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12-127 Genevieve Fire Agreement for NPDES permit compliance technical assistance CITY OF \\ / AGREEMENT �� CITY OF CUPERTINO 10300 Torre Avenue '9,p \/- )'6 ( ? Cupertino, CA 95014 CUPERTINO 408-777-3200 THIS AGREEM -NT, made and entered into this_1st day of July is by and between the CITY OF CUPERTINO Hereinafter "CITY") and Genevieve Fire (address/phone/email) 1195 Thurston Avenue, Los Altos, CA 94024 Hereinafter "CONTRACTOR"), in consideration of their mutual covenants, the parties agree as follows: CONTRACTOR shall provide or furnish the following specified services and/or materials: Professional Services connected with NPDES Permit compliance technical assistance. Check box if services are further described in an Exhibit.2 EXHIBITS: The following attached exhibits hereby are made part of this Agreement: TERM: The services and/or materials furnished under this Agreement shall commence on July 1, 2012 and shall be completed no later than June 30, 2013. COMPENSATION: For the full performance of this Agreement, CITY shall pay CONTRACTOR: $4,800 California Labor Code, Section 1771 requires the payment of prevailing wages to all workers employed on a Public Works contract in excess of$1,000.00. GENERAL TERMS AND CONDITIONS Hold Harmless. Contractor shall, to the fullest extent allowed by law, indemnify, defend, and hold harmless the City and its officers, officials, agents, employees and volunteers against any and all liability, claims, stop notices, actions, causes of action or demands whatsoever from and against any of them, including any injury to or death of any person or damage to property or other liability of any nature, arising out of, pertaining to, or related to the performance of this Agreement by Contractor or Contractor's employees, officers, officials, agents or independent contractors. Contractor shall not be obligated under this Agreement to indemnify City to the extent that the damage is caused by the sole or active negligence or willful misconduct of City, its agents or employees. Such costs and expenses shall include reasonable attorneys' fees of counsel of City's choice, expert fees and all other costs and fees of litigation. Subcontracting. Contractor has been retained due to their unique skills and Contractor may not substitute another, assign or transfer any rights or obligations under this Agreement. Unless prior written consent from City is obtained, only those people whose names are listed this Agreement shall be used in the performance of this Agreement. Assignment. Contractor may not assign or transfer this Agreement, without prior written consent of CITY. Page 1 of 3 FY 2012-13 Genevieve Fire Short Form Agreement Insurance. Contractor shall file with City a Certificate of Insurance consistent with the following requirements Coverage: Contractor shall maintain the following insurance coverage: (1) Workers' Compensation: Statutory coverage as required by the State of California. (2) Liability: Commercial general liability coverage in the following minimum limits: Bodily Injury: $1,000,000 each occurrence $2,000,000 aggregate - all other Property Damage: $500,000 each occurrence $1,000,000 aggregate If submitted, combined single limit policy with aggregate limits in the amounts of$2,000,000 will be considered equivalent to the required minimum limits shown above. (3) Automotive: Comprehensive automobile liability coverage in the following minimum limits: Bodily injury: $250,000 each occurrence Property Damage: $100,000 each occurrence or Combined Single Limit: $1,000,000 each occurrence Consultant agrees not to use her personal automobile in performance of the services under this Agreement. Subrogation Waiver. Contractor agrees that in the event of loss due to any of the perils for which it has agreed to provide comprehensive general and automotive liability insurance, Contractor shall look solely to its insurance for recovery. Contractor hereby grants to City, on behalf of any insurer providing comprehensive general and automotive liability insurance to either Contractor or City with respect to the services of Contractor herein, a waiver of any right to subrogation which any such insurer of said Contractor may acquire against City by virtue of the payment of any loss under such insurance. Termination of Agreement. The City reserves the right to terminate this Agreement with or without cause with a seven (7)-day notice. The Contractor may terminate this Agreement with or without cause with a seven (7)-day written notice. Non-Discrimination. No discrimination shall be made in the employment of persons under this Agreement because of the race, color, national origin, ancestry, religion, gender or sexual orientation of such person Interest of Contractor. It is understood and agreed that this Agreement is not a contract of employment in the sense that the relationship of master and servant exists between City and Page 2 of 3 FY 2012-13 Genevieve Fire Short Form Agreement Agreement is an officer or employee of City. City shall have no right of control as to the manner Contractor performs the services to be performed. Nevertheless, City may, at any time, observe the manner in which such services are being performed by the contractor. The Contractor shall comply with all applicable Federal, State, and local laws and ordinances including, but not limited to, unemployment insurance benefits, FICA laws, and the City business license ordinance. Changes. No changes or variations of any kind are authorized without the written consent of the City. CONTRACT CO-ORDINATOR and representative for CITY shall be: NAME: Cheri Donnelly DEPARTMENT: Public Works This Agreement shall become effective upon its execution by CITY, in witness thereof, the parties have executed this Agreement the day and year firs`: written above. CONTRACTOR: CITY OF CUPERTINO: By i' ;s21•Le.—�"eiv - By `,lien- Dewy.. Title aw v'sv- Gev&4 i\e..re_F(1,27) P.E • Title: Ctw ce r.rncr��c3. c-c lc 5 tk IS . Soc. Sec. #or Tax I.D 565-24-212S APPROVALS EXPENDITURE DISTRIBUTION DEPARTME'!t- AD DATE 'COUNT NUMBER AMOUNT I t(2-/f Z 2:30-8004-7014 $4,800.00 i 0 ...0 ;I ik )21c//1/4)"- .i EY APPR VED AS TO FORM DA/1T CITY CLERK: ATTEST DA E,,k C .r, �- t&1 ;11 Z Page 3 of 3 FY 2012-13 Genevieve Fire Short Form Agreement GENEV-3 OP ID: DP '44C°RC:r CERTIFICATE OF LIABILITY INSURANCE DATE 11/16D/YYYY) 11!16!12 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). PRODUCER CT 650-328-1000 NAME: A Insurance by Allied Brokers-1 650-324-1142 PHONE FAX Lic#0525309 ,A/C No,Ext.):_ (A/C,No): 630 Cowper Street I°-MAIL Palo Alto,CA 94301 ADDRESS: Danielle Petrel) _ INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:The Hartford 29424 INSURED Genevieve Fire-Halvorsen INSURER B: Attn: Genevieve Fire-Halvorsen 1195 Thurston Avenue INSURER C Los Altos, CA 94024 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 POLICY EFF POLICY EXP TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A X COMMERCIAL GENERAL LIABILITY X X 57SBMBD7652 11/16/12 11/16/13 DAMAGE TO RENTED 1,000,000 PREMISES(Ea occurrence) $ CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000 POLICY PRO n LOC $ JECT _,.. .. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000 000 (Ea accident) A ANY AUTO X X 57SBMBD7652 11/16/12 11/16/13 BODILYINJURY(Perperson) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate holder, The City of Cupertino, is additional insured with a waiver of subrogation. CERTIFICATE HOLDER CANCELLATION CITYC U P SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Cupertino Cheri Donnelly — 10300 Torre Avenue AUTHORIZED REPRESENTATIVE Cupertino,CA 95014 ` \/■7") ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD PRODUCER I����� ALLIED IED BROKERS INSURANCE 043910 05 630 COWPER ST. MERCURY PALO ALTO CA 94301 INSURANCE COMPANY AUTOMOBILE POLICY DECLARATIONS , TELEPHONE:(650) 323-8020 IMPORTANT COVERAGE EXCLUSION .. . APPLtCAOLE?O:Ai:k:.COVERA4ES'n l:u(3 n Bud NOrOVItTECt T4i JA ITk --r PER_B- ..........� . ..�.._.w..�. s I INStUhRe E 7l RIS7S:.:PR t ..Ot:ATER:;_..:.:'::...... 0401 05 005292552 FROM06/17/201212:01A 701 2/17/2012 12:O1A . iz agee t ihe 1suaoo e:eftdt4S b phis po a . PERSONS:1NSUREL} ::: shall riot.e1?fi!Iy nor Bosnia to The ber5etil OI e l r bsuf5,ti:at 6tlU _:_ y ._... __ lil%SNIED IINSUiED :. :. �.:i1).tYt(•:4?Bm!'.'Bl$'{CfiHm:W.liei4:•i4pl':.f.CiQ10%:V.ft'FIMS..43Bt(F9:US8 C).tii".....:...::.::::::::::= GENEVIEVE FIRE HALVORSEN ;.:.:: ;::;y:::.:;•:operated.;bY.s.:person;listed;bel ow;regardless;:of;where;::#*:: :; >:; j:'. ; :;;::: :person igsides or5ivhettier Itie person is licensed 2n drivel: .... DRIVERS .�.�.- ...�... .: ..... .... GENEVIEVE FIRE HALVORSEN CHRIS HALVORSEN ANNE HALVORSEN SAMUEL HALVORSEN MAILING 1195 THURSTON AVE ADDRESS LOS ALTOS, CA 94024-6863 :tAR::kEAtt•:E• ,,::..:....::.,.: 1YFH..ItI1:D):SBRIi*.710k .., .._._. :.Y.:.:.:.:,:.::::- Si R1ALNUNIB1rR, .... .,,' y t:US7 Op:vAL17£ .,lldEWtU$ED--:Siiidit DAtt; H1*/CIR:::: 1 2004 I HONDA PILOT EX-L UTL 4X4 4D 2HKY=18524H538537 U 12/2003 2 12004 MAZDA MAZDA 6 S SED 4DR 1 YVFI'80D445N99169 U 12/2004 6AR.1 tOSSAAYEE5liPYADDITIONALINIERES7B1Alt tOSSPAAES ANDADD/VOBIAL1NITIEtTSiA) ..hRA6iid ADDRessE§IGA).AdG REGISTERE6 i1WNERSl DiOTHERTHAN7HOSEUSTFD ABOVE , Coverage applies only if premium charge is listed below. Coverage/Limits are subject to all policy terms. COtfERAGES'. ;••.,........ ........:....... LfMfFFS ...,_. .:. PREMIUMS.. ... 'LION-EACTAFfI"E¢tJIPM£IJT... _. -_-CAR 1 I CAR 2 I CAR ITEMS INSURED AND AMOUNTS OF BODILY INJURY LIABILITY $250,000 EACH PERSON $500,000 EACH ACCIDENT 82 67 I INSURANCE FOR EACH ITEM ARE STATED PROPERTY DAMAGE LIABILITY $100,000 EACHACGDENT 1 149 HEREIN. ITEMS INSURED ARE SUBJECT TO UNINSURED MOTORISTS BODILY INJURY LIABILITY $250,000 EACH PERSON$500,000 EACH ACCIDENT 42 75 i THE DEDUCTIBLE. UNINSURED MOTORISTS is MAXIMUM `-� LAPx� :'.17E1©S IN.SUriI=D vMIY :_::7 PROPERTY DAMAGE LIABILITY ? COLLISION DEDUCTIBLE WAIVER.' 13 13 MEDICAL EXPENSE !$5,000 EXCESS WITH REIMBURSEMENT I5C EXCESS �TO COMPANY IXINO REIMBURSEMENT', 16 23 LEASE/LOAN GAP COVERAGE !CAR CAR CAN REPAIR OR REPLACEMENT...,. ;CAA..._. ..._CAR CAR ..i.. • COST COVERAGE { .. "... ... IDEDUCTIBLECAR1 $1,000 CAR2$1,000 CAR $ ... ......... COMPREHENSIVE 1 1# 8 --*-CkLffOBNtA 0.0.0FT3 :::::i::ii COLLISION DEDUCTIBLECAR1.$1,000 CAR2 $1,000 CAR $ L 144' 179 CA FRAUD FEE ROADSIDE ASSISTANCE • 1$75 Per Occurrence INCL.' INCL. CIGA FEE -- _ RENTAL CAR BENEFIT $ PER DAY DAYS RENTED CAR PHYSICAL DAMAGE$ DEDUCTIBLE PER CLAIM ISEE RCPD PREMIJId BELOW) PREMNINIS•PER CAR Ei4DDRSEMEWTS AttieiiEO teak PDLit 1: : •:::: :. ..... 465 I 514 U-10 04/2010 U-170 : RcrD:rREM RfM:_:;;•:::rDLC.Y.FEE?::::}; TOTAL PREMIUM 979.00 IMPORTANT INFORMATION EFFECTIVE 07/11/2012 This amended policy declarations page replaces all declarations with the same or prior effective date. Reason(s) Amended ADD DRIVER(S) AMEND PERSON(S) EXCLUDED If there is a lapse, coverage will not be provided during the lapse period. This policy change has resulted in an additional premium of $238.00 The enclosed Auto Insurance Bill is part of this policy. It specifies the amount of your premium, your payment options, any applicable fees, and the due date. If you have any questions, please contact your agent or broker at the phone number provided above. MAILED TO: GENEVIEVE FIRE HALVORSEN 1195 THURSTON AVE POUcY:NUMBER 07/1 /2 005292552 LOS ALTOS, CA 94024-6863 Mall ING'Afi1 E: : 07/18/2012 U-1 176 09/2011 _____ INSURED COPY City of Cupertino Urban Runoff Management Program FY 2012-2013 Municipal Regional NPDES Permit Compliance Technical Assistance Summary of Tasks and Estimated Effort by Genevieve Fire, P.E. Permit Due Est.Time Provision Task Description I Date I (Hours) C.2 Municipal Operations C.2a-e Review Urban Runoff Management Plan &Corp Yard SWPPP May-13 3 C.2.e Rural Road and Public Works Construction and Maintenance-staff training Dec-12 5 C.2.f Corporation Yard BMP Implementation-Annual SWPPP revision Oct-12 2 C.4 Industrial and Commercial Site Controls C.4.c Enforcement Response Plan (ERP) review, as needed I On-going I 2 C.6 Construction Site Control C.6.b ,Enforcement Response Plan (ERP) review, as needed I On-going I 2 C.16 Annual Reports Review, as requested I Jun-12 I 8 MISC. (General technical assistance implementing MRP provisions On-going 4 Additional Urban Runoff Mgmt PlanPerformanace Standard Revisions On-going 6 (Total Estimated Hours 32 Total Estimated Cost(@$150/hour) $4,800 Prep. by G. Fire 8/16/10