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18-052 Silicon Valley Bicycle Coalition, for Bike Rodeos. li. I H~ 1d nlt l ( l V • lky J.ic · c Co, · ti on. for refer n CUPF.R ,l 0, muri i ipal ~ ,r•1tior ro fi t ("'Cons dl t ) -h ose · ddr i,\~th r fe rence o th e fol lowi1 1~: RECJ 0 /4/_0 I R, Hn u Hodo. Or l l.,_Q.,_01 , Ci: an Co r1sul ta1 lt ag ed r th e ·irst lm nt for B" ' R B. C ' f irst An: e r dn nt ar o il 1.:t i 'e l; ft:m::cl l · · lh 'I D. tor it_· a1 d Cons ilt ant d -ir e to m o d ify th e erner ton H i: t~rm · ~ d c n<f ti on · sc ro '. TIIFRE FC RI·:. i 11)· •rec:<l · an<l b ·t w e 1. he .'tr ·i · · o t e. E x c-p a fo r h · n l A~ I e pa.11 i~s h eretL Ila ·e atJ. . hi. di li ·at ion r , i1J __ -====-=P...:.;~::.::'l!::..r<1""cn=--',;"-'O;;;.::i.,_,~""c l=..,.,_r __ RECO · DEU FO H. 1u'PR AL 13:· \~~ . l"il le ~~f ! 2-j tJ--t.( h:XPl::NDITURE DI"TRIB ·101 ----,,------ PO #20JH~SU Original .Ame-ndm ,ent #I: to Ju , e _,o, .. 019 ·ooo CITY OF m CUPERTINO SERVICES AGREEMENT ($5,000 OR LESS) 1. Parties. This Agreement ("Agreement") is made and entered into as of April 4th, 2018 ("Effective Date") by and between the City of Cupertino, a municipal corporation ("City") and Silicon Valley Bicycle Coalition ("Contractor"), a-=-N-"-'o=nc..._-=c...P.c....ro'"""fi=1t _______ _ 2. Services. Contractor agrees to provide the programs, classes or activities ("Services") set forth in detail in the Scope of Services, attached and incorporated here as Exhibit A. 3. Time of Performance. This Agreement begins on the Effective Date and ends on November 29, 2018 ("Contract Time"), unless terminated earlier as provided herein. Contractor must deliver the Services in accordance with the Schedule of Performance included or attached to Exhibit A. Time is of the essence for the performance of all the Services. Contractor must have sufficient time, resources, and qualified staff to deliver the Services on time. 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 $"""5_,_0-'--0'--'0'-------- ("Contract Price"), based upon the Scope of Services and the budget and rates included in Exhibit A. The maximum compensation includes all expenses and reimbursements and will remain in place even if Contractor's actual costs exceed the capped amount. Upon City approval of written invoices, Contractor will be paid as follows: (check one; cross out others): 0 A Jump sum amount of$ 5 000 which shall not exceed the Contract Price . D At the rate of$ per hour for a total not to exceed the Contract Price. D Based on the payment schedule included or attached to Exhibit A which shall not exceed the Contract Price. 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. Contractor is not entitled to health benefits, workers compensation or other benefits from the City. Contractor must have the skills and qualifications to perform the Services in a competent and professional manner, and must be licensed , registered , and/or certified and have a City Business License. Contractor will supply all tools, materials and equipment required to perform the Services under this Agreement. 6. Assignment. This Agreement is not assignable. Contractor may not substitute another or transfer any rights or obligations under this Agreement without prior written approval of City . Only those persons w hose names are included in Exhibit A may perform the Services. Project Bicycle Rodeos Services Agreement ($5, 000)/Rev. Nov 3, 2017 Page 1 of6 7. Indemnification. To the fullest extent allowed by law and except for losses caused by the sole and active negligence or willful misconduct of City personnel, Contractor shall indemnify, defend, and hold harmless City, its City Council, boards and commissions, officers, officials, employees, agents, servants, volunteers and consultants ("lndemnitees"), through legal counsel acceptable to City, from and against any and all liab ility, damages, claims, actions, causes of action, demands, charges, losses, costs and expenses (including attorney fees, legal costs and expenses related to litigation and dispute resolution proceedings), of every nature, arising directly or indirectly from this Agreement or in any manner relating to any 9f the following: (a) Breach of contract, obligations, representations or warranties; (b) Negligent or willful acts or omissions committed during performance of the Services; (c) Personal injury, property damage, or economic loss resulting from the work or performance of Contractor or its subcontractors or sub-subcontractors; 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 Agreement. 8. Insurance. Contractor shall comply with the Insurance Requirements, attached and incorporated here as Exhibit B, and must maintain the insurance for the duration of the Agreement, or longer as required by City . City will not execute the Agreement until City approves receipt of satisfactory certificates of insurance and endorsements evidencing the type, amount, class of operations covered, and the effective and expiration dates of coverage. Failure to comply with this provision may result in City, at its sole discretion and without notice, purchasing insurance for Contractor and deducting the costs from Contractor 's compensation or tem1inating the Agreement. 9. Compliance with Laws. Contractor shall comply \Vith all laws and regulations applicable to this Agreement, included without limitation the following Jaws: Labor Laws. Contractor shall comply with all labor laws applicable to this Agreement. If the Scope of Services includes a "public works" component, Contractor is required to comply with prevailing wage laws under Labor Code Section 1720 and other labor laws . 0 Sole Proprietor. If Contractor is a sole proprietorship/individual, it must sign the Affidavit of No Employees included in this Agreement. Discrimination Laws. Contractor shall not discriminate on the basis of race, religious creed, color, ancestry, national origin, ethnicity, handicap, disability, marital status, pregnancy, age, sex, gender, sexual orientation, gender identity , Acquired-Immune Deficiency Syndrome (A IDS) or any other protected class ification. Contractor shall comply with all anti-discrimination Jaws, including Government Code Sections 12900 and 11135, and Labor Code Sections 1735 , 1777 and 3077 .5 . Consistent with City po li cy, Contractor understands that harassment and discrimination directed tov,,ard a job applicant, an employee, a City employee, or any other person, by Contractor or Contractor's employees or sub-contractors will not be to lerated. Project Bicvcle Rodeos SeNices Agreement ($5, 000)/Rev. Nov 3, 2017 Page 2 of 6 Conflicts of Interest. Contractor shall comply with all conflict of interest Jaws applicable to this Agreement and must avoid any conrnct of interest. Contractor warrants that no public official, employee, or member of a City board or commission who might have been involved in the making of this Agreement, has or will receive a direct or indirect financial interest in this Agreement, in violation of California Government Code Section 1090 et seq. Contractor may be required to file a conflict of interest form if Contractor makes certain governmental decisions or serves in a staff capacity, as defined in Section 18700 of the California Code of Regulations. Contractor agrees to abide by the City's rules governing gifts to public officials and employees. 10. Abandonment. City may abandon or postpone the Project at any time. Contractor will be compensated for satisfactory Services performed through the date of abandonment. 11. Termination. City may tenninate this Agreement for cause or without cause at any time. City reserves the right to terminate the Agreement and the remainder of the Services offered by Consultant without notice based upon Contractor's cancellation of a Service (i .e ., program , class or activity) without giving advance notice or obtaining written approval from ·city. 12. Governing Law. This Agreement is governed by the laws of the State of California. Any lawsuits filed related to this Agreement must be filed with the Superior Court for the County of Santa Clara, State of California. Contractor must comply with the claims filing requirements under the Government Code prior to filing a civil action in court . If a dispute arises, Contractor must continue to provide the Services pending resolution of the dispute . If the Parties elect arbitration, the arbitrator's award must be supported by law and substantial evidence and include detailed written findings of law and fact. 13. Entire Agreement. This Agreement represents the full and complete understanding of every kind or nature between the Parties, and supersedes any other agreement or understanding, either oral or written, between the Parties. Any changes to this Agreement will be effective only if in writing and signed by each Party's authorized representative. No verbal agreement or implied covenant will be valid to amend or abridge this Agreement. If there is any inconsistency between the main Agreement and the attachments or exhibits thereto, the text of the main Agreement shall prevail. Each provision and clause required by law for this Agreement is deemed to be inserted and will be inferred herein. 14. Services Coordinator. The Parties designate the following persons as Services Coordinators for this Agreement. Contractor 's designation and any substitution are subject to City approval. For Contractor: Ann Jasper Name Education Programs Director Position ann@bikesiliconvalley.org Contact Project Bic ,cJe Rodeos For City: Chelsea Biklen Name SRTS Coordinator Position (408) 777-7609 Contact Services Agreement ($5, 000)/Rev. Nov 3, 2017 Page 3 of 6 15. Contract Interpretation. There are no intended third party beneficiaries of this Agreement. Neither acceptance of the Services nor payment therefor shall constitute a waiver of any contract provision. City's waiver of a breach shall not constitute waiver of another provision or breach.The headings in this Agreement are for convenience only. The Indemnification and Governing Law sections expressly survive this Agreement. 16. Severability . If a term or provision of the Agreement or its application to a particular situation is found by the comi to be void, ip.valid , illegal or unenforceable, such term/ provision shall remain in effect to the extent allowed by such ruling . All other tenns and provisions of this Agreement or their application to specific situations shall remain in full force and effect. 17. Notices. All notices, demands, requests and approvals must be sent to the persons below in writing, and will be considered effective on the date of personal delivery, upon confirmation of delivery by a reputable overnight delivery service, on the fifth calendar day after deposit thereof in the United States Mail , postage prepaid, registered or certified, or the next business day following electronic submission : To C ity of Cupertino : To Contractor: Select Address Attention : Chelse a Biklen Attention: An-=nc.cJ=as=pe=r __________ _ Emai 1: chelse ab@cupertino.org Email: ann @bikesiliconvalley.org 18. Validity of Contract. This Agreement is valid and enforceable only if (a) it complies with the contract provisions of Cupertino Municipal Code Sections 3.22 and 3 .23, (b) is signed by the City Manager or an authorized designee, and (c) is approved for form by the City Attorney's Office. 19. Execution. Con tractor's signatory warrants that he or she is authorized to execute the Agreement and to legally bind Contractor. This Agreement may be e xecuted in counterparts , each one of which is deemed an original and all of which, taken together, constitute a single binding instrument. Project Bic cle Rodeos Services Agreement ($5, 000)/Rev. Nov 3, 2017 Page 4 of 6 IN WITNESS WHEREOF, t he Parties have caused the Agreement to be executed as of the Effective Date written above . CONTRACTOR CITY OF CUPERTINO A Municip ?t~n By k~ ' "f By :--=---c/1"-----~-- Name: M_ ,&Ac L :Z1MM£;'RMl·VJN Name: (f/t1dSffJ Marks Title: ~ j~{reej-t)r _, _.,.., 6 '"', 3 ° b J Tax ID. No.: I I ,~ ,-.; a 2 S-c APPROVED AS TO FORM: Title: Ct f' MAN&c::,ER .. ' ~- By: , (It;, VQ;.,,r,r .44 ~ i. -7{-/f..,~ RAN OLPH STEVENSON HOM / /J Cupertino City Attorney ATTEST: By: c1~ t4tJ>--¥ GRACE SCHMIDT, City Clerk * q,~ d -p &J.,,,,.eh/ §v#,,,.,,.;Jt,"?r ~'tl,.f,""' J,,,wJ /-&/-i ~ f~ (]..(}Y,.e..&f ?pJJ· -#.. 5Bc~,> ;_ oo5'fso1 * 3ti-b_:~) ), C. f_,,,~, ~vbm,/J? /,Jl/,,,! Zsw, S/.J,m,ef-vr/-L Proj ect Bicycle Rodeos Services Agreement ($5,000)/Rev. Nov 3, 2017 Page 5 of6 Contractor's Affidavit of No Employees State of California County of Santa Clara City of Cupertino I, the undersigned , declare as follows: I am an independent contractor and the owner of _______________ _ I wish to enter into a services contract with the City of Cupertino. I am fully aware of the provisions of section 3700 of the California Labor Code, which requires every employer to provide Workers' Compensation coverage for employees in accordance with the provisions of that Code. I am also aware that I must provide proof of workers' compensation insurance to the City of Cupertino for any and all employees I may have, pursuat'l.t to Section 12 of the City of Cupertino's contract. I hereby certify that I do not have any employees nor will I have any employees working for me or my business during the term of any service contract with the City of Cupertino. I am not required to have Workers' Compensation insurance. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on this __ day of ______ , 2018, at __________ _J California. PRINTNAME SIGNATURE Project Bicycle Rodeos Services Agreement ($5,000)/Rev. Nov 3, 2017 Page 6 of 6 Ex. A-Scope of Work to be Performed by Silicon Valley Bicycle Coalition for the City of Cupertino April 9, 2018 -November 29 1\ 2018 Task: YMCA Workshops and CUSD Bike Rodeos Silicon Valley Bicycle Coalition (SVBC) will provide bicycle and pedestrian safety education and on- bike skills training for schools during four Bike Rodeos. SVBC will provide in-class education , on-bike skills training course , and group rides for two YMCA Workshops . The City of Cupertino will: 1. Provide adequate facilities to host activities provided by SVBC SVBC will: 1. Provide staff and equipment required to conduct educational presentations, bicycle skills courses , and group rides 2. Work with City of Cupertino to schedule four Bike Rodeos 3. Work with City of Cupertino to schedule two YMCA Workshops Task Schedule • The Bike Rodeos and YMCA Workshops are scheduled to take place between April 9, 2018 and November 29th , 2018. • SVEC will arrive one hour prior to each Bike Rodeo and YMCA Workshop to set up the bike skills course Task Payment: • Cost for each Bike Rodeo is $750 , and cost for each YMCA Workshop is $1,000. Payment will be made to Silicon Valley Bicycle Coalition within 30 days following completion of contracted service. Maximum Fee for services provided to the City of Cupertino -Not to exceed $5,000 (FIVE-THOUSAND DOLLARS). EXHIBITB INSURANCE REQUIREMENTS For Services and Activities Involving Children Instructor shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder and the results of that work by the Instructor, his agents , representatives , employees or subcontractors. MINIMUM SCOPE AND LIMIT OF INSURANCE Coverage shall be at least as broad as: V 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 , either the general aggregate limit shall apply separately to this project/location (ISO CG 25 03 or 25 04) or the general aggregate limit shall be twice the required occurrence limit. J' 2. Sexual Abuse/ Molestation insurance or the equivalent are required for contracts involving children in after school activities, recreational programs, athletics, studies, transportation of students. Covers potential claims of abuse or child molestation. Sexual Abuse/Molestation coverage must be included under General Liability or obtained in separate policies in an amount of not less than $1,000,000 per occurrence ($2 ,000,000 aggregate) and $3 ,000 ,000 excess/umbrella coverage. VJ. Automobile Liability: Insurance Services Office Form Number CA 0001 covering, Code 1 (any auto), or if Instructor 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. (Note -required only if auto is used in performance of work) V4 . Workers' Compensation insurance as required by the State of California, with Statutory Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident for bodily injury or disease. (Note -required only iflnstructor has employees). If the contractor maintains broader coverage and /or higher limits than the minimums shown above, the Entity requires and shall be entitled to the broader coverage and/or higher limits maintained by the contractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the Entity. Self-Insured Retentions Self-insured retentions must be declared to and approved b y the Entity . The Entity may require the Instructor to provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention . The policy language shall provide, or be endorsed to provide, that the self-insured retention may be satisfied by either the named insured or Entity. Other Insurance Provisions The general liability policy is to contain, or be endorsed to contain, the following provisions: 1. The Entity, its officers, officials, employees, agents, and volunteers are to be covered as additional insureds with respect to liability arising out of work or operations performed by or on behalf of the Instructor including materials, parts or equipment furnished in connection with such work or operations. 2. For any claims related to this contract, the Instructor's insurance coverage shall be primary insurance coverage at least as broad as ISO CG 20 01 04 13 as respects the Entity, its officers, officials, employees, agents, and volunteers. 3 . The Insurance Company agrees to waive all rights of subrogation against the Entity, its elected or appointed officers, officials, agents, and employees for losses paid under the terms of any policy which arise from work performed by the Instructor for the Entity. This provision also applies to the Instructor 's Workers' Compensation policy. 4. Each insurance policy required above shall provide that coverage shall not be canceled, except with notice to the Entity. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best's rating of no less than A: VII, unless otherwise acceptable to the Entity. Verification of Coverage Instructor shall furnish the Entity with original certificates and amendatory endorsements effecting coverage required by this clause. All certificates and endorsements are to be received and approved by the Entity before work commences. The Entity 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. We strongly recommend obtaining a copy of the policy declarations and endorsement page (make this a requirement in your Contract) to facilitate verification of coverages and spot any undesirable policy limitations or exclusions. Homeowner's Insurance In some cases the Instructor's homeowner's liability insurance may provide coverage sufficient to meet these requirements. Instructor should provide these requirements to his or her agent to confirm and provide verification to the Entity. Special Events Coverage for Instructors Special events coverage is available for an additional fee to provide the liability insurance required by this agreement. Instructor can obtain additional information and cost from the Entity. Special or Low Risk Activities Entity reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. The Entity reserves the right to modify or waive insurance requirements for certain low risk recreational activities. ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) '----/ 04711 72018 T HIS CERTIFICATE IS ISSUED AS A MATIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. T HIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND , EXTEND OR ALTER T HE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITU T E A CONT RACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND T HE CERTIFICATE HO L DER. IMPORTANT: If the certificat e holder is an ADDITIO N AL INSURED , the policy(ies) must have ADDITIONAL INSURE D provisions or be endorsed. If SUBROGATION IS WAIVED , subject to the terms and cond itions of t he policy, certain policies m ay requi r e an endorseme nt. A st at ement on this certificate does not conf er rights t o t he certificat e holder in lieu of such endorsement(s). PRODU CER CO NTACT NAM E: Ame ri can Specialty Insura nce & Risk Services, Inc . r:,gN~o E·"· 260 -969-5203 I FAX IAJC Nol : 260 -969-4 729 dba A.S .I.R.S .I. Insurance Age ncy E-MAI L ADDRESS : 7609 W . Jeffe rso n Blvd ., Sui te 100 INSU R ER IS l AF FORDI NG COVERAGE NAI C # Fort Wayne IN 46804 INSUR E R A : Arch Insu ra nce Company 11150 INS URED INS URE R B : Leag ue of American Wheelm e n dba Leag ue of Ame r ican Bicyclists INSURER C : 1612 K Street NW, Suite 1102 INSU RER D : INSU RER E·: Washi ngton DC 20006 INSURER F: COVERAGES CERTIFICATE NUMBER : 1001525465 REVISION NUMB E R: TH IS IS TO CERTIFY THAT THE POLIC IES OF INS URANCE LISTED BELOW HAVE BEE N ISS UED TO TH E INSUR ED NAMED ABO VE FOR THE POLICY PERIO D IND ICAT ED . NOTWI THS TAN DING ANY REQU IREMEN T . TERM OR COND IT ION OF ANY CONTRACT OR OTH ER DOCUM ENT WITH RESPEC T TO WH ICH TH IS CERT IF ICATE MAY BE ISS UED OR MAY PERTAIN , THE INSURANC E AFF OR DED BY T HE POLI CIES DESCR IBED HEREIN IS SUBJ ECT TO ALL THE TERMS , EXCLUSIONS AND COND IT IONS OF SUCH POLI CI ES. LI MI TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR A DD L SUBR POLIC Y EFF PO LICY EXP LTR TYPE OF IN SU RA NCE '"'"n WV D PO LICY NUM BER IMM /DD /YYYYl IMM/DD/YYYYl LIM ITS X CO MM ERCIAL GENERAL LI A BILI TY EA CH OCC UR REN CE $ 1,000,000 \/ c--:=J CLAIM S-MA DE Ix] OC CUR DAMAGE TO RE NTED PR EMI SES /Ea occurrence) $ 1 ,000,000 MED EXP (A ny one perso n) $ Ex cluded -A y SBCGL005450 1 02/01 /2018 02/01 /2019 PE RS ON AL & ADV INJURY $ 1 ,000 ,000 c-- GEN'L AGGRE GATE LIMI T APPL IES PER: GENERAL AGG RE GAT E $ 5,000 .000 V Fxl D PRO-DLOC PR ODUCTS· COMP/OP AGG $ 5,000,000 POLIC Y JE CT OTHER : C LUB $ AUTOMO BILE LI A BILITY COMBI NED S IN GLE LIM IT $ !Ea accid ent) ~ ANY AUTO BO DILY INJURY (Per pe rso n ) $ 1--OWNED -SC H EDULED BO DILY INJU RY (Per accident) $ ~ AUTOS ON LY -A UTOS HI RED NO N-OWNED PRO PERTY DAMAG E $ AUTOS ONLY AUTOS ONLY /P er accident\ ~ - $ UMBRE LLA LI AB H OCCUR EA CH OCCURR ENCE $ ~ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DE D I I RETE NT IO N $ $ WO RK ERS CO M PE NSATIO N I PER I I OTH- AND EM PLOYERS' LI A BILITY STATUTE ER Y/N AN YPRO PRIETO R/PA RTNE R/EXECUTI VE D N/A E.L. EAC H ACCIDENT $ OFFIC ER/MEMB ER EXCLU DED ? (Ma ndat ory i n NH ) E.L. D IS EASE· EA EMPL OYE E $ If yes, describe un der DE SCRI PTI ON OF OP ERATI ONS be low E.L. DI S EA SE · POLIC Y LI MIT $ DES CRIPTI ON OF OPE RA TIONS / LOCATION S/ VEHI CLES (ACO RD 101, Ad d iti on al Rema rks Sc hed ule, m ay b e attac h ed if more s p ace is r equired) -Coverage app lies to S ILICON VALLE Y BICYC LE COALIT ION, 96 N. 3R D STREET , S U IT E 375 , SA N JOS E , CA 951 12 . -Tne Ce rt ificate Ro la e r sna n 6e an A dd itio na l lns urea , 6ut o nly witn respect to tne ope rat io ns of tne l'famed In su red, ana su6Je ct to tne provis io ns and limitat ions of For m 008 GL002900 Addi tional Ins ured -D es ignated Pe rson or Orga n ization Writte n Contract o r W ritten Agre ement, bu t on ly w ith res pect to SCHEDULED SCHOO L BI KE RO DE OS from Apri l 02, 2018 thro ugh J une 30, 2018 . CERTIFICATE HOLDER CA NCELLATION TH E C IT Y OF C UP ERTI NO 10300 TORR E AV E. SHOULD A NY OF THE ABOVE DESCRIBED POLICIE S BE CA NCELLED BEFORE CU PE RTI NO , CA 95014 THE EXPIRATIO N DA TE THE RE OF , NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS . A UTH OR IZED REP RESE NTATIVE D~J I © 1988-2015 ACORD CORPORATION . All r ights reserved . ACORD 25 (2 016/03) T he A C ORD name and logo a r e regist e r ed mar k s o f ACORD POLICY NUMBER: SBCGL0054501 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION WRITTEN CONTRACT OR WRITTEN AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II -WHO IS AN INSURED is amended to include as an additional insured, any person or organization you are required to add as an additional insured to this policy by written contract or written agreement which is : 1. Currently in effect or coming into effect during the term of this policy; and 2. Executed prior to the occurrence of any "property damage ", "bodily injury", or "personal and advertising injury". It is further understood and agreed that SECTION II -WHO IS AN INSURED is amended to also include as an additional insured, any person or organization designated in the Schedule below. SCHEDULE Additional Insured: Any Certificate Holder identified as an additional insured on a Certificate of Insurance issued by American Specialty Insurance & Risk Services, Inc. dba A.S.I.R.S.I. Insurance Agency, American Specialty Insurance & Risk Services Agency, and AS Insurance & Risk Services Agency Coverage provided to any additional insured designated in the Schedule applies as follows : That person or organization is an additional insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you . However: 1. The insurance afforded to such additional insured only applies to the extent permitted by 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. B. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: 00 SGL0029 00 10 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 If coverage provided to the additional insured is required by a contract or agreement , the most we will pay on behalf of the additional insured is the amount of insurance : 1. Required by the contract or agreement; or 2 . Available under the applicable Limits of Insurance shown in the Declarations; whichever is less . This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations . All other terms and conditions remain unchanged. 00 SGL0029 00 10 16 Includes copyrighted material of Insurance Services Office, Inc ., with its permission. Page 2 of 2 AGENCY CUSTOMER ID: -------------------- LO C #: -------- ADDITIONAL REMARKS SCHEDULE Page 1 AGENCY NAMED INSURED American Specialty Insurance & Risk Services , Inc. League of American Wheelmen dba League of American Bicyclists POLICY NUMBER 1612 K Street NW , Suite 1102 SBCGL0054 501 CARRIER I NAIC CODE Washington , DC 20006 Arch ln·soranc·e Comp·any 11150 EFFECTIVE DATE: 02/01/2018 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: CEHTIFICATE OF LIABILITY II\ISORAI\ICE -Certificate #'10015"254:65 _ Serna! Abase oc Molestaboo co.,,age -$25,000 each o~c=are~25,000 aggrngate 7 6tJ ,_;P/- F i3,J/ of 1 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A C O ·R ,j;, I DATE (MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE ~-04/02/2018 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 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). PRODUCER CONTACT NAME: American Specialty Insurance & Risk Services, Inc. PHONE 260-969-5203 I FAX 260-969-4729 IA/C No Extl : IA/C Nol: dba A.S .I.R.S .I. Insurance Agency E-MAIL ADDRESS : 7609 W. Jefferson Blvd ., Suite 100 INSURER/SI AFFORDING COVERAGE NAIC# Fort Wayne IN 46804 INSURER A : Arch Insurance Company 11150 INSURED INSURER B: Silicon Valley Bicycle Coalition INSURER C: 96 North Third Street , Suite 375 INSURER D : P.O. Bo x 1927 INSURER E : San Jose CA 95109 INSURER F: COVERAGES CERTIFICATE NUMBER: 1001523650 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIC Y PERIOD INDICATED . NOTWITHSTANDING ANY REQUIREMENT , TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES . LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE ,.,en IAR/n POLICY NUMBER IMM/DD/YYYYl IMM/DD/YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ ~ D CLA IMS-MADE D OCCUR DAMAGE TU RENTED PREMISES IEa occurrencel $ MED EXP (Any one person) $ - PERSONAL& ADV INJURY $ - GEN 'L AGGR EGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ =l D PR O-O Loc PRODUCTS· COMP/OP AGG $ POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SIN GLE LIMIT $ I Ea acc ident\ -ANY AUTO BODILY INJURY (Per person) $ -OWNED -SCHEDULED A AUTOS ONLY AUTOS SBAUT0044600 02/01/2018 02/01/2019 BODILY IN JURY (Per ac cide nt) $ x HIRED x NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY rPer accident! NON-OWNED/HIRED AUTO $ 1,000 ,000 v UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ -EXCESS LIAB CLAIMS-MADE AGGR EG ATE $ OED I I RETENTION $ $ WORKERS COMPENSATION I PER I I OTH - AND EMPLOYERS ' LIABILITY STATUTE ER Y/N AN YPROPRIETOR/P ARTNER/EXECUTI VE D N/A E.L. EACH ACC IDENT $ OFF IC ER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ If yes , describe under DESCRIPTION OF OP ER ATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101 , Addltlonal Remarks Schedule , may be attached If more space is required) -Evidence of coverage as respects to the ON-CAMPUS BIKE RODEOS FOR ELEMENTARY AND MIDDLE SCHOOLS, EFFECTIVE APRIL 2 , 2018. -The following physical damage deductibles apply to the Automobile Liability policy: HIRED AUTOS -Collision $1,000 For Each Covered Auto ; Comprehensive $1,000 For Each Covered Auto . CERTIFICATE HOLDER CANCELLATION City of San Mateo , their elected and appointed officials, employees , and agents SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS . 330 West 20th Avenue AUTHORIZED REPRESENTATIVE [2~·~ San Mateo CA 94403 I © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ACORD® CERTIFICATE OF LIABILITY INSURANCE I DAT E (MM IDD /YYYY) ~ 4/3/2018 THIS CERTIFICATE IS ISSUED AS A M ATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATI V ELY O R NEGATIVELY AMEND , EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TH IS CERTIFICATE OF INSURA.N CE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AN D THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an AD D ITIONAL INSURED , the policy(ies) must h ave ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subj ect t o t h e terms and conditi ons of t he policy, certain policies may requ i re an endor sement. A statement on this certificate does not confer rights to t he ce rt ifica te holder in lieu of such endorsement (s ). PRODUCE R CO NTACT N AME : PHONE (800) 533-7215 I FAX (866) 828-2424 l d /C Nn ~xtl: (A/C Nol : H UB I NTE RNATI ONAL INS S ERV ICES IN C E-MAIL Ce rt ificate@ H a nove r .co m ADDRESS: PO BOX 4047 INSURER(S ) A FF ORDI NG COVERAGE NAIC # CONCOR D CA 94524 IN SURE R A : Citizens Ins Co of America 3 1534 INSURED INSURERS : S ILI CON VALLE Y BI CYC LE IN SU RERC : COALITI ON IN SURERD: PO BOX 1927 IN SURER E : SAN JOSE CA 95 1 09 IN SUR ER F : COVERAGES CER T IFICAT E NUMBER: REVISION NUMBER: THI S IS TO CERTI FY THAT THE PO LI CI ES OF INSURANCE LI STED BELOW HAVE BEE N ISSUED TO THE INSURE D NAM ED ABOV E FOR THE POLICY PE RIOD INDI CATED . NO TWITH STAND ING ANY REQ UI REMEN T, TE RM OR CON DIT ION OF ANY CON T RAC T OR OTHE R DOC UMENT WI TH RESP ECT TO WH ICH T HI S CERT IFI CATE MAY BE ISSU ED OR MAY PERTA IN, THE INSURANCE AFF OR DED BY TH E POLICIES D ESCRIBED HE REI N IS SUBJ ECT TO ALL THE TE RMS, EXCLUSIONS AN D COND IT IONS OF SUCH P OLI C IE S. LI MIT S SHOWN MAY HAV E BEE N RED UC ED BY PA ID CLA IMS. IN SR ADDL SUBR POLIC Y EFF POLICY EXP LT R TYPE OF INSU RA NCE INSD WVD POLI CY N UMBER /MM/DD /YYYY\ /MM/DD /YYYY\ LI MITS CO MME RCIAL GENERAL LI A BILITY E ACH OCCURRENC E $ f--D CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES /Ea occu rrence) $ f-- MED EXP (Any one person) $ PERSONAL & ADV INJURY $ f-- GEN'L AGGR EGATE LIMIT APPLIES PER: GEN E RAL AGGREGATE $ R DPRO-O Loc P RODUC TS -COMP/OP AGG $ POLICY JECT OTHER: $ AUTO MOBILE LI ABILITY COMBINED SING LE LIMIT $ (Ea accident) f-- ANY AUTO BODILY INJURY (Per person) $ ~ OWN ED -SCH EDULED BODILY INJURY (Per accident) $ f--AUTOS ON LY -AUTOS HIRED NON-OWNED PROP ERTY DAMAG E $ AUTOS ONLY AUTOS ONLY /Per accident\ ~ - $ UMBRELLA LIAB H OCCUR E ACH OCC U RR ENC E $ - EXCE SS LIAB CLAIMS-MADE AGGR EGATE $ DED I I RETENTION $ $ WORK ERS COMPEN SATIO N ,/ I ~lrf TU TE I I OTH- A ND EMPLOYE RS' LIABILITY ER Y /N 1,000,000 \/ A ANYPROPRIETOR/PARTNER/EXECUTIVE @] N/A N W BF A84850 0 03 05/01/20 18 05/0 1/2019 E.L. EACH ACCIDENT $ OFFICER/M EMBER EXCLUDED? (Man da t ory In NH) E .L. DISEASE· EA EMPLOYEE $ 1,000,000 If yes, describe under DESCR IPTION OF OPERATIONS below E.L. DISEAS E · POLICY LIMIT $ 1,000,000 DES CRIPT IO N OF OPE RATI O NS / LOC A TIO NS / VE H ICLES (AC O RD 101 , A ddition al Rema r ks Sch ed ule, m ay be attac h ed if more space is r equired) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CA NCELLED BEFORE THE EXPIRATION DATE THEREOF , NOT ICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVIS IONS . THE C ITY O F C UPE RTI NO AUTHORIZ ED REPRESENTATIVE 10300 T ORR E AVENU E S LfJltOne,ShetleY CUP E R TI NO CA 950 14 I © 1988 -2 015 ACORD COR P ORA T ION. All rights reserved. ACORD 25 (2016/03) The AC ORD name an d logo are registered marks of ACORD POLICY NUMBER: SBCGL0054501 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED-DESIGNATED PERSON OR ORGANIZATION WRITTEN CONTRACT OR WRITTEN AGREEMENT Th is endorsement modifies insurance provided under the following : COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II -WHO IS AN INSURED is amended to include as an additional insured , any person or organization you are required to add as an additional insured to this policy by written contract or written agreement which is : 1. Currently in effect or coming into effect during the term of this policy ; and 2. Executed prior to the occurrence of any "property damage ", "bodily injury", or "personal and advertising injury". It is further understood and agreed that SECTION II -WHO IS AN INSURED is amended to also include as an additional insured, any person or organization designated in the Schedule below . SCHEDULE Additional Insured: Any Certificate Holder identified as an additional insured on a Certificate of Insurance issued by American Specialty Insurance & Risk Services , Inc. dba A.S.I.R.S.I. Insurance Agency, American Specialty Insurance & Risk Services Agency, and A S Insurance & Risk Services Agency Coverage provided to any additional insured des ignated in the Schedule applies as follows : That person or organization is an additional insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advert ising injury" caused in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you . However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law ; and 2 . If coverage provided to the add itional insured is requ ired by a con tract or agreement , the insurance afforded to such addit ional insured will not be broader than that which you are requ ired by the contrac t or agreement to provide for such addi t ional insured . 8 . With respect to the insurance afforded to t hese addit ional insu reds , the follow ing is added to Section Ill -Lim its Of Insurance : 00 SGL0029 00 10 16 Includes copyrighted material of Insurance Serv ices Office , Inc ., with its permiss ion . Page 1 of 2 If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional Insured is the amount of insurance : 1 . Required by the contract or agreement: or 2. Available under the applicable Limits of Insurance shown in the Declarations: whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions remain unchanged. 00 SGL0029 00 10 16 -------···--··-----·---- Includes copyrighted material of Insurance Services Office , Inc., with its permission. Page 2 of 2