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22-118 Amendment #1 dated 8-7-23 to Startup Space SaaS
1 FIRST AMENDMENT TO AGREEMENT 22-118 BETWEEN THE CITY OF CUPERTINO AND STARTUP SPACE, LLC., FOR STARTUP SPACE PLATFORM This First Amendment to Agreement 22-118 between the City of Cupertino and Startup Space, LLC., is by and between the City of Cupertino, a municipal corporation (hereinafter "City") and Startup Space, LLC., (“Software Provider”), whose address is 2054 Heidelberg Ave, Dunedin, FL 34698, and is made with reference to the following: RECITALS: A. On August 17, 2022, Agreement 22-118 (“Agreement”) was entered into by and between City and Software Provider for Startup Space Platform. B. City and Software Provider desire to modify the Agreement on the terms and conditions set forth herein. NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows: TERM 1. Paragraph 1 of the Agreement is modified to read as follows: The term of this Agreement shall commence on the last date signed below (“Effective Date”). The term of this Agreement is 2 Years, unless the Agreement is terminated prior thereto under the provisions of Section 16, below. The City’s appropriate department head or the City Manager may extend the Term through a written amendment to this Agreement, provided such extension does not include additional contract funds. Extensions requiring additional contract funds are subject to the City’s purchasing policy. SCOPE OF SERVICES 2. Paragraph 2 of the Agreement is modified to read as follows: Subject to the terms and conditions set forth in this Agreement, Software Provider shall perform each and every service to the schedule of performance set forth in the SLA2 (collectively “Services”), attached hereto. COMPENSATION TO SOFTWARE PROVIDER 3. Paragraph 3 of the Agreement is modified to read as follows: Software Provider shall be compensated for services performed pursuant to this Agreement in a total amount not to exceed ($45,000.00) dollars. The payments specified in this section shall be the only payments to be made to Software Provider for services rendered pursuant to this Agreement. Software Provider shall invoice City according to the following schedule of milestones/deliverables: Milestone Amount FY23 $25,000 FY24 Contract Execution $7,000 FY24 Platform Launch with Apple $7,000 FY24 User Onboarding $6,000 Total $45,000 2 City shall pay Contractor within thirty (30) days after receipt of Service Provider’s invoice. City shall return to Contractor any payment request determined not to be a proper payment request as soon as practicable, but not later than seven (7) days after receipt and shall explain in writing the reasons why the payment request is not proper. 4. 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. CITY OF CUPERTINO By Title Date APPROVED AS TO FORM City Attorney ATTEST: City Clerk Date STARTUP SPACE, LLC. By Title Date EXPENDITURE DISTRIBUTION Item Amount Original Agreement $25,000 First Amendment $20,000 Total $45,000 David Ponraj CEO Aug 3, 2023 Christopher D. Jensen CTO Aug 5, 2023 Aug 7, 2023 Page 1 Startup Space Service Level Agreement for Contract Extention Exhibit A Startup Space will perform the following services (collectively the “Services”) on behalf of the Customer: ●Gold Level offering with one Hub on the Startup Space Platform ●Unlimited licenses for individual users as part of Community Hub ●Custom ad hoc reporting for impact reports, grant submissions and fundraising ●Access to all standard Startup Space features including Connect Now, Resource Compass, Knowledge Center, Webinars, Events, Stories, Job Board, and Surveys ●Access to Mentorship, Coworking Space and Cohort Management features ●Integration with external websites and other platforms ●Library of technology and onboarding support videos ●Free Ecosystem Mapping with Assessment report on resource gaps ●Limited platform customization (website skins, metric dashboards, custom tools/features, etc.) ●48 hours of administrative support per month for 3 months, then 10 hours per month ●Includes data entry, content management, training, onboarding, and planning Fees: In consideration for the Services provided, Customer shall pay an annual fee of $20,000. Milestones: Milestone/ Details Date Amount Contract Execution August 2023 $7,000 Platform Launch with Apple Business Connect Integrated December 2023 $7,000 User onboarding and continuous monitoring of Platform usage metrics March 2024 $6,000 SLA2 NOT TO EXCEED $20,000 PER YEAR Contract No. ________ Page 1 of 3 Exhibit B: Insurance Requirements and Proof of Insurance Proof of insurance coverage described below is attached to this Exhibit, with City named as additional insured. 1.MINIMUM SCOPE AND LIMITS OF REQUIRED INSURANCE POLICIES Additional Insureds: 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 Commercial General Liability and Cyber 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 Software Provider’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. Workers' Compensation: As required by the State of California, with Statutory Limits and Employer’s Liability Insurance of no less than $1,000,000 per occurrence for bodily injury or disease. The Workers’ Compensation policy shall be endorsed with a waiver of subrogation in favor of City for all work performed by Software Provider, its employees, agents, and subconsultants. General Liability: For bodily injury, property damage, personal injury liability for premises operations, products and completed operations, contractual liability, and personal and advertising injury with limits no less than $2,000,000 per occurrence (ISO Form CG 00 01). If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO Form CG 25 03 or 25 04) or it shall be twice the required occurrence limit. a. It shall be a requirement that any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits shall be made available to the Additional Insured and shall be (i) the minimum coverage/limits specified in this agreement; or (ii) the broader coverage and maximum limits of coverage of any insurance policy, whichever is greater. b. Additional Insured coverage under Software Provider’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). Contract No. ________ 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 Agreement. 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. Automobile Liability ISO CA 00 01 covering any auto (including owned, hired, and non-owned autos) with limits no less than $1,000,000 per accident for bodily injury and property damage. Cyber Liability: Insurance, with limits not less than: $2,000,000 each occurrence $2,000,000 aggregate - all other Coverage shall be sufficiently broad to respond to the duties and obligations as is undertaken by Software Provider in this Agreement and shall include, but not be limited to, claims involving infringement of intellectual property, including but not limited to infringement of copyright, trademark, trade dress, invasion of privacy violations, information theft, damage to or destruction of electronic information, release of private information, alteration of electronic information, extortion, and network security. The policy shall provide coverage for breach response costs as well as regulatory fines and penalties as well as credit monitoring expenses with limits sufficient to respond to these obligations. If the Software Provider maintains broader coverage and/or higher limits than the minimums shown above, the City requires and shall be entitled to the broader coverage and/or higher limits maintained by the Software Provider . Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. 2. ABSENCE OF INSURANCE COVERAGE. City may direct Software Provider to immediately cease all activities with respect to this Agreement if it determines that Software Provider fails to carry, in full force and effect, all insurance policies with coverages at or above the limits specified in this Agreement. At the City’s discretion, under conditions of lapse, Cit y may purchase appropriate insurance and charge all costs related to such policy to Software Provider. 3. PROOF OF INSURANCE COVERAGE AND COVERAGE VERIFICATION. A Certificate of Insurance, on an Accord form, and completed coverage verification shall be provided to City by each of Software Provider's insurance companies as evidence of the stipulated coverages prior to the Commencement Date of this Agreement, and annually thereafter for the term of this Agreement. All of the insurance companies providing insurance for Software Provider shall be licensed to do insurance business in the State of California and shall have, and provide evidence of, a Best Rating Service rate of A:VII or above. Page 2 of 3 Contract No. ________ Page 3 of 3 4. SUBCONTRACTORS Software Provider 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. 5.HIGHER INSURANCE LIMITS If Software Provider 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 Software Provider . 6.ADEQUACY OF COVERAGE City reserves the right to modify these insurance requirements/coverage based on the nature of the risk, prior experience, insurer or other special circumstances, with not less than ninety (90) days prior written notice. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 08/05/2022 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 SUBROGATIONIS 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 NUTMEG INS AGENCY INC/PHS 76210775 The Hartford Business Service Center 3600 Wiseman Blvd San Antonio, TX 78251 CONTACT NAME: PHONE (A/C, No, Ext): (888) 925-3137 FAX (A/C, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURED STARTUP SPACE LLC 2054 HEIDELBERG AVE DUNEDIN FL 34698-2332 INSURER A : Hartford Underwriters Insurance Company 30104 INSURER B : Hartford Fire Insurance Company 19682 INSURER C : Hartford Casualty Insurance Company 29424 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/Y YYY)LIMITS A COMMERCIAL GENERAL LIABILITY X 76 SBU AT4X1U 08/04/2022 08/04/2023 EACH OCCURRENCE $2,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence)$1,000,000 X General Liability MED EXP (Any one person)$10,000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $4,000,000 X POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $4,000,000 OTHER: A AUTOMOBILE LIABILITY 76 SBU AT4X1U 08/04/2022 08/04/2023 COMBINED SINGLE LIMIT (Ea accident)$2,000,000 ANY AUTO BODILY INJURY (Per person) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) X HIRED AUTOS X NON-OWNED AUTOS PROPERTY DAMAGE (Per accident) UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS- MADE EACH OCCURRENCE AGGREGATE DED RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/ A 76 WEG AT5AEC 08/04/2022 08/04/2023 X PER STATUTE OTH- ER Y/N E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 B FailSafe Technology Errors or Omissions Liability 76 SBU AT4X1U 08/04/2022 08/04/2023 Each Wrongful Act Aggregate Limit $1,000,000 $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SL3032 attached to this policy. CERTIFICATE HOLDER CANCELLATION The City of Cupertino, its City Council 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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY EMBROKER 08/05/2022 Embroker Insurance Services LLC 24 Shotwell Street San Francisco, CA, 94103 8444362765 certificates@embroker.com Startup Space LLC 2054 Heidelberg Ave Dunedin, FL, 34698 CLEAR BLUE SPECIALTY INS CO 37745 The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers 10300 Torre Ave Cupertino, CA, 95014 CLEAR BLUE SPECIALTY INS CO, NAIC# 37745 Technology And Media Errors And Omissions - AX01-5180-01, 08/05/2022 - 08/05/2023 Aggregate $1,000,000.00 Evidence of Coverage SCPHS015 THE HARTFORD BUSINESS SERVICE CENTER 3600 WISEMAN BLVD SAN ANTONIO TX 78251 August 8, 2022 STARTUP SPACE LLC 2054 HEIDELBERG AVE DUNEDIN FL 34698 Policy Information: Policy Number:76 WEG AT5AEC Contact Us Visit https://business.thehartford.com 24/7 access to pay bills, view policy documents, get your certificate of insurance and more. Need Help?Start a live chat online or call us at (888) 925-3137.We’re here weekdays from 8:00 AM to 8:00 PM ET INSURANCE ENDORSEMENT ATTACHED *** PLEASE REVIEW THE CHANGE *** Enclosed is an endorsement for your business insurance policy.Please review it at your convenience.If you have questions or need to make further changes, Please contact us. Thank you for allowing us to service your business needs. Sincerely, Your Hartford Service Team THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. Countersigned by Authorized Representative Form WC 99 00 06 A (1)Printed in U.S.A.Page 1 Process Date:08/08/22 Policy Expiration Date:08/04/23 CHANGE IN INFORMATION PAGE INSURER:Hartford Casualty Insurance Company NCCI Company Number:14397 Audit Period:ANNUAL Policy Effective Date:08/04/22 Policy Expiration Date:08/04/23 Policy Number:76 WEG AT5AEC Endorsement Number:2 Effective Date:08/08/22 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address:STARTUP SPACE LLC 2054 HEIDELBERG AVE DUNEDIN FL 34698 FEIN Number:83-0709571 Producer Name:NUTMEG INS AGENCY INC/PHS Producer Code:76210775 It is agreed that the policy is amended as follows: This is NOT a bill.However, any changes in your premium will be reflected in your next billing statement.You will receive a separate bill from The Hartford. In consideration of no change in premium, it is agreed that: Policy is amended to add the following condition(s): Waiver of Our Right to Recover from Others Endorsement Policy is amended to delete the following condition(s): Waiver of Our Right to Recover from Others Endorsement Policy is amended to revise the following Endorsement Forms reflecting the changes made to your policy. WC000313 WC990006A(.1P) WC990006A(.2) CHANGE IN INFORMATION PAGE (Continued) Policy Number: 76 WEG AT5AEC SCHEDULE IT IS AGREED THAT THE POLICY IS AMENDED AS FOLLOWS: CLASS CODE NUMBER AND DESCRIPTION ESTIMATED TOTAL ANNUAL REMUNERATION RATES PER 100 OF REMUNERATION ESTIMATED ANNUAL PREMIUMS Form WC 99 00 06 A (1)Printed in U.S.A.Page 2 Process Date:08/08/22 Policy Expiration Date:08/04/23 FL Total State Summary Waiver charge 0.00 250 Waiver charge 0.00 0.020000 -250 Florida Total Cost 0 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. Countersigned by Authorized Representative Form WC 00 03 13 Printed in U.S.A. Process Date:08/08/22 Policy Expiration Date:08/04/23 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT Policy Number:76 WEG AT5AEC Endorsement Number:2 Effective Date:08/08/22 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address:STARTUP SPACE LLC 2054 HEIDELBERG AVE DUNEDIN FL 34698 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 shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE City of Cupertino 10300 Torre Avenue, Cupertino, CA 95014-3202 001 Policy Change: Business Owner’s Policy Form SC 00 06 10 18 Page 1 of 3 Process Date:08/08/2022 © 2018, The Hartford Policy Expiration Date:08/04/2023 (May include copyrighted material of Insurance Services Office, Inc., with its permission) Policy Number:76 SBU AT4X1U Policy Period:08/04/2022 to 08/04/2023 Named Insured and Mailing Address: STARTUP SPACE LLC, Economic Impact Catalyst, 2054 HEIDELBERG AVE, DUNEDIN, FL 34698-2332 Policy Change Number:1 Policy Change Effective Date:08/08/2022, Effective hour is the same as stated in the Declarations Page of the Policy. Insurer: Hartford Underwriters Insurance Company, a property and casualty company of The Hartford One Hartford Plaza, Hartford, CT 06155 Name of Agent/Broker: NUTMEG INS AGENCY INC/PHS 8711 UNIVERSITY DRIVE EAST CHARLOTTE, NC 28213 Code:76210775 Coverage Parts Affected: Liability Common This is NOT a bill.However,any changes in your premium will be reflected in your next billing statement.You will receive a separate bill from The Hartford.If you are enrolled in repetitive EFT draws from your bank account, changes in premium will change future draw amounts. As a result of the changes described herein, there is an additional premium in the amount of:$24 *Price is subject to fees and surcharges Countersigned by:08/08/2022 Authorized Representative Date Policy Change: Business Owner’s Policy Form SC 00 06 10 18 Page 2 of 3 Process Date:08/08/2022 © 2018, The Hartford Policy Expiration Date:08/04/2023 (May include copyrighted material of Insurance Services Office, Inc., with its permission) The following Additional Insured has been added as an Additional Insured - Designated Person or Organization. Additional Insured Name Cupertino CITY HALL , 10300 Torre Avenue, CUPERTINO, CA 95014 Policy is amended to add the following Endorsement Forms reflecting the changes made to your policy. FORM NUMBER FORM NAME COVERAGE PART SC 00 06 10 18 POLICY CHANGE Common SL 30 42 10 18 ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION Liability Policy is amended to revise the following Endorsement Forms reflecting the changes made to your policy. FORM NUMBER FORM NAME COVERAGE PART SC 00 02 10 18 SPECTRUM SUPPLEMENTAL SCHEDULE OF AUDITABLE COVERAGES Common Premium associated with this Policy Change has pro rata factor 0.989. Fees and Surcharges Form SC 00 06 10 18 Page 3 of 3 Process Date:08/08/2022 © 2018, The Hartford Policy Expiration Date:08/04/2023 (May include copyrighted material of Insurance Services Office, Inc., with its permission) States laws and regulations may require you to pay taxes, fees, surcharges or other costs.We’ve listed those charges impacted by the changes made to your policy below. DESCRIPTION COST Florida Fire (College) Marshal $0.02 2022-1 FIGA Assessment Surcharge $0.48 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Form SC 00 02 10 18 Page 1 of 2 Process Date:08/08/2022 © 2018, The Hartford Policy Expiration Date:08/04/2023 (May include copyrighted material of Insurance Services Office, Inc., with its permission) SPECTRUM SUPPLEMENTAL SCHEDULE OF AUDITABLE COVERAGES This schedule reflects only those classes and/or coverages that are subject to audit. POLICY NUMBER:76 SBU AT4X1U Revised:08/08/2022 Entries herein,except as specifically provided elsewhere in this policy,do not modify any of the other provisions of this policy. Auditable Coverage Description: LOC 1, BLDG 1: 2054 HEIDELBERG AVEDUNEDIN,FL 34698-2332 Class Code: 11171 Class Code Description: Software, Internet, Application & Web Design Coverage Description Rating Basis Exposure Final Rate Data Breach First Party Sales 1,500,000 0.583000 Data Breach Third Party Sales 1,500,000 0.402000 Liability and Med Exp (Premises/Completed Operations) Sales 1,500,000 0.020000 Products - Completed Operations Sales 1,500,000 0.009000 Technology Services Coverage Extension Plus PremOps Sales 1,500,000 0.001000 Technology Services Coverage Extension Plus Product Sales 1,500,000 0.001000 Data Breach First Party Sales 1,500,000 0.583000 Data Breach Third Party Sales 1,500,000 0.402000 Liability and Med Exp (Premises/Completed Operations) Sales 1,500,000 0.020000 Products - Completed Operations Sales 1,500,000 0.009000 Technology Services Coverage Extension Plus PremOps Sales 1,500,000 0.001000 Technology Services Coverage Extension Plus Product Sales 1,500,000 0.001000 LOC 1, BLDG 1: 2054 HEIDELBERG AVEDUNEDIN,FL 34698-2332 Class Code: 11171 Class Code Description: Software, Internet, Application & Web Design Coverage Description Rating Basis Exposure Final Rate Data Breach First Party Sales 1,500,000 0.583000 Data Breach Third Party Sales 1,500,000 0.402000 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Form SC 00 02 10 18 Page 2 of 2 Process Date:08/08/2022 © 2018, The Hartford Policy Expiration Date:08/04/2023 (May include copyrighted material of Insurance Services Office, Inc., with its permission) Coverage Description Rating Basis Exposure Final Rate Liability and Med Exp (Premises/Completed Operations) Sales 1,500,000 0.020000 Products - Completed Operations Sales 1,500,000 0.009000 Technology Services Coverage Extension Plus PremOps Sales 1,500,000 0.001000 Technology Services Coverage Extension Plus Product Sales 1,500,000 0.001000 Data Breach First Party Sales 1,500,000 0.583000 Data Breach Third Party Sales 1,500,000 0.402000 Liability and Med Exp (Premises/Completed Operations) Sales 1,500,000 0.020000 Products - Completed Operations Sales 1,500,000 0.009000 Technology Services Coverage Extension Plus PremOps Sales 1,500,000 0.001000 Technology Services Coverage Extension Plus Product Sales 1,500,000 0.001000 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Form SL 30 42 10 18 Page 1 of 1 © 2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) ADDITIONAL INSURED – DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM Except as otherwise stated in this endorsement, the terms and conditions of the Policy apply. A.The following is added to Section C. WHO IS AN INSURED: Designated Person Or Organization a.The person(s)or organization(s)shown in the Declarations as Additional Insured –Designated Person Or Organization is also an additional insured,but only with respect to liability for “bodily injury”,“property damage”or “personal and advertising injury”caused,in whole or in part,by your acts or omissions or the acts or omissions of those acting on your behalf: (1)In the performance of your ongoing operations; or (2)In connection with your premises owned by or rented to you. b.If coverage provided to these additional insureds is required by a written contract or written agreement,or when required by a written permit issued by a state or governmental agency or subdivision or political subdivision,the insurance afforded to these additional insureds will not be broader than that which you are required by the contract, agreement, or permit to provide for these additional insureds. c.The insurance afforded to these additional insureds only applies to the extent permitted by law. B.With respect to the insurance afforded such additional insured(s)by this endorsement,the following additional exclusion is added to Section B. EXCLUSIONS: This insurance does not apply to “bodily injury”or “property damage”included within the “products-completed operations hazard”. First Amendment to Startup Space SaaS Final Audit Report 2023-08-07 Created:2023-08-03 By:Marilyn Pavlov (marilynp@cupertino.org) Status:Signed Transaction ID:CBJCHBCAABAAnWswMTI2--ZYx6pIZyNOyebKfuNLllXY "First Amendment to Startup Space SaaS" History Document created by Marilyn Pavlov (marilynp@cupertino.org) 2023-08-03 - 11:22:59 PM GMT- IP address: 69.181.168.76 Document approved by Marilyn Pavlov (marilynp@cupertino.org) Approval Date: 2023-08-03 - 11:29:26 PM GMT - Time Source: server- IP address: 69.181.168.76 Document emailed to Araceli Alejandre (aracelia@cupertino.org) for approval 2023-08-03 - 11:29:27 PM GMT Document approved by Araceli Alejandre (aracelia@cupertino.org) Approval Date: 2023-08-03 - 11:42:16 PM GMT - Time Source: server- IP address: 71.204.144.228 Document emailed to davidponraj@eicatalyst.com for signature 2023-08-03 - 11:42:17 PM GMT Email viewed by davidponraj@eicatalyst.com 2023-08-03 - 11:42:21 PM GMT- IP address: 66.102.8.11 Signer davidponraj@eicatalyst.com entered name at signing as David Ponraj 2023-08-03 - 11:44:41 PM GMT- IP address: 174.211.177.189 Document e-signed by David Ponraj (davidponraj@eicatalyst.com) Signature Date: 2023-08-03 - 11:44:43 PM GMT - Time Source: server- IP address: 174.211.177.189 Document emailed to christopherj@cupertino.org for signature 2023-08-03 - 11:44:45 PM GMT Email viewed by christopherj@cupertino.org 2023-08-03 - 11:53:27 PM GMT- IP address: 174.194.199.212 Signer christopherj@cupertino.org entered name at signing as Christopher D. Jensen 2023-08-04 - 1:12:32 AM GMT- IP address: 136.24.22.111 Document e-signed by Christopher D. Jensen (christopherj@cupertino.org) Signature Date: 2023-08-04 - 1:12:34 AM GMT - Time Source: server- IP address: 136.24.22.111 Document emailed to Bill Mitchell (billm@cupertino.org) for signature 2023-08-04 - 1:12:36 AM GMT Email viewed by Bill Mitchell (billm@cupertino.org) 2023-08-05 - 2:30:27 AM GMT- IP address: 104.47.74.126 Document e-signed by Bill Mitchell (billm@cupertino.org) Signature Date: 2023-08-05 - 6:40:59 PM GMT - Time Source: server- IP address: 73.63.193.111 Document emailed to Kirsten Squarcia (kirstens@cupertino.org) for signature 2023-08-05 - 6:41:00 PM GMT Email viewed by Kirsten Squarcia (kirstens@cupertino.org) 2023-08-05 - 7:39:11 PM GMT- IP address: 104.28.111.146 Document e-signed by Kirsten Squarcia (kirstens@cupertino.org) Signature Date: 2023-08-07 - 2:58:08 PM GMT - Time Source: server- IP address: 64.165.34.3 Agreement completed. 2023-08-07 - 2:58:08 PM GMT