pyrotechnic equipment, trained pyro technicians, shipping, and pyrotechnic products. • Application for specific pyrotechnic permits relating to the production. • The fireworks display will include: Opening 3" Sky Concert Opening Salutes Quantity-60 Main Body-Aerial Shells 3" Sky Concert Selections Quantity-800 Grand Finale 3" Sky Concert Bombardment Shells Quantity-300 • The display will also include appropriate patriotic music to be approved by the City that will be broadcasted at various (4)viewing locations. • The show is expected to last approximately 20 to 25 minutes. Performance of CITY Services: The City will provide:A suitable site("site") for the production, security for the site, access to the site, any permissions necessary to utilize the site for the production, and the other things on its part to be performed as more specifically set forth below in this agreement and in the scope of work. All site arrangements are subject to Contractor's reasonable approval as to pyrotechnic safety, suitability, and security.All other conditions of the site shall be the responsibility of City, including,but not limited to,parking and general safety with respect to eh public, city personnel and other contractors. In addition, City shall: • Provide all on-site labors costs, if any,not provided or performed by contractor personnel including,but no limited to, all site security,police and fire dept. standby personnel, and clean-up crew. • Coordinate any applicable non-pyrotechnic permitting with the local,state or federal government that may hold authority within the production. • Be responsible for costs of all permits required for the presentation of the production and the event as a whole. • Provide a safety zone in accordance with applicable standards and all requirements of the authorities having jurisdiction throughout the entire time that the pyrotechnics are at the site or the load site(if different) on the date of the production and all set-up and load-out dates. • Provide general services including,but not limited to, site and audience security, fencing, adequate work light, dumpster accessibility, a secure office for contractor personnel within the venue, secure parking for contractor vehicles, access to washrooms, tents, equipment storage,hazmat storage, electrical power, fire suppression equipment, access to worksites, necessary credentialing,etc., will be required as necessary. Recreation Services Agreement/Rev. 3-14-2018 Page 8 of 10 EXHIBIT B INSURANCE REQUIREMENTS PROFESSIONAL/CONSULTING SERVICES CONTRACTS Contractor shall procure prior to commencement of Services and maintain for the duration of the contract, at its own cost and expense, the following insurance policies and coverage with companies doing business in California and acceptable to City. 3 INSURANCE POLICIES AND MINIMUMS REQUIRED 1. Commercial General Liability (CGL) for bodily injury, property damage, personal injury liability for premises operations,products and completed operations,contractual liability,and personal and advertising injury with limits no less than$5,000,000 per occurrence (ISO Form CG 00 01). If a general aggregate limit applies,either the general aggregate limit shall apply separately to this project/location(ISO Form CG 25 03 or 25 04)or it shall be twice the required occurrence limit. a. It shall be a requirement that any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits shall be made available to the Additional Insured and shall be (i) the minimum coverage/limits specified in this agreement; or (ii) the broader coverage and maximum limits of coverage of any insurance policy,whichever is greater. b, Additional Insured coverage under Contractor's policy shall be"primary and non-contributory,"will not seek contribution from City's insurance/self-insurance,and shall be at least as broad as ISO Form CG 20 01 (04/13). c. The limits of insurance required may be satisfied by a combination of primary and umbrella or excess ? insurance,provided each policy complies with the requirements set forth in tl-ds Contract.Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary and non-contributory basis for the benefit of City before the City's own insurance or self-insurance shall be called upon to protect City as a named insured. a 2.Automobile Liability: ISO CA 00 01 covering any auto (including owned,hired, and non-owned autos) with.limits no less than$5,000,000 per accident for bodily injury and property damage. 3. Workers' Compensation: As required by the State of California, with Statutory Limits and Employer's Liability Insurance of no less than$1,000,000 per occurrence for bodily injury or disease. 4. Professional Liability for professional acts, errors and omissions, as appropriate to Contractor's profession,with limits no less than$1,000,000 per occurrence or$1,000,000 aggregate.If written on a claims made form: i a a.The Retroactive Date must be shown and must be before the Effective Date of the Contract. b. Insurance must be maintained for at least five(5)years after completion of the Services. c. If coverage is canceled or non-renewed, and not replaced with another claims-made policy form with a Retroactive Date prior to the Contract Effective Date, the Contractor must purchase "extended reporting" coverage for a minimum of five (5)years after completion of the Services. I I Recreation Services Agreement/Rev. 3-14-2018 Page 9 of 10 I OTHER INSURANCE PROVISIONS The aforementioned insurance shall be endorsed and have all the following conditions and provisions: Additional Insured Status The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers ("Additional Insureds") are to be covered as additional insureds on Contractor's CGL policy. General Liability coverage can be provided in the form of an endorsement to Contractor's insurance(at least as broad as ISO Form CG 2010(11/85) or both CG 201.0 and CG 20 37 forms,if later editions are used). Primary Coverage Coverage afforded to City/Additional Insureds shall be primary insurance. Any insurance or self-insurance maintained by City,its officers, officials,employees,or volunteers shall be excess of Contractor's insurance and shall not contribute to it. Notice of Cancellation Contractor shall give City written notice within five(5)business days of giving or receiving notice of material alteration, cancellation,non-renewal or expiration of coverage contained in such policy or such certificate of insurance. Waiver of Subrogation Contractor waives any right to subrogation against City/Additional Insureds for recovery of damages to the extent said losses are covered by the insurance policies required herein. Specifically, the Workers' Compensation policy shall be endorsed with a waiver of subrogation in favor of City for all work performed by Contractor,its employees,agents and subcontractors.This provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer, Deductibles and Self-Insured Retentions Any deductible or self-insured retention must be declared to and approved by the City. At City's option, either: the insurer must reduce or eliminate the deductible or self-insured retentions as respects the City/Additional Insureds; or Contractor must show proof of ability to pay losses and costs related investigations, claim administration and defense expenses. The policy shall provide, or be endorsed to provide,that the self-insured retention may be satisfied by either the insured or the City. Acceptability of Insurers Insurers must be authorized to do business in California with an A.M.Best Rating of A-VII,or better. Verification of Coverage Contractor must furnish acceptable insurance certificates and mandatory endorsements (or copies of the policies effecting the coverage required by this Contract),and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements prior to commencement of the Contract.City retains the right to demand verification of compliance at any time during the Contract term. Subcontractors Contractor shall require and verify that all subcontractors maintain insurance that meet the requirements of this Contract, including naming the City as an additional insured on subcontractor's insurance policies. Higher Insurance Limits If Contractor maintains broader coverage and/or higher limits than the minimums shown above, City shall be entitled to coverage for the higher insurance limits maintained by Contractor. Adequacy of Coverage City reserves the right to modify these insurance requirements/coverage based on the nature of the risk, prior experience, insurer or other special circumstances, with not less than ninety (90) days prior written notice. Recreation Services Agreement/Rev, 3-14-2018 Page 10 of 10 CERTIFICATE OF LIABILITY INSURANCE15DATE(MMIOD/YYYY) /31/2019 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 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 endorsements. PRODUCER CONTACT NAME: Britton Gallagher PHONE FAX One Cleveland Center,Floor 30 _(E-MAILQ.EM)!_tL6;6 $19_DO ac.Ne1:21�f 6 -7101�� 1375 East 9th Street ADDRESS: Cleveland OH 44114 INSURERS)AFFORDING COVERAGE NAIC# INSURER A: 11S10_f..nj &Q_Mp_013y _._._ . .7.43-------- INSURED INSURER B: r Pyro Spectaculars North, Inc. INsuRERc:Ey�T�� 31s1n8L10ss/IanC��slmRaf�.K_�_ 1��2 �__W, P.0.Box Rialto CA 9237 92377 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:616089664 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 ADD C S BR ._ _�—�--^--- POLICY EFF._ POLICY EXP LTR TYPE OF INSURANCE INSRD POLICY NUMBER MM/DD/YYYV MMIDO/YYYY LIMITS B GENERAL LIABILITY S18GL00282-191 1113/2019 1113/2020 EACH OCCURRENCE $1.000.000 X COMMERCIAL GENERAL LIABILITY ABTA - � REM rr $500,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ _ PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2.000,000 GERL POLICY AGGREGATE E LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 X PRO• LOG $ i C AUTOMOBILE LIABILITY S18CA00031-191 1113/2019 1/13/2020 Ala acddent) $1 000 000 _ X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Par accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per occident A UMBRELLA LIAB rXd OCCUR EXC6017995 1/13/2019 1113/2020 EACH OCCURRENCE $5.000.000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED 171 RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN __ TQPY LIMIT ANY OFFICER/ME BER EXCLUDED'ECUTIVE❑ IN/A E.L.EACH ACCIDENT $ _ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ Ues,describe under SCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D Excess Liability P-001-000063946-01 1/13/2019 1/13/2020 Each Occurrence $4,000,000 Aggregate $4,000,000 Total Combined Excess $9,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Certificate Haider is named as an additional insured in regards to General Liability and Excess Liability Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. Date of Display: July 4,2019 Location of Display: Hyde Middle School,Cupertino,CA Additional Insureds include:City of Cupertino, Hyde Middle School,Cupertino Union High School District,Santa Clara County Fire See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Cupertino THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Quinlan Center ACCORDANCE WITH THE POLICY PROVISIONS, 10185 N.Stelling Road Cupertino CA 95014 AUTHORIZED REPRESENTATIVE ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC#: A�® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED Britton Gallagher Pyro Spectaculars North, Inc. P.O. Box 2329 POLICY NUMBER Rialto CA 92377 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Department,County of Santa Clara their officers,agents and employees when acting in their official capacity as such. Primary noncontributory and waiver of subrogation shall apply. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Pyro Spectaculars North, Inc. POLICY NUMBER: S18GL00282-191 COMMERCIAL GENERAL LIABILITY ECG 20 592 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organization(s) ANY PERSON OR LEGAL ENTITY IN WHICH YOU HAVE A WRITTEN CONTRACT, AGREEMENT, OR PERMIT WHICH REQUIRES THAT YOU NAME THE CONTRACTING PARTY AS AN ADDITIONAL INSURED. City of Cupertino Quinlan Center 10185 N.Stelling Road Cupertino,CA 95014 Date of Display:July 4,2019 Location of Display:Hyde Middle School,Cupertino,CA Additional Insureds:City of Cupertino,Hyde Middle School,Cupertino Union High School District, Santa Clara County Fire Department,County of Santa Clara and their officers,agents and employees when acting in their official capacity as such. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is amended to C. The Limits of Insurance afforded to an additional include as an additional insured the person(s) or insured shall be the lesser of the following: organization(s) shown in the Schedule, but only 1. The Limits of Insurance required b the written with respect to liability for "bodily injury", "property agreement between the parties; or y damage" or "personal and advertising injury" but only to the extent caused, in whole or in part, by 2• The Limits of Insurance provided by this Cov- your acts or omissions or the acts or omissions of erage Part. those acting on your behalf: D. With respect to the insurance afforded to an addi- 1. In the performance of your ongoing operations; tional insured, the following additional exclusion or applies: 2. In connection with your premises owned by or This insurance does not apply to "bodily injury", rented to you. "property damage"or"personal and advertising in- B. The insurance afforded to an additional insured jury" arising out of any act or omission of an addi- shall only include the insurance required by the tional insured or any of its employees. terms of the written agreement and shall not be broader than the coverage provided within the terms of the Coverage Part. ECG 20 592 05 09 Copyright, Everest Reinsurance Company 2009 Page 1 of 1 ❑ Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Pyro Spectaculars North, Inc. POLICY NUMBER: S18GL00282-191 COMMERCIAL GENERAL LIABILITY CG 29 88 10 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: city of Cupertino, CA (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV) is amended by the addition of the following: We waive any rights of recovery we may have against the person or organization shown in the Schedule above because of payments we make for "bodily injury" or "property damage" arising out of your ongoing operations. This waiver applies only to the person or organization shown in the Schedule above. CG 29 88 10 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 ❑ Pyro Spectaculars North, Inc. Policy# SI8GL00282-191 COMMERCIAL GENERAL LIABILITY CG 20 0104 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: City of Cupertino,CA COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 1 Pyro Spectaculars, Inc. Pyro Spectaculars North, Inc, Policy#; SI8CA00031-191 COMMERCIAL AUTO ECA 04 506 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTO ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: City Of Cupertino BUSINESS AUTO COVERAGE FORM The following is a summary of the Limits of Insurance and additional coverage provided by this endorsement. For complete details on specific coverage, please refer to policy language in this endorsement and the underlying Business Auto Coverage Form. Coverage Applicable Enhancement Subsidiaries As Insureds Broadened Newl Ac uired Organizations As Insureds Broadened Blanket Additional Insureds Broadened Employees As Insureds(Non-Ownership) Broadened Supplementary Payments -Bail Bonds $3,000 Limit Supplements Payments-Loss Of Earnings $1,000 per day Fellow Employee Bodily Injury Broadened Towing Coveraae-AII Covered Autos Broadened Glass Breakage Coverage-Waiver of Deductible Broadened Loss of Use Expenses $50 per day $1,000 Limit Stolen Vehicle Extra Expense Broadened Airbaq Discharge Broadened Electronic Equipment Permanent) Installed Broadened Single Deductible Provision Broadened Notice To Company Broadened Blanket Waiver Of Subrogation Broadened Unintentional Failure To Disclose Hazards Broadened Bodily IniurV Includes Mental Anguish Broadened Coverage Territory Extension-Mexico Broadened ECA 04 506 03 10 Copyright, Everest Reinsurance Company, 2010 Pagel of 4 ❑ Includes copyrighted material of Insurance Services Office, Inc. used with its permission. INSURED COPY A. Who Is An Insured (2) Is executed after the date of loss. The following is added to Paragraph Al. of Sec- Paragraph e.(2) does not apply if: tion II—Liability Coverage: (1) The terms and conditions of the written d. Any: "insured contract" had been agreed upon (1) Subsidiary which is a legally incorporated prior to the"accident"or"loss"; and entity of which you own greater than 50% (2) You can definitively establish that the terms interest in the voting stock on the effective and conditions of the written "insured con- date of this Coverage Form. However, the tract" ultimately executed are the same as insurance afforded by this provision does those which had been agreed upon prior to not apply to any subsidiary that is an "in- the"accident"or"loss". sured" under any other automobile liability f. Any of your "employees"while using a covered policy, or would bean "insured"under such policy but for the termination of such policy "auto" in your business or your personal af- fairs, provided you do not own, hire or borrow or the exhaustion of such policy's limits of that"auto". insurance. (2) Organization you newly acquire or form, B. Coverage Extensions-Supplementary Payments and over which you maintain majority inter- Paragraphs A.2.a.(2) and A.2.a.(4) of Section II — est. Liability Coverage are replaced by the following: The coverage afforded by this provision: (2) Up to $3,000 for cost of bail bonds (including (a) Is effective on the acquisition date, and bonds for related traffic law violations) required is afforded only until the 180th day after because of an "accident" we cover. We do not you acquire or form the organization or have to furnish these bonds. the end of the policy period, whichever (4) All reasonable expenses incurred by the 'In- is earlier; sured" at our request, including actual loss of (b) Does not apply to "bodily injury" or earnings up to $1,000 a day because of time off "property damage"resulting from an "ac- from work. cident" that occurred before you ac- C. Fellow Employee quired or formed the organization; and The following exception is added to exclusion 5. (c) Does not include any newly acquired or Fellow Employee under paragraph B. Exclusions formed organization that is: of Section II—Liability Coverage: (i) A joint venture or partnership; or This exclusion does not apply if the "bodily injury" results from the use of a "covered auto"you own (ii) An 'insured" under any other auto- or hire. The coverage provided under this excep- '9nsured" under such policy butt foo mobile le liability policy or would tion is excess over any other collectible insurance. r the termination of such policy or the D. Towing exhaustion of such policy's limits of Paragraph A.Z. of Section III — Physical Damage insurance. Coverage is replaced by the following: e. Any person, organization or governmental 2. We will pay for towing and labor costs each entity with respect to the operation, mainte- time that a covered "auto" is disabled. All labor nance, or use of a covered "auto"if you are re- must be performed at the place of disablement quired to add such person, organization or go- of the covered "auto". If the auto is not a private vernmental entity to this policy as an additional passenger type, a $250 deductible will apply to insured in order to comply with the terms of a this coverage but it will not reduce the available written 'insured contract"or written agreement. limit of insurance. For all types of "auto", the This does not apply when such contract or most we will pay under this coverage is$1,000 agreement: per disablement. "Autos"which are disabled do (1) Involves the owner or anyone else from not include stolen vehicles. whom you hire or borrow a covered "auto" unless it is a"trailer"connected to a covered "auto"you own; or Page 2 of 4 Copyright, Everest Reinsurance Company, 2010 ECA 04 506 03 10 ❑ Includes copyrighted material of Insurance Services Office, Inc. used with its permission. INSURED COPY E. Glass Breakage—Hitting A Bird Or Animal— 1. Electronic Equipment Coverage Falling Objects or Missiles Section III — Physical Damage Coverage is The following is added to Paragraph A.3. of Sec- amended as follows: tion III—Physical Damage Coverage: 1. The sublimit in Paragraph C.2. of the Limit Of Any deductible shown in the Declarations will not Insurance Provision is increased to $3,000. apply to glass breakage if such glass is repaired, 2. No Physical Damage Coverage deductible sp- in a manner acceptable to us, rather than replaced. plies to the first $3,000 of 'loss" to electronic If the glass must be replaced and there is no other equipment described in Paragraph C.2. of the damage associated with the 'loss", the deductible Limit Of Insurance Provision. will be $100 unless a lower deductible is shown in J. Single Deductible Provision the Declarations applicable to this coverage. The following is added to Paragraph D. of Section F. Loss Of Use Expenses III—Physical Damage Coverage: Paragraph A.4.b. of Section III —Physical Damage If a Comprehensive or Specified Causes of Loss Coverage is replaced by the following: Coverage 'loss" from "accident" involves two or more covered "autos", only the highest deductible b. Loss Of Use Expenses applicable to those coverages will be applied to the For Hired Auto Physical Damage, we will pay "accident", if the cause of the loss is covered for expenses for which an "insured" becomes le- those vehicles. gally responsible to pay for loss of use of a ve- This provision only applies if you carry Compre- hicle rented or hired without a driver, under a hensive or Specified Causes of Loss Coverage for written rental contract or agreement. We will those vehicles, and does not extend coverage to pay for loss of use expenses if caused by: any covered "autos" for which you do not carry (1) Other than collision only if the Declarations such coverage. indicate that Comprehensive Coverage is If a 'loss" covered under this Coverage Part also provided for any covered "auto"; involves a 'loss" to other property from the same (2) Specified Causes Of Loss only if the Decla- "accident', which is covered under a Commercial rations indicate that Specified Causes Of Property or Inland Marine Coverage Part issued by Loss Coverage is provided for any covered us to you, only the highest deductible applicable to "auto"; or those coverages will be applied to the"accident'. (3) Collision only if the Declarations indicate K Notice To Company that Collision Coverage is provided for any Paragraph A.2. of Section IV — Business Auto covered "auto". Conditions is amended as follows: However, the most we will pay for any ex- 1. With respect to notification requirements, your penseobligation under Paragraph A.2.a. applies only maximum of$1,000.for loss of use is $50 per day, to a when the"accident'or"loss"is known to: maxim G. Extra Expense—Stolen Vehicle a. You, if you are an individual; The following is added to Paragraph A.4. of Sec- b. A partner, if you are a partnership; tion III—Physical Damage Coverage: c. A member, if you are a joint venture or limited liability company; or c. Stolen Vehicle d. An executive officer or insurance manager, We will pay for all reasonable and necessary if you are an organization other than a part- expenses to return a stolen covered "auto" to nership, joint venture or limited liability com- you. pany. H. Airbag Coverage 2. With respect to the requirements pertaining to The following exception is added to Paragraph you providing us with document concerning a B.3.a. of Section III—Physical Damage Coverage: claim or "suit', your obligation under Paragraph A.2.b. will not be considered breached unless The accidental discharge of an airbag shall not be the breach occurs after such claim or "suit' is considered mechanical breakdown if it occurs in a known to: covered "auto"for which Comprehensive coverage a. You, if you are an individual; is purchased. This provision does not apply to 'au- tos" you hire with a driver and is excess over any b. A partner, if you are a partnership; warranty specifically designed to provide this cov- c. A member, if you are a joint venture or erage. limited liability company; or ECA 04 506 03 10 Copyright, Everest Reinsurance Company, 2010 Page 3 of 4 ❑ Includes copyrighted material of Insurance Services Office, Inc. used with its permission. INSURED COPY d. An executive officer or insurance manager, N.Bodily Injury—Including Mental Anguish if you are an organization other than a part- Paragraph C. of Section V—Definitions is replaced nership,joint venture or limited liability com- by the following: pany. C. "Bodily injury" means bodily injury, sickness or L. Blanket Waiver Of Subrogation disease sustained by a person, including "men- The following is added to Paragraph A.5. of Sec- tal anguish" or death resulting from any of tion IV—Business Auto Conditions: these at any time. a. However, we waive any right of recovery we For the purpose of this provision, the term may have against a person, organization or "mental anguish" shall mean any type of mental government entity when you have waived such or emotional illness or distress. right of recovery under a written "insured con- O. Mexico Coverage tract"that is: (1) Currently in effect or becoming effective The coverage provided by this policy for covered during the term of this policy; and autos you own or lease on a long term basis without drivers are extended to "accidents" or (2) Executed prior to the"accident"or "loss", or 'losses"occurring in Mexico if: executed after the"accident"or"loss"if: 1. The covered "auto"is in Mexico for a period not (a) The terms and conditions of the written exceeding 10 days; and "insured contract" had been agreed 2. The covered "auto" is principally garaged and upon prior to the "accident" or "loss"; used in the United States; and and (b) You can definitively establish that the 3. The driver of the covered "auto" does not re- terms and conditions of the written "in- side in Mexico; sured contract" ultimately executed are For Liability Coverage to apply to "accidents" oc- the same as those which had been curring in Mexico, the following must also apply: agreed upon prior to the "accident" or 1. Valid and collectible auto liability insurance for 'loss". the covered "auto" has been purchased from a b. We hereby waive any right of subrogation licensed Mexican Insurance Company and is in against any of your officers, directors or em- force at the time of the"accident"; and ployees which might arise by reason of any 2. The original "suit"for damages is brought with- payment under the insurance afforded by the in the United States. policy for the operation, maintenance, use, For "losses" payable under Physical Damage Cov- loading or unloading of a non-owned "auto". erage this additional restriction applies: This waiver extends only to payments in excess of other valid and collectible insurance available We will pay "losses"under Physical Damage Cov- to the officer, director or employee. erage in the United States, not in Mexico. If the M. Unintentional Failure To Disclose Hazards covered "auto"must be repaired in Mexico in order to be driven, then the most we will pay for loss is The following is added to Paragraph B.2. of Sec- the lesser of the following: tion IV—Business Auto Conditions: 1. The cost of repairing the"auto" or replacing its If you unintentionally fail to disclose any hazards parts in Mexico; or existing on the effective date of this Coverage 2. The cost of repair or replacement at the nearest Form, we will not deny coverage under this Cover- point in the United States where the repairs or age Form because of such failure. However, this replacement could be made. provision does not affect our right to collect addi- tional premium due to us as a result of these un- Other Insurance: disclosed hazards in accordance with our filed rat- The insurance provided by this section will be ex- ing plans. cess over any other collectible insurance. Page 4 of 4 Copyright, Everest Reinsurance Company, 2010 ECA 04 506 03 10 ❑ Includes copyrighted material of Insurance Services Office, Inc. used with its permission. INSURED COPY Pyro Spectaculars, Inc. Pyro Spectaculars North, Inc. COMMERCIAL AUTO Policy#S18CA00031-191 ECA 24 509 04 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION - BLANKET This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART Paragraph c. of the Other Insurance General Condition is replaced by the following: c. Regardless of the provisions of Paragraph a. above, this Coverage Form's Liability Coverage is primary and we will not seek contribution from any other insurance for any liability assumed under an "insured contract" that requires liability to be assumed on a primary noncontributory basis. Additionally, only the coverage and limit of insurance requirements of the "insured contract" shall apply, and in no event shall those requirements exceed the coverage and limits of insurance provided under this policy. ECA 24 509 04 14 Copyright, Everest Reinsurance Company, 2014 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., used with its permission INSURED COPY POLICYHOLDER COPY NF TE •COMPE-NSAFION P.O. BOX 8192, PLEASANTON, CA 94588 INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 05-31-2019 GROUP: POLICY NUMBER: 0804575-2018 CERTIFICATE ID: 819 CERTIFICATE EXPIRES: 10-14-2019 10-14-2018/10-14-2019 CITY OF CUPERTINO, QUINLAN CENTER NF 10185 N STELLING RD CUPERTINO CA 95014-5732 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2019-05-31 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL INSURED: CITY OF CUPERTINO, QUINLAN CENTER ®� ENDORSEMENT #2085 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-14-2008 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2019-05-31 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF CUPERTINO, QUINLAN CENTER EMPLOYER PYRO SPECTACULARS NORTH INC, NF 5301 LANG AVE MCCLELLAN CA 95852 [P17,SP1 (REV.7-2014) PRINTED : 05-31-2019 ENDORSEMENT AGREEMENT ADDITIONAL INSURED EMPLOYER REP B1 STATE 804575-18 RENEWAL NF FUND 5-41-39-14 PAGE 1 HOME OFFICE SAN FRANCISCO EFFECTIVE MAY 31, 2019 AT 12 . 01 A.M. ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME PYRO SPECTACULARS NORTH, INC. 5301 LANG AVE MCCLELLAN, CA 95652 ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED "THAT CITY OF CUPERTINO, QUINLAN CENTER IS HEREBY NAMED AS AN ADDITIONAL INSURED EMPLOYER ON THIS POLICY BUT ONLY AS RESPECTS EMPLOYEES WHOSE NAMES APPEAR ON THE PAYROLL RECORDS OF ! PYRO SPECTACULARS NORTH, INC. (HEREIN CALLED THE PRIMARY INSURED) WHILE THOSE EMPLOYEES ARE ENGAGED IN WORK UNDER THE SIMULTANEOUS DIRECTION AND CONTROL OF THE PRIMARY INSURED AND THE ADDITIONAL INSURED EMPLOYER. IT IS FURTHER AGREED THAT THE PAYMENT OF THE FULL PREMIUM DUE AND PAYABLE UNDER THIS POLICY SHALL REMAIN THE SOLE RESPONSIBILITY OF THE PRIMARY INSURED. NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED, NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: 'TUNE 4, 2019 0015 AUTHORIZED REPRESENT IVE PRESIDENT AND CEO SCIF FORM 10217 (REV.4-2018) OLD DP 217 ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION REP B1 804575-18 STATE RENEWAL NF FUND ,NPURANCG 5-41-39-14 PAGE 1 HOME OFFICE SAN FRANCISCO EFFECTIVE MAY 31, 2019 AT 12 . 01 A.M. AND EXPIRING OCTOBER 14 , 2019 AT 12 . 01 A.M. ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME PYRO SPECTACULARS NORTH, INC. 5301 LANG AVE MCCLELLAN, CA 95652 ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, CITY OF CUPERTINO, QUINLAN CENTER WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY, PYRO SPECTACULARS NORTH, INC. IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE EMPLOYER. IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH EMPLOYEES SHALL BE INCREASED BY 03% . NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: JUNE 4 , 2/019 2570 AUTHORIZED REPRESENT/IVE PRESIDENT AND CEO OLD DP 217 SCIF FORM 10217 IREV.4-20181 EVANSTON INSURANCE COMPANY CERTIFICATE NO.: - CERTIFICATE OF INSURANCE SPECIAL EVENT LIABILITY PROGRAM PRODUCER PUBLIC ENTITY(ADDITIONAL INSURED) Alliant Insurance Services,Inc.in conjunction with Apex Insurance Services P.O.Box 6450 Newport Beach,CA 92658 License No:OC 36861 NAMED INSURED(EVENT HOLDER): EVENT INFORMATION: City of Cupertino Its City Council,Boards and Commissions, TYPE: 411 of July Fireworks Display 2019 officers,employees,agents,servants,volunteers and DATE(S): July 4,2019 consultants LOCATION: Hyde Middle School,Miller Avenue, 10300 Torree Ave Sedp-wick Elementary,Creekside Park,Creekside Cupertino,CA 95798 Community Church and West Valley Presbyterian Church *Liquor Liability Yes❑ No N **Liquor Liability after 12 am ends before 2 am ❑ This is to certify that the insurance policy listed below has been issued to the above insured named(event holder)for the policy period indicated. The insurance described herein is subject to all the terms,exclusions and conditions of such policy(ies)unless amended as described in Special Conditions. INSURANCE CARRIER:Evanston Insurance Company MASTER POLICY NUMBER: SEP41028 MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2019 EXPIRATION:JANUARY 1,2020 COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE General Aggregate Limit $2,000,000 Products&Completed Operations 1,000,000 SPECIAL CONDITIONS: Personal&Advertising Injury 1,000,000 The following endorsements attached to Each Occurrence Limit 1,000,000 the Master Policy do not apply to this Damage To Premises Rented To You(Any One Premises) 100,000 Certificate Of Insurance: Medical Payments(Any One Person) 5,000 MEGL643 Liquor Liability (If purchased) 1,000,000 MEGL1854 Optional Limits Purchased ❑ $1,000,000/$3,000,000 ❑ $2,000,00052,000,000 Damage To Property $100,000 The limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event. OTHER ADDITIONAL INSUREDS Fremont High School District Castello Enterprises Idlewild Center Cupertino Union School District West Valley Presbyterian Church Creekside Community Church CANCELLATION: Should the above described policy be cancelled before the expiration date thereof,notice will be delivered in accordance with the policy provisions. AUTHORIZED REPRESENTATIVE: I i DATE ISSUED: 5/31/19