18-143 Fremont Union High School District, Educational Classes and College WorkshopsCITY OF
m
C U P ERTI NO
No.
RECREATION SERVICES AGREEMENT
;;.0 1CJ ~I ~
FY2018-19
1. Parties. This conh·act is made and entered into as of 7/30/2018 ("Effective Date"), by and
between the City of Cupertino, a municipal corporation ("City"), and with FREMONT UNION HIGH
SCHOOL DISTRICT, 589 WEST FREMONT A VENUE, SUNNYVALE, CA 94087 ("Contractor"), a
CALIFORNIA CORPORATION for EDUCATIONAL CLASSES AND COLLEGE WORKSHOPS .
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 6/30/2019 ("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 e xceed $100,000 ("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 ilwoices .
Invoices are subject to review and audit by City duri11g regular business hours upon 24-hours'
notice . Contractor must mai11tai11 complete and accurate records of payrolls, expenditures,
disbursements and other cost items charged to City or establishi11g the basis for an ilwoice, for a
minimum of four (4) years from the date of final payment.
5. Independent Contractor. Contractor is an i11dependent Contractor and not an employee,
partner, or joi11t 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 w1der this Contract. Contractor is responsible for obtaining permits and licenses required
by law and must obtaiJ.1 a City business license.
Recre ation S ervices Agreement! Rev. 3-2 7-201 8
Pa ge I of6
6. Proprietary/Confidential Informati on. To the ext e nt Contractor may have access to
private or confidential information owned o r controlled by the City, Contractor agrees to treat it
confidential and u se it so lely to perform this Agreement. Contractor mu s t exercise the same standard
of care to protec t City information as a r easonably prudent Contractor would use to protect its own
proprietary data.
7. Ownership of Materials. To the extent Contractor prepares wri tte n materi al , d rawings
o r data in co nnection w ith this co ntract, City will ha ve the p ro p erty r ights to those m aterials and a ll
copyrights, if any, to such work product will constitute City property.
8. Records. Contractor must maintain complete, accurate, and d etail ed acco unting records
r ela tin g to its performance in accordance w ith generall y accepted accounting principles and
procedures. The records must include detailed information about Contractor's services, benchmarks,
d e liv erables and costs/fees, and must be made reasonably available to City . The records and supporting
documents must be kept separate from other files and mainta in e d for four years from the date of City's
final paym en t.
9. Assignment. This Contract is not assignable. Contractor may not substitute another or
transfer any rights or obligati o n s under this Contract without prior written approval of City. Only those
person s whose names are include d in Exhibit A may p e rfo r m the Servic es.
10 . Pub licity and Signs. An y publicity generated by Contractor related to thi s co ntract or
the Services during th e Contract Time and for one ye ar thereafter must reference City contributions.
The words "City of Cupertino" shall be di splayed in all pieces of publicity, including flyers, press
r eleases, posters, brochures, public service announcements, interviews and newspaper ar ticl es. No
signs may be posted, exhibited or displayed on or about City p ro per ty, ex cept signage r e quired b y Jaw
or under this Agreement without prior written a pproval fro m City.
11. Inde mnificatio n. To th e fullest extent allowed by law and exce pt for lo sses ca used b y
the sole negligence or willful miscondu ct of City personnel, Contractor agrees t o i ndemnify, defend ,
and hold harmless the City, its Ci ty Council, boards and commissions, officers, officials, employees,
agents, servants, voluntee rs and Contractors (collectively, "Indemnitees"), through legal counsel
acceptable to City, from and again st any liability for damages, claims, actions, cau ses of action,
demands, charges, losses, costs and e xpenses (including attorney fees, legal costs and expenses related
to litigation, arbih·ations, administrative and regulatory procee d ings), of every nature, arising out of or
in any way related to Contractor's or ConlTactor's agents p e rformance of thi s co ntract or the Services.
Th is includes but is not limite d to Liability resulting in personal injury, death, property damage, or
economic losses. Contractor must pay any costs City may incur in e n forc ing this provision and must
accept a tender of defense upon receiving notice from City . Contractor's payments may b e d e ducte d or
offs et to cover any money the City lost due to a claim or counterclaim arising out 0£ this C ontract.
12. Insurance. Contractor shall comply w ith the insurance r e quirements in Exhibit B. City
will not execute the Agreement until it has re ceived and approved satisfacto ry certificates of in surance
and endorseme nts evid encing the type, amount, and dates of coverage. Alternatively, City in its sole
discretion may purchase insurance and d e duct the costs from pa y m e nts to Contrac tor, or te rmin a te the
contract.
Recreation Services Agreement! Rev . 3-27-2018
Page 2 of6
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 VU 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 reguirements
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 reguired to file a conflict of interest form for engaging in
governmental decisions or serv in g in a staff capacity, and is hereby advised to review the reguirements
of California Political Reform Act and th e 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 ru les
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 crim in al background check and verify all employees
providing services under this contract have met this reguirement.
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 reguired under California Health and Safety Code
Section 124235, AB2007, and other laws pertaining to concussion evaluation, removal from
play, and return to play protocols. (Refer to Center for Disease Control & Prevention,
h ttps://, vww. eek. gc,v /headsu p/i nd ex. htm I).
D. Submit reguired 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.
Reguire coaches and administrators to successfully complete the concussion and head injury
education at least once either online or in person, before supervising a paTticipant.
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.
Check one (if applicable):
~ This contract requires services for children.
-===============··=······=·-=·····-=·-=--.. =-·--·-=-=-----=-=-=-----=--·-=-···-=-.... = ..... =-···-=···--=---=-=---·=--.. -=--==
Recreation Services Agreement/ Rev. 3-2 7-2018
Page3of6
D This contract currently does not require serv ice s for ch ildren. If in the future, services
for children are required, the conh·act will require a 'vvritten amendment' to include the
appropriate insurance coverages as required in 1 Exhibit B -Insurance Requirements for
Recreation Contracts1
, proof of finger printing and additional require ments 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: Daniel Mestizo Name: Christine Mallery
Position: Recreation Coordinator Position: Chief Business Officer/Associate
Contact: d,1niclrnca ·cupe rtino .o r g: I 408-777-3134 Superintendent
Contact: Ch ristinc rrnil lcrv c,t fohsJ .org I 408-522-2245
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 th e
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 Conh·actor 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 Law1 Venue and Dispute Resolution. This contract is governed by the laws
of th e State of California . Any legal actions or proceedings fi led 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 Clara1 State of California. At City's request1 Contractor is
required to continue to provide Services pending resolution of any dispute. If the Parties elect
arbitration1 the arbitrator1 s award must be supported by law and substantial evidence and include
detailed written findings of law and fact.
18. Attorney Fees. If City is required to pursue litigation1 arbitration or other administrative
or regulatory proceedi.ng 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 thi s Agreement.
19. Third Party Beneficiaries. There are no third party beneficiaries under this Contract.
20. Waiver. Neither acceptance of Services nor pay ment thereof constitutes a waiver of any
contract provision. City waiver of a breach shall not constitute waiver of another term1 provision,
covenant or condition1 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 herein1 and supe rsede any other contract or understanding, either oral or
Recreation Services Agreement/ R ev. 3-2 7-2018
Page 4 of6
written, bet\-veen the Parties. This Agreement may not be modified or ame nde d 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 b y 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 pa r t of the contract or
intended to affect, limit or amplify the terms or provisions of this Agreement.
24. Severability/Partial Invalidity. If any conh·act term or prov ision, or th e ir 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 b y th ei r 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 prov ision s 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 li s ted b e low. 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, p os tage prepaid, registered or certified, or the nex t bu s iness day following
e le ctronic submission.
To City of Cupertino:
Office of the City Manager
10300 Torre Ave., Cupertino CA 95014
cc: Representative/Coor dinator:
Daniel Mestizo
Email : danielm@c upertino.org
To Contractor:
Fremont Union High School Distri ct
589 W est Fremont Avenue, Sunnyvale, CA 94087
cc: Representative/Coordinator:
Christine Mallery
Email: Christine_mallery@fuhsd .org
27. Validity of Contract. This contract is valid and enforceable only if it complies with the
prov isions of Cupertino Municipal Code Chapters 3.22 and 3.23, is signed b y the City Manager or
a uthorized design ee, and is approved for form by the City Attorney's Office .
28. Execution. The person executing this contract on b e half of Conh·actor 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
toge the r, constih1te a single binding instrument.
Rec r eation Services Agreement/ Rev. 3-2 7-2 018
Page S of6
IN WITNESS WHEREOF, the parties have caused this contract to b e executed .
CONTRACTOR
Fremont Union High School District
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Title C [) r J .
D ate 0·-10-/X
Tax I.D. No.: 77 ---()()) ))ju
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APPROVED AS TO FORM: ) i ~ ~
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Contract/Encumbered Amount: $100,0 00
Account No.: 580-62-613 700-702
CITY OF CUPERTINO
A Municipal Corporati on
By -~
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Title pJ~
Date )-i.J'--i S
ATTEST:
GRACE SCHM IDT
City Clerk
-····-·---··· --·-···--······-··--····-·
Recreation Services Agreement/ Rev. 3-2 7-201 8
Pa ge 6 o f6
EXHIBIT A
SCOPE OF WORK, PERFORMANCE AND PAYMENT SCHEDULES
The CONTRACTOR will provide EDUCATIONAL CLASSES AND COLLEGE
WORKSHOPS in, but not limited to, the following:
COLLEGE PLANNING WORKSHOP, COLLEGE ESSAY WORKSHOP, GEOMETRY
ENRICHMENT, ART PORTFOLIO, COLLEGE PREP A TORY WORKSHOPS
Location and Time of CONTRACTOR Services:
Refer to the Recreation Schedule dated FALL 2018 -FALL 2019 for agreed upon dates, times, and
class locations . The City, at its sole discretion, may change the agreed terms.
Compensation for CONTRACTOR Services:
ConlTactor shall be compensated for services performed pursuant to this Agreement. Compensation
shall consist of the following: 80% of the class fee based on final class rosters. The total compensation
to the Contractor shall not exceed $100,000.
Eligible Participant Minimum and Maximums for CONTRACT OR Services:
Mini.mum :
Maximum:
10
18-64
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
"self"):
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 p ertaining 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 r e leased to them.
In the event of an injury occurring to a participant, th e Contractor will notify the City w ithin 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.
Teresa Filice
Olga Fostiy
Onette Zabinski
Carley Stavis
Malissa Goldstein
Ana Franco
Gregg Buie
Monique Balentine
McKenna Parfet
Fremont Union High School District Teachers for City of Cupertino
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 c01mection 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 Forn1 CG 00 01 cove1ing CGL on an
"occurrence" basis, including property damage, bodily injmy 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 1 (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 pe1form work under this contract.
D Otherwise, proof of Contractor's personal auto insurance w ith limits required by state la w
siiffices. Contractor s hall not tran spo rt or use its personal vehicle to transport participants or
pe1form ·wo rk 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.
I}§ Required if Contractor has employees.
D 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, (i.e ., 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 less than $1,000,000 per
occurrence . If a general aggregate limit applies, it must apply separately to this contract or be twice the
required occmTence limit.
M Required if Contract involves services to children.
Insurance coverage required may be satisfied by a combination of Primaiy 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 of Insurers: 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 c01mnissions, officers, officials, employees, agents, servants
and volunteers are to be covered as additional insureds with respect to liability arising out of work or
Exh. B In surance for R ecreatio n Contracts Updated 3-26-18
I
operations perfo1111ed by or on behalf of the Contractor including materials , pa1ts 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 01 04
13 as respects the City , its officers , officials , employees , agents , and vol unteers.
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 .
Prima,y 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/indenmitees . 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 prov ision that such coverage shall
also apply on a "primaiy and non-contiibut01y" basis·for the benefit of the Additional Insureds before City's
own insurance is tiiggered.
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 recei ved a waiver of subrogation endorsement from the insurer.
Verification of 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, ce1tified
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 confinn 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 City Manager's Office for infonnation 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 In suran ce for R ec reation Contra cts Updat ed 3-26-18
2
EXHIBITD
Contractor's Mandated Reporter Declaration
The m,dersigned does hereby certify that:
1. I am a representative of FREMONT UNION HIGH SCHOOL DISTRICT; that I am
familiar with the facts herein and am authorized and qualified to execute this declaration .
2. I declare that FREMONT UNION HIGH SCHOOL DISTRICT has complied with
fingerprinting and criminal backgrotu1d investigation requirements with respect to all
Contractor's employees w ho 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 successfull y 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"):
8. TI1e 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.
I declare under penalty of perjury that the foregoing is true and correct.
FREMONT UNION HIGH SCHOOL DISTRICT
By: CHRISTINE MALLEU
Title: CHIEF BUSINESS OFFICER/ASSOCIATE SUPERINTENDENT
(-;·7 ~) I y Date: ,/( .;-~fu .f ,'
Teresa Filice
Olga Fostiy
Onette Zabinski
Carley Stavis
Malissa Goldstein
Ana Franco
Gregg Buie
Monique Balentine
McKenna Parfet
Fremont Union High School District Teachers for City of Cupertino
Northern Ca lifornia ReliEF I Issue Date
Protected In su rance Program for Schools CERTIFICATE OF COVERAGE 7/3/2 018
ADMINISTRATOR: LI CE NSE # 0451271 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
Keenan & Associates AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
1732 North First Street, Suite 100 CERTIFICATE DOES NOT AMEND , EXTEND OR ALTER THE COVERAGE
San Jose , CA 95112 AFFORDED BY THE COVERAGE DOCUMENTS BELOW.
ENTITIES AFFORDING COVERAGE:
408-441-0754 www.keena n.com ENT ITY A: Northern California ReliEF
COVERED PARTY : ENTITY B: Protected Insurance Program for Schools Fremont Union High School District
P.O . Box F ENT IT Y C:
589 West Fremont Avenue ENTITY D: Sunnyvale CA 94087
ENTITY E:
THI S IS TO CERTIF Y THAT THE COVERAGES LI STED BELOW HAVE BEEN ISSUED TO THE COVERED PAR TY NAME D A BOV E FOR THE PER IOD INDI CATED . NOTWITHSTAND IN G ANY
REQUIR EM ENT , TERM OR COND IT ION OF ANY CONTRACT OR OTHER DOC UMENT W ITH RESPEC T T O W H ICH THI S CERTIFI CA TE MAY BE ISSUED OR MAY PERTAI N. THE COVER AG E
AF FORDED HEREIN IS SUBJ ECT TO ALL THE TERMS A ND CO NDI T IONS OF SUCH COVERAGE DOCUMENTS.
MEMBER
ENT COVERAGE EFFECTIVE/ RETAINED LIMIT
LTR TYPE OF COVERAGE DOCUMENTS EXPIRATION DATE / DEDUCTIBLE LIMITS
A GENERAL LIABILITY COMB INED SIN GLE LIMIT EACH OCCURRENCE
I v'] GENERAL L IAB ILITY NCR 00109-32 7/1/2018 $ 25,000 $ 1,000 ,000 I d CLA IMS MADE (v') OCCURRENCE
I GOVERN MENT COD ES 7/1 /2019
I ERRORS & OM ISS ION S
I I
A AUTOMOBILE LIABILITY COMB INED SIN GLE LIMIT EACH OCCURRE NCE
I a ANY A UTO NCR 00109-32 7/1/2018 $ 25 ,000 $ 1,000 ,000
I HIRED AUTO 7/1/20 19 I NON-OWNED A UTO
I ::i-GARAGE LI ABILITY
I AUTO PHYS ICAL DAMAGE
A PROPERTY NCR 00109-32 7/1/20 18 $ 25 ,000 s 250,250 ,000
I ~ALL RISK 7/1/2019 EACH OCC URREN CE
I EXCLUDES EARTHQUAKE & FLOOD
[ ] BU IL DER 'S RISK
A STUDENT PROFESSIONAL LIABILITY NCR 00109-32 7/1/2018 $ 25,000 $ Included
7/1/2019 EACH OCCURRENCE
B WORKERS COMPENSATION [ J WC STATUTORY LIMIT S [ /J OTH ER
[ If EMPLOYERS' LI AB ILITY PIPS0012115 7/1/2018 $
7/1/2019 $ 1,000,000
E.L. EACH ACC IDENT
EXCESS WORKERS COMPENSATION $ 1,000,000
[ ] EMPLOYERS' LI AB ILITY $ E.L. DISEASE -EAC H EMPLOYEE
$ 1,0 00 ,000
E.L. DI SEAS E -POLICY LIMITS
OTHER $
$
DESCRIPTION OF OPERATIONS/LOCATIONSN EHICLES/RESTRICTIONS/SPECIAL PROVISIONS:
As respects to Ag reement between th e City of Cupertino and Frem ont Uni on High School Di stri ct for Edu cat iona l Classes and College Workshops
from July 1, 2018 through Saturday , June 30, 2019. * Sexual Abuse and Molestation $1,000 ,000 per occurrence.
C ERTIFI CATE HOLDER : Educationa l Clas ses CANCELLATION ...... SHOULD ANY OF THE A BO V E DESCRIBED COVERAGES BE
CA NCELED BEFORE THE EXPIRATION DATE THEREOF , THE ISS UING ENTIT Y/JPA
City of Cupertino .its council, boards and W ILL ~~),-~ MAIL 30 DAYS WR ITTEN NOTICE TO THE CERTIFICATE
HOLDERNAMEDTOTHELEFT.~~~~~~~K~~~ commissions, officers, employees and volunteers ~l:S~r'i~Ai<l~>w<t.~r'i¥f<S¥).(M¥:~~~nM~~:::SX
Attn : Daniel Mestizo ~N~ell'(~.l<ll'(~~~-
10 300 Torre Avenue ~~ Cupertino CA 95014
John Stephens AU THORIZED REPRESENT AT IVE
W\\"w cCcnsUnlmc com
2980209 I FREMOUNI1 I 18 /19 Super Poo l P&L I Frances Freeman ! 7 /3/2018 11:12:58 AM (PDT ) I Page 1 of 2
COVERED PARTY
Fremont Union High School District
ENDORSEMENT
ADDITIONAL COVERED PARTY
COVERAGE DOCUMENT
NCR 00109-32
ADMINISTRATOR
Keenan & Associates
Subject to all its terms , conditions , exclusions, and endorsements, such additional
covered party as is afforded by the coverage document shall also apply to the following
entity but only as respects to liability arising directly from the actions and activities of the
covered party described under "as respects" below.
Additional Covered Party·
City of Cupertino ,its cou ncil , boards and
co mmissions, officers, employees and vo lunteers
Attn: Daniel Mestizo
10300 Torre Avenue
Cupertino CA 95014
As Respects·
As respects to Agreement between the City of Cupertino and Fremont Union High School District for Educational
Classes and College Workshops from July 1, 2018 through Saturday , June 30 , 2019 . * Sexual Abuse and
Molestation $1,000,000 per occurrence.
The City of Cupertino, its City Council , boards and commissions, officers , employees and volunteers are named
as additional covered parties under all coverages except any professional liability coverage, required by this
Agreement.
This coverage shall be primary to the certificate holders coverage as
respects to the actions and activities of the Covered Party due to their
sole negligence .
The insurance of the Additional Covered Party shall not be called upon to
contribute to a loss covered by the Covered Party's coverage.
Issue Date 7/3/2018
2980209 I FREMOUN!l I 18 /1 9 Super Pool P&L I Frances Freeman ! 7/3/2018 11:12:58 AM (PDT ) I Page 2 of 2
Authorized Representative