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17-065 Fire & Risk Alliance, LLC; Fire Protection and Life Safety Consulting Services for the Apple Campus 2 Project1 FOURTH AMENDMENT TO AGREEMENT 17-065 BETWEEN THE CITY OF CUPERTINO AND FIRE & RISK ALLIANCE, LLC FOR LIFE & SAFETY REVIEW AT APPLE CAMPUS 2 This Fourth Amendment to Agreement 17-065 between the City of Cupertino and Fire & Risk Alliance, for reference dated 5/26/2020, is by and between the CITY OF CUPERTINO, a municipal corporation (hereinafter "City") and Fire & Risk Alliance, a California Corporation (“Contractor”) whose address is 530 Showers Drive, Suite 7-287, Mountain View, CA 94040 and is made with reference to the following: RECITALS: A. On 7/1/2016, Agreement 17-065 (“Agreement”) was entered into by and between City and Contractor for life and safety review. B. On 2/24/2017, City and Contractor entered into a First Amendment to the Agreement. C. On 2/8/2018, City and Contractor entered into a Second Amendment to the Agreement. D. On 5/24/2019, City and Contractor entered into a Third Amendment to the Agreement. E. The Agreement, the First Amendment, the Second Amendment, and the Third Amendment are collectively referred to as the “Agreement,” unless otherwise indicated. F. City and Contractor desire to modify the Agreement on the terms and conditions set forth herein. NOW, THEREFORE, it is mutually agreed by and between and undersigned parties as follows: 1. Paragraph 1 of the Agreement is modified to read as follows: Term. The term of this agreement shall commence on July 1, 2016, and shall terminate on June 30, 2022, unless terminated earlier as set forth herein. 2. The following Exhibits to the Agreement are replaced with the following exhibits attached hereto: a. Exhibit A – General Consulting Agreement Fire Protection and Life Safety Consulting Services, Cupertino Building Department, Apple Campus 2 b. Exhibit D – Insurance Requirements, Design Professionals & Consultants Contracts 3. Exhibit B-1, attached hereto, is added to the Agreement. 4. Exhibit A-A attached hereto, is added to the Agreement. 5. Except as expressly modified herein, all other terms and covenants set forth in the Agreement shall remain the same and shall be in full force and effect. IN WITNESS WHEREOF, the parties hereto have caused this modification of Agreement to be executed. CONTRACTOR By Title Date CITY OF CUPERTINO By Title Date APPROVED AS TO FORM City Attorney ATTEST: City Clerk Robert J Wheeler Managing Partner Jun 30, 2020 Heather M. Minner Jul 1, 2020 Dir CDD Jul 1, 2020 Fire & Risk Alliance, LLC 2551 San Ramon Valley Blvd., Suite 207, San Ramon, CA 94583 www.fireriskalliance.com W-650-382-0999 General Consulting Agreement Fire Protection and Life Safety Consulting Services Cupertino Building Department Apple Campus 2 Prepared for: Mr. Albert Salvador, P.E., C.B.O City of Cupertino 10300 Torre Avenue Cupertino, CA 95014 Prepared by: Fire & Risk Alliance, LLC 530 Showers Drive Suite 7-287 Mountain View, CA 94040 May 27, 2020 The distribution of this document to third parties is prohibited without written approval from Fire & Risk Alliance, LLC. Cupertino Building Department Table of Contents Page ii TABLE OF CONTENTS 1.0 INTRODUCTION .................................................................................................. 1 2.0 SCOPE OF WORK ............................................................................................... 1 3.0 PERIOD OF PERFORMANCE ............................................................................. 2 4.0 ADDITIONAL SERVICES .................................................................................... 2 5.0 PRICING AND INVOICING .................................................................................. 2 6.0 INDEMNIFICATIONS ........................................................................................... 3 7.0 LIMITS OF LIABILITY .......................................................................................... 3 8.0 TERMINATION OF SERVICES ............................................................................ 3 9.0 APPLICABLE LAW ............................................................................................. 3 10.0 RESPONSE.......................................................................................................... 4 Cupertino Building Department General Consulting Agreement Proposal Page 1 1.0 INTRODUCTION Fire & Risk Alliance, LLC (FRA) is pleased to provide this proposal to provide continued support to the City of Cupertino (Client) for fire & life-safety plan review services for the Apple Campus 2 (AC2) project in Cupertino, CA. FRA will support the City with the review of the project fire and life-safety plans; Requests for Information (RFIs); project architectural Bulletins; and any other reviews requested by the City. FRA will provide the necessary technical support to the City in a timely fashion (fifteen (15) business days for initial reviews and five (5) business days for back check reviews). The primary scope of services in this proposal will be in relation to Tantau 14, Marcom Building. In addition to review services, the scope of this proposal includes fire/life safety building-related inspection services. 2.0 SCOPE OF WORK FRA offers the following Basic Scope of Services: Provide general fire protection/life safety code consulting review and inspection services for the AC2 project on an as-requested basis. The building design is nearing completion, therefore the majority of remaining activities are related to review of RFIs during construction, and building- related fire/life safety inspections. Activities provided may include, but will not be limited to, the following: 1)Participation in meetings with the City. FRA will meet with the City as requested to provide status updates, review technical and scheduling aspects of the project including AM&Ms, planning and scheduling issues and related project issues. 2)Attend design team meetings as necessary. FRA will participate in design team meetings as requested to collaborate, understand, review and discuss the technical issues of the project, especially those involving the alternate approaches for achieving appropriate levels of life safety. 3)Review building plans and submittals for the project as necessary. Submittals will be reviewed for compliance with the provisions of the applicable California Building Code (CBC) and the California Fire Code (CFC) as adopted and amended by the City of Cupertino and the Santa Clara Fire Protection District (2010 Codes for Phase 1 buildings; 2013 Codes for Phase 2 buildings). 4)Review RFIs’ for conformance with any project agreements that have been discussed with, and agreed to by, the Authorities Having Jurisdiction. 5)Review project Bulletins for conformance with any project agreements that have been discussed with, and agreed to by, the Authorities Having Jurisdiction. 6)Conduct fire/life safety building-related inspections of Tantau 14, Marcom Building. It is anticipated that inspection-related services will be accomplished by having one (1) person onsite one (1) day per week during construction. The inspections will cover issues common to both the CBC and CFC, such as, but not limited to, means of egress provisions, fire rated construction and opening protectives. Exhibit A Cupertino Building Department General Consulting Agreement Proposal Page 2 3.0 PERIOD OF PERFORMANCE The proposed scope of work described herein is for the period from July 1, 2020 to June 30, 2022. 4.0 ADDITIONAL SERVICES Additional services beyond the level of effort included in this proposal can be provided based on a mutually agreeable billing rate. 5.0 PRICING AND INVOICING FRA is requesting a no-cost time extension to the contract to account for the unknown completion schedule. It is likely the completion of the project will occur sometime after June 30, 2021. If there are any questions, please contact me at 650-605-7553. Thank you for your consideration. Sincerely, Robert J. Wheeler, P.E. Principal Fire Protection Engineer Fire & Risk Alliance, LLC Exhibit B-1 Cupertino Building Department General Consulting Agreement Proposal Page 3 6.0 INDEMNIFICATIONS Each party shall indemnify and hold harmless the other party, its affiliates, directors, officers, and employees (collectively, the “indemnified party”) against and from any and all suits, actions, proceedings at law or in equity, claims (groundless or otherwise), liabilities, losses, damages, judgments, payments, deficiencies, settlements, penalties, fines, fees, economic losses, costs and expenses, including reasonable fees and disbursements of counsel selected by the indemnified party (whether incurred in a third party action, or in an action brought by either party against the other to enforce its rights under this agreement), (collectively, “liabilities”) arising out of or incurred in connection with bodily injury (including death) to any person or damage to the property (tangible or intangible) or interest of any person, firm or corporation to the extent that such injury or damage shall have been occasioned by, shall have resulted from, or shall in any way be attributed to the willful or negligent acts or omissions of the indemnifying party, its affiliates, officers, directors, employees, or subcontractors in any way related to this agreement or the performance of the indemnifying party’s obligations under this agreement, provided that the indemnifying party shall not be responsible for liabilities resulting directly from the negligence, gross negligence, or willful misconduct of the indemnified party. 7.0 LIMITS OF LIABILITY In recognition of the relative risks and benefits of the Project to both the Client and the Consultant, the risks have been allocated such that the Client agrees, to the fullest extent permitted by law, to limit the liability of the Consultant and Consultants officers, directors, partners, employees, shareholders, owners and subconsultants for any and all claims, losses, costs, damages of any nature whatsoever or claims expenses from any cause or causes, including attorneys' fees and costs and expert-witness fees and costs, so that the total aggregate liability of the Consultant and Consultants officers, directors, partners, employees, shareholders, owners and subconsultants shall not exceed $5,000,000, or the Consultant's total fee for services rendered on this Project, whichever is greater. It is intended that this limitation apply to any and all liability or cause of action however alleged or arising, unless otherwise prohibited by law. 8.0 TERMINATION OF SERVICES This agreement may be terminated upon 10 days written notice by either party should the other fail to perform his obligations hereunder. In the event of termination, the Client shall pay for all services rendered to the date of termination, all reimbursable expenses, and reimbursable termination expenses. 9.0 APPLICABLE LAW Unless otherwise specified, this agreement shall be governed by the laws of the State of Illinois. Cupertino Building Department General Consulting Agreement Proposal Page 4 10.0 RESPONSE Execution of this proposal indicates the Client finds all terms and conditions of this agreement acceptable. NOTE: This proposal is only valid for 30 days from date of issue. By: City of Cupertino Signature Printed Name Title Date Revised: April 30, 2020 – Services Agreements 1 Exhibit A-A – SHELTER IN PLACE AND SOCIAL DISTANCING REQUIREMENTS A.Health Laws Acknowledged. It is acknowledged that Consultant’s/Contractor’s (“Contractor”) duty to comply with Laws, as defined in Section 13 of the Contract/Agreement (“Contract”), includes immediate compliance by Contractor and its subcontractors with the restrictions on travel and the Social Distancing Requirements set forth in the most recent health order issued by the County of Santa Clara Health Department in response to the COVID-19 pandemic, and any subsequent amendments or superseding orders thereto (the “Health Order”), and any other local, state, or federal laws that have been or may be enacted in response to the COVID-19 pandemic (collectively, “Health Laws”). B.Health Order Compliance. Contractor shall comply with any restrictions on travel and social distancing requirements in the Health Order when preforming work under this Contract. If a scope of work item, notice to proceed, or work order under this Contract specifies work that cannot be performed in compliance with the Health Order or other Health Laws, Contractor shall refrain from conducting the work and immediately inform the City. C.Individuals at High Risk of Severe Illness. Nothing in this Contract shall be interpreted to require any person at high risk of severe illness from COVID-19 to leave their residence to perform work under the Contract. Contractor will inform the City if other arrangements for the work must be made, and City will do so, with no penalty to Contractor, although Contractor will not be compensated for work performed by the City or third parties. Information from the Center for Disease Control (“CDC”) on “high risk” categories is available at the CDC's website at: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/people-at-higher-risk.html. D.Health Order Requirements and Best Practices. Contractor will immediately undertake all appropriate measures to ensure compliance with the Social Distancing Requirements in the Health Order by all individuals performing work under this Contract, including Contractor's or any subcontractor's workers, employees, representatives, vendors, or suppliers (collectively, "workers"), and shall maintain these measures for as long as required by the Health Order or other Health Laws. As long as required by the operative Health Order or other Health Laws, these measures shall include, but are not limited to, the following: 1. Meetings/Site Access. Use electronic alternatives to in person meetings, e.g., conference calls, video-conferencing, etc., to the greatest extent possible. Limit access to any project site or any work area to workers who are necessary to perform in-person work. Require non-essential personnel to work from home to the extent possible. Avoid all non-essential travel. 2. Distancing. Where workers perform in-person work at a project site or a work area, prohibit workers from being less than six feet apart, unless and only to the extent that would compromise worker safety or violate safety Laws for specific operations. Prohibit handshaking or any physical contact among workers, with the sole and limited exception Revised: April 30, 2020 – Services Agreements 2 of any physical contact required for worker safety or to comply with safety Laws. Prohibit workers from sharing a vehicle. E. Changed Requirements. It is understood and acknowledged that circumstances pertaining to the COVID-19 pandemic are evolving rapidly and that new local, state, or federal requirements may modify the requirements under this Exhibit. Contractor agrees to work cooperatively with the City to implement new or changed requirements as quickly as possible. F. Subcontracts. Contractor shall include the terms of this Exhibit in all subcontracts and require any agents, subcontractors, or subconsultants to comply with its provisions. 1229192.7 Exh. D-Insurance Requirements for Design Professionals & Consultant Contracts 1 Form Updated Sept. 2019 Consultant shall procure prior to commencement of Services and maintain for the duration of the contract, at its own cost and expense, the following insurance policies and coverage with companies doing business in California and acceptable to City. INSURANCE POLICIES AND MINIMUMS REQUIRED 1. Commercial General Liability (CGL) 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 Consultant's policy shall be "primary and non-contributory," will not seek contribution from City’s insurance/self-insurance, and shall be at least as broad as ISO Form CG 20 01 (04/13). c. The limits of insurance required may be satisfied by a combination of primary and umbrella or excess insurance, provided each policy complies with the requirements set forth in this Contract. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary basis for the benefit of City before the City’s own insurance or self- insurance shall be called upon to protect City as a named insured. 2. 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. 3. 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.  Not required. Consultant has provided written verification of no employees. 4. Professional Liability for professional acts, errors and omissions, as appropriate to Consultant’s profession, with limits no less than $2,000,000 per occurrence or $2,000,000 aggregate. If written on a claims made form: a. The Retroactive Date must be shown and must be before the Effective Date of the Contract. b. Insurance must be maintained for at least five (5) years after completion of the Services. c. If coverage is canceled or non-renewed, and not replaced with another claims-made policy form with a Retroactive Date prior to the Contract Effective Date, the Consultant must purchase “extended reporting” coverage for a minimum of five (5) years after completion of the Services. EXHIBIT D Insurance Requirements Design Professionals & Consultants Contracts Exh. D-Insurance Requirements for Design Professionals & Consultant Contracts 2 Form Updated Sept. 2019 OTHER INSURANCE PROVISIONS The aforementioned insurance shall be endorsed and have all the following conditions and provisions: Additional Insured Status The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers (“Additional Insureds”) are to be covered as additional insureds on Consultant’s CGL and automobile liability policies. General Liability coverage can be provided in the form of an endorsement to Consultant’s insurance (at least as broad as ISO Form CG 20 10 (11/ 85) or both CG 20 10 and CG 20 37 forms, if later editions are used). Primary Coverage Coverage afforded to City/Additional Insureds shall be primary insurance. Any insurance or self-insurance maintained by City, its officers, officials, employees, or volunteers shall be excess of Consultant’s insurance and shall not contribute to it. Notice of Cancellation Each insurance policy shall state that coverage shall not be canceled or allowed to expire, except with written notice to City 30 days in advance or 10 days in advance if due to non-payment of premiums. Waiver of Subrogation Consultant waives any right to subrogation against City/Additional Insureds for recovery of damages to the extent said losses are covered by the insurance policies required herein. Specifically, the Workers’ Compensation policy shall be endorsed with a waiver of subrogation in favor of City for all work performed by Consultant, its employees, agents and subconsultants. This provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer. Deductibles and Self-Insured Retentions Any deductible or self-insured retention must be declared to and approved by the City. At City’s option, either: the insurer must reduce or eliminate the deductible or self-insured retentions as respects the City/Additional Insureds; or Consultant must show proof of ability to pay losses and costs related investigations, claim administration and defense expenses. The policy shall provide, or be endorsed to provide, that the self-insured retention may be satisfied by either the insured or the City. Acceptability of Insurers Insurers must be licensed to do business in California with an A.M. Best Rating of A-VII, or better. Verification of Coverage Consultant must furnish acceptable insurance certificates and mandatory endorsements (or copies of the policies effecting the coverage required by this Contract), and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements prior to commencement of the Contract. City retains the right to demand verification of compliance at any time during the Contract term. Subconsultants Consultant shall require and verify that all subconsultants maintain insurance that meet the requirements of this Contract, including naming the City as an additional insured on subconsultant’s insurance policies. Higher Insurance Limits If Consultant maintains broader coverage and/or higher limits than the minimums shown above, City shall be entitled to coverage for the higher insurance limits maintained by Consultant. Adequacy of Coverage City reserves the right to modify these insurance requirements/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. 05/26/2020 Hankoff Insurance Group, Inc. 20 Crossroads Drive, Suite 215 Owings Mills MD 21117 Kellie Jackson (410) 363-0661 (410) 363-0685 Kellie@hankoffinsurance.com Fire & Risk Alliance, LLC 7640 Standish Place Derwood MD 20855-2754 ACE Property And Casualty Insurance Company 20699C Chubb Indemnity Insurance Company 12777 Continental Casualty Company 20443 20-21 A SERMDD946946073N 01/14/2020 01/14/2021 2,000,000 1,000,000 5,000 2,000,000 4,000,000 4,000,000 Employee Benefits 1,000,000 A SERMDD946946073N 01/14/2020 01/14/2021 2,000,000 A 0 UMBMDD946946443N 01/14/2020 01/14/2021 10,000,000 10,000,000 B N 71774431 01/14/2020 01/14/2021 1,000,000 1,000,000 1,000,000 C Professional/Pollution MCH591926081 01/14/2020 01/14/2021 Pro/Poll Occ/Agg/Ded 5,000,000/50,000 Cyber Limit/Ded 10,000,000/25,000 EPLI Limit/Ded 1,000,000/10,000 Philadelphia Insurance Companies, NAIC# 18058, Cyber Liability #PHSD1511589 Eff/Exp dates: 1/14/2020-1/14/2021, Claims-made. Philadelphia Insurance Companies, NAIC# 18058, EPLI Liability #PHSD1499713 Eff/Exp dates: 1/14/2020-1/14/2021, Claims-made. CNA- Continental Insurance Company, NAIC# 35289, Excess Umbrella Policy#- 6080129090 Eff/Exp dates: 1/14/2020-1/14/2021. Limit $3,000,000; Retention $10,000 City of Cupertino 10300 Torre Avenue 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. 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 Fire&Risk Alliance_4th Amendment Final Audit Report 2020-07-01 Created:2020-06-30 By:Abby Ayende (AbigailA@cupertino.org) Status:Signed Transaction ID:CBJCHBCAABAAEzJsOiy8WBRGto48oaBQD_9nSPgg2YI4 "Fire&Risk Alliance_4th Amendment" History Document created by Abby Ayende (AbigailA@cupertino.org) 2020-06-30 - 4:07:10 PM GMT- IP address: 108.204.1.114 Document emailed to Abby Ayende (AbigailA@cupertino.org) for approval 2020-06-30 - 4:07:26 PM GMT Document approved by Abby Ayende (AbigailA@cupertino.org) Approval Date: 2020-06-30 - 4:08:07 PM GMT - Time Source: server- IP address: 108.204.1.114 Document emailed to Araceli Alejandre (aracelia@cupertino.org) for approval 2020-06-30 - 4:08:11 PM GMT Document approved by Araceli Alejandre (aracelia@cupertino.org) Approval Date: 2020-06-30 - 4:23:13 PM GMT - Time Source: server- IP address: 24.23.184.82 Document emailed to Robert J Wheeler (rwheeler@fireriskalliance.com) for signature 2020-06-30 - 4:23:15 PM GMT Email viewed by Robert J Wheeler (rwheeler@fireriskalliance.com) 2020-06-30 - 6:04:22 PM GMT- IP address: 108.65.78.99 Document e-signed by Robert J Wheeler (rwheeler@fireriskalliance.com) Signature Date: 2020-06-30 - 6:07:01 PM GMT - Time Source: server- IP address: 108.65.78.99 Document emailed to Heather M. Minner (minner@smwlaw.com) for signature 2020-06-30 - 6:07:03 PM GMT Email viewed by Heather M. Minner (minner@smwlaw.com) 2020-06-30 - 10:53:43 PM GMT- IP address: 45.41.142.4 Document e-signed by Heather M. Minner (minner@smwlaw.com) Signature Date: 2020-06-30 - 10:54:53 PM GMT - Time Source: server- IP address: 52.39.49.65 Document emailed to Benjamin Fu (benjaminf@cupertino.org) for signature 2020-06-30 - 10:54:55 PM GMT Email viewed by Benjamin Fu (benjaminf@cupertino.org) 2020-07-01 - 10:54:23 PM GMT- IP address: 104.47.46.254 Document e-signed by Benjamin Fu (benjaminf@cupertino.org) Signature Date: 2020-07-01 - 10:54:40 PM GMT - Time Source: server- IP address: 24.130.171.172 Document emailed to Kirsten Squarcia (kirstens@cupertino.org) for signature 2020-07-01 - 10:54:42 PM GMT Email viewed by Kirsten Squarcia (kirstens@cupertino.org) 2020-07-01 - 11:46:21 PM GMT- IP address: 104.47.45.254 Document e-signed by Kirsten Squarcia (kirstens@cupertino.org) Signature Date: 2020-07-01 - 11:46:33 PM GMT - Time Source: server- IP address: 148.64.105.190 Signed document emailed to Araceli Alejandre (aracelia@cupertino.org), Robert J Wheeler (rwheeler@fireriskalliance.com), Kirsten Squarcia (kirstens@cupertino.org), Benjamin Fu (benjaminf@cupertino.org), and 3 more 2020-07-01 - 11:46:33 PM GMT DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 04/24/2017 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). CONTACT 1-800-527-9049 PRODUCER Traci Stoecker / Leslie Babcock NAME: Holmes Murphy and Associates FAX PHONE 800-527-9049 (A/C, No): (A/C, No, Ext): - Peoria E-MAIL ADDRESS: 311 S.W. Water Street INSURER(S) AFFORDING COVERAGENAIC # Suite 211 Peoria, IL 61602-4108 SENTINEL INS CO LTD11000 INSURER A : INSURED HARTFORD ACCIDENT & IND CO 22357 INSURER B : Fire & Risk Alliance, LLC XL SPECIALTY INS CO 37885 INSURER C : INSURER D : 7640 Standish Place INSURER E : Rockville, MD 20855 INSURER F : 49669580 COVERAGESCERTIFICATE 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. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY AX83SBAIL076201/14/18 01/14/171,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED X 1,000,000 CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) 10,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- X 2,000,000 POLICYLOCPRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT A83SBAIL076201/14/18 01/14/17 AUTOMOBILE LIABILITY$ 1,000,000 (Ea accident) BODILY INJURY (Per person)$ ANY AUTO ALL OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOSAUTOS NON-OWNED PROPERTY DAMAGE X$ X HIRED AUTOS (Per accident) AUTOS $ UMBRELLA LIAB X X83SBAIL076201/14/184,000,000 A01/14/17 EACH OCCURRENCE$ OCCUR EXCESS LIAB 4,000,000 CLAIMS-MADEAGGREGATE$ $ DEDRETENTION$ PEROTH- WORKERS COMPENSATION X B83WEGAA554607/26/1607/26/17 STATUTEER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ Y N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below CProfessional LiabilityDPR991039301/14/18Each Claim5,000,000 01/14/17 Aggregate Claims Made5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: 142-001 City of Cupertino, it's City Council, boards and commissions, officers, employees and volunteers are additional insured on the general and auto liability as required by written contract with the insured, per policy terms and conditions. The general and auto liability contain a 30 day notice of cancellation in favor of the certificate holder as required by written contract with the insured, per policy terms and conditions. Waiver of Subrogation applies to all policies per policy terms and conditions. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Cupertino THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE , © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01)The ACORD name and logo are registered marks of ACORD amcneillil 49669580