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18-001 Mark Wright CITY OF No. �1 Il O FY2018-21 CUPERTINO RECREATION SERVICES AGREEMENT 1. Parties. This contract is made and entered into as of 7/1/2018 ("Effective Date"),by and between the City of Cupertino, a municipal corporation ("City"), and with MARK WRIGHT, "Contractor"), a SOLE PROPRIETORSHIP for KARATE CLASSES. 2. Services. Contractor agrees to provide the Services included in the Scope of Work and in accordance with the Schedule of Performance attached in Exhibit A. 3. Term. This contract begins on the Effective Date and ends on 6/30/2021 ("Contract Time"),unless extended or terminated as provided herein. Time is of the essence and Contractor must have sufficient time, resources, and qualified staff to deliver the Services as required. Contractor must promptly notify City of any actual or potential delays to afford the Parties adequate opportunity to address or mitigate such delays. 4. Compensation. City will pay Contractor for satisfactory performance of the Services an amount that will based upon actual costs but that will be capped so as not to exceed$75,000("Contract Price"),based upon the Scope of Services,budget,performance schedule,and rates included in Exhibit A. The maximum compensation includes all costs, expenses and reimbursements and will remain in place even if Contractor's actual costs exceed the capped amount. Contractor must submit invoices and the information required in Exhibit A in order to receive payment. City will compensate Contractor within 30 days after approval of written invoices. Invoices are subject to review and audit by City during regular business hours upon 24-hours' notice. Contractor must maintain complete and accurate records of payrolls, expenditures, disbursements and other cost items charged to City or establishing the basis for an invoice, for a minimum of four (4) years from the date of final payment. 5. Independent Contractor.Contractor is an independent Contractor and not an employee, partner, or joint venture of City. Contractor is solely responsible for the means and methods of performing the Services and for the persons hired to work under this Agreement.No civil service status or other right of employment will be acquired by virtue of Contractor's performance of the Services. Contractor is not entitled to City's health benefits, worker's compensation or any other benefit. Contractor must have the skills and qualifications to perform the Services in a competent and professional manner. Contractor will supply all tools, materials and equipment required to perform the Services under this Contract. Contractor is responsible for obtaining permits and licenses required by law and must obtain a City business license. Recreation Services Agreement/Rev. 3-27-2018 Page 1 of 6 6. Proprietary/Confidential Information.To the extent Contractor may have access to private or confidential information owned or controlled by the City, Contractor agrees to treat it confidential and use it solely to perform this Agreement. Contractor must exercise the same standard of care to protect City information as a reasonably prudent Contractor would use to protect its own proprietary data. 7. Ownership of Materials. To the extent Contractor prepares written material, drawings or data in connection with this contract, City will have the property rights to those materials and all copyrights, if any, to such work product will constitute City property. 8. Records. Contractor must maintain complete, accurate, and detailed accounting records relating to its performance in accordance with generally accepted accounting principles and procedures. The records must include detailed information about Contractor's services, benchmarks, deliverables and costs/fees,and must be made reasonably available to City.The records and supporting documents must be kept separate from other files and maintained for four years from the date of City's final payment. 9. Assignment. This Contract is not assignable. Contractor may not substitute another or transfer any rights or obligations under this Contract without prior written approval of City.Only those persons whose names are included in Exhibit A may perform the Services. 10. Publicity and Signs. Any publicity generated by Contractor related to this contract or the Services during the Contract Time and for one year thereafter must reference City contributions. The words "City of Cupertino" shall be displayed in all pieces of publicity, including flyers, press releases, posters, brochures, public service announcements, interviews and newspaper articles. No signs may be posted, exhibited or displayed on or about City property,except signage required by law or under this Agreement without prior written approval from City. 11. Indemnification. To the fullest extent allowed by law and except for losses caused by the sole negligence or willful misconduct of City personnel, Contractor agrees to indemnify, defend, and hold harmless the City, its City Council, boards and commissions, officers, officials, employees, agents, servants, volunteers and Contractors (collectively, "Indemnitees"), through legal counsel acceptable to City, from and against any liability for damages, claims, actions, causes of action, demands, charges, losses, costs and expenses (including attorney fees,legal costs and expenses related to litigation, arbitrations, administrative and regulatory proceedings), of every nature, arising out of or in any way related to Contractor's or Contractor's agents performance of this contract or the Services. This includes but is not limited to Liability resulting in personal injury, death, property damage, or economic losses. Contractor must pay any costs City may incur in enforcing this provision and must accept a tender of defense upon receiving notice from City. Contractor's payments may be deducted or offset to cover any money the City lost due to a claim or counterclaim arising out of this Contract. 12. Insurance. Contractor shall comply with the insurance requirements in Exhibit B. City will not execute the Agreement until it has received and approved satisfactory certificates of insurance and endorsements evidencing the type, amount, and dates of coverage. Alternatively, City in its sole Recreation Services Agreement/Rev. 3-27-2018 Page 2 of 6 discretion may purchase insurance and deduct the costs from payments to Contractor, or terminate the contract. 13. Compliance with Laws and Other City Requirements. Requirements for all Contracts. This contract is subject to local, state and federal laws and regulations prohibiting discrimination,including Title VII of the Civil Rights Act of 1964, the California Fair Employment Practices Act,the Americans with Disabilities Act of 1990,and other laws that pertain to fair employment and anti-discrimination practices. Contractor must comply with labor laws pertaining to prevailing wages, working hours, overtime, payroll records, and other requirements imposed by the Department of Industrial Relations.If Contractor does not have employees,it must sign the Affidavit of No Employees, attached as Exhibit C. Contractor is responsible for verifying employment eligibility of employees pursuant to the Immigration Reform and Control Act of 1986. Contractor must comply with conflict of interest laws and regulations applicable to this Agreement and avoid conflicts of interest. Contractor may be required to file a conflict of interest form for engaging in governmental decisions or serving in a staff capacity,and is hereby advised to review the requirements of California Political Reform Act and the California Code of Regulations. Services may only be performed by persons who are not employed by City and who do not have a contractual relationship with City other than this contract. Contractor agrees to abide by City policies and administrative rules prohibiting gifts to City officials and employees. Additional Requirements for Services Provided to Minors: Contractor and its employees who provide services under this Agreement must comply with these additional requirements: A. Undergo fingerprinting and a criminal background check and verify all employees providing services under this contract have met this requirement. B. Complete a Tuberculosis screening test as required by law and as set forth in Exhibit D. C. Comply with the Mandatory Reporting under California Penal Code 11164-11174.3 and with the protocols, reporting, and training required under California Health and Safety Code Section 124235, A132007, and other laws pertaining to concussion evaluation, removal from play, and return to play protocols. (Refer to Center for Disease Control & Prevention, httl2s://www.cdc.gov/headsuj2/­­­.index.html). D. Submit required forms and acknowledgments included in Exhibit D, and ensure its each participant is provided with a concussion information sheet, signs and returns the forms to the City as required by Health and Safety Code Section 124235. Require coaches and administrators to successfully complete the concussion and head injury education at least once either online or in person, before supervising a participant. Contractor shall offer training, educational materials, or both to each Contractor administrator on a yearly basis. (Training resources are available at the Center for Disease Control&Prevention (link cited above). E. If providing instruction, Contractor must acknowledge and comply with all requirements set forth in the Recreation&Community Services Instructor Manual. Recreation Services Agreement/Rev.3-27-2018 Page 3 of 6 Check one (if applicable): ® This contract requires services for children. ❑ This contract currently does not require services for children. If in the future, services for children are required, the contract will require a 'written amendment' to include the appropriate insurance coverages as required in'Exhibit B—Insurance Requirements for Recreation Contracts', proof of finger printing and additional requirements under Paragraph 13. The contract amendment will also require the approval of the Director of Recreation and Community Services and City Attorney. 14. Coordination of Services. The Parties designate the following persons as Services Coordinators with the responsibility to oversee the delivery of Services in accordance with the terms of this Agreement. Contractor's designation and any substitution are subject to City approval. For City: For Contractor: Name:Jeff Ordway Name:Mark Wright Position:Recreation Coordinator Position: Owner Contact:.ie.ffo@cu12e.rtJ.no.or9;408-777-3327 Contact:_ 15. Abandonment. City may abandon or postpone the Activity or Program and will notify Contractor as soon as possible. Contractor will be paid for satisfactory Services rendered through the date of abandonment upon submission of final invoices approved by City. 16. Termination. City may terminate this contract for cause or without cause at any time and will notify Contractor as soon as possible.Contractor will be paid for satisfactory services rendered through the date of termination upon submission of final invoices approved by City. 17. Governing Law,Venue and Dispute Resolution.This contract is governed by the laws of the State of California. Any legal actions or proceedings filed against City in connection with this contract must comply with the government claims filing requirements and must be filed with the Superior Court for the County of Santa Clara, State of California. At City's request, Contractor is required to continue to provide Services pending resolution of any dispute. If the Parties elect arbitration, the arbitrator's award must be supported by law and substantial evidence and include detailed written findings of lav and fact. 18. Attorney Fees. If City is required to pursue litigation,arbitration or other administrative or regulatory proceeding to enforce its rights or the terms of this Agreement, the prevailing party will be entitled to reasonable attorney fees and costs. This Section survives this Agreement. 19. Third Party Beneficiaries. There are no third party beneficiaries under this Contract. Recreation Services Agreement/Rev.3-27-2018 Page 4 of 6 20. Waiver. Neither acceptance of Services nor payment thereof constitutes a waiver of any contract provision. City waiver of a breach shall not constitute waiver of another term, provision, covenant or condition, or a subsequent breach,whether of the same or a different character. 21. Entire Agreement. This Agreement and all referenced Exhibits are hereby attached and incorporated into the Agreement by this reference and represent the full and complete understanding as to those matters contained herein, and supersede any other contract or understanding, either oral or written,between the Parties.This Agreement may not be modified or amended except in writing signed by both Parties.If there is any inconsistency between the main contract and any attachments or exhibits thereto, the main contract shall prevail. 22. Inserted Provisions.Each provision or clause required by law or this contract is deemed to be included and will be inferred herein. Either party may request an amendment to cure any mistaken insertion or omission of a required provision. 23. Headings. The headings are for convenience only and are not a part of the contract or intended to affect, limit or amplify the terms or provisions of this Agreement. 24. Severability/Partial Invalidity. If any contract term or provision, or their application to a particular situation, is found by the court to be void, invalid, illegal or unenforceable, such term or provision shall remain in force and effect to the extent allowed by such ruling.All other contract terms and provisions and their application to specific situations will remain in full force and effect. 25. Survival.All provisions which by their nature must continue after the Agreement ends, including without limitation Indemnification, Insurance, Ownership of Materials,Records, Governing Law and Attorney Fees, will survive the expiration or termination of this Agreement. 26. Notices.All notices and instruments pertaining to material provisions of this contract or significant disputes which are required by law or under this contract to be in writing must be sent to the persons listed below. The notices will be deemed effective on the date of personal delivery or the date confirmed by a reputable overnight delivery service, on the fifth calendar day after deposit in the United States Mail, postage prepaid, registered or certified, or the next business day following electronic submission. To City of Cupertino: To Contractor: Office of the City Manager 10300 Torre Ave., Cupertino CA 95014 cc: Representative/Coordinator: cc: Representative/Coordinator: Mark Wright Jeff Ordway Email: Email: jeffo@cupertino.org Recreation Services Agreement/Rev.3-27-2018 Page 5 of 6 27. Validity of Contract. This contract is valid and enforceable only if it complies with the provisions of Cupertino Municipal Code Chapters 3.22 and 3.23, is signed by the City Manager or authorized designee, and is approved for form by the City Attorney's Office. 28. Execution. The person executing this contract on behalf of Contractor represents and warrants that Contractor has full right, power, and authority to execute this contract and to carry out all actions and services required. This contract constitutes a legally binding obligation of Contractor, and may be executed in counterparts, each one of which is deemed an original and all of which, taken together, constitute a single binding instrument. IN WITNESS WHEREOF,the parties have caused this contract to be executed. CONTRACTOR CITY OF CUPERTINO Mark Wright A Municipal Corporation s�`/`%C��� /' By77 O Name_ Name-L.Z i Title Title Date " 3 _ Z c'1 Date Tax I.D. No.:Refer to W9 APPROVED AS TO FORM: ATTEST: RANOLPH STEVENSON HOM GRACE SCHMIDT � Cupertino City Attorney City Clerk Fiscal Year 2018-19 ContractlEncumbered Amount: $25,000 Account No.:580-63-620 700-702 Fiscal Year 2019-20 ContractlEncumbered Amount:$25,000 Account No.:580-63-620 700-702 Fiscal Year 2020-21 ContractlEncumbered Amount: $25,000 Account No.:580-63-620 700-702 Recreation Services Agreement/Rev. 3-27-2018 Page 6 of 6 1 I EXHIBIT A SCOPE OF WORK, PERFORMANCE AND PAYMENT SCHEDULES The CONTRACTOR will provide KARATE CLASSES in,but not limited to, the following: KARATE TOTS, KIDZ KARATE: BEGINNING &KIDZ KARATE:ADVANCED Location and Time of CONTRACTOR Services: Refer to the Recreation Schedule dated SUMMER 2018 THROUGH SPRING 2021 for agreed upon dates, times, and class locations. The City, at its sole discretion, may change the agreed terms. Compensation for CONTRACTOR Services: Contractor shall be compensated for services performed pursuant to this Agreement. Compensation shall consist of the following: 67%OF THE RESIDENT REGISTRATION FEE. The total compensation to the Contractor shall not exceed $75,000. Eligible Participant Minimum and Maximums for CONTRACTOR Services: Minimum: 5 Maximum: 30 If less than the required minimum number of participants enroll in and pay for a particular class as identified in the schedule before the class is scheduled to start, the City may cancel the particular class and/or terminate this Agreement without additional notice or payment to Contractor. List of all Contractor Employees working for the City of Cupertino (if no Employees,identify -r 1 .4r)1 .4 1/0L4n. i rs n Performance of CONTRACTOR Services: In the case Contractor unilaterally cancels performance of a class, camp, activity or service without City approval, City reserves the right to immediately and without notice cancel the remainder of programs/services offered and or performed by Contractor. The Contractor shall follow all guidelines pertaining to registration procedures as listed in the quarterly recreation schedule. Participants may not take part in the program unless they are listed on the class roster or can show proof of enrollment. All participants and volunteers need to complete the City's Waiver of Liability form prior to taking part in the program. If applicable, contractors who are responsible for supervising minors must remain with the class until a parent of legal guardian has arrived and all minors are released to them. In the event of an injury occurring to a participant, the Contractor will notify the City within 1 hour and complete an Incident Report in the form approved by the City. The Incident Report must be submitted to the City within 24 hours of the injury occurring. Exhibit B Insurance Requirements for Recreation Contracts As required by Section 12 of the Agreement, Contractor shall procure and maintain the following insurance for the duration of the contract against claims arising from or in connection with Contractor, its agents, representatives,employees or subcontractors Services under this Agreement. Minimum 'Scope and Limit of Insurance. Coverage shall be at least as broad as: 1. Commercial General Liability (CGL): Insurance Services Office Form CG 00 01 covering CGL on an "occurrence" basis, including property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence., If a general aggregate limit applies, it must apply separately to this project/location (CG 25 03 or 25 04)or be twice the required occurrence limit, 2. Automobile Liability: ISO CA 0001 covering Code I (any auto), or if Contractor has no owned autos; Code 8 (hired) and 9 (non-owned), with limits no less than $1,000,000 per accident for bodily injury and property damage. ❑ Required if automobile is used to perforin work under this contract. Otherwise, proof of Contractor's personal auto insurance with limits required by state law suffices. Contractor shall not transport or use its personal vehicle to transport participants or perform work under this contract. 3. Workers' Compensation: As required by the State of California, with Statutory and Employer's Liability Insurance limits of no less than$1,000,000 per accident for bodily injury or disease. Required if Contractor has employees. ❑ If no employees, Contractor must.sign Affidavit of No Employees. 4. Sexual Abuse/Molestation: Insurance or the equivalent as required for activities/services involving minors, (ie., after school activities, recreational programs, athletics, study/training events and transportation of minors). Coverage may be included under General Liability or be obtained in a separate policy, such as Educators Legal Liability (ELL) policy, with a limit of no Tess than $1,000;000 per occurrence. If a general aggregate limit applies, it must apply separately to this contract or be twice the required occurrence limit. X Required if Contract involves services to children. Insurance coverage required may be satisfied by combination of Primary and Excess/Umbrella insurance. Self-Insured Retentions: Self-insured retentions must be approved by City. City may require Contractor to provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention.. The policy language must provide, or be endorsed to provide, that the self- insured retention may be satisfied by either the named insured or City. Acceptability oflnsurers: Insurance must be issued by insurers acceptable to City and licensed to do business in the State of California,with an A.M. Best's financial strength rating of"A"or better and a financial size rating of"VII"or better. OTHER INSURANCE PROVISIONS: The CGL policy must contain, or be endorsed to contain, the following provisions: 1. The City, its City Council, boards and commissions, officers, officials, employees, agents, servants and volunteers are to be covered as additional insureds with respect to liability arising out of work or Exh. R Insurance for Recreation Contracts Updated 3-26-18 1 operations performed by or on behalf of the Contractor including materials, parts or equipment furnished in connection with such work or operations. 2. Contractor's insurance shall be primary insurance coverage at least as broad as ISO CG 20 0104 1.3 as respects the City, its officers, officials, employees, agents,and volunteers. 3. The Insurance Company agrees to waive all rights of subrogation against the City, its elected or appointed officers,;officials, agents, and employees for losses paid under the terms of any policy which arise from work performed by Contractor for City. This provision also applies to the Contractor's Workers' Compensation policy. 4. Each insurance policy required by this contract shall provide that coverage shall not be canceled, except with notice to the City. Primary Coverage: The Additional Insured coverage under Contractor's policy shall be primary non- contributory and at least as broad as ISO CG 20 01 04 13 as respects the City and all the insureds/indemnitees. If the limits of insurance required are satisfied in part by Umbrella/Excess Insurance, the Umbrella/Excess Insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a "primary and non-contributory" basis for the benefit of the Additional Insureds before City's own insurance is triggered. Notice of Cancellation: Each insurance policy shall provide that coverage shall not be canceled or allowed to expire without written notice to City 30 days in advance or 10 days in advance if due to non-payment of premiums.Such notice must be sent to City via email or certified mail to the attention of the City Manager. Waiver of Subrogation: Contractor grants City a waiver of any right to subrogation which any insurer of said Contractor may acquire against City by virtue of payment of any loss under such insurance. Contractor will obtain any endorsement that may be necessary to effect this waiver of subrogation, but this provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer. Verification qf Coverage:,Contractor shall furnish the City with original certificates and amendatory endorsements effecting coverage required by this clause.All certificates and endorsements are to be received and approved by the City before work commences. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements affecting the coverage required by these specifications,at any time.At a minimum Contractor must provide acceptable copies of the policy declarations and endorsement page verifying the required insurance coverages. Homeowner's Insurance: Contractor's homeowner's liability insurance may provide coverage sufficient to meet these requirements. Contractor should provide these requirements to his or her agent to confirm and provide verification to City. Special Events Coverage: Insurers may provide special events coverage for a reduced fee,or City may be able to offer this coverage.Contractor should contact the CityManager's Office for information or assistance. Special Risks or Circumstances:City reserves the right to modify these requirements based on the nature of the risk,prior experience, insurer, coverage,or other special circumstances. Exh.B Insurance for Recreation Contracts Updated 3-26-18 2 EXHIBIT D Contractor's Mandated Reporter Declaration The undersigned does hereby certify that: 1. I am a representative of MARK WRIGHT; that I am familiar with the facts herein and am authorized and qualified to execute this declaration. 2. 1 declare that MARK WRIGHT has complied with fingerprinting and criminal background investigation requirements with respect to all Contractor's employees who may have contact with minors in the course of providing services pursuant to the Agreement, and the California Department of Justice has determined that none of those employees has been convicted of a felony, as that term is defined in California Penal Code Section 11105.3. 3. I declare that each coach and administrator shall be required to successfully complete concussion and head injury education at least once, either online or in person,before supervising a participant, as required by California Health and Safety Code Section 124235, et seq. 4. On a yearly basis, all participants shall be required to sign and return a concussion and head injury information sheet in compliance with California Health and Safety Code Section 124235, which may be in the form attached as D-1. 5. That a complete and accurate list of Contractor's employees, who may come in contact with minors during the course and scope of the Agreement, are included below. 6. All of the below mentioned employees have tested negative for TB, or X-ray results for TB, and have current documentation on file with Contractor. 7. All of the below mentioned employees have received training and understand their responsibilities under the Mandated Reporter laws of this state and are willing and able to comply. List of all Contractor Employees working for the City (if no Employees, identify"self"): 1/e4ri..v71rrR 8. The Contractor will notify the City of Cupertino in writing of any new employees and will be added to the above list prior to beginning work at the City of Cupertino. P I declare under penalty of perjury that the foregoing is true and correct. MARK WRIGHT Bye ��� � NameJ�m& Title 66vovc--- Date S 3/ - .Z v12? CERTIFICATE OF LIABILITY INSURANCE ATE(MM/DD/010 MM/04/10/2DATE ole010 YI PROW" THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION t>A1vea+aannarABa.y'`nc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE >-mson resalLeat MI- HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR Ste?w +aatid+V,a}4 CAs269I-T38a a>�a3a T�3s ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC 0 INSURER A Phitadelphia Indemnity Insurance Company INS. Imams wrw"1 INSURER 8'. INSURER C. INSURER D. INSURER E COVERAGES 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 CERIFICATION 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_ AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ IDSA ' ADO'L POLICY EFFECTIVE POLICY EXPIRATION LTR sNS" TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YYYY) DATE(MM/DD/YYYY) LIMITS A j I GENERM LIABILITY PHPK1511806- 06/23/2018 05/23/2019 EACH OCCURENCE $1,000,000 #1 X COMMERCIAL GENERAL LIABILITY 002 PREMISES Ea occTuErrLencet SI00.D00 CLAIMS MADE X❑ OCCUR MED EXP(Any one person) 52,500 # )[ PROFESSKWAL LIABILITY PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE 53.000.000 GENT AGGREGATE UMiT APPLIES PER. PRODUCTS-COMP/OP AGG 53,000.000 7t I-,CY PROJECT IF LOC 3 AVTOMOME UABIUT'F COMBINED SINGLE LIMIT ANY 4UTO (EA accident) ALL CIA?AD AUTOS BODILY INJURY j SCHEWt£DAUTOS (Per person) HOLED AOTOS BODILY INJURY -~ 114001-OWNED AUTOS IPer accident) i PROPERTY DAMAGE (Per accident) �GAIRAGE L;ABIUTY AUTO ONLY-EA ACCIDENT i 1 ANY ALTO OTHER THAN EA ACC AUTO ONLY: AGG DXCCEU/UMBRELLA LIARIL1TY EACH 0 CURENCE t CsCC, L_.� CLQMSMADE AGGREGATE �� OEEtci''TiE1E .. »TENTKA �jFF11 TORYLIMITS ER _ AttiT' ppp TOR+PARTNEROED UECLITIVE E.L.EACH ACCIDENT pfflCEAJABFYIBER xCLU -- — .— �-- 1I� 1tr NW) E.L.DISEASE-EA AMPLOYEE S+<E.C{ARPB�Q�N'S�w. E.L.DISEASE-POLICY LIMIT OTHQ i a DE NOF O/CJIAT)M(LOCATIONS/VEHICLES/EXCLUSIONS ADDED By ENDORSEMENT/SPECIAL PROVISIONS { :1o"ain#VVW6 flsil tho folmWq enstty is added as on additional Insured but only with respects)to the operations of the named Insured except that liability rasultlnB from the addii�onal�nwred's sole r.;aeMe CERTIFICATE HOLDER CANCELLATION _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCILLED BEFORE THE EXPIRATION DATE `sy m 1_pp�ew ea eat cow tuvels and CowArossion,othtws.employees and volunterrs shall be named THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE st.e/ta 3ylrYE4 farmer A2 kWAfaurai r49*4d by tTsia a8reemont CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR 1%iEY sorer%C-0 Bw LIABILITY OF ANY KIND UPON THE INSURER,fTS AGENTS OR REPRESENTATIVLS. ; .rAAUTHORIZID REPRESENTATIVE . ..` 101r ® 1988-2009 ACORD CORPORATION.All rights reserved. he ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK1511806-002 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organ izations : City of Cupertino its City Council, Boards and Commissions, Officers,Officials, Employees,Agents, Servants, Volunteers and Consultants 10300 Torre Ave Cupertino CA 95014-3202 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury", "property If coverage provided to the additional insured is damage or personal and advertising injuryrequired by a contract or agreement, the most we caused, in whole or in part, by your acts or will pay on behalf of the additional insured is the omissions or the acts or omissions of those acting amount of insurance: on your behalf: 1. Required by the contract or agreement; or 1. In the performance of your ongoing operations; or 2. Available under the applicable Limits of 2. In connection with your premises owned by or Insurance shown in the Declarations; rented to you. whichever is less. However: This endorsement shall not increase the 1. The insurance afforded to such additional applicable Limits of Insurance shown in the insured only applies to the extent permitted by Declarations. law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 26 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: PHPK1511806-002 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of Cupertino its City Council, Boards and Com missions,Officers,Officials, Employees,Agents, Servants, Volunteers and Consultants, 10300 Torre Ave, Cupertino, CA 95014-3202 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or"your work"done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. ISO Properties, Inc. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 D Forms Schedule — General Liability Policy Number: PHPK1511806-002 Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue: Form/Edition Description CG 00 01 04 13 Commercial General Liability Coverage Form CG 21 67 12 04 Fungi or Bacteria Exclusion CG 21 70 01 15 Cap On Losses From Certified Acts Of Terrorism CG 32 34 01 05 California Changes Commercial General Liability GL Coverage Part Declarations Page Coverage Part Declarations Commercial GL Supplemental Commercial GL Coverage Supplemental Schedule Schedule IL 00 17 11 98 Common Policy Conditions IL 02 70 09 12 California Changes-Cancellation And Nonrenewal IL N 177 09 12 California Premium Refund Disclosure Notice PI-BELL-1 11-09 Bell Endorsement PI-FW-001 (01/07) Coverage C-Athletic Activities Exclusion Deletion PI-FW-002 04 16 Fitness and Wellness Liability Insurance Exclusions PI-FW-003 (01/07) Fitness and Wellness Liability Insurance Extension PI-FW-004 04 16 Independent Contractors Providing Professional Training Services PI-FW-005 (01/07) Punitive Damages Exclusion PI-FW-006 (01/07) Sexual Abuse Endorsement PI-FW-007 (01/07) Specific Claimant Exclusion PI-FW-008 (01/07) Violation of Communication or Information Law Exclusion PI-FW-009 (06/11) Blanket Additional Insured PI-GL-001 09 17 Exclusion -Lead Liability PI-GL-002 CA 02 08 Exclusion -Asbestos Liability PI-TER-DN1 01 15 Disclosure Notice Of Terrorism Ins Coverage Rejection Page 1 of 1 PI-FW-006(01/07) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY SEXUAL ABUSE ENDORSEMENT This endorsement modifies insurance provided under the following. Commercial General Liability Coverage Part SCHEDULE Sexual Abuse limits of Insurance Sexual Abuse Each Occurrence Limit $1,000,000 Sexual Abuse Aggregate Limit $3,000,000 A. Except as otherwise provided by this endorsement, this policy does not apply to "bodily injury," "property damage" or"personal and advertising injury" caused by, based upon or arising, in whole or in part, out of any: 1. Actual, threatened or alleged "sexual abuse" or"sexual harassment"; or 2. "Negligent employment" of any person who caused or commits or is alleged to have caused or committed "sexual abuse"or"sexual harassment." As respects coverage afforded by this endorsement, following changes apply to the COMMERCIAL COMMERCIALGENERAL LIABILITY COVERAGE FORM: B. Paragraph 1. of Section I—Coverages_Coverage A— Bodily injury and Property Damage Liability is deleted and replaced by the following. 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of"bodily injury" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages, including any "suit" alleging that the "bodily injury" arose out of"sexual abuse" caused or committed by the insured. However, we will have no duty to defend or continue to defend any insured against: (1) any "suit" seeking damages for"bodily injury" to which this insurance does not apply: (2) any "suit" for which the insured is found to have in fact caused or committed and act of "sexual abuse": or (3) any"suit for which the insured is found to have in fact caused or committed and act of " sexual abuse." We may, at our discretion, investigate any"occurrence" and settle any claim or"suit" that may result. But: Page 1 of 4 PI-FW-006 (01/07) (a) The amount we will pay for damages is limited as described in Section F—Limits Of Insurance of this endorsement; and (b) Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments, settlements or"defense expenses" under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided under Section D of this endorsement — Supplementary Payments — Coverage A and B. b. This insurance applies to "bodily injury"only if: (1) the"bodily injury" is caused by an "occurrence"that first commences in the "coverage territory"at a specific date and time on or after the effective date of this endorsement and during the policy period; (2) the"bodily injury"arises out of "sexual abuse"caused or committed by your "employee"; and (3) the "sexual abuse"arises out of your"negligent employment" of that"employee." C. The insurance provided by this endorsement is subject to the following additional exclusions: 2. Exclusions This insurance does not apply to: a. Any person who: (1) Has admitted to or been found guilty of, or pled guilty or nolo contendere to any act involving "sexual abuse"; (2) Participated in, directed or knowingly allowed "sexual abuse"; or (3) Has failed to comply with any applicable law, ordinance or regulation which requires the reporting of"sexual abuse"after having knowledge of the "sexual abuse." b. Any expense associated with a criminal trial, proceeding or investigation, or to any expense for appeals for any"suit" against you or any person insured. c. Any claim for damages arising out of"sexual abuse"which is part of a series of related acts of"sexual abuse" if the first of such series of acts took place before the effective date of this endorsement. d. Any claim for damages arising out of"sexual abuse" alleged to have been caused or committed by any"employee"who had previously committed such an act of which any insured had knowledge. e. Any liability of others assumed by you under any contract or agreement, either oral or written. f. Any claim made against an insured by another insured. g. Any "sexual abuse"caused or committed by or which is alleged to have been caused or committed by any independent contractor or employee or agent of such independent contractor. h. "Sexual harassment." i. "Bodily injury" arising from any violation or alleged violation of the civil rights of any person. Page 2 of 4 PI-FW-006 (01/07) D. SUPPLEMENTARY PAYMENTS- COVERAGES A AND B With respect to the insurance provided by this endorsement, Paragraph 1.a. and Paragraph 2. of Section I —Supplementary Payments —Coverages A and B are deleted. E. WHO IS AN INSURED With respect to the insurance provided by this endorsement, Paragraph 2. of Section II —Who Is An Insured is deleted. F. LIMITS OF INSURANCE For purposes of the coverage provided by this endorsement, the following is added to Section III — Limits Of Insurance of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM and applies solely to this coverage: 1. The Sexual Abuse Limits of Insurance shown in the SCHEDULE of this endorsement and the rules below fix the most we will pay for damages and "defense expenses", regardless of the number of: a. Insureds; b. Claims made or"suits" brought; or c. Persons or organizations making claims or bringing "suits." 2. The Sexual Abuse Aggregate Limit shown in the SCHEDULE of this endorsement is the most we will pay for the sum of all damages and "defense expenses" because of all "bodily injury"arising out of"sexual abuse." 3. Subject to 2. above, the Sexual Abuse Each Occurrence Limit shown in the SCHEDULE of this endorsement is the most we will pay for the sum of all damages and "defense expenses" because of all "bodily injury"arising out of"sexual abuse"from any one"occurrence." 4. Subject to 1., 2., and 3. above, covered damages for which insurance is afforded by this endorsement will apply against and reduce the General Aggregate Limit of this policy, as described in Paragraph 2. of Section III—Limits Of Insurance of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM. The Limits of Insurance of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed to be part of the last preceding period for purposes of determining the Limits of Insurance. G. For purposes of the coverage provided by this endorsement, the following definitions are added to Section V—Definitions of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: 1. "Defense expenses" means.- a. eans:a. Fees, costs and expenses charged by attorneys retained by us; and b. Reasonable and necessary fees, costs and expenses resulting from the investigation, adjustment, defense or appeal of a claim. "Defense expenses"do not include: a. Salaries, loss of earnings, reimbursement for the insured's time or attendance required at any investigation, defense or appearance; or b. Other remuneration by or to any insured. Page 3 of 4 PI-FW-006 (01/07) 2. "Negligent employment" means negligent selection, investigation, supervision, training or retention of an "employee." 3. "Sexual abuse" means actual or alleged physical abuse arising out of a single, continuous or repeated exposure of one or more persons to acts of a sexual nature involving inappropriate physical contact caused by or committed by: a. One person; or b. Two or more persons acting together or in related acts or series of acts. All related, interrelated, repeated or continuous episodes of "sexual abuse" involving the same claimant or perpetrator shall be deemed to be a single'occurrence." 4. "Sexual harassment" means inappropriate non-physical actions or verbal comments or suggestions of a sexual nature. H. For purposes of the coverage provided by this endorsement, Paragraph 13. of Section V — Definitions of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to include: 13. "Occurrence" means any act of"sexual abuse." Page 4 of 4 PI-FW-009 (06/11) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Blanket Additional Insured Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION II —WHO IS AN INSURED is amended to include the following as an additional insured, but only with respect to liability arising out of your operations, and in accordance with a required Certificate of Insurance: 1. Managers, Owners or Lessors of the Premises Leased, Rented, or Loaned to You, but only with respect to that part of the premises leased, rented or loaned to you subject to the following additional exclusions: This insurance does not apply to: a. Any "occurrence"which takes place after you cease to be a tenant in that premises; b. Structural alterations, new construction or demolition operations performed by or on behalf of the manager, owner or lessor of the premises; c. Any design defect or structural maintenance of the premises or loss caused by a premises defect. 2. Lessor of Leased Equipment, but only with respect to liability for"bodily injury", "property damage" or"personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s)subject to the following additional exclusions: This insurance does not apply to: Any"occurrence"which takes place after the equipment lease expires. 3. Sponsors, but only with respect to their liability as a sponsor to you. 4. Co-Promoters, but only with respect to their liability as a co—promoter to you 5. Subcontractors 6. Grantor of Franchise, but only with respect to their liability as grantor of franchise to you. With respect to any additional insured covered under this policy, this insurance does not apply to the sole negligence of such additional insured. Page 1 of 1 POLICY CHANGE DOCUMENT POLICY NO: CHANGE # 2 CHANGE EFFECTIVE: 06/23/2018 PHPK1511806-002 Philadelphia Indemnity Insurance Company PRODUCER: Maguire Insurance Agency, Inc. NAMED INSURED: mark wright MAILING ADDRESS POLICY PERIOD: FROM 06/23/2018 TO 06/23/2019 at 12:01 A.M. Standard Time at your mailing address shown above. DESCRIPTION: In consideration of the premium reflected, the policy is amended as indicated below: Added Additional Insured: City of Cupertino its City Council, Boards and Commissions, Officers,Officials, Employees, Agents, Servants, Volunteers and Consultants 10300 Torre Ave Cupertino, CA 95014-3202 Added Form CG2404—Waiver of Transfer of Rights of Recovery Against Others To Us. Total Annual Total Prorate Additional/Return Premium $0.00 Additional/Return Premium $0.00 Total Annual Total Prorate Additional/Return Additional/Return Tax/Surcharge/Fee $0.00 Tax/Surcharge/Fee $0.00 Page 1 of 1 Additional Insured Schedule Additional Insured Schedule Policy Number:PHPK1511806-002 City of Cupertino City of Cupertino its City Council, Boards and Commissions, Officers,Officials, Employees, Agents, Servants, Volunteers and Consultants city or cupertino its city council bards and commission, officers,employees and volunterrs shall be named as an additional insured under alll insurance required by this agreement Page 1 of 1 POLICYHOLDER COPY NA STATE P.Q. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 06-04-2018 GROUP: POLICY NUMBER: 9213769-2017 CERTIFICATE 10: 1 CERTIFICATE EXPIRES: 07-04-2018 07-04-2017/07-04-2018 Cl TY CF CX PERTI NO NA 10300 TORI-E AVE CUPERTI NO CA 95014-3202 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer. We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy' described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO UNLESS I ND CATED OTHERW SE BY ENDCRSEMENtT, COVERAGE UNDER TH S PCLI CY EXCLUDES THE FCL LOW NCx THOSE NAKED I N THE PO-I CY DECLARATI Q'VS AS AN I NDI VI DUAL EMPLOYER OR A HUSBAND AND W FE ENPLOYER; EMPLOYEES CXMRED CN A OONPREHENSI VE PERSCNAL LIABILITY INSURANCE POLICY ALSO AFFORD NG CALI FORM A VCRKERS' C CIVPENSATI ON BENER TS; EM:11- WEES EXCLUDED UNDER CALI FORM A VO WERS' OQ\/PENSATI ON LAW EMPLOYER S LI ABI LI TY LI M T I NCLUDI % DEFENSE COSTS: $1, 000, 000 PER OOCURRENCE. EMPLOYER V)R Q-IT, NARK DBA: VIRI GGT V1AY SHOTCKAN NA 5820 LALCR DR SAN JOSE CA 95123 1601,CNI tR:rv.7-2014) PRI NTED : 06-04-2018 Prepared on February 5,2018 Page 1 of 4 Nationwide® Your Policy Declarations is on your side Personal Auto Policy Policy Period:Mar 6,2018-Mar 6, 2019 Policy Number: Policyholder(Named Insured): Account Number: 7255551749 Mark A.Wright Keep these Declarations for your records. General Policy Information Issued:February 5,2018 These Declarations are a part of the policy named above and identified by the policy number above.They supersede any CD Declarations issued earlier.Your policy provides the coverages and limits shown in the schedule of coverages.They apply 0 to each insured vehicle as indicated.Your policy complies with the motorist's financial responsibility laws of your state "' only for vehicles for which Property Damage and Bodily Injury Liability coverages are provided. a 0 00 Policy Period:March 6,2018-March 6,2019 but only if the required premium for this period has been paid and only CD rn for twelve month renewal periods if renewal premiums have been paid as required.This policy is initially effective at(1) � the time the application for insurance is completed,or(2) 12:01 a.m.on the first day of the policy period,whichever is later. Each renewal period begins and ends at 12:01 a.m.Standard time at the address of the named insured stated herein.This policy term expires at 12:01 a.m.at the address of the named insured stated herein. Your carrier is Amco Insurance Company, NAIC#19100. How You Saved on this Policy with Allied • Multi-Policy Persistency Discount 0 Multi-Car Discount • Air Bag Discount • Anti-Theft Device . Good Driver Discount Elite Driver Discount Insured Drivers Name Date of Birth Marital Status License Number Prepared on February 5,2018 Page 2 of 4 Nationwide' Your Policy Declarations is on your side Personal Auto Policy r) Policy Period:Mar 6,2018-Mar 6, 2019 For coverage definitions and descriptions, Policy Number: visit www.alliedinsurance.com Account Number: 7255551749 Insured Vehicles and Schedule of Coverages Coverages Limits of Liability Premium Bodily Injury Liability $500,000 Per Person $247.68 $500,000 Per Occurrence Property Damage Liability $100,000 Per Occurrence $165.60 Medical Payments $5,000 Per Person $17.82 Uninsured Motorist Bodily Injury $100,000 Per Person $77.64 $300,000 Per Accident Uninsured Motorist Property Damage $3500 Per Occurrence $6.58 Liability Total for this Vehicle $515.32 Coverages Limits of Liability Premium Bodily Injury Liability $500,000 Per Person $342.06 $500,000 Per Occurrence Property Damage Liability $100,000 Per Occurrence $225.70 F:�C Medical Payments $5,000 Per Person $33.94 ICt Uninsured Motorist Bodily Injury $100,000 Per Person $104.42 $300,000 Per Accident Comprehensive Actual Cash Value Less A $500 Deductible $45.60 Collision Actual Cash Value Less A$500 Deductible $296.98 Waiver Of Collision Deductible $5.88 Total forth is Vehicle $1,054.58 Coverages Limits of Liability Premium Bodily Injury Liability $500,000 Per Person $331.18 $500,000 Per Occurrence Property Damage Liability $100,000 Per Occurrence $162.78 Medical Payments $5,000 Per Person $25.62 Uninsured Motorist Bodily Injury $100,000 Per Person $105.20 $300,000 Per Accident Comprehensive Actual Cash Value Less A$500 Deductible $94.90 Collision Actual Cash Value Less A$500 Deductible $623.72 Waiver Of Collision Deductible $5.88 Total for this Vehicle $1,349.28 , Policy Level Schedule of Coverages Allied Extra Coverages See Endorsement Total for Policy Coverages $0.00 Continued on the next page IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2009/01)