Loading...
20-082 Amendment #3 dated 6-20-23 CDBG Grant Program1 THIRD AMENDMENT TO COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM CITY/NON-PROFIT PUBLIC SERVICE CONTRACT This Third Amendment to Contract is entered into between LIVE OAK ADULT DAY SERVICES ("CORPORATION") and the CITY OF CUPERTINO ("CITY") as of July 1, 2023 (the "Effective Date") to amend the Community Development Block Grant Program City/Non-Profit Public Service Contract (the "Contract") dated July 1, 2020. WITNESSETH WHEREAS, CITY has applied for and received CDBG Entitlement program funds from the United States Department of Housing and Urban Development ("HUD") as an entitlement jurisdiction pursuant to the provisions of Title I of the Housing and Community Development Act of 1974, as amended; and, WHEREAS, CITY has granted CORPORATION a portion of its CDBG funds for the Program (as described below) to be operated within the City for the benefit of low and very low-income households and meeting at least one (1) of the National Objectives of the CDBG program as outlined in Title 24 of the Code of Federal Regulations, Section 570.208; THEREFORE, the parties agree as follows: 1. Section I, entitled "Program", is deleted in its entirety and replaced with the following: For the period of July 1, 2020 to June 30, 2021, CITY agreed to allocate a portion of its current CDBG entitlement, and/or program income as defined in 24 CFR 570 Subpart J, "Grant Administration," to CORPORATION in the sum of Twenty One Thousand One Hundred Fifty Two and Sixty One Cents ($21,152.61) (the "CDBG Funds") for the purpose of implementing the CORPORATION'S program, as more particularly described in Exhibits A-D, A-1 through D-1 and A-2 through D-2 to the Contract (the "Program"), and said Exhibits set forth below, as they may be amended or modified, are attached to this Contract and incorporated herein by reference. For the period of July 1, 2021 to June 30, 2022 CITY agrees to allocate a portion of its current CDBG entitlement, and/or program income as defined in 24 CFR 570 Subpart J, "Grant Administration," to CORPORATION in the sum of Twenty Two Thousand Seven Hundred Twenty and Eighteen Cents ($22,720.18) for the purpose of implementing the CORPORATION'S Program. For the period of July 1, 2022 to June 30, 2023 CITY agrees to allocate a portion of its current CDBG entitlement, and/or program income as defined in 24 CFR 570 Subpart J, "Grant Administration," to CORPORATION in the sum of Twenty One Thousand Four Hundred Five and Seventy Six Cents ($21,405.76) for the purpose of implementing the CORPORATION'S Program. For the period of July 1, 2023 to June 30, 2024 CITY agrees to allocate a portion of its current 2 CDBG entitlement, and/or program income as defined in 24 CFR 570 Subpart J, "Grant Administration," to CORPORATION in the sum of Nineteen Thousand Fifty Four and Five Cents ($19,054.05) for the purpose of implementing the CORPORATION'S Program. Exhibit A: Program Description Exhibit B-3: Program Work Plan Exhibit C-3: Program Budget Exhibit D-3: Program Budget Exhibit E: Basic Insurance and Bond Requirements For Non-Profit Contracts Exhibit F: CDBG Regulations The total allocation for July 1, 2020, through June 30, 2024 shall not exceed Eighty Four Thousand Three Hundred Thirty Two and Sixty Cents. ($84,332.60). 2. The following sentence is added to the end of Section II, "Term,": The term of this Contract (the "Term") has been extended once per this Section II to end on June 30, 2024, unless otherwise amended or terminated earlier pursuant to Section VII or Section VII 3. Exhibits B-3, C-3 and D-3, attached hereto, are added to the CONTRACT. 4. Exhibit E to the CONTRACT is replaced with Exhibit E attached hereto. 5. All terms, covenants and conditions stated in the CONTRACT, which are not herein amended, remain in full force and effect. [Signatures on following page.] Page 3 of 11 FY 2022-2023 Community Development Block Grant Program City/Non-Profit Public Service Contract Amendment IN WITNESS WHEREOF, the parties have executed this Second Amendment as of the Effective Date. CORPORATION: CITY: LIVE OAK ADULT DAY SERVICES, CITY OF CUPERTINO, a municipal benefit a California nonprofit public corporation corporation ___________________________________ __________________________________ Dr. Ann E. Peterson Date Benjamin Fu Date Executive Director Director of Community Development APPROVED AS TO FORM AND ATTEST: LEGALITY: ___________________________________ _________________________________ Christopher Jensen Date Kirsten Squarcia Date City Attorney City Clerk EXPENDITURE DISTRIBUTION PO #2021-095 265-72-711-600-623 Original Contract: $21,152.61 Amendment #1: $22,720.18 Amendment #2 $21,405.76 Amendment #3 $19,054.05 Final $84,332.60 Jun 16, 2023 Christopher D. Jensen Jun 20, 2023 Jun 20, 2023 Page 4 of 11 FY 2022-2023 Community Development Block Grant Program City/Non-Profit Public Service Contract Amendment EXHIBIT A PROGRAM DESCRIPTION FY 2023-24 Agency Name: Live Oak Adult Day Services DUNS #: 148217268 Chief Financial Officer: Dr. Ann E.Peterson Program Manager: Dr. Ann E.Peterson Program # (For Office Use Only) 260-72-710-600-623 Street Address: 1147 Minnesota Ave City: San Jose State: CA Zip Code: 95125 Telephone number: 408-971-9363 Fax Number: Program Manager E-mail Address: Liveoak1147minnesota@gmail.com Name of Program: Senior Adult Day Care/Caregiver Respite Program Location: 1147 Minnesota Ave, San Jose, CA 95125 Program Description: The specialized program of adult day care for frail, dependent low-income Cupertino seniors is geared to maximize the social experience and mental stimulation of elderly clients, improve/sustain innate resilience and mental and physical functioning, and enhance their overall quality of life through recreation, exercise, companionship and nutritious meals. Cupertino seniors with chronic age-related disorders (dementia, Alzheimers, Parkinsons, stroke, etc.) attend the center every weekday, receiving special care and individualized attention from professional staff and devoted volunteers who schedule daily activities, serve meals and snacks and assist those with special needs. Caregiver respite services, i.e., counseling, in-home assessments, information and referrals, and Caregiver Support Workshops, are provided to client families to reduce stress and help them care for and maintain their senior loved ones at home. Page 5 of 11 FY 2022-2023 Community Development Block Grant Program City/Non-Profit Public Service Contract Amendment EXHIBIT B-3 PROGRAM WORK PLAN FY 2023-24 AGENCY NAME: Live Oak Adult Day Care Services PROGRAM NAME: Senior Adult Day Care/Caregiver Respite HUD National Objectives: LMC: Low/mod limited clientele benefit Low/Mod Income Type: 5A: Senior Services Objectives Benchmarks for Each Quarter 1st 2nd 3rd 4th TOTAL Enroll 20 appropriate, low-income Cupertino seniors in adult day care program 10 4 3 3 20 Page 6 of 11 FY 2022-2023 Community Development Block Grant Program City/Non-Profit Public Service Contract Amendment EXHIBIT C-3 PROGRAM BUDGET FY 2022-23 AGENCY NAME: Live Oak Adult Day Care Services PROGRAM NAME: Senior Adult Day Care/Caregiver Respite Proposed Program Expenses FY 2022-23 Salaries/Benefits/Payroll/Taxes $19,054.05 Total Expenses $19,054.05 Page 7 of 11 FY 2022-2023 Community Development Block Grant Program City/Non-Profit Public Service Contract Amendment EXHIBIT D BASIC INSURANCE AND BOND REQUIREMENTS FOR NON-PROFIT CONTRACTS Definition of Contractor: The "Contractor" as the word is used in this Exhibit D is the party contracting with the City of Cupertino for the direct distribution of BMR AHF funds. Indemnity The Contractor shall indemnify, defend, and hold harmless the City of Cupertino (hereinafter "City"), its officers, agents and employees from any loss, liability, claim, injury or damage arising out of, or in connection with performance of this Contract by Contractor and/or its agents, employees or subcontractors, excepting only loss, injury or damage caused solely by the acts or omissions of personnel employed by the City. It is the intent of the parties to this Contract to provide the broadest possible coverage for the City. The Contractor shall reimburse the City for all costs, attorneys' fees, expenses and liabilities incurred with respect to any litigation in which the Contractor is obligated to indemnify, defend and hold harmless the City under this Contract. Insurance Without limiting the Contractor's indemnification of the City, the Contractor shall provide and maintain at its own expense, during the term of this Contract, or as may be further required herein, the following insurance coverages and provisions: A. Evidence of Coverage Prior to commencement of this Contract, the Contractor shall provide on the City's own form or a form approved by the City's Insurance Manager an original plus one copy of a Certificate of Insurance certifying that coverage as required herein has been obtained and remains in force for the period required by this Contract. The contract number and program name must be stated on the Certificate of Insurance. The City's Special Endorsement form shall accompany the certificate. Individual endorsements executed by the insurance carrier may be substituted for the City's Special Endorsement form if they provide the coverage as required. In addition, a certified copy of the policy or policies shall be provided by the Contractor upon request. This verification of coverage shall be sent to the address as shown on the City's Certificate of Insurance form and to the Community Development Department at the address set forth in this Contract at Section VI. PROGRAM COORDINATION, Paragraph C., NOTICES. The Contractor shall not issue a Notice to Proceed with the work under this Contract until it has obtained all insurance required and such insurance has been approved by the City. This approval of insurance shall neither relieve nor decrease the liability of the Contractor. B. Notice of Cancellation of Reduction of Coverage All policies shall contain a special provision for thirty (30) days prior written notice of any cancellation or reduction in coverage to be sent to the Community Development Department, 10300 Torre Avenue, Cupertino, CA 95014. Page 8 of 11 FY 2022-2023 Community Development Block Grant Program City/Non-Profit Public Service Contract Amendment C. Qualifying Insurers All policies shall be issued by companies which hold a current policy holder's alphabetic and financial size category rating of not less than A VIII, according to the current Best's Key Rating Guide, unless otherwise approved by the City's Insurance Manager. D. Insurance Required 1. Comprehensive General Liability Insurance - for bodily injury (including death) and property damage which provides limits of not less than one million dollars ($1,000,000) combined single limit (CSL) per occurrence. OR 2. Commercial General Liability Insurance - for bodily injury (including death) and property damage which provides limits as follows: a. General limit per occurrence - $1,000,000 b. General limit aggregate - $2,000,000 c. Products/Completed Operations- $1,000,000 aggregate d. Personal Injury limit - $1,000,000 If coverage is provided under a Commercial General Liability Insurance form, the carrier shall provide the City Insurance Manager with a quarterly report of the amount of aggregate limits expended to that date. If over 50% of the aggregate limits have been paid or reserved, the City may require additional coverage to be purchased by the Contractor to restore the required limits. 3. For either type of insurance, coverage shall include: a. Premises and Operations b. Products/Completed Operations with limits of one million dollars ($1,000,000) per occurrence/ aggregate to be maintained for two (2) years following acceptance of the work by the City. c. Contractual Liability expressly including liability assumed under this Contract. d. Personal Injury liability. e. Independent Contractors' (Protective) liability. f. Severability of Interest clause providing that the coverage applies separately to each insured except with respect to the limits of liability. Page 9 of 11 FY 2022-2023 Community Development Block Grant Program City/Non-Profit Public Service Contract Amendment 4. For either type of insurance, coverage shall include the following endorsements, copies of which shall be provided to the City: a. Additional Insured Endorsement: Such insurance as is afforded by this policy shall also apply to the City of Cupertino, and members of the City Council, and the officers, agents and employees of the City of Cupertino, individually and collectively, as additional insureds. b. Primary Insurance Endorsement: Such insurance as is afforded by the additional insured endorsement shall apply as primary insurance, and other insurance maintained by the City of Cupertino, its officers, agents, and employees shall be excess only and not contributing with insurance provided under this policy. c. Notice of Cancellation or Change of Coverage Endorsement: This policy may not be cancelled nor the coverage reduced by the Company without 30 days prior written notice of such cancellation or reduction in coverage to the City of Cupertino at the address shown on the Certificate of Insurance. d. Contractual Liability Endorsement: This policy shall apply to liability assumed by the insured under written contract with the City of Cupertino. e. Personal Injury Endorsement: The provisions of this policy shall provide Personal Injury coverage. f. Severability of Interest Endorsement: The insurance afforded by this policy shall apply separately to each insured that is seeking coverage or against whom a claim is made or a suit is brought, except with respect to the Company's limit of liability. 5. Comprehensive Automobile Liability Insurance for bodily injury (including death) and property damage which provides total limits of not less than one million dollars ($1,000,000) combined single limit per occurrence applicable to all owned, non-owned and hired vehicles. 6. Worker's Compensation and Employer's Liability Insurance for: a. Statutory California Workers' Compensation coverage including a broad form all- states endorsement. Page 10 of 11 FY 2022-2023 Community Development Block Grant Program City/Non-Profit Public Service Contract Amendment b. Employer's Liability coverage for not less than one million dollars ($1,000,000) per occurrence for all employees engaged in services or operations under this Contract. c. Inclusion of the City and its governing board(s), officers, representatives, agents, and employees as additional insureds, or a waiver of subrogation. 7. Professional Errors and Omissions Liability Insurance This type of insurance should be provided by persons/entities you contract with to provide you with professional services. a. Limits of not less than one million dollars ($1,000,000). b. If this policy contains a self retention limit, it shall not be greater than ten thousand dollars ($10,000) per occurrence/event. c. This coverage shall be maintained for a minimum of two (2) years following termination of this Contract. The City must first approve any exceptions to the above requirements. 8. Bond Requirements Fidelity Bond - Before receiving compensation under this Contract, Contractor will furnish City with evidence that all officials, employees, and agents handling or having access to funds received or disbursed under this Contract, or authorized to sign or countersign checks, are covered by a BLANKET FIDELITY BOND in an amount of AT LEAST fifteen percent (15%) of the maximum financial obligation of the City cited herein. If such bond is cancelled or reduced, Contractor will notify City immediately, and City may withhold further payment to Contractor until proper coverage has been obtained. Failure to give such notice may be cause for termination of this Contract, at the option of the City. 9. Special Provisions The following provisions shall apply to this Contract: a. The foregoing requirements as to the types and limits of insurance coverage to be maintained by the Contractor and any approval of said insurance by the City or its insurance consultant(s) are not intended to and shall not in any manner limit or qualify the liabilities and obligations otherwise assumed by the Contractor pursuant to this Contract, including but not limited to the provisions concerning indemnification. b. The City acknowledges that some insurance requirements contained in this Contract may be fulfilled by self-insurance on the part of the Contractor. Page 11 of 11 FY 2022-2023 Community Development Block Grant Program City/Non-Profit Public Service Contract Amendment However, this shall not in any way limit liabilities assumed by the Contractor under this Contract. The City shall approve any self-insurance in writing. c. The City reserves the right to withhold payments to the Contractor in the event of material noncompliance with the insurance requirements outlined above. d. If the Contractor fails to maintain such insurance as is called for herein, the City must order the Contractor to immediately suspend work at Contractor's expense until a new policy of insurance is in effect. DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACTPRODUCERNAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: PRODUCER CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDL SUBRINSR POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITSPOLICY NUMBERLTR (MM/DD/YYYY)(MM/DD/YYYY)INSR WVD GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY $PREMISES (Ea occurrence) CLAIMS-MADE OCCUR MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS - COMP/OP AGG $ PRO-$POLICY LOCJECT COMBINED SINGLE LIMITAUTOMOBILE LIABILITY $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ ALL OWNED AUTOS BODILY INJURY (Per accident)$ SCHEDULED AUTOS PROPERTY DAMAGE $(PER ACCIDENT)HIRED AUTOS $NON-OWNED AUTOS $ UMBRELLA LIAB EACH OCCURRENCE $OCCUR EXCESS LIAB CLAIMS-MADE AGGREGATE $ $DEDUCTIBLE $RETENTION $ WC STATU-OTH-WORKERS COMPENSATION TORY LIMITS ERAND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $N / AOFFICER/MEMBER EXCLUDED? (Mandatory in NH)E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION 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 © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2009/09) OP ID: TT2 09/14/2022 Tina Tremani X340 San Jose Insurance Agency Inc. Atlantic-Pacific Ins. Brokers 2542 S. Bascom Ave #280 Campbell, CA 95008 San Jose Insurance Agency 408-371-3700 tina@sanjoseins.com LIVEO-5 Live Oak Adult Day Services, I 1147 Minnesota Ave San Jose, CA 95125 Nonprofit Ins Alliance of Ca 11384 State Compensation Insurance 35076 1,000,000 A X X 202201332NPO 09/10/2022 09/10/2023 500,000 X 20,000 X Social Services 202201332NPO 09/10/2022 09/10/2023 1,000,000 Professional 2,000,000 2,000,000 X Agg Profe 3,000,000 1,000,000 A NO OWNED VEHICLES X 202201332NPO 09/10/2022 09/10/2023 X 202201332NPO 09/10/2022 09/10/2023 X B 930114-22 07/01/2022 07/01/2023 1,000,000 X 1,000,000 1,000,000 A Directors & Office 202201332NPO 09/10/2022 09/10/2023 DOLI 1,000,000 A Improper Sexual Ab 202201332NPO 09/10/2022 09/10/2023 Limit 1,000,000 Adult day care and related services. The City of Cupertino is named as additional insured and said insurance is primary and non contributory as required by written contract Waiver of subrogation applies in favor of The City of Cupertino under Blanket Waiver As Required by Contract *10 day cancellation for nonpayment of premium CITYCUP City of Cupertino Community Development Dept 10300 Torre Avenue Cupertino, CA 95014 POLICY NUMBER: 2022-01332 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT FOR PUBLIC ENTITIES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE City of Cupertino Name of Person or Organization: A. C.With respect to the insurance provided to the additional insured(s), Condition 4. Other Insurance of SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: Section II – WHO IS AN INSURED is amended to include: 4. Any public entity as an additional insured, and the officers, officials, employees, agents and/or volunteers of that public entity, as applicable, who may be named in the Schedule above, when you have agreed in a written contract or written agreement presently in effect or becoming effective during the term of this policy, that such public entity and/or its officers, officials, employees, agents and/or volunteers be added as an additional insured(s) on your policy, but only with respect to liability for “bodily injury”, “property damage” or “personal and advertising injury” caused, in whole or in part, by: a. Your negligent acts or omissions; or b. The negligent acts or omissions of those acting on your behalf; in the performance of your ongoing operations. No such public entity or individual is an additional insured for liability arising out of the sole negligence by that public entity or its designated individuals. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. B. Section III – LIMITS OF INSURANCE is amended to include: 8. The limits of insurance applicable to the public entity and applicable individuals identified as an additional insured(s) pursuant to Provision A.4. above, are those specified in the written contract between you and that public entity, or the limits available under this policy, whichever are less. These limits are part of and not in addition to the limits of insurance under this policy. 4. Other Insurance a. Primary Insurance This insurance is primary if you have agreed in a written contract or written agreement: (1) That this insurance be primary. If other insurance is also primary, we will share with all that other insurance as described in c. below; or Page 1 of 2NIAC-E61 02 19 POLICY NUMBER: 2022-01332 Paragraphs (1) and (2) do not apply to other insurance to which the additional insured(s) has been added as an additional insured or to other insurance described in paragraph b. below. b. Excess Insurance This insurance is excess over: 1. Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder’s Risk, Installation Risk or similar coverage for "your work"; (b) That is fire, lightning, or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises temporarily occupied by you with permission of the owner; or (d)If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION I – COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE. (e) (1)When this insurance is excess, we will have no duty under Coverages A or B to defend the additional insured(s) against any "suit" if any other insurer has a duty to defend the additional insured(s) against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured(s)’ rights against all those other insurers. (2)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: (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 Declarations of this Coverage Part. (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self-insured amounts under all that other insurance. c. Methods of Sharing If all of the other insurance available to the additional insured(s) 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 other the other insurance available to the additional insured(s) 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 limit of insurance to the total applicable limits of insurance of all insurers. Any other insurance available to an additional insured(s) under this Endorsement covering liability for damages which are subject to this endorsement and for which the additional insured(s) has been added as an additional insured by that other insurance. (2) The coverage afforded by this insurance is primary and non-contributory with the additional insured(s)’ own insurance. Page 2 of 2NIAC-E61 02 19 POLICY NUMBER:COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – SCHEDULED PERSON OR ORGANIZATION CG 20 10 12 19 2022-01332 Named Insured: Live Oak Adult Day Services, Inc. Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. All insured premises and operations. Location(s) Of Covered Operations Name Of Additional Insured Person(s) Or Organization(s) SCHEDULE COMMERCIAL GENERAL LIABILITY COVERAGE PART This endorsement modifies insurance provided under the following: 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: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and A. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. © Insurance Services Office, Inc., 2012 Page 1 of 10CG 20 10 12 19 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C.With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. © Insurance Services Office, Inc., 2012 Page 2 of 10CG 20 10 12 19 CDBG Grant Program Final Audit Report 2023-06-20 Created:2023-06-15 By:City of Cupertino (webmaster@cupertino.org) Status:Signed Transaction ID:CBJCHBCAABAAXRwk7GB-Ei2ujatfSDNGy4ZTJuo6Ph_p "CDBG Grant Program" History Document created by City of Cupertino (webmaster@cupertino.org) 2023-06-15 - 5:13:56 PM GMT- IP address: 35.229.54.2 Document emailed to Araceli Alejandre (aracelia@cupertino.org) for approval 2023-06-15 - 5:16:56 PM GMT Document approved by Araceli Alejandre (aracelia@cupertino.org) Approval Date: 2023-06-15 - 7:30:08 PM GMT - Time Source: server- IP address: 64.165.34.3 Document emailed to Ann Peterson (liveoak1147minnesota@gmail.com) for signature 2023-06-15 - 7:30:09 PM GMT Email viewed by Ann Peterson (liveoak1147minnesota@gmail.com) 2023-06-15 - 8:07:13 PM GMT- IP address: 172.226.18.48 Document e-signed by Ann Peterson (liveoak1147minnesota@gmail.com) Signature Date: 2023-06-16 - 1:51:27 PM GMT - Time Source: server- IP address: 67.253.81.98 Document emailed to christopherj@cupertino.org for signature 2023-06-16 - 1:51:29 PM GMT Email viewed by christopherj@cupertino.org 2023-06-16 - 2:00:03 PM GMT- IP address: 172.225.88.156 Signer christopherj@cupertino.org entered name at signing as Christopher D. Jensen 2023-06-16 - 9:10:32 PM GMT- IP address: 136.24.22.111 Document e-signed by Christopher D. Jensen (christopherj@cupertino.org) Signature Date: 2023-06-16 - 9:10:34 PM GMT - Time Source: server- IP address: 136.24.22.111 Document emailed to Benjamin Fu (benjaminf@cupertino.org) for signature 2023-06-16 - 9:10:35 PM GMT Email viewed by Benjamin Fu (benjaminf@cupertino.org) 2023-06-16 - 9:28:03 PM GMT- IP address: 146.75.154.1 Document e-signed by Benjamin Fu (benjaminf@cupertino.org) Signature Date: 2023-06-20 - 4:45:59 PM GMT - Time Source: server- IP address: 64.165.34.3 Document emailed to Kirsten Squarcia (kirstens@cupertino.org) for signature 2023-06-20 - 4:46:00 PM GMT Email viewed by Kirsten Squarcia (kirstens@cupertino.org) 2023-06-20 - 4:53:09 PM GMT- IP address: 104.28.111.131 Document e-signed by Kirsten Squarcia (kirstens@cupertino.org) Signature Date: 2023-06-20 - 10:54:13 PM GMT - Time Source: server- IP address: 64.165.34.3 Agreement completed. 2023-06-20 - 10:54:13 PM GMT