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12-033 Amendment #2 08-18-2020SECOND AMENDMENT TO AGREEMENT 12-033 BETWEEN THE CITY OF CUPERTINO AND LIFETIME TENNIS INC., DBA LIFETIME ACTIVITIES INC. FOR INSTRUCTION AND SUPERVISION OF CAMPS, CLASSES, LESSONS, RETAIL SERVICES, AND COURT MAINTENANCE This Second Amendment to Agreement 12-033 between the City of Cupertino and Lifetime Tennis Inc., DBA Lifetime Activities Inc., for reference dated 8/18/2020, is by and between the CITY OF CUPERTINO, a municipal corporation (hereinafter "City") and Lifetime Tennis Inc., DBA Lifetime Activities Inc., a California Corporation (“Contractor” or “Tennis Pro”) whose address is 1901 South Bascom Ave., Suite 1225, Campbell, CA 95008, and is made with reference to the following: RECITALS: A. On 3/20/2012, Agreement 12-033 (“Original Agreement”) was entered into by and between City and Contractor for tennis lessons, retail service, and court maintenance. B. On 7/1/2018, City and Contractor entered a First Amendment to the Original Agreement. C. The Agreement and the First Amendment are collectively referred to as the “Agreement” unless otherwise indicated. D. City and Contractor desire to modify the Agreement on the terms and conditions set forth herein. NOW, THEREFORE, it is mutually agreed by and between and undersigned parties as follows: 1. Compensation The following sentences are added to the end of Paragraph 4 of the Agreement: Notwithstanding the foregoing, for the period of March 13, 2020 to May 26, 2020 the City agrees to waive the rent charged to Contractor. For the period of July 1, 2020 to June 30, 2021, Contractor shall remit 23% of the gross revenue generated by Contractor’s programs to the City. City and Contractor may mutually agree for Contractor to teach a class online rather than in person, provided that City and Contractor mutually agree to compensation for that online class. Compensation for that online class shall be specified in writing in a separate agreement before online instruction for a class begins. 2. Exhibits A and B of the Agreement are replaced with new Exhibits A and B attached hereto. 3. Except as expressly modified herein, all other terms and covenants set forth in the Agreement shall remain the same and shall be in full force and effect. IN WITNESS WHEREOF, the parties hereto have caused this modification of Agreement to be executed. CONTRACTOR By Title Date__________________________ CITY OF CUPERTINO By Title Date__________________________ APPROVED AS TO FORM City Attorney ATTEST: City Clerk Date__________________________ EXPENDITURE DISTRIBUTION PO #2018-155 570-63-621 700-702 Original $7,600,000 Amendment #1: $10,800,000 Amendment #2: $0 Total: $18,400,000 1263653.1 Dana Gill CEO Aug 28, 2020 Heather M. Minner Deborah L. Feng City Manager Aug 28, 2020 Aug 28, 2020 EXHIBIT A SCOPE OF WORK, PERFORMANCE AND PAYMENT SCHEDULES The CONTRACTOR will provide INSTRUCTION AND SUPERVISION in, but not limited to, the following: TENNIS, BADMINTON, TABLE TENNIS, BASKETBALL, VOLLEYBALL, PICKLEBALL AND CHESS 1. Duties of Lifetime Tennis Inc., DBA Lifetime Activities Inc. a) Class and camp instruction for all City-sponsored groups as determined by the City. Class size and court usage shall be established and approved by the City. All instruction shall be provided at a quality consistent with the standards found at other facilities in the area which are open to the public. b) Will provide all necessary and appropriate equipment for the purpose of teaching high quality programs, including, but not limited to, tennis balls, ball machines, nets, and table tennis tables. This equipment shall be stored at the Cupertino Sports Center in space provided by Lifetime Tennis Inc., DBA Lifetime Activities Inc. c) Will respond to all public complaints no later than two (2) days after the complaint was registered. Both complaints and responses will be documented and forwarded to the City no later than the first of each month. 2. Optional Services a) The City shall have the sole right to establish the use of all tennis courts at the Sports Center and Lifetime Tennis Inc., DBA Lifetime Activities Inc.’s right to give private lessons on any court is subject to the City’s right to priority usage for the City sponsored events. b) Utilize courts #5 and #6 at Memorial Park for the sole purpose of teaching tennis lessons (Exception: Lifetime Tennis Inc., DBA Lifetime Activities Inc. is prohibited from using said courts on Tuesdays from 8:00 a.m. to Noon). 3. Collection of Fees and Charges a) All fees and charges for classes, camps, and private lessons provided by Lifetime Tennis Inc., DBA Lifetime Activities Inc. shall be collected from the public by the City. The fees and charges for all classes, lessons, and camps for both city-sponsored and private pupils will be established solely by the City pursuant to its normal procedure for establishing such fees and charges. b) During the term of this Agreement, Lifetime Tennis Inc., DBA Lifetime Activities Inc. is granted the exclusive privilege of providing tennis instruction at the Cupertino Sports Center other than that which is provided by City employees in connection with City-sponsored programs. 4. Retail Service a) The Retail Service to commence on July 1, 2018, and continue through June 30, 2024. b) The Retail Service that Lifetime Tennis Inc., DBA Lifetime Activities Inc. will be offering at the Cupertino Sports Center will consist of the following: • Racquet restringing for tennis and racquetball racquets. • Grip- build-up service • Various accessories for tennis racquets (grips, vibration dampers, etc.) • Tennis racquet demo program and tennis racquet sales • Table tennis paddles • Pre-packaged food and beverages. c) The Retail Service will be located in the existing pro shop space located next to the lobby of the Cupertino Sports Center. d) Hours of Operation • Monday-Saturday 8:00 a.m. – 9:30 p.m. • Sunday 8:00 a.m. – 8:00 p.m. Any changes to the hours of operation must be authorized by the City representative. e) Monthly Financial Statements – No later than fifteen (15) days after the end of each month Lifetime Tennis Inc., DBA Activities Inc. shall submit to the City of Cupertino a written statement for the preceding month showing the gross revenue and expenses for the Retail Service. f) Court Maintenance - Lifetime Tennis Inc., DBA Lifetime Activities Inc. is to provide at its own expense, weekly maintenance services for all 18 tennis courts at the Cupertino Sports Center. This service is to include biweekly court washing and alternating biweekly court blowing/sweeping. In addition, Lifetime Tennis Inc., DBA Lifetime Activities Inc. will provide all necessary materials to provide these maintenance services. Materials include, but are not limited to, court washing wands, industrial grade hoses, hose carrier cart, portable air blower, and toolkit. 5. Facility Closure a) The City reserves the right to close the facility for maintenance, for five consecutive week days, once per fiscal year, commencing in the fiscal year 2019/2020. The City will consider programming schedules and high traffic times of the facility when scheduling the closure. Location and Time of CONTRACTOR Services: Refer to the Recreation Schedule dated SUMMER 2018 - SPRING 2024 for agreed upon dates, times, and locations of a class, camp, activity, program, or service (“class”). The City, at its sole discretion, may change the agreed dates, times and locations of a class, or may cancel a class. Eligible Participant Minimum and Maximums for CONTRACTOR Services: Minimum: 2 - 4 Maximum: 99 If less than the required minimum number of participants enroll in and pay for a particular class as identified in the schedule before the class is scheduled to start, the City may cancel the particular class and/or terminate this Agreement without additional notice or payment to Contractor. List of all Contractor Employees working for the City of Cupertino (if no Employees, identify “self”): Jack Chan Naveen SastriShoggy Park Danielle Bautista Raymond Uyehara Cyril Macasero Jack Tang Wootak Kim Performance of CONTRACTOR Services Class Cancellation Contractor will only receive compensation for a class that is performed. If performance of a class is cancelled by the City or Contractor before instruction begins, Contactor will not receive compensation for the class. If the City or Contractor cancels performance of certain meetings of a class, Contractor will only receive compensation for those meetings of the class that are performed. In the case Contractor unilaterally cancels performance of a class without City approval, City reserves the right to immediately and without notice cancel the remainder of classes offered and or performed by Contractor. COVID-19 Health Order Compliance Contractor acknowledges that its duty to comply with Laws, as stated in Section 13 of the Agreement, includes compliance by Contractor with the restrictions on travel and the Social Distancing Requirements set forth in Section 13.k of the health order issued by the County of Santa Clara Public Health Department on March 31, 2020, in response to the COVID-19 pandemic, and any subsequent amendments or superseding orders thereto (the “Health Order”), and any other local, state, or federal laws or policies that have been or may be enacted in response to the COVID-19 pandemic (collectively, “Health Laws”). Contractor shall comply with these restrictions on travel and Social Distancing Requirements when preforming work under this Agreement. If this Agreement specifies work that cannot be performed in compliance with the Health Order or Health Laws, Contractor shall refrain from conducting the work and immediately inform the City. Contractor shall likewise comply with any City protocols designed to help prevent the spread of COVID-19. Contractor acknowledges that the need to comply with the Health Order and Health Laws may result in the City canceling performance of any class or meetings of a class referenced in this Agreement. Registration, Enrollment, and Supervision The Contractor shall follow all guidelines pertaining to registration procedures as listed in the quarterly recreation schedule. Participants may not take part in the program unless they are listed on the class roster or can show proof of enrollment. All participants and volunteers need to complete the City’s Waiver of Liability form prior to taking part in the program. If applicable, contractors who are John Vest Jennifer Shem Mei Jin Dana Gill Justin Yee Ali Khadem Juan Garcia Sophie Leopold responsible for supervising minors must remain with the class until a parent of legal guardian has arrived and all minors are released to them. Injury of a Class Participant In the event of an injury occurring to a participant, the Contractor will notify the City within 1 hour and complete an Incident Report in the form approved by the City. The Incident Report must be submitted to the City within 24 hours of the injury occurring. 1263650.1 Exh. B Insurance for Recreation Contracts Updated May 2020 As required by the Agreement, Contractor shall procure prior to commencement of Services and maintain the following insurance for the duration of the Agreement against claims arising from or in connection with Contractor, its agents, representatives, employees or subcontractors Services under this Agreement. Minimum Scope and Limit of Insurance. Coverage shall be at least as broad as: 1. Commercial General Liability (CGL): Insurance Services Office Form CG 00 01 covering CGL on an “occurrence” basis, including property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence. If a general aggregate limit applies, it must apply separately to this project/location (CG 25 03 or 25 04) or 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 Consultant'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 this Contract. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary basis for the benefit of City before the City’s own insurance or self-insurance shall be called upon to protect City as a named insured. law 2. Automobile Liability (select one):  ISO CA 0001 covering Code 1 (any auto), or if Contractor has no owned autos, Code 8 (hired) and 9 (non-owned), with limits no less than $1,000,000 per accident for bodily injury and property damage. (Required if automobile is used to perform work under this contract.)  Proof of Contractor’s personal auto insurance with limits required by state law. (Contractor shall not transport or use its personal vehicle to transport participants or perform work under this contract.)  Automobile insurance is waived. (Contractor shall never use a vehicle while working under this contract, other than to commute to and from the work site. Contractor shall not use a vehicle to travel between City sites, between classes, etc.) 2. Workers’ Compensation: As required by the State of California, with Statutory and Employer’s Liability Insurance limits of no less than $1,000,000 per accident for bodily injury or disease.  Required if Contractor has employees.  If no employees, Contractor must sign Affidavit of No Employees. 2. Sexual Abuse/Molestation: Insurance or the equivalent as required for activities/services involving minors, (i.e., after school activities, recreational programs, athletics, study/training events and transportation of minors). Coverage may be included under General Liability or be obtained in a separate policy, such as Educators Legal Liability (ELL) policy, with a limit of no less than $1,000,000 per occurrence. If a general aggregate limit applies, it must apply separately to this contract or be twice the required occurrence limit.  Required if Contract involves services to children. Insurance coverage required may be satisfied by a combination of Primary and Excess/Umbrella insurance. Exhibit B Insurance Requirements for Recreation Contracts Exh. B Insurance for Recreation Contracts Updated May 2020 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 Consultant’s CGL and automobile liability policies. General Liability coverage can be provided in the form of an endorsement to Consultant’s insurance (at least as broad as ISO Form CG 20 10 (11/ 85) or both CG 20 10 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 Consultant’s insurance and shall not contribute to it. Notice of Cancellation Each insurance policy shall state that coverage shall not be canceled or allowed to expire, except with written notice to City 30 days in advance or 10 days in advance if due to non-payment of premiums. Waiver of Subrogation Consultant 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 Consultant, its employees, agents and subconsultants. 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 Consultant 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 licensed to do business in California with an A.M. Best Rating of A-VII, or better. Verification of Coverage Consultant 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. Subconsultants Consultant shall require and verify that all subconsultants maintain insurance that meet the requirements of this Contract, including naming the City as an additional insured on subconsultant’s insurance policies. Higher Insurance Limits If Consultant 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 Consultant. Adequacy of Coverage City reserves the right to modify these insurance requirements/coverages based on the nature of the risk, prior experience, insurer or other special circumstances, with not less than ninety (90) days prior written notice. 1223215.2 Retroactive Date (CG 00 02 Only)N/A In New York COMMERCIAL GENERAL LIABILITY POLICY DECLARATIONS RENEWAL OF NUMBER: Named Insured And Mailing Address (No.,Street,Town or City,County,State,Zip Code) IN RETURN FOR THE PAYMENT OF THE PREMIUM,AND SUBJECT TO ALL TERMS OF THIS POLICY,WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. Policy Period:From ____________To ____________,at 12:01 A.M.Standard Time at your mailing address shown above. POLICY NUMBER: Producer Number,Name and Mailing Address Limits Of Insurance $ MDGL 1500 03 14 $ Business Description And Location Of Premises Form Of Business: Business Description: Location Of All Premises You Own,Rent Or Occupy: This insurance does not apply to "'bodily injury","property damage"or "personal and advertising injury"which occurs before the Retroactive Date,if any,shown below. Retroactive Date: Includes copyrighted material of Insurance Services Office,Inc., with its permission. General Aggregate Limit (Other Than Products-Completed Operations) Products-Completed Operations Aggregate Limit Personal And Advertising Injury Limit Each Occurrence Limit Damage To Premises Rented To You Limit Any One Premises Medical Expense Limit Any One Person $ $ $ $ (Enter Date Or "None"If No Retroact Date applies) SEE ATTACHED "EXTENSION OF DECLARATIONS" InsuredInsured 5,000,000 1,000,000 None 2,000,000 1,000,000 100,000 5,000 Markel Insurance Company 8502AH010514 -2 8502AH010514-1 Lifetime Tennis,Inc.dba Lifetime Activities 5801 Valley Avenue Pleasanton,CA 94566 07-01-2020 07-01-2021 Corporation Amateur Sports 88707 /Bollinger Inc DBA RPS Bollinger PO Box 1322 Morristown,NJ 07960 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION Copyright,Insurance Services Office,Inc.,2012CG20260413 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 SCHEDULE POLICY NUMBER: Page 1 of 1 1. Name Of Additional Insured Person(s)Or Organization(s): Information required to complete this Schedule,if not shown above,will be shown in the Declarations. Section II -Who Is An Insured is amended to include as an additional insured the person(s)or organization(s)shown in the Schedule,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 omis- sions or the acts or omissions of those acting on your behalf: 1.In the performance of your ongoing opera- tions;or 2.In connection with your premises owned by or rented to you. 2. The insurance afforded to such additional in- sured only applies to the extent permitted by law;and A. However: If coverage provided to the additional insured is required by a contract or agreement,the in- surance afforded to such additional insured will not be broader than that which you are re- quired by the contract or agreement to pro- vide for such additional insured. With respect to the insurance afforded to these additional insureds,the following is added to Section III -Limits Of Insurance: B. 1.Required by the contract or agreement;or 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: 2.Available under the applicable Limits of Insur- ance shown in the Declarations; whichever is less. This endorsement shall not increase the applica- ble Limits of Insurance shown in the Declarations. The City of Cupertino,its City Council,boards and commissions,officers,employees, agents,servants and volunteers 10300 Torre Ave Cupertino,CA 95014 But only as required by contract with the named insured to provide primary insurance. The insurance provided by this endorsement is primary.Other insurance afforded to the above named additional insured shall apply as excess of,and does not contribute with, the insurance provided by this endorsement. 8 5 0 2 AH0 1 0 5 1 4 -2 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART EMPLOYEE BENEFITS LIABILITY COVERAGE Unless specifically stated herein,all terms,conditions and exclusions of the policy shall apply to this coverage. A. COVERAGE Employee Benefits Programs ESTIMATED NUMBER OF EMPLOYEES LIMITS OF INSURANCE ADVANCE PREMIUM $* $ $ $*See Policy Schedule RATE (EACH EMPLOYEE)ESTIMATED PREMIUM * Total The following is added to Section I -Coverages - EMPLOYEE BENEFITS LIABILITY COVERAGE Insuring Agreement We will pay those sums that the insured becomes legally obligated to pay as damages because of any act,error,or omission of the insured,or of any other person for whose acts the insured is legally liable to which this insurance applies.We will have the right and duty to defend the insured against any "suit" seeking those damages.However,we will have no duty to defend the insured against any "suit"seeking damages to which this insurance does not apply.We may,at our discretion,investigate any report of an act, error or omission and settle any "claim"or "suit"that may result.But: Page 1 of 5 1. MGL100 (07/05) SCHEDULE Deductible:See Section D First 5,000 Next 5,000 Over 10,000 each employee aggregate This insurance does not apply No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments. The amount we will pay for damages is limited as described in Paragraph D.-LIMITS OF INSURANCE; a. 2.Exclusions Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements. b. c.The negligent act,error or omission must take place in the "coverage territory".We will have the right and duty to defend any "suit"seeking those damages. Damages arising out of any intentional, dishonest,fraudulent,criminal or malicious act,error or omission,committed by any insured,including the willful or reckless violation of any statute. "Bodily injury"or "property damage"or "personal and advertising injury"; Loss arising out of an insufficiency of funds to meet any obligations under any plan included in the "employee benefit program"; Loss arising out of failure of performance of contract by any insurer; a. b. d. c. Any "claim"or "suit"based upon:e. failure of any investment to perform as represented by any insured;or (1) COMMERCIAL GENERAL LIABILITY POLICY NUMBER: 1,000,000 2,000,000 8502AH010514 -2 Markel Insurance Company Any "claim"arising out of your failure to comply with the mandatory provisions of any law concerning workers'compensation, unemployment insurance,social security or disability benefits or any similar law. f. Loss for which any insured is liable because of liability imposed on a fiduciary by the Employee Retirement Income Security Act of 1974,as now or hereafter amended or by any similar federal,state or local laws. g. Errors in providing information on past performance of investment vehicles. (3) advice given to any person to participate or not to participate in any plan included in the "employee benefit program";or (2) Any "claim"for benefits to the extent that such benefits are available,with reasonable effort and cooperation of the insured,from the applicable funds accrued or other collectible insurance. Taxes,fines or penalties,including those imposed under the Internal Revenue Code or any similar state or local law. Damages arising out of wrongful termination of employment,discrimination,or other employment-related practices. h. i. j. All references to Supplementary Payments - Coverages A and B are amended to also include Employee Benefits Liability. Supplementary PaymentsB. Paragraphs 1.b.and 2.of the Supplementary Payments provision do not apply to Employee Benefits Liability. a. b. C. For the purposes of the coverage provided by this endorsement: For the purposes of the coverage provided by this endorsement,Paragraphs 2.and 3.of Section II - Who Is An Insured are replaced by the following: Each of the following is also an insured: Each of your "employees"who is or was authorized to administer your "employee benefit program." Your legal representative if you die,but only with respect to duties as such.That representative will have all your rights and duties under this endorsement. 2. a. b. MGL100 (07/05)Page 2 of 5 Any persons,organizations or "employees" having proper temporary authorization to administer your "employee benefit program"if you die,but only until your legal representative is appointed. c. Any organization you newly acquire or form,other than a partnership,joint venture,or limited liability company and over which you maintain ownership or majority interest,will be deemed to be a Named Insured if there is no other similar insurance applied to that organization.However: Coverage under this provision is afforded only until the 90th day after you acquire or form the organization,or until the end of the policy period, whichever is earlier. Coverage under this provision does not apply to any negligent act,error or omission that occurred before you acquired or formed the organization. 3. a. b. For the purposes of the coverage provided by this endorsement,Section III -Limits of Insurance is replaced by the following: The Limits of Insurance shown in the Schedule and the rules below fix the most we will pay regardless of the number of: Insureds; "Claims"made or "suits"brought; D. 1.Limits of Insurance a. (1) (2) Acts,errors or omissions;or The Aggregate Limit is the most we will pay for all damages because of acts,errors or omissions negligently committed in the "administration"of your "employee benefit program". b. Person or organizations making "claims"or bringing "suits"; Benefits included in your "employee benefit program". (3) (4) (5) Subject to the Aggregate Limit,the Each Employee Limit is the most we will pay for all damages sustained by any one "employee", including the "employee's"dependents and beneficiaries,because of acts,errors or omissions or a series of related acts,errors or omissions negligently committed in the "administration"of your "employee benefit program". c. However,the amount paid under this endorsement shall not exceed,and will be subject to,the limits and restrictions that apply to the payment of benefits in any plan included in the "employee benefit program". Our obligation to pay damages on behalf of the insured applies only to the amount of damages in excess of the $1,000 deductible applicable to Each Employee.The limits of insurance applicable to Each Employee will not be reduced by the amount of this deductible. The Aggregate limit shall not be reduced by the application of such deductible amount. The deductible amount stated in the Schedule applies to all damages sustained by any one "employee",including such "employee's" dependents and beneficiaries,because of all acts,errors or omissions to which this insurance applies. The Limits of Insurance of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months,starting with the beginning of the policy period shown in the Declarations of the policy to which this endorsement is attached,unless the policy period is extended after issuance for an additional period of less than 12 months.In that case,the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. a. Deductible2. b. The terms of this insurance,including those with respect to: Our right and duty to defend any "suits" seeking those damages;and (1) c. Your duties,and the duties of any other involved insured in the event of an act, error or omission or "claim";apply irrespective of the application of the deductible amount. (2) We may pay any part or all of the deductible amount to effect settlement of any "claim"or "suit"and,upon notification of the action taken,you shall promptly reimburse us for such part of the deductible amount as we have paid. d. The purposes of the coverage provided by this endorsement,Conditions 2.and 4.of Section IV - Commercial General Liability Conditions are replaced by the following: Duties In The Event Of An Act,Error Or Omission,Or "Claim"Or "Suit" You must see to it that we are notified as soon as practicable of an act,error or omission which may result in a "claim".To the extent possible,notice should include: 2. a. E. The names and addresses of anyone who may suffer damages as a result of the act, error or omission. (1) (2) What the act,error or omission was and when it occurred;and If a "claim"is made or "suit"is brought against any insured,you must: b. Notify us as soon as practicable (1) (2) Immediately record the specifics of the "claim"or "suit"and the date received; You and any other involved insured must:c. You must see to it that we receive written notice of the "claim"or "suit"as soon as practicable. Authorize us to obtain records and other information; (1) (2) Immediately send us copies of any demands,notices,summonses or legal papers received in connection with the "claim"or "suit"; (3)Cooperate with us in the investigation or settlement of the "claim"or defense against the "suit";and (4)Assist us,upon our request,in the enforcement of any right against any person or organization which may be liable to the insured because of an act, error or omission to which this insurance may also apply. No insured will,except at that insured's own cost,voluntarily make a payment,assume any obligation or incur any expense without our consent. d. Other Insurance Primary Insurance 4. a. This insurance is primary except when b. below applies.If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary.Then,we will share with all that other insurance by the method described in c.below. MGL100 (07/05)Page 3 of 5 Excess Insuranceb. When this insurance is excess,we will have no duty to defend the insured against any "suit"if any other insurer has a duty to defend the insured against that "suit".If no other insurer defends,we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance,we will pay only our share of the amount of the loss,if any, that exceeds the sum of the total amount that all such other insurance would pay for the loss in absence of this insurance;and the total of all deductible and self-insured amounts under all that other insurance. (3) We will share the remaining loss,if any,with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Schedule of this endorsement. (1) (2) This insurance is excess over any of the other insurance,whether primary, excess,contingent or on any other basis that is effective prior to the beginning of the policy period shown in the Schedule of this insurance. (4) Method Of Sharingc. If all of the other insurance permits contribution by equal shares,we will follow this method also.Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains,whichever comes first. If any of the other insurance does not permit contribution by equal shares,we will contribute by limits.Under this method,each insurer's share is based on the ratio of its applicable limits of insurance of all insurers. For the purposes of the coverage provided by this endorsement,the following definitions are added to the Definitions Section: 1. Providing information to "employees", including their dependents and beneficiaries,with respect to eligibility for or scope of "employee benefit programs"; a. F. "Administration"means: 2. Handling records in connection with the "employee benefit program";or b. Effecting,continuing or terminating any "employee's"participation in any benefit included in the "employee benefit program". c. However,"administration"does not include handling payroll deductions. "Cafeteria plans"means plans authorized by applicable law to allow employees to elect to pay for certain benefits with pre-tax dollars. 3."Claim"means any demand,or "suit",made by an "employee"or an "employee's" dependents and beneficiaries,for damages as the result of an act,error or omission. 4."Employee benefit program"means a program providing some or all of the following benefits to "employees",whether provided through a "cafeteria plan"or otherwise: Group life insurance,group accident or health insurance,dental,vision and hearing plans,and flexible spending accounts,provided that no one other than an "employee"may subscribe to such benefits and such benefits are made generally available to those "employees" who satisfy the plan's eligibility requirements; a. Profit sharing plans,employee savings plans,employee stock ownership plans, pension plans and stock subscription plans,provided that no one other than an "employee"may subscribe to such benefits and such benefits are made generally available to all "employees"who are eligible under the plan for such benefits; b. Unemployment insurance,social security benefits,workers'compensation and disability benefits; c. Vacation plans,including buy and sell programs;leave of absence programs, including military,maternity,family,and civil leave;tuition assistance plans; transportation and health club subsidies; and d. Any other similar benefits designated in the Schedule or added thereto by endorsement. e. MGL100 (07/05)Page 4 of 5 MGL100 (07/05)Page 5 of 5 All other terms and conditions remain the same. For the purposes of the coverage provided by this endorsement,Definitions 5.and 18.in the Definitions Section are replaced by the following: 5. G. "Employee"means a person actively employed,formerly employed,on leave of absence or disabled,or retired."Employee" includes a "leased worker"."Employee" does not include a "temporary worker". 18."Suit"means a civil proceeding in which damages because of an act,error or omission to which this insurance applies are alleged."Suit"includes: An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent;or a. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. b. THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. ABUSE OR MOLESTATION COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM The following is added to Section I -Coverages: COMMERCIAL GENERAL LIABILITY The following exclusion is added to Paragraph 2.Exclusions under Section I -Coverages,Coverage A -Bodily In- jury And Property Damage Liability and Coverage B -Personal And Advertising Injury Liability: A. B. Insuring Agreement This insurance does not apply to: 1. We will pay those sums the insured becomes legally obligated to pay as damages because of "bodily in- jury"arising out of abuse,molestation or exploitation to which this insurance applies.We will have the right and duty to defend the insured against any "suit"seeking such damages.However,we will have no duty to defend the insured against any "suit"seeking damages to which this insurance does not apply.Nor do we have a duty to defend any insured who is alleged to have taken part in the abuse,molestation or ex- ploitation.We may,at our discretion,investigate and settle any claim or "suit"that may result.But: a. Page 1 of 3IncludescopyrightedmaterialofInsuranceServicesOffice,Inc., with its permission. MGL 1262 08 14 POLICY NUMBER: $Aggregate SCHEDULE Abuse Or Molestation Limits Of Insurance $Each Person The amount we will pay for damages is limited as described in Paragraph C.Limits Of Insurance be- low;and (1) The following changes apply only to the coverage provided by this endorsement. Abuse Or Molestation "Bodily injury","property damage"or "personal and advertising injury"arising out of the actual or threatened abuse, molestation or exploitation by anyone.This exclusion applies even if the claim against the insured alleges negli- gence or other wrongdoing in the employment,investigation,supervision,reporting to the proper authorities or fail- ure to so report,training or retention. ABUSE OR MOLESTATION COVERAGE Our right and duty to defend ends when we have used up the applicable limit of insurance in the pay- ment of judgments or settlements under Abuse Or Molestation Coverage. (2) This insurance applies to "bodily injury"arising out of abuse,molestation or exploitation only if the abuse, molestation or exploitation: b. Takes place in the "coverage territory";(1) Results from the insured's negligence in employment,investigation,supervision,reporting to the proper authorities or failure to so report,training or retention;and (2) First occurs during the policy period.(3) Abuse,molestation or exploitation which first occurs during the policy period includes any continuation, change or resumption of that abuse,molestation or exploitation after the end of the policy period. c. Multiple acts of abuse,molestation or exploitation of any one person by one or more perpetrators will be deemed to have first occurred at the time of the first act of such abuse,molestation or exploitation and shall be subject to the coverage and limits in effect at the time of the first act of abuse,molestation or ex- ploitation. d. 1,000,000 2,000,000 8502AH010514 -2 Markel Insurance Company Exclusions2. Fines And Penaltiesa. Participating Insuredb. This insurance does not apply to: Any fines,penalties,punitive damages,exemplary damages or aggravated damages. Any insured who takes part in the abuse,molestation or exploitation. Passive Insuredc. Any insured who remains passive upon gaining knowledge of any actual,alleged or threatened abuse,mo- lestation or exploitation. Section III -Limits Of Insurance is replaced by the following:C. SECTION III -LIMITS OF INSURANCE The Limits of Insurance shown in the Schedule of this endorsement and the rules below fix the most we will pay under Abuse Or Molestation Coverage regardless of the number of: 1. Insureds;a. Claims made or "suits"brought;orb. Persons or organizations making claims or bringing "suits".c. The Aggregate Limit shown in the Schedule of this endorsement is the most we will pay under Abuse Or Mo- lestation Coverage for the sum of all damages. 2. Subject to Paragraph 2.above,the Each Person limit shown in the Schedule of this endorsement is the most we will pay under Abuse Or Molestation Coverage for damages because of "bodily injury"arising out of abuse, molestation or exploitation committed upon any one person,regardless of the number of acts of abuse,mo- lestation or exploitation committed,the period of time over which such acts occur,or the number of perpetrators taking part in the abuse,molestation or exploitation. 3. The coverage provided by this endorsement does not provide any duplication or overlap of any other coverage provided elsewhere in this policy.No coverage is provided for abuse,molestation or exploitation under this poli- cy except as provided in this endorsement. 4. The Limits of Insurance provided by this endorsement are in addition to,not part of,the Limits of Insurance provided by the Commercial General Liability Coverage Form. 5. Section IV -Commercial General Liability Conditions is amended as follows:D. The Limits of Insurance shown in the Schedule of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months,starting with the beginning of the policy period shown in the Declarations of the Commercial General Liability Coverage Form,unless the policy period is extended after is- suance for an additional period of less than 12 months.In that case,the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. The heading and Paragraph a.of Condition 2.is replaced by the following:1. Duties In The Event Of Abuse,Molestation,Exploitation,Claim Or Suit2. You must see to it that we are notified as soon as practicable of an act or allegation of abuse,molesta- tion or exploitation which may result in a claim.To the extent possible,notice should include: a. How,when and where the abuse,molestation or exploitation took place;(1) The names and addresses of any injured persons and witnesses;and(2) The nature and location of any injury or damage arising out of the abuse,molestation or exploita- tion. (3) Page 2 of 3IncludescopyrightedmaterialofInsuranceServicesOffice,Inc., with its permission. MGL 1262 08 14 The following is added to Paragraph b.Excess Insurance of Condition 4.Other Insurance:2. The insurance provided by this endorsement is excess over any other insurance provided to any insured, whether such other insurance is provided on a primary,excess,contingent or any other basis,unless such oth- er insurance is written to be specifically excess of this insurance. All other terms and conditions remain unchanged. Page 3 of 3IncludescopyrightedmaterialofInsuranceServicesOffice,Inc., with its permission. MGL 1262 08 14 The following Condition is added:3. Multiple Coverage Forms Or Policies Issued By Us When two or more Coverage Forms or policies issued by us or any other Markel Corporation owned or op- erated insurance company apply to the same claim,"suit"or loss,the maximum limit of our liability under all such Coverage Forms or policies combined shall not exceed the highest applicable limit of liability under any one Coverage Form or policy among them. Definition 3."bodily injury"under Section V -Definitions is amended as follows:E. "Bodily injury"means bodily injury,sickness,disease,mental anguish or emotional distress sustained by a person, including death resulting from any of these at any time. POLICY NUMBER: EXCESS/UMBRELLA DECLARATIONS Page 1 of 4MDUB10000314IncludescopyrightedmaterialofInsuranceServicesOffice,Inc. with its permission. Named Insured and Mailing Address: Policy Period From:To: At 12:01 a.m.standard time at your mailing address shown above Policy Premium:$ Limits of Insurance: General Aggregate $ Products-Completed Operations Aggregate $ Each Occurrence $ Each Person -Personal And Advertising Injury $ Self Insured Retention -Each Occurrence $ Retroactive Date:Per Underlying Claims-made Coverage,if applicable. Direct Billed Agency Billed THIS POLICY PROVIDES CLAIMS-MADE COVERAGE FOR THE UNDERLYING INSURANCE SHOWN AS CLAIMS-MADE IN THE SCHEDULE OF UNDERLYING INSURANCE.PLEASE READ THE ENTIRE FORM CAREFULLY. This insurance does not apply to Coverage A -Bodily Injury And Property Damage Liability and Coverage B - Personal And Advertising Injury written under Section II -Umbrella Liability Coverage which occurs before the Retroactive Date shown below.N/A in New York This policy provides Excess Liability coverage only or Umbrella Liability coverage only. IN RETURN FOR THE PAYMENT OF THE PREMIUM AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. (Enter a date only when one or more underlying insurance coverages are claims-made.) RENEWAL OF POLICY: Only the policy provisions applicable to the type of coverage checked in the above box will apply.Please refer to the appropriate sections of the policy for what is and is not covered according to the coverage type. Insured X 1,000,000 1,000,000 1,000,000 1,000,000 4,165.00 X Markel Insurance Company 4602AH010515-14602AH010515-2 Lifetime Tennis,Inc.dba Lifetime Activities 5801 Valley Avenue Pleasanton,CA 94566 07-01-2020 07-01-2021 Forms and Endorsements attached to this policy at time of issuance: Issue Date:At:By: (Authorized Representative) These declarations,together with the Coverage Form(s)and any Endorsement(s),complete the above numbered policy. Page 2 of 4MDUB10000314IncludescopyrightedmaterialofInsuranceServicesOffice,Inc. with its permission. Producer Number,Name and Mailing Address MJIL1000(06/10),MDUB1000(03/14),MUB0001(03/14),MUB315(08/03),MIL1214(09/17),MUB-TERR-1(01/15),MUB1202(02/11),MUB1212(01/15),MUB1360(01/15),MUB1400-CA(03/14) 88707 /Bollinger Inc DBA RPS Bollinger PO Box 1322 Morristown,NJ 07960 07-10-2020 Glen Allen,VA JOHN K.CLARK Named Insured:Policy Number: Page 3 of 4MDUB10000314IncludescopyrightedmaterialofInsuranceServicesOffice,Inc. with its permission. EXCESS/UMBRELLA POLICY SCHEDULE OF UNDERLYING INSURANCE Carrier,Policy Number, Policy Period (If Applicable)Type of Coverage Underlying Limits of Insurance Commercial General Liability $ $ (An "X"in the Type of Coverage boxes below ()indicates these coverages are provided by the underlying policies.) Carrier: Each Wrongful Act AggregateProfessionalLiability $ $ Policy Number: Each Employee Aggregate Employee Benefits Liability $ $ Each Common Cause Aggregate Liquor Liability $ $ Policy Period: Occurrence Policy Period: Claims-MadeCarrier: Policy Number:Liquor Liability General Aggregate Occurrence Claims-MadeCarrier: Policy Number: Policy Period: Carrier: Policy Number: Policy Period: Occurrence Claims-Made Occurrence Claims-Made Bodily Injury by Accident Bodily Injury by Disease - Each Person Bodily Injury by Disease - Policy Limit Stop Gap -Employers Liability $ $ $ Carrier: Policy Number: Policy Period: Garage Liability Carrier: Policy Number: Policy Period: $ $ Carrier: Policy Number: Policy Period: Business Automobile Liability Each Accident$ Owned Automobiles Non-Owned Automobiles Hired Automobiles Owned Automobiles Hired Automobiles Non-Owned Automobiles Each Accident -Garage Operations -Auto Only Other than Auto Only Aggregate -Garage Operations - Other than Auto Only $ $ Products-Completed Operations Aggregate Each Occurrence Personal And Advertising Injury - Each Person Or Organization $ $ $ X X Hartford Accident &Indemnity Co 57UECVX5953 08/19/2019 08/19/2020 X X X X 1,000,000 MARKEL INSURANCE COMPANY 8502AH010514-2 07/01/2020 07/01/2021 X 5,000,000 2,000,000 1,000,000 1,000,000 MARKEL INSURANCE COMPANY 8502AH010514-2 07/01/2020 07/01/2021 X 1,000,000 2,000,000 Lifetime Tennis,Inc.dba 4602AH010515 -2 Page 4 of 4MDUB10000314IncludescopyrightedmaterialofInsuranceServicesOffice,Inc. with its permission. Carrier,Policy Number, Policy Period (If Applicable)Type of Coverage Underlying Limits of Insurance Per Occurrence Per Occurrence Carrier: Policy Period: $ $ $ Policy Number: $ $ $ Policy Period: $ $ $ Occurrence Claims-MadeCarrier: Policy Number: Occurrence Claims-MadeCarrier: Policy Number: Policy Period: Carrier: Policy Number: Policy Period: Occurrence Claims-Made Occurrence Claims-Made Policy Period: Carrier: Policy Number: Carrier: Policy Number: Policy Period: Carrier: Policy Number: Occurrence Claims-Made $ $ $ $ $ $ $ $ $ Aggregate Per Person,Per Occurrence Carrier: Policy Number: Each Wrongful Act Aggregate Aggregate Each Occurrence Aggregate Personal &Advertising Injury Each Occurrence Policy Period: General Aggregate Each Occurrence $ $ Policy Period: Aggregate Each Occurrence Bodily Injury by Accident Bodily Injury by Disease - Each Person Bodily Injury by Disease - Policy Limit $ $ $ Occurrence Claims-Made Occurrence Claims-Made Occurrence Claims-Made X X Cypress Insurance LIWC013452 07/01/2020 07/01/2021 Employer's LiabilityX 1,000,000 1,000,000 1,000,000 MARKEL INSURANCE COMPANY 8502AH010514-2 07/01/2020 07/01/2021 Sexual Abuse &MolestationX 2,000,000 1,000,000 22357 Hartford Accident & Indemnity Company PO Box 33015 San Antonio TX 78265-9519 57UECVX5953 8/19/2020 8/19/2021 2014 Toyota Rav4 2T3YFREVXEW092957 Leavitt Pacific Insurance Brokers, Inc. License #0D79674 1570 The Alameda, Suite 101 San Jose CA 95126 Lifetime Tennis, Inc. 5801 Valley Avenue Pleasanton CA 94566 http://www.leavitt.com/leavittpacificWeb Address: ACORD 50 CA (2004/07) COMPANY NAME AND ADDRESSCOMPANY NUMBER POLICY NUMBER EFFECTIVE DATE YEAR AGENCY/COMPANY ISSUING CARD INSURED SEE IMPORTANT NOTICE ON REVERSE SIDE THIS POLICY MEETS THE REQUIREMENTS OF § 16056 OF THE CALIFORNIA VEHICLE CODE CALIFORNIA INSURANCE IDENTIFICATION CARD THIS CARD MUST BE KEPT IN THE INSURED VEHICLE AND PRESENTED UPON DEMAND IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information: 1. Name and address of each driver, passenger and witness. 2. Name of Insurance Company and policy number for each vehicle involved. © ACORD CORPORATION 2004 INS050CA (0405).02a MAKE/MODEL VEHICLE IDENTIFICATION NUMBER EXPIRATION DATE 22357 Hartford Accident & Indemnity Company PO Box 33015 San Antonio TX 78265-9519 57UECVX5953 8/19/2020 8/19/2021 2007 Ford Ranger 1FTYR10U07PA06190 Leavitt Pacific Insurance Brokers, Inc. License #0D79674 1570 The Alameda, Suite 101 San Jose CA 95126 Lifetime Tennis, Inc. 5801 Valley Avenue Pleasanton CA 94566 http://www.leavitt.com/leavittpacificWeb Address: ACORD 50 CA (2004/07) COMPANY NAME AND ADDRESSCOMPANY NUMBER POLICY NUMBER EFFECTIVE DATE YEAR AGENCY/COMPANY ISSUING CARD INSURED SEE IMPORTANT NOTICE ON REVERSE SIDE THIS POLICY MEETS THE REQUIREMENTS OF § 16056 OF THE CALIFORNIA VEHICLE CODE CALIFORNIA INSURANCE IDENTIFICATION CARD THIS CARD MUST BE KEPT IN THE INSURED VEHICLE AND PRESENTED UPON DEMAND IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information: 1. Name and address of each driver, passenger and witness. 2. Name of Insurance Company and policy number for each vehicle involved. © ACORD CORPORATION 2004 INS050CA (0405).02a MAKE/MODEL VEHICLE IDENTIFICATION NUMBER EXPIRATION DATE 22357 Hartford Accident & Indemnity Company PO Box 33015 San Antonio TX 78265-9519 57UECVX5953 8/19/2020 8/19/2021 2015 Nissan Frontier 1N6BD0CT2FN766999 Leavitt Pacific Insurance Brokers, Inc. License #0D79674 1570 The Alameda, Suite 101 San Jose CA 95126 Lifetime Tennis, Inc. 5801 Valley Avenue Pleasanton CA 94566 http://www.leavitt.com/leavittpacificWeb Address: ACORD 50 CA (2004/07) COMPANY NAME AND ADDRESSCOMPANY NUMBER POLICY NUMBER EFFECTIVE DATE YEAR AGENCY/COMPANY ISSUING CARD INSURED SEE IMPORTANT NOTICE ON REVERSE SIDE THIS POLICY MEETS THE REQUIREMENTS OF § 16056 OF THE CALIFORNIA VEHICLE CODE CALIFORNIA INSURANCE IDENTIFICATION CARD THIS CARD MUST BE KEPT IN THE INSURED VEHICLE AND PRESENTED UPON DEMAND IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information: 1. Name and address of each driver, passenger and witness. 2. Name of Insurance Company and policy number for each vehicle involved. © ACORD CORPORATION 2004 INS050CA (0405).02a MAKE/MODEL VEHICLE IDENTIFICATION NUMBER EXPIRATION DATE 05/15/20 57 UEC VX5953 SC RENEWAL OF:57 UEC VX5953 LIFETIME TENNIS INC SEE IH1204 5801 VALLEY AVE PLEASANTON CA 94566 (ALAMEDA COUNTY) 08/19/20 08/19/21 12:01 A.M., $7,441.00 COMMERCIAL AUTO HARTFORD ACCIDENT AND INDEMNITY COMPANY ONE HARTFORD PLAZA HARTFORD,CONNECTICUT 06155 $7,441.00 HM0001 HM00100107SD4 IL00171198 IH12040312 IH99400409 IH99410409 IL00210908 IL02700811 HA00250615 LEAVITT PACIFIC INS BROKERS INC Countersigned by 57 UEC VX5953 $7,441.00 HA00040302 HA00120615T CA00011013 HA21020614 CA04241013 CA21541116 CA01211013 CA01430517 CA03051013 CA23441116 HA00240614 HA99080614 HA99160312 HA99481214 COMMERCIAL AUTOMOBILE COVERAGE PART -DECLARATIONS BUSINESS AUTO COVERAGE FORM Form HA 00 25 06 15 Page 1 of 4 ©2015,The Hartford (Includes copyrighted material of Insurance Services Office,Inc.,with its permission.) 57 UEC VX5953 01 1,000,000 $5,646.00 02 $308.00 02 SEE FORM HA2102 OR STATE FORM(S) $635.00 02, SEE FORM HA2102 OR STATE FORM(S) INCL Form HA 00 25 06 15 Page 2 of 4 COMMERCIAL AUTOMOBILE COVERAGE PART -DECLARATIONS BUSINESS AUTO COVERAGE FORM (Continued) POLICY NUMBER: ITEM TWO -SCHEDULE OF COVERAGES AND COVERED AUTOS This policy provides only those coverages where a charge is shown in the advance premium column below.Each of these coverages will apply only to those ''autos''shown as covered ''autos''.''Autos''are shown as "covered autos''for a particular coverage by the entry of one or more of the symbols from the COVERED AUTOS Section of the Business Auto Coverage Form next to the name of the coverage. Coverages Covered Autos Limit The Most We Will Pay for Any One Accident or Loss Advance Premium COVERED AUTOS LIABILITY $ PERSONAL INJURY PROTECTION (or equivalent No-Fault coverage) Separately stated in each Personal Injury Protection Endorsement. ADDED PERSONAL INJURY PROTECTION (or equivalent added No-Fault coverage) Separately stated in each Added Personal Injury Protection Endorsement. OPTIONAL BASIC ECONOMIC LOSS (New York only) $25,000 each eligible injured person. PROPERTY PROTECT ION INSURANCE (Michigan only) Separately stated in the Property Protection Insurance Endorsement. MEDICAL EXPENSE AND INCOME LOSS BENEFITS (Virginia only) Separately stated in the Medical Expense and Income Loss Benefits Endorsement. AUTO MEDICAL PAYMENTS $Each Insured or the limit separately stated for each "auto"in ITEM THREE. UNINSURED MOTORISTS $ UNDERINSURED MOT ORISTS (When not included in Uninsured Motorist Coverage) $ 57 UEC VX5953 07 $155.00 07 $683.00 07 $2.00 $12.00 $7,441.00 Form HA 00 25 06 15 Page 3 of 4 COMMERCIAL AUTOMOBILE COVERAGE PART -DECLARATIONS BUSINESS AUTO COVERAGE FORM (Continued) POLICY NUMBER: ITEM TWO -SCHEDULE OF COVERAGES AND COVERED AUTOS (Continued) Coverages Covered Autos Limit The Most We Will Pay for Any One Accident or Loss Advance Premium PHYSICAL DAMAGE See ITEM FOUR for hired or borrowed ''autos''. COMPREHENSIVE COVERAGE Actual Cash Value,Cost of Repair,or the Stated Amount shown in ITEM THREE,whichever is smallest,minus any deductible shown in ITEM THREE for each covered ''auto''. SPECIFIED CAUSES OF LOSS COVERAGE Actual Cash Value,Cost of Repair,or the Stated Amount shown in ITEM THREE,whichever is smallest,minus $deductible for each covered ''auto''for ''loss''caused by mischief or vandalism. COLLISION COVERAGE Actual Cash Value,Cost of Repair,or the Stated Amount shown in ITEM THREE,whichever is smallest,minus any deductible shown in ITEM THREE for each covered ''auto''. TOW ING AND LABOR $or the amount separately stated for each "auto"in ITEM THREE,whichever is greater,for each disablement. DOWNTIME LOSS AND RENTAL REIMBURSEMENT & TOW ING COVERAGE Downtime Loss or Rental Reimbursement up to a maximum of $100 per day,subject to a combined maximum of $3,000 per loss. Towing up to a maximum of $500 per “disablement”subject to a maximum $2,500 per policy period Endorsement Premium (Not included above) TOTAL ADVANCE PREMIUM: 57 UEC VX5953 FORM HA0012 ATTACHED IF ANY 2.711 $2.71 $95.00 10 $356.00 $356.00 Form HA 00 25 06 15 Page 4 of 4 COMMERCIAL AUTOMOBILE COVERAGE PART -DECLARATIONS BUSINESS AUTO COVERAGE FORM (Continued) POLICY NUMBER: ITEM THREE -SCHEDULE OF COVERED AUTOS YOU OWN Applicable only if ''Schedule of Covered Autos You Own''is issued to form a part of this Coverage Form. ITEM FOUR -SCHEDULE OF HIRED OR BORROWED AUTO COVERAGE AND PREMIUMS COVERED AUTOS LIABILITY COVERAGE RATING BASIS IS COST OF HIRE.Cost of hire means the total amount you incur for the hire of "autos"you don't own (not including "autos"you borrow or rent from your partners or "employees"or their family members). Cost of hire does not include charges for services performed by motor carriers of property or passengers. State Estimated Cost of Hire Rate Per Each $100 Cost of Hire Advance Premium TOTAL COVERED AUTOS HIRED AUTO ADVANCE PREMIUM: ITEM FIVE -SCHEDULE FOR NON-OWNERSHIP LIABILITY Named Insured's Business Rating Basis Number Advance Premium Other than a Soc ial Service Agency Number of Employees Number of Partners Social Service Agency Number of Employees Number of Volunteers TOTAL ADVANCE PREMIUM: PAGE 1 (CONTINUED ON NEXT PAGE) 57 UEC VX5953 --------------------------------------------------------------------------- NO.00001 14 TOYT SPORT UTILITY VEHI ID NO.2T3YFREVXEW092957 GARAGED:PLEASANTON CA TERR:175 CLASS:73910 ORIG.COST NEW:$29,824 USE:PPT TAX LOC:ZIP CODE:94566 COVERAGES:SEQ.NO.00003 PREMIUMS LIABILITY $1,020.00 AUTO MEDICAL PAYMENTS $5,000 EACH "INSURED"$42.00 UNINSURED MOTORISTS $288.00 UNDERINSURED MOTORISTS INCL COMPREHENSIVE $500 DEDUCTIBLE $42.00 COLLISION $500 DEDUCTIBLE $327.00 TOWING AND LABOR $50 PER DISABLEMENT $2.00 ENDORSEMENT PREMIUM WAIVER OF COLLISION DEDUCTIBLE $12.00 DISCOUNTS APPLIED: ANTI-THEFT --------------------------------------------------------------------------- NO.00002 07 FORD PICKUP ID NO.1FTYR10U07PA06190 GARAGED:RICHMOND CA TERR:139 CLASS:01199 ORIG.COST NEW:$15,610 TAX LOC:ZIP CODE:94805 RADIUS:L SIZE:4700 COVERAGES:SEQ.NO.00004 PREMIUMS LIABILITY $2,260.00 AUTO MEDICAL PAYMENTS $5,000 EACH "INSURED"$145.00 UNINSURED MOTORISTS $175.00 UNDERINSURED MOTORISTS INCL COMPREHENSIVE $500 DEDUCTIBLE $38.00 COLLISION $500 DEDUCTIBLE $90.00 DISCOUNTS APPLIED: ANTI-THEFT --------------------------------------------------------------------------- Form HA 00 12 06 15 SCHEDULE OF COVERED AUTOS YOU OWN (ITEM THREE OF THE DECLARATIONS) POLICY NUMBER: Absence,if any,of a limit entry below means that the limit entry shown in the corresponding ITEM TWO of the Declarations Limit Column applies instead. PAGE 2 57 UEC VX5953 --------------------------------------------------------------------------- NO.00003 15 NISS PICKUP ID NO.1N6BD0CT2FN766999 GARAGED:FREMONT CA TERR:181 CLASS:01199 ORIG.COST NEW:$21,970 TAX LOC:ZIP CODE:94536 RADIUS:L SIZE:2500 COVERAGES:SEQ.NO.00005 PREMIUMS LIABILITY $1,915.00 AUTO MEDICAL PAYMENTS $5,000 EACH "INSURED"$121.00 UNINSURED MOTORISTS $172.00 UNDERINSURED MOTORISTS INCL COMPREHENSIVE $500 DEDUCTIBLE $75.00 COLLISION $500 DEDUCTIBLE $266.00 DISCOUNTS APPLIED: ANTI-THEFT --------------------------------------------------------------------------- Form HA 00 12 06 15 SCHEDULE OF COVERED AUTOS YOU OWN (ITEM THREE OF THE DECLARATIONS)(Continued) POLICY NUMBER: Absence,if any,of a lim it entry below means that the limit entry shown in the corresponding ITEM TWO of the Declarations Limit Column applies instead. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 07/23/20 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Aon Risk Services, Inc of Florida 1001 Brickell Bay Drive, Suite #1100 Miami, FL 33131-4937 CONTACT NAME:Aon Risk Services, Inc of Florida PHONE (A/C, No, Ext):800-743-8130 FAX (A/C, No):800-522-7514 EMAIL ADDRESS:ADP.COI.Center@Aon.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : American Home Assurance Co. 19380 INSURED ADP TotalSource DE IV, Inc. 10200 Sunset Drive Miami, FL 33173 L/C/F Lifetime Tennis, Inc. 5801 Valley Ave Pleasanton, CA 94566 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 3103511 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. LIMITS SHOWN ARE AS REQUESTED. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY)LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence)$ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ OWNED AUTOS ONLY SCHEDULED AUTOS BODILY INJURY (Per accident)$ HIRED AUTOS ONLY NON-OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEC RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A X WC 027118133 CA 07/01/20 07/01/21 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) All worksite employees working for LIFETIME TENNIS, INC., paid under ADP TOTALSOURCE, INC’s payroll, are covered under the above stated policy. WAIVER OF SUBROGATION IN FAVOR OF CERTIFICATE HOLDER AS RESPECTS OF JOB PERFORMED BY LIFETIME TENNIS, INC. AS REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION City of Cupertino Its City Council, Boards and Commissions, Officers, Officials, Employees, Agents, Servants, and Volunteers 10300 Torre Ave Cupertino, CA 95014 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA This endorsement changes the policy to which it is attached effective on inception date of the policy unless a different date is indicated below. (The following" attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement. Effective on 07/23/2020 at 12:01 AM, forms a part of Policy No. WC 027118133 Issued to: ADP TotalSource DE IV, Inc. 10200 Sunset Drive Miami, FL 33173 L/C/F Lifetime Tennis, Inc. 5801 Valley Ave Pleasanton, CA 94566 By: American Home Assurance Co. Premium: N/A We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be Additional Premium Percent% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization City of Cupertino Its City Council, Boards and Commissions, Officers, Officials, Employees, Agents, Servants, and Volunteers 10300 Torre Ave Cupertino, CA 95014 WC 04 03 06 Countersigned by (Ed. 4-84) Authorized Representative Lifetime Activities 2nd Amendment Final Audit Report 2020-08-28 Created:2020-08-27 By:Kevin Khuu (KevinK@cupertino.org) Status:Signed Transaction ID:CBJCHBCAABAAkegTXG5LNoMZ3kHjXhx7OK7lG_7DMzBp "Lifetime Activities 2nd Amendment" History Document created by Kevin Khuu (KevinK@cupertino.org) 2020-08-27 - 10:36:20 PM GMT- IP address: 73.70.97.4 Document emailed to Araceli Alejandre (aracelia@cupertino.org) for approval 2020-08-27 - 10:50:05 PM GMT Document approved by Araceli Alejandre (aracelia@cupertino.org) Approval Date: 2020-08-28 - 1:27:19 AM GMT - Time Source: server- IP address: 73.170.27.253 Document emailed to Dana Gill (danag@lifetimeactivities.com) for signature 2020-08-28 - 1:27:21 AM GMT Email viewed by Dana Gill (danag@lifetimeactivities.com) 2020-08-28 - 1:38:06 AM GMT- IP address: 67.164.37.239 Document e-signed by Dana Gill (danag@lifetimeactivities.com) Signature Date: 2020-08-28 - 4:43:08 AM GMT - Time Source: server- IP address: 67.164.37.239 Document emailed to Heather M. Minner (minner@smwlaw.com) for signature 2020-08-28 - 4:43:09 AM GMT Email viewed by Heather M. Minner (minner@smwlaw.com) 2020-08-28 - 6:32:12 PM GMT- IP address: 45.41.142.177 Document e-signed by Heather M. Minner (minner@smwlaw.com) Signature Date: 2020-08-28 - 6:32:57 PM GMT - Time Source: server- IP address: 52.39.49.65 Document emailed to Deborah L. Feng (debf@cupertino.org) for signature 2020-08-28 - 6:32:59 PM GMT Email viewed by Deborah L. Feng (debf@cupertino.org) 2020-08-28 - 6:37:25 PM GMT- IP address: 104.47.46.254 Document e-signed by Deborah L. Feng (debf@cupertino.org) Signature Date: 2020-08-28 - 6:37:59 PM GMT - Time Source: server- IP address: 24.6.12.22 Document emailed to Kirsten Squarcia (kirstens@cupertino.org) for signature 2020-08-28 - 6:38:01 PM GMT Email viewed by Kirsten Squarcia (kirstens@cupertino.org) 2020-08-28 - 6:38:44 PM GMT- IP address: 104.47.46.254 Document e-signed by Kirsten Squarcia (kirstens@cupertino.org) Signature Date: 2020-08-28 - 6:38:56 PM GMT - Time Source: server- IP address: 148.64.105.190 Signed document emailed to Kirsten Squarcia (kirstens@cupertino.org), Deborah L. Feng (debf@cupertino.org), Araceli Alejandre (aracelia@cupertino.org), Kevin Khuu (KevinK@cupertino.org), and 3 more 2020-08-28 - 6:38:56 PM GMT