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13-097 The Wilfred Jarvis Institute, Consultant Services for Conducting Investigation of Personnel Complaints and Team Development and Effectiveness Training OFFICE OF THE CITY CLERK CITY HALL 10300 TORRE AVENUE- CUPERTINO, CA 95014-3255 TELEPHONE: (408) 777-3223• FAX: (408) 777-3366 WEBSITE: www.cupertinc).org CUPERTINO September 23, 2013 The Winfred Jarvis Institute 23505 Oak Valley Road Cupertino, CA 95014 Re: First Amendment to Agreement for Consultant Service Related to Investigation of Personnel Complaints Enclosed is a fully executed copy of the first amendment to your agreement with the City of Cupertino. If you have any additional questions, please contact the Administrative Services department at (408) 777-3220. Sincerely, kL)" 11�� Dorothy Stee ott Senior Office Assistant Enclosure cc: Administrative Services FIRST AMENDMENT TO AGREEMENT BETWEEN THE CITY OF CUPERTINO AND THE WILFRED JARVIS INSTITUTE FOR CONSTULANT SERVICES This First Amendment to the Consultant Services Agreement between the City of Cupertino and The Wilfred Jarvis Institute, for reference dated September 10, 2013, is by and between the CITY OF CUPERTINO, a municipal corporation (hereinafter "City") and The Wilfred Jarvis Institute, a California corporation, whose address is 23505 Oak Valley Road, Cupertino, CA 94014, (hereinafter "Consultant"), and is made with reference to the following: RECITALS: A. On June 4th, 2013, an agreement was entered into by and between City and Consultant(hereinafter "Agreement"). B. City and Consultant desire to modify the Agreement to provide for additional coaching and mentoring services on the terms and conditions set forth herein. NOW, THEREFORE, it is mutually agreed by and between and undersigned parties as follows: 1. The following Exhibits to the Agreement are amended and replaced to read as shown in the attachments to this Amendment: a. Exhibit "A,"-Scope b. Exhibit "C"- Compensation 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. [signatures on following page] Page I of 4 First Amendment The Wilfred Jarvis Institute IN WITNESS WHEREOF, the parties hereto have caused this modification of Agreement to be executed. The Wilfred Jarvis Institute CITY OF CUPERTINO A Municipal Corporation By By Carol Atwood, Dir. of. Admin. Services Title Date 1-? 3 Date APPROVED AS TO FORM: n By Y Carol Korade, City Attorney ATTEST: By 1� Grace Schmidt, City Clerk Account Nos. 110-4510-7014-$5,150.00 110-8101-7014-$11,750.00 110-8201-7014-$6,000.00 TOTAL -$22,900 Total Amount$22,900.00 1S1 Amendment Amount-$6,000 Original Amount-$16,900.00 Page 2 of 4 First Amendment The Wilfred Jarvis institute EXHI131T A Consultant shall complete the tasks described in this exhibit as directed by City's project manager. Prior to commencing work on each task,Consultant shall provide City with a description of the activities necessary to complete that task, schedule,and anticipated maximum budget. Task 1. Investigation Conduct investigation of personnel complaints as directed by City. Task 2. Team Development and Effectiveness Training Engage the Public Works Service Center leader and staff in an effort to increase their cohesiveness and productivity as a team by: (a) Completing a team effectiveness assessment to initiate the development and training process, (b) Conducting team training as approved by City's Director of Public Works, (c) Facilitating team activities as approved by City's Director of Public Works, and (d) Coaching and mentoring individuals as well as the team,or a subset thereof, as approved by City's Director of Public Works. (e) Complete at least two subsequent team effectiveness assessments(during and at the end of the training process)and review changes in results,which will be used as a way of monitoring progress. (f) Coach and mentor up to seven (7) additional individuals as approved by City's Director of Public Works. Page 3 of 4 First Amendment The Wilfred Jarvis Institute EXHIBIT C COMPENSATION—Amended September 10,2013 City shall compensate Consultant for professional services in accordance with the terms and conditions of this Agreement based on the rates and compensation schedule set forth below. Compensation shall be calculated based on the hourly rates set forth below up to the not to exceed budget amount set forth below. The compensation to be paid to Consultant under this Agreement for all services described in Exhibit "A" and reimbursable expenses shall not exceed five thousand one hundred fifty dollars ($5,150.00) for Task A and seventeen thousand seven hundred fifty dollars ($17,750.00) for Task B, for a total amount not to exceed twenty two thousand nine hundred dollars ($22,900.00). Any work performed or expenses incurred for which payment would result in a total exceeding the maximum amount of compensation set forth herein shall be at no cost to the City. CONSULTANT shall not exceed any of the specified budget amounts for any Task without prior written authorization from the CITY. The CITY may approve in writing the transfer of budget amounts between any of the Tasks listed above provided the total AGREEMENT amount does not exceed twenty two thousand nine hundred dollars($22,900.00). Hourly Rates Minh Lee -Work with individuals: $200/hour -Work with groups/team training: $250/hour Invoices In order to request payment, Consultant shall submit monthly invoices to the CITY describing the services performed and the applicable charges (including an identification of personnel who performed the services, hours worked, task(s) for which work was performed, hourly rates, and reimbursable expenses), based upon Consultant's billing rates. Reimbursable Expenses Administrative, overhead, secretarial time or overtime, word processing, photocopying, in house printing, insurance and other ordinary business expenses are included within the scope of payment for services and are not reimbursable expenses. City shall reimburse consultant for reasonable travel. Travel expenses are limited to the lesser of actual expenses or expenses that would be authorized for City employee travel pursuant to City policy. Additional Services Consultant shall provide additional services outside of the services identified in Exhibit"A" only by advance written authorization from the City's Project Manager prior to commencement of any additional services. Consultant shall submit, at the Project Manager's request, a detailed written proposal including a description of the scope of additional services, schedule, and proposed maximum compensation. Page 4-if 4 First Amendment The Wilfred Jarvis Institute ` OFFICE OF THE CITY CLERK / CITY HALL 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 TELEPHONE: (408)777-3223• FAX: (408) 777-3366 44,5t.�9ss WEBSITE:www.cupertino.org CUPERTINO July 3, 2013 The Wilfred Jarvis Institute 23505 Oak Valley Road Cupertino, CA 95014 Re: Agreement Enclosed is a fully executed original copy of your agreement with the City of Cupertino If you have any questions or need additional information, please contact the Planning Department at (408) 777-3308. Sincerely, 5411 Brittany Care Senior Office Assistant City of Cupertino Enclosure cc: Planning AGREEMENT BETWEEN THE CITY OF CUPERTINO AND THE WILFRED JARVIS INSTITUTE FOR CONSULTANT SERVICES THIS AGREEMENT, for reference dated June 4, 2013, 2013, is by and between CITY OF CUPERTINO, a municipal corporation (hereinafter referred to as "City"), and The Wilfred Jarvis Institute, a California corporation whose address is hereinafter referred to as "Consultant"), and is made with reference to the following: RECITALS: A. City is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to carry on its business as it is now being conducted under the Constitution and the statutes of the State of California and the Cupertino Municipal Code. B. Consultant is specially trained., experienced and competent to perform the special services which will be required by this Agreement; and C. Consultant possesses the skill, experience, ability, background, certification and knowledge to provide the services described in this Agreement on the terms and conditions described herein. D. City and Consultant desire to enter into an agreement for consultant services upon the terms and conditions herein. NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows: 1. TERM: The term of this Agreement shall commence on June 1, 2013, and shall terminate on May 31, 2014, unless terminated earlier as set forth herein. 2. SERVICES TO BE PERFORMED: Consultant shall perform each and every service set forth in Exhibit "A" according to the project schedule set forth in Exhibit B, which exhibits are attached hereto and incorporated herein by this reference, in accordance with the terms and conditions set forth in this agreement. Consultant's Project Manager to represent consultant during the day-to-day work on the Project is Minh Le. Consultant's Project Manager shall have supervisory responsibility for the performance, progress, and execution of the Services. If circumstances cause the substitution of the project director, project coordinator, or any other key personnel for any reason, the appointment of a substitute project director and the assignment of any key new or replacement personnel will be subject to the prior written approval of the City. Consultant, at City's request, also agrees to promptly remove personnel who City finds do not perform the Services in an acceptable manner. 3. COMPENSATION TO CONSULTANT: Consultant shall be compensated for services performed pursuant to this Agreement in the amounts set forth in Exhibit "C" which is attached hereto and incorporated herein by this reference. Consultant shall submit monthly invoices to the City in accordance with the provisions set forth in Exhibit "C." 4. TIME IS OF THE ESSENCE: Consultant and City agree that time is of the essence regarding the performance of this Agreement. 5. STANDARD OF CARE: Consultant agrees to perform all services hereunder in a manner commensurate with the prevailing standards of like professionals in the San Francisco Bay Area and agrees that all services shall be performed by qualified and experienced personnel who are not employed by the City nor have any contractual relationship with City. 6. INDEPENDENT PARTIES: City and Consultant intend that the relationship between them created by this Agreement is that of employer-independent contractor. The manner and means of conducting the work are under the control of Consultant, except to the extent they are limited by statute, rule or regulation and the express terms of this Agreement. No civil service status or other right of employment will be acquired by virtue of Consultant's services. None of the benefits provided by City to its employees, including but not limited to, unemployment insurance, workers' compensation plans, vacation and sick leave are available from City to Consultant, its employees or agents. Deductions shall not be made for any state or federal taxes, FICA payments, PERS payments, or other purposes normally associated with an employer-employee relationship from any fees due Consultant. Payments of the above items, if required, are the responsibility of Consultant. 6. IMMIGRATION REFORM AND CONTROL ACT (IRCA): Consultant assumes any and all responsibility for verifying the identity and employment authorization of all of his/her employees performing work hereunder, pursuant to all applicable IRCA or other federal, or state rules and regulations. Consultant shall indemnify and hold City harmless from and against any loss, damage, liability, costs or expenses arising from any noncompliance of this provision by Consultant. 7. NON-DISCRIMINATION: Consistent with City's policy that harassment and discrimination are unacceptable employer/employee conduct, Consultant agrees that harassment or discrimination directed toward a job applicant, a City employee, or a citizen by Consultant or Consultant's employee or subcontractor on the basis of race, religious creed, color, national origin, ancestry, handicap, disability, marital status, pregnancy, sex, age, or sexual orientation will not be tolerated. Consultant agrees that any and all violations of this provision shall constitute a material breach of this Agreement. 8. HOLD HARMLESS: Consultant shall, to the fullest extent allowed by law, with respect to all services performed in connection with the Agreement, indemnify, defend, and hold harmless the City and its officers, officials, agents, employees and volunteers from and against any and all liability, claims, actions, causes of action or demands whatsoever against any of them, including any injury to or death of any person or damage to property or other liability of any nature, whether physical, emotional, consequential or otherwise, arising out, pertaining to, or related to the performance of this Agreement by Consultant or Consultant's employees, officers, officials, agents or independent contractors. 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. 9. INSURANCE: On or before the commencement of the term of this Agreement, Consultant shall furnish City with certificates showing the type, amount, class of operations covered, effective dates and dates of expiration o f insurance coverage in compliance with paragraphs 9A, B, C, D and E. Such certificates, which do not limit Consultant's indemnification, shall also contain substantially the following statement: "Should any of the above insurance covered by this certificate be canceled or coverage reduced before the expiration date thereof, the insurer affording coverage shall provide thirty (30) days' advance written notice to the City of Cupertino by certified mail, Attention: City Manager." It is agreed that Consultant shall maintain in force at all times during the performance of this Agreement all appropriate coverage of insurance required by this Agreement with an insurance company that is acceptable to City and licensed to do insurance business in the State of California. Endorsements naming the City as additional insured shall be submitted with the insurance certificates. A. COVERAGE: Consultant 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: $500,000 each occurrence $1,000,000 aggregate - all other Property Damage: $100,000 each occurrence $250,000 aggregate If submitted, combined single limit policy with aggregate limits in the amounts of$1,000,000 will be considered equivalent to the required minimum limits shown above. (3) Automotive: Comprehensive automotive liability coverage in the following minimum limits: Bodily Injury: $300,000 each occurrence Property Damage: $50,000 each occurrence or Combined Single Limit: $500,000 each occurrence B. SUBROGATION WAIVER: Consultant agrees that in the event of loss due to any of the perils for which he/she has agreed to provide comprehensive general and automotive liability insurance, Consultant shall look solely to his/her insurance for recovery. Consultant hereby grants to City, on behalf of any insurer providing comprehensive general and automotive liability insurance to either Consultant or City with respect to the services of Consultant herein, a waiver of any right to subrogation which any such insurer of said Consultant may acquire against City by virtue of the payment of any loss under such insurance. C. FAILURE TO SECURE: If Consultant at any time during the term hereof should fail to secure or maintain the foregoing insurance, City shall be permitted to obtain such insurance in the Consultant's name or as an agent of the Consultant and shall be compensated by the Consultant for the costs of the insurance premiums at the maximum rate permitted by law and computed from the date written notice is received that the premiums have not been paid. D. ADDITIONAL INSURED: City, its City Council, boards and commissions, officers, employees and volunteers shall be named as an additional insured under all insurance coverage, except any professional liability insurance, required by this Agreement. The naming of an additional insured shall not affect any recovery to which such additional insured would be entitled under this policy if not named as such additional insured. An additional insured named herein shall not be held liable for any premium, deductible portion of any loss, or expense of any nature on this policy or any extension thereof. Any other insurance held by an additional insured shall not be required to contribute anything toward any loss or expense covered by the insurance provided by this policy. E. SUFFICIENCY OF INSURANCE: The insurance limits required by City are not represented as being sufficient to protect Consultant. Consultant is advised to confer with Consultant's insurance broker to determine adequate coverage for Consultant. 10. CONFLICT OF INTEREST: Consultant warrants that it is not a conflict of interest for Consultant to perform the services required by this Agreement. Consultant may be required to fill out a conflict of interest form if the services provided under this Agreement require Consultant to make certain governmental decisions or serve in a staff capacity as defined in Title 2, Division 6, Section 18700 of the California Code of Regulations. 11. PROHIBITION AGAINST TRANSFERS: Consultant shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest therein, directly or indirectly, by operation of law or otherwise, without prior written consent of City. Any attempt to do so without said consent shall be null and void, and any assignee, sub-lessee, hypothecate or transferee shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. However, claims for money by Consultant from City under this Agreement may be assigned to a bank, trust company or other financial institution without prior written consent. Written notice of such assignment shall be promptly furnished to City by Consultant. The sale, assignment, transfer or other disposition of any of the issued and outstanding capital stock of Consultant, or of the interest of any general partner or joint- venture or syndicate member or co-tenant, if Consultant is a partnership or joint venture or syndicate or co-tenancy, which shall result in changing the control of Consultant, shall be construed as an assignment of this Agreement. Control means fifty percent (50%) or more of the voting power of the corporation. 12. SUBCONTRACTOR APPROVAL: Unless prior written consent from City is obtained, only those people and subcontractors whose names and resumes are attached to this Agreement shall be used in the performance of this Agreement. Consultant may change or add subcontractors only with the prior written approval of City. In the event that Consultant employs subcontractors, such subcontractors shall be required to furnish proof of workers' compensation insurance and shall also be required to carry general, automobile and professional liability insurance in reasonable conformity to the insurance carried by Consultant. In addition, any work or services subcontracted hereunder shall be subject to each provision of this Agreement. 13. PERMITS AND LICENSES: Consultant, at his/her sole expense, shall obtain and maintain during the term of this Agreement, all appropriate permits, certificates and licenses including, but not limited to, a City Business License, that may be required in connection with the performance of services hereunder. 14. REPORTS: A. Each and every report, draft, work product, map, record and other document, hereinafter collectively referred to as "Report", reproduced, prepared or caused to be prepared by Consultant pursuant to or in connection with this Agreement, shall be the exclusive property of City. Consultant shall not copyright any Report required by this Agreement and shall execute appropriate documents to assign to City the copyright to Reports created pursuant to this Agreement. Any Report, information and data acquired or required by this Agreement shall become the property of City, and all publication rights are reserved to City. Consultant may retain a copy of any report furnished to the City pursuant to this Agreement. B. All Reports prepared by Consultant may be used by City in execution or implementation of: (1) The original Project for which Consultant was hired; (2) Completion of the original Project by others; (3) Subsequent additions to the original project; and/or (4) Other City projects as appropriate. C. Consultant shall, at such time and in such form as City may require, furnish reports concerning the status of services required under this Agreement. D. All Reports required to be provided by this Agreement shall be printed on recycled paper. All Reports shall be copied on both sides of the paper except for one original, which shall be single sided. E. No Report, information or other data given to or prepared or assembled by Consultant pursuant to this Agreement shall be made available to any individual or organization by Consultant without prior approval by City. 15. RECORDS: Consultant shall maintain complete and accurate records with respect to sales, costs, expenses, receipts and other such information required by City that relate to the performance of services under this Agreement. Consultant shall maintain adequate records of services provided in sufficient detail to permit an evaluation of services. All such records shall be maintained in accordance with generally accepted accounting principles and shall be clearly identified and readily accessible. Consultant shall provide free access to such books and records to the representatives of City or its designees at all proper times, and gives City the right to examine and audit same, and to make transcripts therefrom as necessary, and to allow inspection of all work, data, documents, proceedings and activities related to this Agreement. Such records, together with supporting documents, shall be kept separate from other documents and records and shall be maintained for a period of three (3) years after receipt of final payment. If supplemental examination or audit of the records is necessary due to concerns raised by City's preliminary examination or audit of records, and the City's supplemental examination or audit of the records discloses a failure to adhere to appropriate internal financial controls, or other breach of contract or failure to act in good faith, then Consultant shall reimburse City for all reasonable costs and expenses associated with the supplemental examination or audit. 16. NOTICES: All notices, demands, requests or approvals to be given under this Agreement shall be given in writing and conclusively shall be deemed served when delivered personally or on the second business day after the deposit thereof in the United States Mail, postage prepaid, registered or certified, addressed as hereinafter provided. All notices, demands, requests, or approvals from Consultant to City shall be addressed to City at: City of Cupertino 10300 Torre Ave. Cupertino CA 95014 Attention: City Manager All notices, demands, requests, or approvals from City to Consultant shall be addressed to Consultant at: Minh Le, President The Wilfred Jarvis Institute 23505 Oak Valley Road Cupertino CA 95014 17. TERMINATION: In the event Consultant fails or refuses to perform any of the provisions hereof at the time and in the manner required hereunder, Consultant shall be deemed in default in the performance of this Agreement. If such default is not cured within the time specified after receipt by Consultant from City of written notice of default, specifying the nature of such default and the steps necessary to cure such default, City may terminate the Agreement forthwith by giving to the Consultant written notice thereof. City shall have the option, at its sole discretion and without cause, of terminating this Agreement by giving seven (7) days' prior written notice to Consultant as provided herein. Upon termination of this Agreement, each party shall pay to the other party that portion of compensation specified in this Agreement that is earned and unpaid prior to the effective date of termination. 18. COMPLIANCES: Consultant shall comply with all state or federal laws and all ordinances, rules and regulations enacted or issued by City. 19. CONFLICT OF LAW: This Agreement shall be interpreted under, and enforced by the laws of the State of California excepting any choice of law rules which may direct the application of laws of another jurisdiction. The Agreement and obligations of the parties are subject to all valid laws, orders, rules, and regulations of the authorities having jurisdiction over this Agreement (or the successors of those authorities.) Any suits brought pursuant to this Agreement shall be filed with the courts of the County of Santa Clara, State of California. 20. ADVERTISEMENT: Consultant shall not post, exhibit, display or allow to be posted, exhibited, displayed any signs, advertising, show bills, lithographs, posters or cards of any kind pertaining to the services performed under this Agreement unless prior written approval has been secured from City to do otherwise. 21. WAIVER: A waiver by City of any breach of any term, covenant, or condition contained herein shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant, or condition contained herein, whether of the same or a different character. 22. INTEGRATED CONTRACT: This Agreement represents the full and complete understanding of every kind or nature whatsoever between the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or nature are merged herein. No verbal agreement or implied covenant shall be held to vary the provisions hereof. Any modification of this Agreement will be effective only by written execution signed by both City and Consultant. 22. INSERTED PROVISIONS: Each provision and clause required by law to be inserted into the Agreement shall be deemed to be enacted herein, and the Agreement shall be read and enforced as though each were included herein. If through mistake or otherwise, any such provision is not inserted or is not correctly inserted, the Agreement shall be amended to make such insertion on application by either party. 23. CAPTIONS: The captions in this Agreement are for convenience only, are not a part of the Agreement and in no way affect, limit or amplify the terms or provisions of this Agreement. IN WITNESS WHEREOF, the parties have caused the Agreement to be executed. CONSULTANT CITY OF CUPERTINO A Municipal Corporation The Wilfred Jarvis Instit to By /if— By '(.c--e � �V Title fir .,,� �., Title d�/�! PYt ---;E-R.ti1 -) Date 6. A'MZv Date (p- 4 —i RECOMMENDED FOR • ' ' ' OVAL: By Title APPROVED AS TO FORM: 13y Cit %ftorney ATTEST: C. lerk EXHIBIT A SCOPE OF SERVICES Consultant shall complete the tasks described in this exhibit as directed by City's project manager. Prior to commencing work on each task, Consultant shall provide City with a description of the activities necessary to complete that task, schedule, and anticipated maximum budget. Task 1. Investigation Conduct investigation of personnel complaints as directed by City. Task 2. Team Development and Effectiveness Training Engage the Public Works Service Center leader and staff in an effort to increase their cohesiveness and productivity as a team by: (a) Completing a team effectiveness assessment to initiate the development and training process, (b) Conducting team training as approved by City's Director of Public Works, (c) Facilitating team activities as approved by City's Director of Public Works, and (d) Coaching and mentoring individuals as well as the team, or a subset thereof, as approved by City's Director of Public Works. (e) Complete at least two subsequent team effectiveness assessments (during and at the end of the training process) and review changes in results, which will be used as a way of monitoring progress. EXHIBIT B SCHEDULE OF PERFORMANCE Consultant shall perform the Services within a timeframe mutually agreed by the project managers for Consultant and City, so long as all work is completed within the term of the Agreement. EXHIBIT C COMPENSATION City shall compensate Consultant for professional services in accordance with the terms and conditions of this Agreement based on the rates and compensation schedule set forth below. Compensation shall be calculated based on the hourly rates set forth below up to the not to exceed budget amount set forth below. The compensation to be paid to Consultant under this Agreement for all services described in Exhibit "A" and reimbursable expenses shall not exceed five thousand one hundred fifty dollars ($5,150.00) for Task A and eleven thousand seven hundred fifty dollars ($11,750.00) for Task B, for a total amount not to exceed sixteen thousand nine hundred dollars ($16,900.00). Any work performed or expenses incurred for which payment would result in a total exceeding the maximum amount of compensation set forth herein shall be at no cost to the City. Hourly Rates Minh Lee -Work with individuals: $200/hour -Work with groups/team training: $250/hour Invoices In order to request payment, Consultant shall submit monthly invoices to the CITY describing the services performed and the applicable charges (including an identification of personnel who performed the services, hours worked, task(s) for which work was performed, hourly rates, and reimbursable expenses), based upon Consultant's billing rates. Reimbursable Expenses Administrative, overhead, secretarial time or overtime, word processing, photocopying, in house printing, insurance and other ordinary business expenses are included within the scope of payment for services and are not reimbursable expenses. City shall reimburse consultant for reasonable travel. Travel expenses are limited to the lesser of actual expenses or expenses that would be authorized for City employee travel pursuant to City policy. Additional Services Consultant shall provide additional services outside of the services identified in Exhibit A only by advance written authorization from the City's Project Manager prior to commencement of any additional services. Consultant shall submit, at the Project Manager's request, a detailed written proposal including a description of the scope of additional services, schedule, and proposed maximum compensation. ii a DATE(MM/DD/YYYY) AC D CERTIFICATE OF LIABILITY INSURANCE 6/25/2013 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 CONTACT NAME: James Marek Stratton Agency, Inc. PHONE (A/C.No.Ex0:888-888-4501 (A/C,No):650 508 0121 957-C Industrial Road E-MAIL San Carlos CA 94070 .ADDRESS:.. -&i - a) r-t•I.•- _ INSURER(S)AFFORDING COVERAGE NAIC# INSURER A Sentinel Insurance Company. LTD 11000 INSURED WILFJAR-01 INSURER B: The Wilfred Jarvis Inst. INSURER C: Mr. Minh Le INSURER D: 23505 Oak Valley Road Cupertino CA 95014 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:514800896 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 ADDL SUER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER _ (MMIDD/YYYY) (MMIDDIYYYY) A GENERAL LIABILITY Y 57SBAAZ5747 9/19/2012 3/19/2013 EACH OCCURRENCE $1,000,000 _____ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $1,000,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $10,000 X Business Owner PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 ' GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $2,000,000 $ POLICY I PRO- Kl LOC COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ _ AUTOS AUTOS PROPERTY DAMAGE NON-OWNED (Per accidert) $ HIRED AUTOS AUTOS _ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE .$ DED RETENTION$ — $ WORKERS COMPENSATION IAC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED'? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,desa,be under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below _ I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Certificate holder is named add Additional Insured for General Liability per form SS00080405 per contractual agreements. RE: Leadership and Organizational Development- 10300 Torre Avenue; Cupertino,CA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Cupertino ACCORDANCE WITH THE POLICY PROVISIONS. 10300 Torre Avenue Cupertino CA 95014-3202 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD PROGRESSIVE PROGRESSIVE' PO BOX 94739 CLEVELAND,OH 44101 Named insured Policyhumber: 03523354-7 Underwritten by: Progressive Express Ins Company THE WILFRED JARVIS March 11,2013 INSTITUTE Policy Period:May 16,2013-May 16,2014 23505 OAK VALLEY RD Page 1 of CUPERTINO,CA 95014 progressive.com Online Service Make payments,check billing activity,print policy documents,or check the status of a claim. Commercial Auto 1-800-895-2886 Insurance Coverage Summary For hours ersery dayna claims service, 24 This is your Renewal Declarations Page This Renewal Declarations Page is effective only if the minimum amount due to renew your policy is received or postmarked by May 16,2013. Your coverage begins on May 16,2013 at 12:01 a.m. This policy expires on May 16,2014 at 12:01 a.m. Your insurance policy and any policy endorsements contain a full explanation of your coverage.The policy limits shown for an auto may not be combined with the limits for the same coverage on another auto,unless the policy contract allows the stacking of limits. The policy contract is form 6912(06/10).The contract is modified by forms 2852CA (09/06),4757(03/05),4852CA (10/04),4881 CA (12/04)and Z228(01/11). The named insured organization type is a corporation. Outline of coverage Description Limits Deductible Premium Liability To Others $960 Bodily Injury Liability $100,000 each person/$300,000 each accident Property Damage Liability $50,000 each accident Uninsured/Underinsured Motorist $100,000 each person/$300,000 each accident 273 Uninsured Motorist Property Damage Rejected Medical Payments $5,000 each person 54 Comprehensive 156 See Auto Coverage Schedule Lirrit of liability less deductible Collision 879 See Auto Coverage Schedule Limit of liability less deductible Subtotal policy premium $2,322.00 California Vehicle Assessment Fee 5.40 Total 12 month policy premium and fees $2,327.40 Rated drivers 1. MINH LE 2. ANHTHU LE Continued Form 6189 CA 106(10) Policy number: 03523354-7 THE WILFRED JARVIS Paget of 2 Auto'coverage schedule 1. 2004 Dodge Grand Caravan Actual Cash Value (plus$2,000.00 Permanently Attached Equip) VIN: 2D4GP44L44R553500 Garaging Zip Code: 95014 Radius: 50 Liability Liability UMNIM 81 Med Pay Premium $329 $91 $18 Comp Comp Collision Collision Physical Damage Deductible Premium Deductible Premium Auto Total Premium $1,000 $46 $1,000 $106 $590 2. 2012 Toyota Camry Hybrid Actual Cash Value (plus$2,000.00 Permanently Attached Equip) VIN: 4T1 BD1 FK6CU012254 Garaging Zip Code: 95014 Radius: 50 Liability liability UMNIM 81 Med Pay Premium $339 $91 $18 " 'ssi=is Comp Comp Collision Collision Physical Damage Deductible Premium Deductible Premium Auto Total 6 Premium $1,000 $47 $1,000 $315 $810 � t� 0 3, 2013 Mini Cooper S Actual Cash Value (plus$2,000.00 Permanently Attached Equip) °g Ji VIN: WMWSV3C57DT390793 Garaging Zip Code: 95014 Radius: 50 0 = Liability liability UMNIM 81 Med Pay Premium $292 $91 $18 § - o _ Comp Comp Collision Collision o INISSIMIGM Physical Damage Deductible Premium Deductible Premium Auto Total U eitmm, Premium $1,000 $63 $1,000 $458 $922 8 N mawl I Premium discounts Policy a U 03523354-7 Business Experience,Paid In Full and Package Company officers (Ali e a. President Secretary Form 6489 CA(06110) Additional Insured Request Form Date:June 24, 2013 Name:The Wilfred Jarvis Institute Policy#: 57SBAAZ5747 Term:09/19/2012-09/19/2013 1. Complete name &address of entity requesting Additional Insured endorsement: The City of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3202 2. Business Relationship with Insured: Client of Wilfred Jarvis Institute 3. Contract Number and Specific Job Location: Agreement between The City of Cupertino And The Wilfred Jarvis Institute For Consultant Services 10300 Torre Avenue Cupertino,CA 95014-3202 4. Description of job: Leadership and Organizational Development 1__"' A,LORI DATE(MM/DDNYYY) CERTIFICATE OF LIABILITY INSURANCE 1 09-05-2013 THIS CERTIFICATEIS 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 CONTACT STRATTON AGENCY/PHS PHONE FAx 151631 P: (866) 467-8730 F: (888) 443-6112 '(A/C NoExt): (866)467-8730 (A/C,No): (888) 443-6112 ADDRESS: PO BOX 33015 - SAN ANTONIO TX 78265 INSURERS)AFFORDING COVERAGE NAIC M I INSURER A: Sentinel Ins Co LTD i- INSURED i I INSURER B INSURER C THE WILFRED JARVIS INSTITUTE INSURER D 23505 OAK VALLEY RD CUPERTINO CA 95014 INSUEE INSU 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. ALM INSR TYPE OF INSURANCE LIMITS LTR INSR WVD POLICY NUMBER _ (MM/DDNYYY) (MM/DDNYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1, 000, 0 0 0 COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ 1, 000, 0 0 0 A CLAIMS-MADE U OCCUR MED EXP(Any one person) $ 10, 000 X General Liab `J u 57 SBA AZ5747 09/19/2013 09/19/2014 PERSONAL&ADV INJURY $ 1, 000, 000 GENERAL AGGREGATE 5 2, 000, 000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2, 000, 0 0 0 POLICY L JRCT U LI LOC _ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ _ _ ALL OWNED I I SCHEDULED L__J u BODILY INJURY(Per accident) $ AUTOS u AUTOS HIRED AUTOS I NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) $ UMBRELLA LIAB U OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE L u AGGREGATE $ DED I RETENTION $ _ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVES I N/A I E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? u u (Mandatory in NH) E.L. DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ uu DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Those usual to the Insured' s Operations . Re: Leadership and Organizational Development - 10300 Torre Avenue, Cupertino, CA. Certificate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 attached to this policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE The City of Cupertino DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10300 TORRE AVE AUTHORIZE PRESENTATIVE�] CUPERTINO, CA 95014 ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD