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24-006 Amendment #1 dated 12-20-24 Charles E Jones Enterprises for Leading and Managing Meetings1 FIRST AMENDMENT TO AGREEMENT 826 BETWEEN THE CITY OF CUPERTINO AND JONES ENTERPRISES FOR LEADING AND MANAGING MEETINGS This First Amendment to Agreement 826 is by and between the City of Cupertino, a municipal corporation (hereinafter "City") and Jones Enterprises, a (“Contractor”) whose address is 1005 Whiteoak Drive, San Jose, CA 95129, and is made with reference to the following: RECITALS: A. On January 16, 2024 Agreement 826 (“Agreement”) was entered into by and between City and Contractor for Leading and Managing Meetings, with a term expiring December 31, 2024. B. City and Contractor desire to modify the Agreement on the terms and conditions set forth herein. NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows: 1. Paragraph 3.1 of the Agreement is modified to read as follows: This Agreement begins on the Effective Date and ends on December 31, 2025 (“Contract Time”), unless terminated earlier as provided herein. Contractor’s Services shall begin on the effective date and shall be completed by December 31, 2025. 2. Paragraph 3.2 of the Agreement is modified to read as follows: 3.2 Schedule of Performance. Contractor must deliver the Services in accordance with the Schedule of Performance, attached and incorporated here as Exhibit B-1. Exhibit B to the Agreement is replaced with Exhibit B-1, attached hereto. 3. Except as expressly modified herein, all other terms and covenants set forth in the Agreement shall remain the same and shall be in full force and effect. SIGNATURES CONTINUE ON THE FOLLOWING PAGE 2 IN WITNESS WHEREOF, the parties hereto have caused this modification of Agreement to be executed. CITY OF CUPERTINO By Title Date APPROVED AS TO FORM City Attorney ATTEST: City Clerk Date JONES ENTERPRISES By Title Date Charles E Jones Jr Owner 12/20/2024 Christopher D. Jensen City Manager 12/20/2024 Kirsten Squarcia 12/20/2024 3 EXPENDITURE DISTRIBUTION Agreement Amount Original 10,000.00 1st Amendment No Increase Total 10,000.00 EXHIBIT B-1 Schedule of Performance The Services shall commence upon execution of the agreement and shall continue through December 31, 2025. Exh. D-Insurance Requirements for Consulting Agreement with Jones Enterprises 1 Rev: December 2024 Consultant shall procure prior to commencement of Services and maintain for the duration of the contract, at its own cost and expense, the following insurance policies and coverage with companies doing business in California and acceptable to City. INSURANCE POLICIES AND MINIMUMS REQUIRED 1. Commercial General Liability (CGL) for bodily injury, property damage, personal injury liability for premises operations, products and completed operations, contractual liability, and personal and advertising injury with limits no less than $2,000,000 per occurrence (ISO Form CG 00 01). If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO Form CG 25 03 or 25 04) or it shall be twice the required occurrence limit. a. It shall be a requirement that any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits shall be made available to the Additional Insured and shall be (i) the minimum coverage/limits specified in this agreement; or (ii) the broader coverage and maximum limits of coverage of any insurance policy, whichever is greater. b. Additional Insured coverage under Consultant's policy shall be "primary and non-contributory," will not seek contribution from City’s insurance/self-insurance, and shall be at least as broad as ISO Form CG 20 10 (04/13). c. The limits of insurance required may be satisfied by a combination of primary and umbrella or excess insurance, provided each policy complies with the requirements set forth in this Contract. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary basis for the benefit of City before the City’s own insurance or self- insurance shall be called upon to protect City as a named insured. 2. Automobile Liability: Business Automobile Liability insurance is not required under this Agreement except in the event Consultant uses vehicles in the operation of its business to provide services under this Agreement, Consultant shall, prior to such use, provide the City with evidence of Business Automobile Liability insurance coverage in the amount of one million dollars ($1,000,000) combined single limit per accident for owned, non-owned and hired vehicles (All Autos-Symbol 1). Evidence shall be provided with a Certificate of insurance, along with an additional insured endorsement in favor of the City, primary and non-contributory coverage and endorsement, and Waiver of Subrogation coverage and endorsement under the policy prior to the use of any automobile. 3. Workers’ Compensation: As required by the State of California, with Statutory Limits and Employer’s Liability Insurance of no less than $1,000,000 per occurrence for bodily injury or disease. [X] Not required. Consultant has provided written verification of no employees. 4. Professional Liability for professional acts, errors and omissions, as appropriate to Consultant’s profession, with limits no less than $2,000,000 per occurrence or claim, $2,000,000 aggregate. If written on a claims made form: a. The Retroactive Date must be shown and must be before the Effective Date of the Contract. b. Insurance must be maintained for at least five (5) years after completion of the Services. c. If coverage is canceled or non-renewed, and not replaced with another claims-made policy form with a Retroactive Date prior to the Contract Effective Date, the Consultant must purchase “extended reporting” coverage for a minimum of five (5) years after completion of the Services. EXHIBIT D Insurance Requirements Exh. D-Insurance Requirements for Consulting Agreement with Jones Enterprises 2 Rev: December 2024 OTHER INSURANCE PROVISIONS The aforementioned insurance shall be endorsed and have all the following conditions and provisions: Additional Insured Status The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers (“Additional Insureds”) are to be covered as additional insureds on Consultant’s CGL and automobile liability policies. General Liability coverage can be provided in the form of an endorsement to Consultant’s insurance (at least as broad as ISO Form CG 20 10 (11/ 85) or both CG 20 10 and CG 20 37 forms, if later editions are used). Primary Coverage Coverage afforded to City/Additional Insureds shall be primary insurance. Any insurance or self-insurance maintained by City, its officers, officials, employees, or volunteers shall be excess of Consultant’s insurance and shall not contribute to it. Notice of Cancellation Each insurance policy shall state that coverage shall not be canceled or allowed to expire, except with written notice to City 30 days in advance or 10 days in advance if due to non-payment of premiums. Waiver of Subrogation Consultant waives any right to subrogation against City/Additional Insureds for recovery of damages to the extent said losses are covered by the insurance policies required herein. Specifically, the Workers’ Compensation policy shall be endorsed with a waiver of subrogation in favor of City for all work performed by Consultant, its employees, agents and subconsultants. This provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer. Deductibles and Self-Insured Retentions Any deductible or self-insured retention must be declared to and approved by the City. At City’s option, either: the insurer must reduce or eliminate the deductible or self-insured retentions as respects the City/Additional Insureds; or Consultant must show proof of ability to pay losses and costs related investigations, claim administration and defense expenses. The policy shall provide, or be endorsed to provide, that the self-insured retention may be satisfied by either the insured or the City. Acceptability of Insurers Insurance shall be placed with insurers admitted in the State of California and with an AM Best rating of A- VII or higher. Verification of Coverage Consultant must furnish acceptable insurance certificates and mandatory endorsements (or copies of the policies effecting the coverage required by this Contract), and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements prior to commencement of the Contract. City retains the right to demand verification of compliance at any time during the Contract term. Subconsultants Consultant shall require and verify that all subconsultants maintain insurance that meet the requirements of this Contract, including naming the City as an additional insured on subconsultant’s insurance policies. Higher Insurance Limits If Consultant maintains broader coverage and/or higher limits than the minimums shown above, City shall be entitled to coverage for the higher insurance limits maintained by Consultant. Adequacy of Coverage City reserves the right to modify these insurance requirements/coverage based on the nature of the risk, prior experience, insurer or other special circumstances, with not less than ninety (90) days prior written notice. Hiscox Insurance Company Inc. 104 South Michigan Avenue, Suite 600, Chicago, IL 60603-5950 November 17, 2024 Charles E Jones Jr 1005 White Oak Dr San Jose, CA 95129 Named Insured: Charles E Jones Jr Policy: Professional Liability Insurance Policy Number: P102.753.902.2 NOTICE OF RENEWAL Dear Charles E Jones Jr, Thank you for choosing Hiscox to protect your business. It’s been our pleasure to serve you this past year. As your next period of coverage approaches, we want to make you aware of certain changes that will go into effect when your policy renews. Important Policy Information: Your new period of policy coverage is scheduled to begin on January 1, 2025 at which time your current policy will expire. Please see your new policy documents enclosed and review them carefully, as the following updates have been made to your policy. ●New Endorsement - Anti-Stacking Endorsement (Single Limit) DPL E0005 CW (12/23) ●New Endorsement - Misappropriation of Funds Exclusion Endorsement DPL E0003 CW (08/23) Important Premium Information: We've updated your policy to account for year-over-year economic trends and the average rate of business growth so that your business can maintain a sufficient level of coverage. If you have made any changes to your business, it is important to let us know so that we can customize your policy accordingly. Your annual revenues are estimated to be $11,000.00. Your annual premium for your next period of coverage is $560.00. Your payment(s) will be collected in the amount(s) and on the date(s) outlined in the billing summary also enclosed, and they will be charged to the same account you provided to us. Important Reminders: Your business doesn't stand still, and neither should your insurance. Each new policy year is a good opportunity to review your coverage against any changes in your business to make sure your policy still fits your needs. Have any of the following happened in the last year? ●Your business grew or reduced gross sales or payroll by more than 25%. ●You have merged with or acquired another organization. ●Your business operations or services changed. ●Someone else bought your business. ●You or your business had a claim made against you or experienced a loss. ●Your card or payment information on file with Hiscox has changed. If any of these took place, or if you have any questions about your renewing policy, please call us at 855-740-2349 and have your policy number ready so we can discuss the relevant details with you. If we do not hear from you, your policy will renew based on the information we already have on file, at our current rates. Your next period of coverage will then start on the date referenced above. We look forward to helping protect your business for another year. Sincerely, Hiscox Hiscox Insurance Company, Inc. Notice of Conditional Renewal of Insurance Policy Page 1 of 2 HIC-NOCR-02012021 Name and Address of Insured:Insured Charles E Jones Jr DBA Jones Enterprises Street Address 1005 White Oak Dr City, State, Zip Code San Jose, CA, 95129 Policy Information: Type of Policy Professional Liability Policy Number P102.753.902.2 Effective Date of Notice 01/01/2025 12:01 A.M. Standard Time Date of Mailing 10/18/2024 Applicable Item(s) will be Marked. Name and Address of Agent/Broker:Agent/Broker Street Address City, State, Zip Code You are notified in accordance with the terms and conditions of the policy described above, and in accordance with applicable state law, that the policy premium will be changed effective on the date indicated above under EFFECTIVE DATE OF NOTICE. Change in Policy Premium Expiring Premium: Renewal Premium: Change in Policy Coverage X You are notified in accordance with the terms and conditions of the policy described above, and in accordance with applicable state law, that the policy coverage will be changed as follows, effective on the date indicated above under EFFECTIVE DATE OF NOTICE: Your policy will contain a Misappropriation of Funds Exclusion Endorsement, which precludes claims involving theft, misappropriation, commingling, conversion, or failure to safeguard funds, monies, assets, or property, regardless of ownership. This may result in a reduction of coverage. Your renewal policy will contain an Anti-Stacking Endorsement, which caps payments for covered claims, related claims, or occurrences that are also covered by another Hiscox policy to the highest available limit under any one policy. This may result in a reduction of coverage. Important Notice See below. NOTICE TO MARYLAND INSUREDS: If you have questions regarding the change in coverage and/or increase in premium, you may contact your Company Representative at the following number: (800) 867-4001 NOTICE TO NEW JERSEY INSUREDS: Coverage will cease on the EFFECTIVE DATE OF NOTICE indicated above, if premium is not paid by that date indicated in the billing notice. NOTICE TO NEW YORK INSUREDS: The first Named Insured or his/her authorized agent/broker may request in writing loss information with respect to this policy and previous policies we have written for you. Please direct all such requests to USClaimsLossRuns@Hiscox.com. We will provide this information within 10 days from the date we receive your request. Hiscox Insurance Company, Inc. Notice of Conditional Renewal of Insurance Policy Page 2 of 2 HIC-NOCR-02012021 NOTICE TO UTAH INSUREDS: Failure to pay the renewal premium by the EFFECTIVE DATE OF NOTICE shown above extinguishes your right to renewal. NOTICE TO VIRGINIA INSUREDS: You have the right, within 15 days of receipt of this notice, to request in writing, the Commissioner of Insurance review this action. Virginia Bureau of Insurance, P.O Box 1157, Richmond, VA 23218-1157. NOTICE TO WISCONSIN INSUREDS: You have the right to cancel the policy before the EFFECTIVE DATE OF NOTICE shown above. Appointed Representative Hiscox Insurance Company, Inc. Hiscox Insurance Company, Inc. Notice of Conditional Renewal of Insurance Policy Page 1 of 2 HIC-NOCR-02012021 Name and Address of Insured:Insured Charles E Jones Jr DBA Jones Enterprises Street Address 1005 White Oak Dr City, State, Zip Code San Jose, CA, 95129 Policy Information: Type of Policy Businessowners Policy Policy Number P102.753.903.2 Effective Date of Notice 01/01/2025 12:01 A.M. Standard Time Date of Mailing 10/18/2024 Applicable Item(s) will be Marked. Name and Address of Agent/Broker:Agent/Broker Street Address City, State, Zip Code You are notified in accordance with the terms and conditions of the policy described above, and in accordance with applicable state law, that the policy premium will be changed effective on the date indicated above under EFFECTIVE DATE OF NOTICE. Change in Policy Premium Expiring Premium: Renewal Premium: Change in Policy Coverage X You are notified in accordance with the terms and conditions of the policy described above, and in accordance with applicable state law, that the policy coverage will be changed as follows, effective on the date indicated above under EFFECTIVE DATE OF NOTICE: In order to mitigate the effect of a rising trend in loss costs, Hiscox has changed its policy terms and conditions. As a result, your policy for the new policy period will include the following changes: Your renewal policy will contain an Anti-Stacking Endorsement, which caps payments for covered claims, related claims, or occurrences that are also covered by another Hiscox policy to the highest available limit under any one policy. This may result in a reduction of coverage. Important Notice See below. NOTICE TO MARYLAND INSUREDS: If you have questions regarding the change in coverage and/or increase in premium, you may contact your Company Representative at the following number: (800) 867-4001 NOTICE TO NEW JERSEY INSUREDS: Coverage will cease on the EFFECTIVE DATE OF NOTICE indicated above, if premium is not paid by that date indicated in the billing notice. NOTICE TO NEW YORK INSUREDS: The first Named Insured or his/her authorized agent/broker may request in writing loss information with respect to this policy and previous policies we have written for you. Please direct all such requests to USClaimsLossRuns@Hiscox.com. We will provide this information within 10 days from the date we receive your request. Hiscox Insurance Company, Inc. Notice of Conditional Renewal of Insurance Policy Page 2 of 2 HIC-NOCR-02012021 NOTICE TO UTAH INSUREDS: Failure to pay the renewal premium by the EFFECTIVE DATE OF NOTICE shown above extinguishes your right to renewal. NOTICE TO VIRGINIA INSUREDS: You have the right, within 15 days of receipt of this notice, to request in writing, the Commissioner of Insurance review this action. Virginia Bureau of Insurance, P.O Box 1157, Richmond, VA 23218-1157. NOTICE TO WISCONSIN INSUREDS: You have the right to cancel the policy before the EFFECTIVE DATE OF NOTICE shown above. Appointed Representative Hiscox Insurance Company, Inc. INSURER(S) AFFORDING COVERAGE NAIC # INSURER F : INSURER E : INSURER D : NAME:CONTACT INSURER C : INSURER B : (A/C, No):FAX E-MAILADDRESS: CUSTOMER ID: PRODUCER PRODUCER (A/C, No, Ext):PHONE INSURED INSURER A : The ACORD name and logo are registered marks of ACORD 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. LOCATION OF PREMISES / DESCRIPTION OF PROPERTY (Attach ACORD 101, Additional Remarks Schedule, if more space is required) REVISION NUMBER:CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGES $$ $BOILER & MACHINERY / EQUIPMENT BREAKDOWN $ $ $ TYPE OF POLICY CRIME POLICY NUMBER $ $ $ $ NAMED PERILS CAUSES OF LOSS TYPE OF POLICYINLAND MARINE $ RENTAL VALUE CONTENTS BUILDING DEDUCTIBLES WIND $ $ $ $ $ $ $ $ $ BLANKET BLDG & PP BLANKET PERS PROP BLANKET BUILDING EXTRA EXPENSE BUSINESS INCOME PERSONAL PROPERTY BUILDING FLOOD EARTHQUAKE SPECIAL BROAD BASIC CAUSES OF LOSS PROPERTY POLICY EXPIRATION DATE (MM/DD/YYYY) POLICY EFFECTIVE DATE (MM/DD/YYYY) INSR LTR LIMITSCOVERED PROPERTYPOLICY NUMBERTYPE OF INSURANCE $$ $ SPECIAL CONDITIONS / OTHER COVERAGES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) © 1995-2015 ACORD CORPORATION. All rights reserved. ACORD 24 (2016/03) AUTHORIZED REPRESENTATIVE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CANCELLATION CERTIFICATE OF PROPERTY INSURANCE DATE (MM/DD/YYYY) CERTIFICATE HOLDER 844-357-0403Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA 5 Concourse Parkway Suite 2150 Atlanta GA, 30328 The City of Cupertino, its city counsels, officers, officials, agents, servants and volunteers 1005 White Oak Dr San Jose, CA 95129 P102.753.903.1 A Hiscox Insurance Company Inc.10200 Charles E Jones Jr DBA Jones Enterprises 1005 White Oak Dr San Jose, CA 95129 X X $ 1,000 01/01/2024 01/01/2025 $ 10,000X X X contact@hiscox.com 12/10/2024 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS AUTOSAUTOS NON-OWNEDHIRED AUTOS SCHEDULEDALL OWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD MTTU Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA 5 Concourse Parkway Suite 2150 Atlanta GA, 30328 (888) 202-3007 contact@hiscox.com Hiscox Insurance Company Inc 10200 Charles E Jones Jr DBA Jones Enterprises 1005 White Oak Dr San Jose, CA 95129 The City of Cupertino, its city counsels, officers, officials, agents, servants and volunteers 1005 White Oak Dr San Jose, CA 95129 01/01/202501/01/2024P102.753.903.1Y CGL is on BOP Form X A X X X 2,000,000 0 10,000 2,000,000 2,000,000 2,000,000 12/10/2024 A Guide To Your Professional Liability Policy © Hiscox Inc. 2010 Page 1 The following is a guide to your Professional Liability policy. We have identified several key coverage items along with the limits and deductibles you have selected. To make it easier, we have also added a brief explanation of those items. We want you to feel confident about your new policy. If any of the information below is incorrect or if you have any questions, please contact one of our advisors at 844-357-0840 (Mon-Fri, 7am-10pm ET) or manage your policy at: www.hiscox.com/ manage-your-policy. Your business details Name:Charles E Jones Jr Business name:Charles E Jones Jr DBA Jones Enterprises Address:1005 White Oak Dr City:San Jose State:CA Zip code:95129 Occupation:Management consulting Telephone number:408-406-2501 Email address:chappiejones@gmail.com Your Professional Liability Policy Policy number:P102.753.902.1 Policy effective dates: This determines the time period during which your coverage applies. From: To: January 1, 2024 January 1, 2025 Total cost of policy:$560.00 Your limits explained Each claim limit The total amount we will pay for damages, claim expenses (e.g. defense costs), and supplemental payments for each claim. $2,000,000 Aggregate limit The total amount we will pay for damages, claim expenses (e.g. defense costs), and supplemental payments during the policy period. $2,000,000 Deductible The amount your business must pay (per claim) before we will make any payment under the policy. This does not apply to supplemental payments. $500 ~·~ HISCOX encourage courage· © Hiscox Inc. 2010 Page 2 Other policy information 14 Day full refund Be confident that you have made the right choice. We give you 14 days to review your policy. If you are not satisfied and have not had any claims or losses, you can cancel your policy back to its start date and receive a full refund. Notice of claim If you have a claim, please call us at 866-424-8508. You may also e-mail us at reportaclaim@hiscox.com What does my Professional Liability Policy cover? For a summary showing examples of what you are and are not covered for, please read the Coverage Summary document. This guide does not modify the terms and conditions of your policy, which are contained in your policy documents, nor does it imply any claim is covered or not covered. We recommend that you read your policy documents to learn the details of your coverage. Hiscox Insurance Company Inc. Your Insurance Documents Enclosed you will find the policy documents that make up your insurance contract with us. Please read through all of these documents. If you have any questions or need to update any of your information please call us at 844-357-0840 (Mon-Fri, 7am-10pm ET). Your insurance documents Declarations Page This contains specific policy information, such as the limits and deductibles you have selected. Policy Wording This details the terms and conditions of your coverage, subject to policy endorsements. Endorsements These documents modify the Policy Wording or Declarations Page. These include relevant terms and conditions as required by your state and are part of your policy. Notices These documents provide information that may affect your coverage such as optional terrorism coverage (if purchased) and other important items required by your state. Application Summary This is a summary of the information that you provided to us as part of your application. Please review this document and let us know if any of the information is incorrect. Reporting a claim Please inform us immediately if you have a claim or loss to report. Please have your policy number available, which can be found on the declarations page, so we can handle your call quickly. Contact us via the methods below or file a claim using our online form at https://www.hiscox.com/manage-your-policy/claims-center. Email: reportaclaim@hiscox.com Phone: 866-424-8508 Mail:Hiscox Claims Center 5 Concourse Parkway Suite 2150 Atlanta, GA 30328 Declarations Page HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600, Chicago, Illinois, 60603 (914) 273-7400 Businessowners Insurance for Management consulting DECLARATIONS – Effective 01/12/2024 (updates denoted by *) v2 Standard Package BOP D0001A CW (11/19)Page 1 of 9 In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. Policy no.:P102.753.903.1 1.Named insured:Charles E Jones Jr DBA Jones Enterprises Address:1005 White Oak Dr San Jose, CA 95129 Email address:chappiejones@gmail.com 2.Policy period:Inception Date: 01/01/2024 Expiration Date: 01/01/2025 Inception date shown shall be at 12:01 A.M. (Standard Time) to Expiration date shown above at 12:01 A.M. (Standard Time) at the address of the Named Insured. 3.General terms and BOP P0001A CW conditions wording:The General terms and conditions apply to this policy in conjunction with the specific wording detailed in each section below. 4.Policy limits: Business Personal Property $10,000 each occurrence BOP General Liability $2,000,000 aggregate 5.Endorsements:See Schedule 6.Notification of claims to:Web : https://www.hiscox.com/manage-your-policy/claims-center Phone: 1-866-424-8508 Email: reportaclaim@hiscox.com Mail: Attn: Direct Claims Hiscox 5 Concourse Parkway, Suite 2150 Atlanta GA, 30328 Please inform us immediately if you have a claim or loss to report . 7.Policy premium:$500.00 ~'~ HISCOX encourage courage• HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600, Chicago, Illinois, 60603 (914) 273-7400 Businessowners Insurance for Management consulting DECLARATIONS – Effective 01/12/2024 (updates denoted by *) v2 Standard Package BOP D0001A CW (11/19)Page 2 of 9 SCHEDULE OF DESCRIBED LOCATIONS Loc#Bldg#Premises Address Mortgage Holder(s)Limits Summary 1 1 1005 White Oak Dr San Jose, CA 95129 Location Type: Primary Business Personal Property: $10,000 ~'~ HISCOX encourage courage• HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600, Chicago, Illinois, 60603 (914) 273-7400 Businessowners Insurance for Management consulting DECLARATIONS – Effective 01/12/2024 (updates denoted by *) v2 Standard Package BOP D0001A CW (11/19)Page 3 of 9 Business Personal Property Coverage Part: BOP-BPP P0001A CW (06/20) Business personal property coverage Limit of Insurance 1: Any location where you perform your business activities Business Personal Property Limit:$10,000 Each occurrence Deductible: $1,000 Theft of furs, fur garments, and garments trimmed with fur: $2,500 Each occurrence (Shared) Theft of jewelry, watches, and similar:$2,500 Each occurrence (Shared) Theft of patterns, dies, molds, and forms:$2,500 Each occurrence (Shared) Additional Coverages Limit of Insurance Business income:Actual Loss up to 6 months Period of restoration: 6 months Waiting period: 72 hours Business income from dependent properties:$10,000 Each occurrence Period of restoration: 6 months Waiting period: 72 hours Civil authority:Actual Loss up to 30 days Waiting period: 72 hours Extended business income:Actual Loss up to 30 days Interruption of computer operations:$10,000 Aggregate Period of restoration: 6 months Waiting period: 72 hours Electronic data:$10,000 Aggregate (Shared) Extra expense:Actual Loss up to 6 months Period of restoration: 6 months Waiting period: 72 hours ~'~ HISCOX encourage courage• HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600, Chicago, Illinois, 60603 (914) 273-7400 Businessowners Insurance for Management consulting DECLARATIONS – Effective 01/12/2024 (updates denoted by *) v2 Standard Package BOP D0001A CW (11/19)Page 4 of 9 Forgery or alteration:$5,000 Each occurrence (Shared) Glass:$10,000 Each occurrence Money orders and counterfeit money:$5,000 Each occurrence (Shared) Coverage Extensions Limit of Insurance Accounts receivable:$10,000 Each occurrence (Shared) Lock and key replacement:$2,500 Each occurrence (Shared) Newly acquired business personal property:$100,000 per building Personal effects:$10,000 Each occurrence (Shared) Temporary business resumption expenses:$10,000 Each occurrence (Shared) Valuable papers and records:$10,000 Each occurrence (Shared) All limits designated as “shared” are a part of, and not in addition to, the Business Personal Property Limit. No deductible will apply to loss you sustain under Business income or Extra expense. ~'~ HISCOX encourage courage• HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600, Chicago, Illinois, 60603 (914) 273-7400 Businessowners Insurance for Management consulting DECLARATIONS – Effective 01/12/2024 (updates denoted by *) v2 Standard Package BOP D0001A CW (11/19)Page 5 of 9 BOP General Liability Coverage Part: BOP-GL P0001A CW (11/19) Liability coverage Limit of Insurance BOP General Liability Limit:$2,000,000 Each occurrence / $2,000,000 Aggregate Deductible: $0 Products and completed operations:$2,000,000 Each occurrence (Shared) Personal and advertising injury:$2,000,000 Each claim (Shared) Damage to premises rented to you:$0 Any one premises (Shared) Medical payments:$10,000 Each person All limits designated as “shared” are a part of, and not in addition to, the BOP General Liability Limit. ~'~ HISCOX encourage courage• HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600, Chicago, Illinois, 60603 (914) 273-7400 Businessowners Insurance for Management consulting DECLARATIONS – Effective 01/12/2024 (updates denoted by *) v2 Standard Package BOP D0001A CW (11/19)Page 6 of 9 Optional Coverages Limit of Insurance Advertising expense to regain customers $2,500 aggregate (Shared) Backup or overflow of a sewer, drain or sump $10,000 aggregate (Shared) Brand & labels $5,000 aggregate (Shared) Business income - denial of access to premises Business income/extra expense: Actual Loss up to 14 days Extra Expense Days:14 Period of Restoration Maximum Consecutive Days: 14 Waiting Period: 72 Business income for billable hours $10,000 each occurrence / $10,000 aggregate Business income for websites $10,000 aggregate (Shared) Waiting Period: 72 hours Contingent transit business income and extra expense $2,500 aggregate Contractual penalties coverage $2,500 each occurrence (Shared) Electronic data loss Liability $25,000 each occurrence, $25,000 aggregate (Shared) Electronic vandalism $2,500 each occurrence, $2,500 aggregate (Shared) $2,500 computer software each occurrence $2,500 computer software aggregate Employee dishonesty $5,000 each occurrence (Shared) Equipment breakdown coverage $5,000 each occurrence (Shared) Expediting Expenses Sublimit: $5,000 Fungi Sublimit: $5,000 Hazardous Substances Sublimit: $5,000 Data Sublimit: $5,000 PR Sublimit: $5,000 Spoilage Sublimit: $5,000 Expediting expenses $10,000 each occurrence (Shared) Fine arts coverage extension $5,000 each occurrence (Shared) Hired auto – physical damage $10,000 each auto / $10,000 aggregate (Shared) Deductible: $1,000 each occurrence Money and securities coverage On premises: $10,000 each occurrence (Shared) Off premises: $10,000 each occurrence (Shared) ~'~ HISCOX encourage courage• HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600, Chicago, Illinois, 60603 (914) 273-7400 Businessowners Insurance for Management consulting DECLARATIONS – Effective 01/12/2024 (updates denoted by *) v2 Standard Package BOP D0001A CW (11/19)Page 7 of 9 Ordinance or law coverage (undamaged portion of building; demolition cost; tenants’ improvements and betterments) Demolition Cost: $10,000 each building Demolition Cost and Increased Cost of Construction Coverages Combined: $10,000 each building Tenants’ Improvements and Betterments: $10,000 each building Outdoor signs $10,000 each occurrence (Shared) Sales representative samples $10,000 aggregate Unauthorized business credit card use $1,000 each occurrence (Shared) Utility Services – time element & direct damage Utility services interruption limit (Direct damage): $10,000 each occurrence (Shared) Utility services interruption limit (Time element): $10,000 each occurrence Waiting Period: 24 hours Worldwide property coverage with portable electronic devices sublimit $10,000 each occurrence (Shared) Portable devices sublimit: $5,000 each occurrence (Shared) All coverages designated as “”shared” are a part of, and not in addition to, the applicable Policy Limit stated in Item 4 above. Coverage under the above Optional Coverages is afforded by endorsement to the policy. Purchased Optional Coverages may be subject to unique terms and conditions. Please review all endorsements thoroughly. ~'~ HISCOX encourage courage• HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600, Chicago, Illinois, 60603 (914) 273-7400 Businessowners Insurance for Management consulting DECLARATIONS – Effective 01/12/2024 (updates denoted by *) v2 Standard Package BOP D0001A CW (11/19)Page 8 of 9 IN WITNESS WHEREOF, the Insurer indicated above has caused this Policy to be signed by its President and Secretary, but this Policy shall not be effective unless also signed by the Insurer’s duly authorized representative. President Secretary Authorized Representative Kevin Kerridge January 12, 2024 Hiscox Inc. ~'~ HISCOX encourage courage• HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600, Chicago, Illinois, 60603 (914) 273-7400 Businessowners Insurance for Management consulting DECLARATIONS – Effective 01/12/2024 (updates denoted by *) v2 Standard Package BOP D0001A CW (11/19)Page 9 of 9 Schedule of Endorsements NUMBER TITLE GENERAL (APPLICABLE TO MORE THAN ONE COVERAGE PART) BOP D0001A CW (11/19)Businessowners Declarations BOP E1005 CW (11/19)Policy Changes BOP GENERAL LIABILITY COVERAGE PART BOP-GL E5003 CW (11/19)Additional Insured Endorsement (Designated Person or Organization) ~'~ HISCOX encourage courage• HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600, Chicago, IL 60603 (914) 273-7400 DPL D001 CW (11/19)Page 1 Professional Liability Errors & Omissions Insurance Declarations This is a "Claims Made and Reported" Policy in which Claim Expenses are included within the Limit of Liability unless otherwise noted. Those words (other than the words in the captions) which are printed in Boldface are defined in the Policy. Declaration Effective Date:January 1, 2025 Policy No.:P102.753.902.2 Renewal of:P102.753.902.1 1.Named Insured:Charles E Jones Jr DBA Jones Enterprises 2.Address:1005 White Oak Dr San Jose, CA 95129 Email Address:chappiejones@gmail.com 3.A.Limit of Liability:$2,000,000 Each Claim 3.B.$2,000,000 Aggregate for all Claims 4.Deductible:$500 Each Claim 5.Notice:Phone: Email: Mail: 866-424-8508 reportaclaim@hiscox.com Hiscox 5 Concourse Parkway, Suite 2150 Attn: Direct Claims Atlanta GA, 30328 6.Policy period:From:January 1, 2025 To:January 1, 2026 At 12:01 A.M. (Standard Time) at the address shown above. 7.Retroactive Date:June 1, 1971 8.Premium:$560.00 9.Attachments: DPL D001 CW (11/19) - Professional Liability Errors & Omissions Insurance Declarations DPL P001 CW (05/13) - Professional Liability Coverage Form DPL E5424 CW (02/15) - Blanket Additional Insured Endorsement DPL E5018 CW (08/15) - Management/Business Consulting Services Endorsement DPL E5102 CA (01/10) - California Amendatory Endorsement DPL E1901 CW (08/21) - Cyber Incidents Exclusion Endorsement DPL E1919 CW (03/23) - War, Civil War, Cyberwarfare, and NCBR Exclusion Endorsement DPL E1918 CW (03/23) - Cannabis Exclusion Endorsement DPL E0003 CW (08/23) - Misappropriation of Funds Exclusion Endorsement HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600, Chicago, IL 60603 (914) 273-7400 DPL D001 CW (11/19)Page 2 DPL E0005 CW (12/23) - Anti-Stacking Endorsement (Single Limit) INT N003 CW (01/19) - Policyholder Notice Electronic Delivery INT N001 CW (01/09) - Economic And Trade Sanctions Policyholder Notice IN WITNESS WHEREOF, the Insurer indicated above has caused this Policy to be signed by its President and Secretary, but this Policy shall not be effective unless also signed by the Insurer's duly authorized representative. President Secretary Authorized Representative Date: January 1, 2025 Policy Wording © Hiscox Inc. All rights reserved. DPL P001 CW (05/13) PROFESSIONAL LIABILITY – US DIRECT ERRORS AND OMISSIONS INSURANCE DPL P001 CW (05/13) © Hiscox Inc. All rights reserved. 2 PROFESSIONAL LIABILITY – US DIRECT ERRORS AND OMISSIONS ABOUT THIS POLICY The Hiscox Professional Liability – US Direct policy is designed to offer coverage for the risks entities face in performing their Professional Services. We urge You to read this Policy carefully so You understand the insurance that You have purchased, and the full extent of Your and Our rights and duties under this Policy. Please note that all words and phrases that appear in bold-type (except headings) have special meaning and are defined in the Definitions section of this Policy. Coverage for all Claims is subject to the entire terms and conditions of the policy. Coverage for Claims Made Against You You have purchased insurance that provides coverage for Claims made against You. We will pay Damages on Your behalf for any Claim that falls within the Insuring Agreement and within all of the terms and conditions outlined in the policy. Covered Claims are for Your Wrongful Acts in providing or failing to provide Professional Services. To determine who is an Insured please refer to the Definitions and Spousal and Domestic Partner section of the policy. Additionally, for coverage to apply, You must comply with all Your obligations as outlined in the Notice of Claims, Notice of Potential Claims, and the rest of the policy. The most We will pay is outlined in the Limits of Liability Section and items We will not pay are outlined in the Exclusions section. You are responsible for payments as outlined in the Deductible section. DPL P001 CW (05/13) © Hiscox Inc. All rights reserved. 3 PROFESSIONAL LIABILITY – US DIRECT ERRORS AND OMISSIONS In consideration of the premium charged and in reliance on the statements made and information provided to Us, including but not limited to the statements made and information provided in and with the Application, which is made a part of this Policy, as well as subject to the Limits of Liability, the Deductible and all of the terms, conditions, limitations and exclusions of this Policy, We and You agree as follows: I. INSURING AGREEMENT, DEFENSE AND SETTLEMENT A. INSURING AGREEMENT We shall pay on Your behalf Damages and Claim Expenses in excess of the Deductible resulting from any covered Claim that is first made against You during the Policy Period and reported to Us pursuant to the terms of the Policy for Wrongful Acts committed on or after the Retroactive Date. We shall also pay on Your behalf all Supplemental Payments in connection with any covered Claim that is first made against You during the Policy Period and reported to Us pursuant to the terms of the Policy for Wrongful Acts committed on or after the Retroactive Date. No Deductible shall apply to Supplemental Payments. B. DEFENSE 1. We shall have the right and the duty to defend any covered Claim, even if such Claim is groundless, false or fraudulent. 2. We shall have the right to appoint defense counsel upon being notified of such Claim. 3. Notwithstanding paragraph 2., We shall have no obligation to pay Claim Expenses until You have satisfied the applicable Deductible. 4. Our duty to defend shall terminate upon the exhaustion of the Limit of Liability as set forth in Item 3. of the Declarations. C. SETTLEMENT 1. We shall have the right to solicit and negotiate settlement of any Claim. 2. We shall not, however, enter into a settlement without Your prior consent, which consent shall not be unreasonably withheld. 3. If You shall refuse to consent to any settlement recommended by Us, Our liability for such Claim shall not exceed the amount for which such Claim could have been settled plus Claim Expenses incurred up to the date of such refusal. DPL P001 CW (05/13) © Hiscox Inc. All rights reserved. 4 PROFESSIONAL LIABILITY – US DIRECT ERRORS AND OMISSIONS II. NOTICE OF CLAIMS AND NOTICE OF POTENTIAL CLAIMS A. NOTICE OF CLAIMS 1. As a condition precedent to any coverage under this Policy, You shall give written notice to Us of any Claim as soon as practicable, but in all events no later than: a. the end of the Policy Period (or any purchased Optional Extended Reporting Period); or b. 60 days after the end of the Policy Period (or any purchased Optional Extended Reporting Period) so long as such Claim is made within the last 60 days of such Policy Period (or any purchased Optional Extended Reporting Period). 2. Such notice shall be sent to Us at the address set forth in Item 5. of the Declarations. 3. Such notice shall include any and all documents related to such Claim, including every demand, notice, summons or other applicable information received by You or by Your representative. B. NOTICE OF POTENTIAL CLAIMS If You first become aware during the Policy Period of any Wrongful Act that might be reasonably likely give rise to a covered Claim, You may give written notice to Us of such potential Claim during the Policy Period. Such notice must include to the fullest extent possible: 1. the identity of the potential claimant; 2. the identity of the person(s) who allegedly committed the Wrongful Act; 3. the date of the alleged Wrongful Act; 4. specific details of the alleged Wrongful Act; and 5. any written notice from the potential claimant describing the Wrongful Act. If such notice is accepted as a “potential Claim,” then any actual Claim that is subsequently made shall be deemed to have been first made on the date such “potential Claim” was first reported to Us. Provided, however, You may not report “potential Claims” during any purchased Optional Extended Reporting Period. C. OPTIONAL EXTENDED REPORTING PERIOD 1. If We or the Named Insured cancel or non-renew this Policy (as described by Endorsement hereto), then the Named Insured shall have the right to purchase for an additional premium an Optional Extended Reporting Period. Provided, DPL P001 CW (05/13) © Hiscox Inc. All rights reserved. 5 PROFESSIONAL LIABILITY – US DIRECT ERRORS AND OMISSIONS however, the right to purchase an Optional Extended Reporting Period shall not apply if: a. this Policy is canceled by Us for nonpayment of premium (as described by Endorsement hereto); or b. the total premium for this Policy has not been fully paid. 2. The Optional Extended Reporting Period will apply only to Claims that: a. are first made against You and reported to Us during such Optional Extended Reporting Period; and b. are for Wrongful Acts committed on or after the Retroactive Date but prior to the effective date of cancellation or non-renewal (as described by Endorsement hereto). 3. The additional premium for such Optional Extended Reporting Period shall not exceed 200% of the annualized expiring premium for an Optional Extended Reporting Period of 3 years. The additional premium for such Optional Extended Reporting Period shall be fully earned at the inception of such Optional Extended Reporting Period. 4. Notice of election and full payment of the additional premium for the Optional Extended Reporting Period must be received within 30 days after the effective date of cancellation or non-renewal (as described by Endorsement hereto). In the event the additional premium is not received within the 30 days, any right to purchase the Optional Extended Reporting Period shall lapse and no further Optional Extended Reporting Period shall be offered. The Limits of Liability applicable during any purchased Optional Extended Reporting Period shall be the remaining available Limits of Liability under this canceled or non-renewed Policy (as described by Endorsement hereto). There shall be no separate or additional Limit of Liability available for any purchased Optional Extended Reporting Period and the purchase of any Optional Extended Reporting Period shall in no way increase the Limit of Liability set forth in Item 3. of the Declarations. III. EXCLUSIONS This Policy does not apply to and We shall have no obligation to pay any Damages, Claim Expenses or Supplemental Payments for any Claim: A. based upon or arising out of any actual or alleged fraud, dishonesty, criminal conduct, or any knowingly wrongful, malicious, or intentional acts or omissions; provided, however, that: 1. We will pay Claim Expenses until there is a final adjudication establishing such conduct, at which time You shall reimburse Us for such Claim Expenses; and 2. this exclusion shall not apply to otherwise covered intentional acts or omissions resulting in a Personal Injury. DPL P001 CW (05/13) © Hiscox Inc. All rights reserved. 6 PROFESSIONAL LIABILITY – US DIRECT ERRORS AND OMISSIONS B. based upon or arising out of any actual or alleged gaining of any profit or advantage to which You were not legally entitled. C. based upon or arising out of any actual or alleged wrongful termination, retaliation or discrimination against or harassment of any past, present, future or potential Employee, including but not limited to any violations of federal, state or local statutory or common law. D. based upon or arising out of any actual or alleged Wrongful Act that: 1. was committed prior to the Retroactive Date; 2. has been the subject of any notice given under any other policy of which this Policy is a renewal or replacement; or 3. You had knowledge of prior to the Policy Period and had a reasonable basis to believe that such Wrongful Act could give rise to a Claim; provided, however, that if this Policy is a renewal or replacement of a previous policy issued by Us providing materially identical coverage, the Policy Period referred to in this paragraph will be deemed to refer to the inception date of the first such policy issued by Us. E. brought by or on behalf of any federal, state or local government agency or professional or trade licensing organization; provided, however, this exclusion shall not apply to claims brought in their capacity as a client receiving Your Professional Services. F. brought by or on behalf of one Insured against another Insured. G. brought by or on behalf of any person or entity maintaining Effective Control of You. H. based upon or arising out of any actual or alleged violation of the following laws, including any similar provisions of any federal, state or local statutory or common law: 1. the Securities Act of 1933 (as amended); 2. the Securities Exchange Act of 1934 (as amended); 3. any state blue sky or securities laws (as amended); 4. the Racketeer Influenced and Corrupt Organizations Act, 18 U.S.C. § 1961 et seq. (as amended); 5. the Employee Retirement Income Security Act of 1974 (as amended); including any rules or regulations promulgated thereunder. I. based upon or arising out of any actual or alleged obligation under any Workers’ Compensation, Unemployment Compensation, Employers Liability or Disability Benefit Law, including any similar provisions of any federal, state or local statutory or common law. J. based upon or arising out of any actual or alleged liability of others that You assume under any contract or agreement unless such liability would have attached in the absence of such contract or agreement. DPL P001 CW (05/13) © Hiscox Inc. All rights reserved. 7 PROFESSIONAL LIABILITY – US DIRECT ERRORS AND OMISSIONS K. based upon or arising out of any actual or alleged Bodily Injury or Property Damage. L. based upon or arising out of any actual, alleged or threatened discharge, dispersal, release or escape of Pollutants, including any direction or request to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize Pollutants. M. based upon or arising out of any actual or alleged infringement of any copyright, trademark, trade dress, trade name, service mark, service name, title, slogan or patent or theft of trade secret. N. based upon or arising out of any actual or alleged false or deceptive advertising of Your goods or services or misrepresentation in advertising of Your goods or services, including but not limited to any wrongful description of prices of Your goods or services or the quality or performance of Your goods or services. O. based upon or arising out of any actual or alleged breach of contract or breach of any implied or express warranty or guarantee; provided, however, this Exclusion shall not apply to: 1. any obligation you have to perform your Professional Services with reasonable skill or care; or 2. any liability You would have had in absence of such contract, warranty or guarantee. P. based upon or arising out of any actual or alleged violation of any federal, state or local statutes, ordinances or regulations regarding or relating to unsolicited telemarketing, solicitations, emails, faxes or any other communications of any type or nature, including but not limited to any “anti-spam” and “do-not-call” statutes, ordinances, or regulations. Q. based upon or arising out of any actual or alleged failure to procure or maintain adequate insurance or bonds. R. based upon or arising out of any actual or alleged failure to protect any non-public, personally identifiable information in Your care, custody or control. S. based upon or arising out of any actual or alleged actuarial services, medical or nursing services, insurance agent/broker services, legal services or services as an architect or engineer. IV. LIMITS OF LIABILITY, DEDUCTIBLE AND RELATED CLAIMS A. LIMIT OF LIABILITY DPL P001 CW (05/13) © Hiscox Inc. All rights reserved. 8 PROFESSIONAL LIABILITY – US DIRECT ERRORS AND OMISSIONS Regardless of the number of Claims made during the Policy Period (or applicable Extended Reporting Period), the maximum that We shall be liable to pay for all covered Damages, Claim Expenses and Supplemental Payments shall be as follows: 1. The amount set forth in Item 3.A. of the Declarations as “Each Claim” shall be the maximum amount for each covered Claim. 2. The amount set forth in Item 3.B. of the Declarations as “Aggregate for all Claims” is the maximum amount for all Claims combined. 3. Notwithstanding 1. and 2. above, Our liability for Supplemental Payments shall not exceed $250 per day for each Insured up to $5,000 per Claim, which amounts shall reduce the amounts described in 1. and 2. above. B. DEDUCTIBLE 1. We shall not be responsible for payment of Damages or Claims Expenses until the Deductible amount has been satisfied. 2. We may at Our discretion advance payment of Damages or Claims Expenses within the Deductible amount on Your behalf, but You shall reimburse Us for any such amounts as soon as We request such reimbursement. 3. No Deductible amount shall apply to Supplemental Payments. C. RELATED CLAIMS For purposes of the applicable Deductible and Limit of Liability, all Claims based upon or arising out of continuous, repeated, related or interrelated Wrongful Acts shall be considered a single Claim first made against You in the Policy Period the first such Claim was made. V. OTHER MATTERS AFFECTING COVERAGE A. ESTATES, HEIRS, LEGAL REPRESENTATIVES, SPOUSES & DOMESTIC PARTNERS This Policy shall apply to Claims brought against: 1. the heirs, executors, administrators, trustees in bankruptcy, assignees and legal representatives of any Insured in the event of such Insured’s death or disability; or 2. the legal spouse or legal domestic partner of any Insured; but only: 1. for the Wrongful Acts of such Insured; or DPL P001 CW (05/13) © Hiscox Inc. All rights reserved. 9 PROFESSIONAL LIABILITY – US DIRECT ERRORS AND OMISSIONS 2. in connection with their ownership interest in property which the claimant seeks as recovery for actual or alleged Wrongful Acts of such Insured. B. INSURED DUTY TO COOPERATE You shall have the duty to cooperate with Us in the defense, investigation and settlement of any Claim, including but not limited to: 1. upon request, submit to examination and interrogation under oath by Our representative; 2. attend hearings, depositions and trials as requested by Us; 3. assist in securing and giving evidence and obtaining the attendance of witnesses; 4. provide written statements to Our representative and meet with such representative for the purpose of investigation and/or defense; and 5. provide all documents We may reasonably require. C. INSURED OBLIGATION NOT TO INCUR EXPENSE OR ADMIT LIABILITY You shall not, except at Your own cost, make any payment, incur any expense, admit any liability, settle any Claim or assume any obligation without Our prior consent. D. ACTION AGAINST THE INSURER No action shall be taken against Us unless: 1. You have complied fully with all the terms and conditions of this Policy; and 2. the amount of Your obligation to pay shall have been finally determined either by judgment against You after actual trial, or by written agreement between You, Us and the claimant. No person or organization shall have any right under this Policy to join Us as a party to any Claim against You nor shall We be impleaded by You or Your legal representatives in any such Claim. E. OTHER INSURANCE This Policy shall be excess insurance over any other valid and collectable insurance available to You, whether such other insurance is stated to be primary, contributory, excess, contingent or otherwise, unless such other insurance is written only as a specific excess insurance over the Limit of Liability provided in this Policy. F. SUBROGATION 1. In the event of any payment by Us under this Policy, We shall be subrogated to all of Your rights of recovery to such payment. 2. You shall do everything that may be necessary to secure and preserve such subrogation rights, including but not limited to the execution of any documents necessary to allow Us to bring suit in Your name. DPL P001 CW (05/13) © Hiscox Inc. All rights reserved. 10 PROFESSIONAL LIABILITY – US DIRECT ERRORS AND OMISSIONS 3. You shall do nothing to prejudice such subrogation rights without first obtaining Our written consent. 4. Any recovery shall first be paid to Us up to the amount of any Damages, Claim Expenses or Supplemental Payments that We have paid. Any remaining amounts shall be paid to You. 5. Notwithstanding the above, no subrogation shall be had against any Insured. G. ALTERATION AND ASSIGNMENT No change in, modification of or assignment of interest under this Policy shall be effective unless made by written endorsement to this Policy signed by Our authorized representative. H. REPRESENTATIONS As a condition precedent of Our obligations under this Policy, You represent that: 1. the statements and representations made by You in the Application are true and are the basis of the Policy and are to be considered as incorporated into and constituting a part of this Policy; 2. the statements and representations made by You in the Application shall be deemed material to the acceptance of the risk assumed by Us under the Policy; 3. this Policy is issued in reliance upon the truth of the statements and representations made by You in the Application; and 4. in the event the Application contains misrepresentations which materially affect the acceptance of the risk assumed by Us under this Policy, this Policy shall be void ab initio. I. BANKRUPTCY OR INSOLVENCY Your bankruptcy or insolvency shall not relieve Us of any of Our obligations under this Policy. J. TERRITORY This Policy shall apply to Wrongful Acts committed anywhere in the world, provided that any action, arbitration, or other proceeding for, in relation to, or arising from the Claim is brought within the United States, its territories or possessions, or Canada. K. FALSE OR FRAUDULENT CLAIMS If any Insured shall commit fraud in proffering any Claim or regarding the amount or otherwise, this Insurance shall become void as to such Insured from the date such fraudulent claim is proffered. L. NAMED INSURED RESPONSIBILITIES DPL P001 CW (05/13) © Hiscox Inc. All rights reserved. 11 PROFESSIONAL LIABILITY – US DIRECT ERRORS AND OMISSIONS It shall be the responsibility of the Named Insured to act on behalf of all other Insureds with respect to the following: 1. giving and receiving notice of cancellation and/or non-renewal (as described by Endorsement hereto); 2. payment of premium 3. receipt of return premiums; 4. acceptance of changes to this Policy; and 5. payment of Deductibles. M. EXAMINATION OF YOUR BOOKS AND RECORDS We may examine and audit Your books and records as they related to this Policy at any time during the Policy Period (or any purchased Optional Extended Reporting Period) or up to three years after the end of the Policy Period (or any purchased Optional Extended Reporting Period). N. TITLES Titles of sections of and endorsements to this Policy are inserted solely for convenience of reference and shall not be deemed to limit, expand or otherwise affect the provisions to which they relate. VI. DEFINITIONS A. Application means the signed application for the Policy, whether submitted on-line, over the phone or on paper, including any attachments and other materials or statements submitted in conjunction therewith. If this Policy is a renewal or replacement of a previous policy or policies issued by Us, Application shall also include all signed applications and other materials that were submitted therewith and attached thereto. B. Bodily Injury means physical injury to or sickness, disease or death of a person, or mental injury, mental anguish, emotional distress, pain or suffering, or shock sustained by a person. C. Claim means any written demand for Damages or for non-monetary relief. D. Claim Expenses means the following that are incurred by Us or by You with Our prior written consent: 1. all reasonable and necessary fees, costs and expenses (including the fees of attorneys and experts) incurred in the investigation, defense and appeal of a Claim; and 2. premiums on appeal bonds, attachment bonds or similar bond. Provided, however, We shall have no obligation to apply for or furnish any such bonds. Claim Expenses shall not mean and We shall not be obligated to pay: 1. salaries, wages or expenses other than Supplemental Payments; or DPL P001 CW (05/13) © Hiscox Inc. All rights reserved. 12 PROFESSIONAL LIABILITY – US DIRECT ERRORS AND OMISSIONS 2. the defense of any criminal investigation, criminal grand jury proceeding, or criminal action. E. Damages means a monetary judgment or monetary award that You are legally obligated to pay (including pre- or post-judgment interest) or a monetary settlement negotiated by Us with Your consent. Damages shall not mean and We shall not be obligated to pay: 1. fines, penalties, taxes, sanctions levied against You; 2. any punitive or exemplary damages or that portion of any multiplied damages award which exceeds the damage award so multiplied, provided, however, that, if such damages are otherwise insurable under applicable law and regulation, We will pay an award of punitive or exemplary damages in excess of the Deductible and up to a maximum sum of $250,000. This limit shall be a part of and not in addition to the Limit of Liability set forth in Items 3. of the Declarations; 3. the return, reduction or restitution of Your fees, commissions, profits, or charges for goods provided or services rendered, including any over-charges or cost over-runs; 4. liquidated damages; or 5. Your cost of complying with injunctive relief. F. Effective Control means: 1. ownership of more than 50% of the issued and outstanding voting securities; or 2. having the right pursuant to written contract, by-laws, charter, operating agreement or similar documents to elect, appoint or designate a majority of the board of directors, management committee members of a partnership or the members of the management board of a limited liability company (or equivalent management structure). G. Employee means any past, present or future: 1. employee (including any part-time, seasonal or temporary employee or any volunteer); 2. partner, director, officer, member or board member (or equivalent position); 3. independent contractor; or 4. leased worker; of an Organization, but only in their performance of Professional Services on behalf of or at the direction of such Organization. H. Insured means You or Your. I. Named Insured means the individual, corporation, partnership, limited liability company, limited partnership, or other entity set forth in Item 1 of the Declarations. J. Optional Extended Reporting Period means any applicable Optional Extended Reporting Period contemplated by the OPTIONAL EXTENDED REPORTING PERIOD Clause. DPL P001 CW (05/13) © Hiscox Inc. All rights reserved. 13 PROFESSIONAL LIABILITY – US DIRECT ERRORS AND OMISSIONS K. Organization means the Named Insured and any Subsidiary. L. Personal Injury means injury, other than Bodily Injury, arising out of one of more of the following offenses: 1. false arrest, detention or imprisonment; 2. malicious prosecution; 3. wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of premises; 4. slander, libel, defamation or disparagement of goods, products or services; or 5. oral or written publication of material in connection with Your advertising that violates a person’s right of privacy. M. Policy Period means the period of time set forth in Item 6. of the Declarations. N. Pollutants means any solid, liquid, gaseous, biological, radiological or thermal irritant or contaminant, including smoke, vapor, dust, fibers, mold, spores, fungi, germs, soot, fumes, acids, alkalis, chemicals and W aste. “Waste” includes, but is not limited to, materials to be recycled, reconditioned or reclaimed and nuclear materials. O. Professional Services means only those services specified in Endorsement to this Policy as performed by or on behalf of an Organization for others for a fee or other compensation. P. Property Damage means physical loss of or physical damage to or destruction of any tangible property, including the loss of use thereof. For purposes of this definition, “tangible property” shall not include electronic data. Q. Retroactive Date means the date set forth in Item 7. of the Declarations. R. Subsidiary means: 1. any entity of which the Named Insured has Effective Control (“Controlled Entity”) on or before the Policy Period, either directly or indirectly through one or more Controlled Entities; 2. any entity of which the Named Insured forms or acquires Effective Control during the Policy Period, either directly or indirectly through one or more Controlled Entities, but only for the first 90 days after such formation or acquisition (or until the end of the Policy Period, whichever is earlier). Provided, however, with respect to a Subsidiary described in paragraph 2. of this definition, We shall only cover Claims alleging Wrongful Acts committed while the Named Insured had Effective Control of such Subsidiary, either directly or indirectly through one or more Controlled Entities. An entity ceases to be a Subsidiary once the Named Insured no longer has Effective Control of such entity, either directly or indirectly through one or more Controlled Entities, and this Policy will not respond to Claims made against such entity thereafter. DPL P001 CW (05/13) © Hiscox Inc. All rights reserved. 14 PROFESSIONAL LIABILITY – US DIRECT ERRORS AND OMISSIONS S. Supplemental Payments means the reasonable expenses incurred by You, including loss of wages, if You are required by Us to attend arbitration proceedings or trial in the defense of a covered Claim. T. We, Us, Our or Insurer means the insurance company set forth in the Declarations. U. Wrongful Act means any actual or alleged breach of duty, negligent act, error, omission or Personal Injury committed by You in the performance of Your Professional Services. V. You or Your means any: 1. Organization; 2. Employee; 3. joint venture in which an Organization participates pursuant to written agreement, but only for: a. Wrongful Acts committed by such Organization; and b. the percentage of otherwise covered Damages and Claims Expenses in proportion to such Organization’s participation in the joint venture. Endorsements Hiscox Insurance Company Inc. Endorsement 41 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises Waiver of Transfer of Rights of Recovery Against Others Page 1 of 1 BOP E1006 CW (11/19) Includes copyrighted material of Insurance Services Office, Inc. with its permission In consideration of the premium charged, and on the understanding this endorsement leaves all other terms, conditions, and exclusions unchanged, it is agreed the General Terms and Conditions are amended as follows: SCHEDULE Person(s) or Organization(s) The City of Cuppertino The following is added to the end of Section V. Other provisions affecting coverage, K. Subrogation: However, with respect to any loss under the General Liability Coverage Part, you may waive your rights of recovery against the person(s) or organization(s) listed in the Schedule above for: 1.an occurrence that caused bodily injury or property damage; 2.personal and advertising injury caused by an offense arising out of your business operations; or 3.bodily injury and property damage included in the products-completed operations hazard. Endorsement Effective:December 10, 2024 Policy No.:P102.753.903.1 By: Kevin Kerridge (Appointed Representative) Hiscox Insurance Company Inc. Endorsement 38 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises Policy Changes Page 1 of 2 BOP E1005 CW (11/19) Includes copyrighted material of Insurance Services Office, Inc. with its permission In consideration of the premium charged, and on the understanding this endorsement leaves all other terms, conditions, and exclusions unchanged, it is agreed: If selected below, the following changes will apply to your policy. Any change that is shown on the Declarations will be shown in a revised version of the Declarations and reissued to you. Item:Summary of change made (if not shown in revised Declarations page): Named insured Address Policy period Total premium Policy limits See Declaration page for details Optional extension period See Declaration page for details Deductible(s)See Declaration page for details Payment plan Classification/class code Insured’s business/ legal status Additional interested parties X Endorsements Endorsement # 39 entitled Additional Insured Endorsement (Designated Person or Organization) is added. If selected below, the above changes will result in a change in the premium as follows: Additional premium due Return premium To be adjusted at audit All other terms and conditions remain unchanged. □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ ~'~ HISCOX encourage courage· Hiscox Insurance Company Inc. Endorsement 38 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises Policy Changes Page 2 of 2 BOP E1005 CW (11/19) Includes copyrighted material of Insurance Services Office, Inc. with its permission Endorsement Effective:January 12, 2024 Policy No.:P102.753.903.1 By: Kevin Kerridge (Appointed Representative) ~'~ HISCOX encourage courage· Hiscox Insurance Company Inc. Endorsement 39 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises Additional Insured Endorsement (Designated Person or Organization)Page 1 of 1 BOP-GL E5003 CW (11/19) Includes copyrighted material of Insurance Services Office, Inc. with its permission In consideration of the premium charged, and on the understanding this endorsement leaves all other terms, conditions, and exclusions unchanged, it is agreed the General Liability Coverage Part is amended as follows: SCHEDULE Name of Person(s) or Organization(s): The City of Cupertino, its city counsels, officers, officials, agents, servants and volunteers I.The following is added to the end of Section III. Who is an insured: DP-A.Designated person or organization Any person(s) or organization(s) shown in the Schedule above will be added to this Coverage Part as an additional insured, but only with respect to their liability for bodily injury, property damage, or personal and advertising injury arising out of: 1.your acts or omissions; 2.the acts or omissions of those acting on your behalf in the performance of your ongoing operations; or 3.in connection with premises owned by or rented to you. However, the coverage afforded to such additional insured(s): a.applies only to the extent permitted by law; and b.will not be broader than you are required by contract or agreement to provide for such additional insured(s). If coverage provided to the additional insured(s) listed in the Schedule above is required by a contract or agreement, the most we will pay on behalf of any such additional insured is the amount of insurance: i.required by such contract or agreement; or ii.available under the applicable limits stated in the Declarations, whichever is less. II.This Endorsement will not increase the applicable limits stated in the Declarations. Endorsement Effective:January 12, 2024 Policy No.:P102.753.903.1 By: Kevin Kerridge (Appointed Representative) ~'~ HISCOX encourage courage· Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: DPL E5424 CW (02/1)Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 E5424.1 Blanket Additional Insured Endorsement (PL) In consideration of the premium charged, it is understood and agreed that the Policy is amended as follows: 1. In Clause VI. DEFINITIONS, paragraph V., “’You’ or ‘Your’,”is amended to include the following at the end thereof: You or Your shall also include any Additional Insured but only for the Wrongful Acts of those contemplated in paragraphs 1., 2. or 3. of the definition of ”’You’ or ‘Your’”: 2. The following definition is added to Clause VI. DEFINITIONS: AI-A.Additional Insured means any person(s) or organization(s) with whom You have agreed in a written contract or agreement to add them as an additional insured to a policy providing the type of coverage afforded by this Policy, provided the contract or agreement: 1. is currently in effect or becomes effective during the Policy Period; and 2. was executed before the Professional Services from which the Claim arises were performed. 3. In Clause III.EXCLUSIONS, paragraph F. is deleted in its entirety and replaced with the following: F. brought by or on behalf of one Insured against another Insured; provided, however, this Exclusion will not apply to any Claim brought by an Additional Insured in any capacity other than that of an Additional Insured. All other terms and conditions remain unchanged. P102.753.902.2 Charles E Jones Jr DBA Jones Enterprises 1 01/01/2025 Hiscox Insurance Company Inc. Endorsement 2 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises Management/Business Consulting Services Endorsement Page 1 of 2 In consideration of the premium charged, it is understood and agreed that the Policy is amended as follows: 1.In Clause VI. DEFINITIONS, paragraph O., “Professional Services,” is amended to read as follows: O.Professional Services means management consulting and/or business consulting services performed for others for compensation, including but not limited to: i.advising on general business operations, strategy, organizational structure, human resources, marketing and sales campaigns, systems or ecological/” green” issues; and ii.project management. 2.Clause VI. DEFINITIONS is amended to include the following at the end thereof: MC-A.Employee Benefit Plan means any plan created or maintained by an employer or employee organization for the benefit of its employees, directors, partners, trustees, or officers, including but not limited to pension plans and employee welfare plans. 3.Clause III. EXCLUSIONS is amended to include the following at the end thereof: MC-A.based upon or arising out of any actual or alleged commingling of or inability or failure to safeguard funds. MC-B.based upon or arising out of any actual or alleged compilation of audited financial statements. MC-C.based upon or arising out of the performance of or failure to perform audit attestation services. MC-D.based upon or arising out of the performance of any services in connection with mergers and/or acquisitions. MC-E.based upon or arising out of the performance of any services in connection with the valuation of any entity or tangible or intangible property. MC-F.based upon or arising out of any actual or alleged promise, warranty, or guarantee of the future value of any real or personal property. MC-G.based upon or arising out of any actual or alleged insolvency, receivership, bankruptcy, liquidation, or financial inability of any Employee Benefit Plan or insurance company. MC-H.based upon or arising out of any actual or alleged sale of any Employee Benefit Plan. MC-I.based upon or arising out of any actual or alleged performance or failure to perform investment advisory services, including but not limited to the following: 1.the selection of any investment manager, investment advisory, custodial, or similar firm; 2.the promise or guarantee of the future performance of value of investments, or rate of return or interest; 3.the fluctuation in the value of any security; 4.any failure of investments to perform as expected or desired; or 5.acting as an investment advisor as defined in Section 202(11) of the Investment Advisors Act of 1940. Hiscox Insurance Company Inc. Endorsement 2 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises Management/Business Consulting Services Endorsement Page 2 of 2 MC-J.based upon or arising out of Your performance of or failure to perform Professional Services in connection with the following industries, fields, or activities: 1.actuarial advice; 2.aerospace consulting or advice; 3.architecture or engineering advice; 4.construction management or advice; 5.credit counseling; 6.environmental consulting or advice; 7.financing or financial auditing; 8.general contracting; 9.home/physical inspection services; 10.insurance placement or advice; 11.investment or tax advice; 12.land acquisition; 13.law enforcement training; 14.legal advice or the practice of law; 15.lobbying and/or political advice; 16.medical advice or the practice of medicine; 17.mining consulting or advice; 18.oil, gas, or petroleum consulting or advice; 19.physical installation services; 20.property management; 21.repossession services; 22.safety consulting or advice; 23.Your sale of any goods or products; or 24.staffing/placement services. All other terms and conditions remain unchanged. Endorsement effective:January 1, 2025 Policy No.:P102.753.902.2 Endorsement No:2 By: Kevin Kerridge (Appointed Representative) DPL E5018 CW (08/15) Hiscox Insurance Company Inc. Endorsement 3 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises California Amendatory Endorsement Page 1 of 3 This endorsement modifies insurance provided under the following: PROFESSIONAL LIABILITY - ERRORS AND OMISSIONS INSURANCE In consideration of the premium charged, it is understood and agreed that the Policy is modified as follows: 1.Section V. OTHER MATTERS AFFECTING COVERAGE is amended to include the following at the end thereof: CANCELLATION Notice of Cancellation A.The Named Insured may cancel this Policy by giving Us advance written notice stating when thereafter such cancellation shall be effective. If the Named Insured cancels this Policy, the refund may be less than pro rata. Provided, however, if this Policy shall be cancelled by the Named Insured within 14 days of the inception of the Policy Period without having submitted a Claim, We shall return in full any premium amount actually paid to Us. In such event, the effective date of cancellation shall be deemed to be the inception date of the Policy Period. B.Policies In Effect For 60 Days or Less If this Policy has been in effect for sixty (60) days or less, and is not a renewal of a Policy We have previously issued, We may cancel this Policy by mailing or delivering to the Named Insured at the mailing address shown in the Declarations and to the producer of record, if any, advance written notice of cancellation stating the reason for cancellation at least : Ten (10) days before the effective date of cancellation if We cancel for: (a)Non-payment of premium; or (b)Discovery of fraud by: i.The Insured or the Insured's representative in obtaining this insurance; or ii.The Insured or the Insured's representative in pursuing a Claim under the Policy. Thirty (30) days before the effective date of cancellation if We cancel for any other reason. C.Policies In Effect For More Than 60 Days If this Policy has been in effect for more than sixty (60) days, We may also cancel this Policy by mailing or delivering to the Named Insured at the address shown in the Declarations, the producer of record, if any, written notice, including the reason for cancellation, stating when not less than thirty (30) days thereafter (or ten (10) days thereafter when cancellation is due to non-payment of premium or discovery of fraud), the cancellation shall be effective. We may only cancel this Policy for one or more of the following reasons: (a)Nonpayment of premium, including payment due on a prior policy issued by Us and due during the current policy term covering the same risks; (b)Discovery of fraud or material misrepresentation by: i.The Insured or the Insured's representative in obtaining this insurance; or ii.The Insured or the Insured's representative in pursuing a Claim under the Policy. Hiscox Insurance Company Inc. Endorsement 3 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises California Amendatory Endorsement Page 2 of 3 (c)A judgment by a court or an administrative tribunal that the Insured has violated a California or Federal law, having as one of its necessary elements an act which materially increases any of the risks insured against; (d)Discovery of willful or grossly negligent acts or omissions, or of any violations of state laws or regulations establishing safety standards, by the Insured or the Insured's representative, which materially increase any of the risks insured against; (e)Failure by the Insured or the Insured's representative to implement reasonable loss control requirements, agreed to by the Insured as a condition of policy issuance, or which were conditions precedent to Our use of a particular rate or rating plan, if that failure materially increases any of the risks insured against; (f)A determination by the Commissioner of Insurance that the i.Loss of, or changes in, our reinsurance covering all or part of the risk would threaten Our financial integrity or solvency; or ii.Continuation of the policy coverage would: a.Place Us in violation of California law or the laws of the state where We are domiciled; or b.Threaten Our solvency. (g)A change by the Insured or the Insured's representative in the activities or property of the commercial or industrial enterprise, which results in a materially added, increased or changed risk, is included in the Policy. D.The mailing of the notice of cancellation shall be sufficient proof of notice and this Policy shall terminate at the date and hour specified in such notice. If We cancel this Policy, any return premium shall be calculated pro rata. Payment or tender of any unearned premium by Us shall not be a condition precedent to the effectiveness of the cancellation, but such payment shall be made as soon as practicable. Nonrenewal A.If We elect not to renew this Policy, We will mail or deliver to the Named Insured written notice of nonrenewal, stating the reason for nonrenewal, not less than sixty (60) days, but not more than one hundred twenty (120) days before the end of the Policy Period. We will mail the notice of nonrenewal to the Named Insured at the last mailing address known Us. If the notice of nonrenewal is mailed, proof of mailing will be sufficient proof of notice. B.We are not required to send notice of nonrenewal in the following situations: (a)If the transfer or renewal of a policy, without any changes in terms, conditions or rates, is between Us and a member of Our insurance group. (b)If the policy has been extended for 90 days or less, provided that notice has been given in accordance with paragraph A above. Hiscox Insurance Company Inc. Endorsement 3 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises California Amendatory Endorsement Page 3 of 3 (c)If the Named Insured has obtained replacement coverage, or if the Named Insured has agreed, in writing, within 60 days of the termination of the Policy, to obtain that coverage. (d)If the Policy is for a period of no more than 60 days and the Named Insured is notified at the time of issuance that it will not be renewed. (e)If the Named Insured requests a change in the terms or conditions or risks covered by the Policy within 60 days of the end of the Policy Period. (f)If We made a written offer to the Named Insured, in accordance with the timeframes shown in paragraph A above, to renew the Policy under changed terms or conditions or at an increased premium rate, when the increase exceeds 25%. 2.Section VII. DEFINITIONS, Paragraph E Damages, is modified to the extent necessary to provide the following: Punitive and exemplary damages shall not be insurable in cases where California law governs the Claim. 3.The Policy is amended by adding the following Clause at the end thereof: Policy Conflicts To the extent any term or condition contained in the Policy or any Endorsement attached thereto conflicts with any term or condition contained in this or any other State Amendatory Endorsement attached to the Policy, such terms and conditions most favorable to the Insured shall apply. All other terms and conditions remain unchanged. Endorsement effective:January 1, 2025 Policy No.:P102.753.902.2 Endorsement No:3 By: Kevin Kerridge (Appointed Representative) DPL E5102 CA (01/10) Hiscox Insurance Company Inc. Endorsement 4 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises Cyber Incidents Exclusion Endorsement Page 1 of 1 In consideration of the premium charged, it is understood and agreed that the Policy is amended as follows: 1.In Clause III. EXCLUSIONS, Exclusion R. is deleted in its entirety and replaced with the following: R.based upon or arising out of any actual or alleged: 1.unauthorized acquisition, access, use, or disclosure of, improper collection or retention of, or failure to protect any non-public personally identifiable information or confidential corporate information that is in Your care, custody, or control; 2.violation of any privacy law or consumer data protection law protecting against the use, collection, or disclosure of any information about a person or any confidential corporate information; 3.total or partial damage to, loss, corruption, deterioration, destruction, or alteration of, or the inability or impaired ability to access or manipulate any electronic data, software, electronic databases, computers, or any part of a computer system or network; 4.denial of service or delay, disruption, impairment, failure, or outage of any part of a computer system or network; 5.unauthorized or unlawful access to any electronic data or any part of a computer system or network, including through the transmission of any malicious code, such as a computer virus, worm, logic bomb, malware, spyware, Trojan horse, or other fraudulent or unauthorized computer code; or 6.threat, hoax, or demand relating to subparts 1 through 5 above. All other terms and conditions remain unchanged. Endorsement effective:January 1, 2025 Policy No.:P102.753.902.2 Endorsement No:4 By: Kevin Kerridge (Appointed Representative) DPL E1901 CW (08/21) Hiscox Insurance Company Inc. Endorsement 5 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises War, Civil War, Cyberwarfare, and NCBR Exclusion Endorsement Page 1 of 2 In consideration of the premium charged, it is understood and agreed that the Policy is amended as follows: 1.The following is added to the end of Clause III. EXCLUSIONS: This Policy does not apply to and We will have no obligation to pay any Damages, Claim Expenses, or Supplemental Payments for any Claim: WC-A.based upon or arising out of, directly or indirectly occasioned by, happening through, or in consequence of: 1.war, invasion, acts of foreign enemies, hostilities (whether war is declared or not), civil war, rebellion, revolution, insurrection, military, or usurped power; 2.confiscation, nationalization, requisition, destruction of, or damage to property by or under the order of any government, public, or local authority; 3.Cyberwarfare, to the extent not otherwise excluded by paragraph 1; or 4.any NCBR Malicious Act. 2.For purposes of this Endorsement, the following definitions apply: Cyberwarfare means any: 1.unauthorized access to, or use, alteration, corruption, damage, manipulation, misappropriation, theft, deletion, or destruction of, any computer hardware or electronic data; 2.creation, transmission, or introduction into a computer system, computer network, or electronic data of a computer virus or harmful code; or 3.restriction or inhibition of access to a computer system, computer network, or electronic data, including through a denial-of-service (DoS) attack, committed by, or on behalf of, a State. In determining by whom any action listed in parts 1. through 3. above is committed, We will consider to whom any governing body (including the governing body's intelligence, law enforcement, or military services) attributes such action, regardless of whether: A.the computer system, computer network, or electronic data is physically located within the jurisdiction of that governing body; or B.there are inconsistent statements within different branches or agencies of that governing body (including intelligence, law enforcement, or military services) as to whom the action is attributable to. However, if: i.a governing body has not attributed any such action to a State, or any person, group, association, or entity acting on the State's behalf; and Hiscox Insurance Company Inc. Endorsement 5 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises War, Civil War, Cyberwarfare, and NCBR Exclusion Endorsement Page 2 of 2 ii.there is at least one Media Report or a cybersecurity forensic firm report indicating that such action is attributed to a State or any person, group, association, or entity acting on the State's behalf, then We will not pay any Damages, Claim Expenses, or Supplemental Payments resulting from any action listed in parts 1. through 3. above until any governing body attributes such action to a State or any person, group, association, or entity acting on the State's behalf. If a governing body does not attribute such action to a State or any person, group, association, or entity acting on the State's behalf, or declares it is unable to do so, then a Media Report or cybersecurity forensic firm report will be conclusive evidence that the act was committed by, or on behalf of, a State. For purposes of this definition, "Media Report" means an article published by the Associated Press, Reuters, Wall Street Journal, or the British Broadcasting Corporation. For purposes of this definition, "State" means a sovereign state, state-like entity, quasi-state, proto- state, or a state-sponsored actor or group. NCBR Malicious Act means an act or series of acts that harms another person or damages property through the physical release or dispersal of Nuclear, Chemical, Biological, or Radiological Agents or Materials, which is carried out by any person or group of persons, whether acting alone, on behalf of, or in connection with any organization. Nuclear, Chemical, Biological, or Radiological Agents or Materials means: 1.nuclear reaction, nuclear radiation or radioactive particles, whether released or dispersed by nuclear or conventional devices; 2.any chemical compound; or 3.any pathogen, in sufficient concentration to cause harm to people or damage to property. All other terms and conditions remain unchanged. Endorsement effective:January 1, 2025 Policy No.:P102.753.902.2 Endorsement No:5 By: Kevin Kerridge (Appointed Representative) DPL E1919 CW (03/23) Hiscox Insurance Company Inc. Endorsement 6 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises Cannabis Exclusion Endorsement Page 1 of 1 In consideration of the premium charged, it is understood and agreed that the Policy is amended as follows: 1.The following is added to the end of Clause III. EXCLUSIONS: This Policy does not apply to and We shall have no obligation to pay any Damages, Claim Expenses, or Supplemental Payments for any Claim: CA-1.based upon or arising out of, directly or indirectly occasioned by, or in consequence of: 1.the design, cultivation, manufacture, storage, transport, processing, packaging, handling, testing, distribution, sale, serving, furnishing, possession, protection, or disposal of Cannabis by anyone; 2.the actual, alleged, threatened, or suspected use, inhalation, ingestion, absorption, or consumption of, contact with, exposure to, existence of, or presence of Cannabis by anyone; or 3.the performance of or failure to perform any services or operations of any kind, including but not limited to any banking, advisory, consulting, legal, compliance, financial, design, or logistical services, in connection with or relating to Cannabis. This exclusion applies even if the Claim against any Insured alleges negligence or other wrongdoing in the supervision, hiring, employment, training, or monitoring of others by that Insured. 2.The following is added to the end of Clause VI. DEFINITIONS: CA-A.Cannabis means any good or product that consists of or contains any amount of Tetrahydrocannabinol (THC) or any other cannabinoid, regardless of whether any such THC or cannabinoid is natural or synthetic. Cannabis includes but is not limited to any of the following containing such THC or cannabinoid: 1.any plant of the genus Cannabis L., or any part thereof, such as seeds, stems, flowers, stalks and roots; or 2.any compound, byproduct, extract, derivative, mixture or combination, such as: a.resin, oil or wax; b.hash or hemp; or c.infused liquid or edible cannabis; whether or not derived from any plant or part of any plant set forth in paragraph 1 above. All other terms and conditions remain unchanged. Endorsement effective:January 1, 2025 Policy No.:P102.753.902.2 Endorsement No:6 By: Kevin Kerridge (Appointed Representative) DPL E1918 CW (03/23) Hiscox Insurance Company Inc. Endorsement 7 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises Misappropriation of Funds Exclusion Endorsement Page 1 of 1 In consideration of the premium charged, it is understood and agreed that the Policy is amended as follows: The following is added to the end of Clause III. EXCLUSIONS: This Policy does not apply to and We will have no obligation to pay any Damages, Claim Expenses, or Supplemental Payments for any Claim: MF-A.based upon or arising out of any actual or alleged theft, misappropriation, commingling, conversion of, or inability or failure to safeguard any funds, monies, assets, or property, regardless of ownership. All other terms and conditions remain unchanged. Endorsement effective:January 1, 2025 Policy No.:P102.753.902.2 Endorsement No:7 By: Kevin Kerridge (Appointed Representative) DPL E0003 CW (08/23) Hiscox Insurance Company Inc. Endorsement 8 NAMED INSURED: Charles E Jones Jr DBA Jones Enterprises Anti-Stacking Endorsement (Single Limit)Page 1 of 1 In consideration of the premium charged, it is understood and agreed that the Policy is amended as follows: The following is added to the end of Clause IV. LIMITS OF LIABILITY, DEDUCTIBLE AND RELATED CLAIMS: D.Multiple policies issued by us If this Policy provides coverage for any Claim, Wrongful Act, occurrence, or offense which is also covered by another policy issued by Us or a related company, the maximum We will pay under all such policies is a single Limit of Liability, which will not exceed the highest applicable Limit of Liability available for the Claim, Wrongful Act, occurrence, or offense under any one policy. All other terms and conditions remain unchanged. Endorsement effective:January 1, 2025 Policy No.:P102.753.902.2 Endorsement No:8 By: Kevin Kerridge (Appointed Representative) DPL E0005 CW (12/23) Notices Policyholder Notice Electronic Delivery Page 1 of 1 INT N003 CW (01/19) If you received your insurance policy by email, it is because you have chosen electronic delivery of your policy documents and important notices, including cancellation and nonrenewal notices where permitted by law. We also will send any renewal policy documents to you by email at the address you have provided. If you are currently receiving paper documents and would like to have ease of retrieval and access and save on storage space, you will need to contact us and update your preferences. Most documents can be sent electronically within minutes. For electronic documents, you will need a computer or mobile device with Internet access and the ability to receive external emails. You also will need software such as Adobe Reader®that allows you to view and save PDF documents, and a printer to create paper copies. At any time you may request a paper copy of your policy,or you may withdraw your consent to receive documents by email. We will then send documents to you by US mail at no added cost. You must notify us if your email or street address changes. To update your email or street address, or to request paper documents,please contact us at 888-202-3007. Hiscox Insurance Company Inc. ECONOMIC AND TRADE SANCTIONS POLICYHOLDER NOTICE INT N001 CW 01 09 Page 1 of 1 Hiscox is committed to complying with the U.S. Department of Treasury Office of Foreign Assets Control (OFAC) requirements. OFAC administers and enforces economic sanctions policy based on Presidential declarations of national emergency. OFAC has identified and listed numerous foreign agents, front organizations, terrorists, and narcotics traffickers as Specially Designated Nationals (SDN’s) and Blocked Persons. OFAC has also identified Sanctioned Countries. A list of Specially Designated Nationals, Blocked Persons and Sanctioned Countries may be found on the United States Treasury’s web site http://www.treas.gov/offices/enforcement/ofac/. Economic sanctions prohibit all United States citizens (including corporations and other entities) and permanent resident aliens from engaging in transactions with Specially Designated Nationals, Blocked Persons and Sanctioned Countries. Hiscox may not accept premium from or issue a policy to insure property of or make a claim payment to a Specially Designated National or Blocked Person. Hiscox may not engage in business transactions with a Sanctioned Country. A Specially Designated National or Blocked Person is any person who is determined as such by the Secretary of Treasury. A Sanctioned Country is any country that is the subject of trade or economic embargoes imposed by the laws or regulations of the United States. In accordance with laws and regulations of the United States concerning economic and trade embargoes, this policy may be rendered void from its inception with respect to any term or condition of this policy that violates any laws or regulations of the United States concerning economic and trade embargoes including, but not limited to the following: (1) Any insured under this Policy, or any person or entity claiming the benefits of such insured, who is or becomes a Specially Designated National or Blocked Person or who is otherwise subject to US economic trade sanctions; (2) Any claim or suit that is brought in a Sanctioned Country or by a Sanctioned Country government, where any action in connection with such claim or suit is prohibited by US economic or trade sanctions; (3) Any claim or suit that is brought by any Specially Designated National or Blocked Person or any person or entity who is otherwise subject to US economic or trade sanctions; (4) Property that is located in a Sanctioned Country or that is owned by, rented to or in the care, custody or control of a Sanctioned Country government, where any activities related to such property are prohibited by US economic or trade sanctions; or (5) Property that is owned by, rented to or in the care, custody or control of a Specially Designated National or Blocked Person, or any person or entity who is otherwise subject to US economic or trade sanctions. Please read your Policy carefully and discuss with your broker/agent or insurance professional. You may also visit the US Treasury’s website at http://www.treas.gov/offices/enforcement/ofac/. Page 1 of 5 CA 0 1 0 R B D Renewal auto policy declarations Your policy effective date is November 4, 2024 Information as of September 12, 2024 Summary Named Insured(s) Charles Jones, Kelli Jones Mailing address 1005 White Oak Dr San Jose CA 95129-3157 Policy number 927 224 739 Your policy provided by Allstate Northbrook Indemnity Company Policy period Beginning November 4, 2024 through May 4, 2025 at 12:01 a.m. standard time Your Allstate agency is Pinnacle One Ins 1125 Saratoga Ave San Jose CA 95129 (408) 257-1234 rvarich@allstate.com Some or all of the information on your Policy Declarations is used in the rating of your policy or it could affect your eligibility for certain coverages. Please notify us immediately if you believe that any information on your Policy Declarations is incorrect. We will make corrections once you have notified us, and any resulting rate adjustments, will be made only for the current policy period or for future policy periods. Please also notify us immediately if you believe any coverages are not listed or are inaccurately listed. Total Amount Due for the Policy Period Please review your insured vehicles and verify their VINs are correct. Vehicles covered Identification Number Premium 2020 Tesla 3 5YJ3E1EB7LF635835 $1,669.38 2021 Tesla Y 5YJYGDEE3MF094621 1,179.39 California Fraud Assessment Fee 1.76 Additional coverages 19.08 Total*$2,869.61 * Your bill will be mailed separately. Before making a payment, please refer to your latest bill, which includes payment options and installment fee information. If you do not pay in full, you will be charged an installment fee(s). See the Important payment and coverage information section for details about installment fees. Discounts (included in your total premium) Anti-theft $20.62 Good Driver (20%)$694.48 Multiple Policy $85.36 Distinguished Driver $606.35 Total discounts $1,406.81 Discounts per vehicle 2020 Tesla 3 $807.25 Anti-theft $10.78 Good Driver (20%)$399.62 Multiple Policy $49.16 Distinguished Driver $347.69 2021 Tesla Y $599.56 Anti-theft $9.84 Good Driver (20%)$294.86 Multiple Policy $36.20 Distinguished Driver $258.66 Listed drivers on your policy Charles Jones Kelli Jones Excluded drivers from your policy None Renewal auto policy declarations Policy number: 927 224 739 Policy effective date:November 4, 2024 CA 0 1 0 R B D X2 1 01 0 07 4 24 0 9 1 3 A E 0 1 1 4 5 00 0 0 0 0 9 2 7 2 2 4 7 3 9 2 4 0 9 1 3 A E 0 1 1 4 5 A U T AU T R2 4 C A 20 2 4 0 9 1 3 0 3 0 8 0 3 01 A- 00 1 1 4 5 -00 7 -0-02-00 Page 2 of 5 Coverage detail for 2020 Tesla 3 Coverage Limits Deductible Premium Automobile Liability Insurance Not applicable $488.96 • Bodily Injury $250,000 each person $500,000 each occurrence • Property Damage $100,000 each occurrence Auto Collision Insurance Actual cash value $1,000 $776.52 Waiver of deductible applies Auto Comprehensive Insurance Actual cash value $250 $204.94 Rental Reimbursement Not purchased* Towing and Labor Costs Not purchased* Uninsured Motorists Insurance for Bodily Injury $250,000 each person $500,000 each accident Not applicable $198.96 Automobile Medical Payments Not purchased* Coordinated Medical Protection Not purchased* Sound System Not purchased* Tape Not purchased* Total premium for 2020 Tesla 3 $1,669.38 * This coverage can provide you with valuable protection. To help you stay current with your insurance needs, contact your Allstate agent to discuss coverage options and other products and services that can help protect you. VIN 5YJ3E1EB7LF635835 Rating information Your premium is determined based on certain information, including the following: •This vehicle is driven 0-3 miles to work/school, married person licensed 50 years. Allstate uses mileage information as one factor to help determine your premium amount. Important Note: The annual mileage figure applicable to this vehicle for the expiring policy period was: 11,500 - 11,999. The annual mileage figure applicable to this vehicle for the current policy period is: 16,000 - 16,499. The following odometer information was used to determine your annual mileage for current policy period: Odometer Reading: 32,601 Odometer Reading: 47,293 Date : 08/07/2023 Date : 07/06/2024 If any of the information shown above is incorrect, missing or changes in the future, please contact your Allstate representative. Please keep in mind that a change in any of the information may result in an adjustment to your premium. Renewal auto policy declarations Policy number: 927 224 739 Policy effective date:November 4, 2024 CA 0 1 0 R B D Page 3 of 5 Coverage detail for 2021 Tesla Y Coverage Limits Deductible Premium Automobile Liability Insurance Not applicable $268.07 • Bodily Injury $250,000 each person $500,000 each occurrence • Property Damage $100,000 each occurrence Auto Collision Insurance Actual cash value $1,000 $588.60 Waiver of deductible applies Auto Comprehensive Insurance Actual cash value $250 $186.86 Rental Reimbursement Not purchased* Towing and Labor Costs Not purchased* Uninsured Motorists Insurance for Bodily Injury $250,000 each person $500,000 each accident Not applicable $135.86 Automobile Medical Payments Not purchased* Coordinated Medical Protection Not purchased* Sound System Not purchased* Tape Not purchased* Total premium for 2021 Tesla Y $1,179.39 * This coverage can provide you with valuable protection. To help you stay current with your insurance needs, contact your Allstate agent to discuss coverage options and other products and services that can help protect you. VIN 5YJYGDEE3MF094621 Rating information Your premium is determined based on certain information, including the following: •This vehicle is driven 0-3 miles to work/school, married person licensed 48 years. Lienholder Digital Federal Credit Union Allstate uses mileage information as one factor to help determine your premium amount. Important Note: The annual mileage figure applicable to this vehicle for the expiring policy period was: 3,500 - 3,999. The annual mileage figure applicable to this vehicle for the current policy period is: 4,500 - 4,999. The following odometer information was used to determine your annual mileage for current policy period: Odometer Reading: 10,122 Odometer Reading: 14,523 Date : 08/07/2023 Date : 07/06/2024 If any of the information shown above is incorrect, missing or changes in the future, please contact your Allstate representative. Please keep in mind that a change in any of the information may result in an adjustment to your premium. Renewal auto policy declarations Policy number: 927 224 739 Policy effective date:November 4, 2024 CA 0 1 0 R B D X2 1 01 0 07 4 24 0 9 1 3 A E 0 1 1 4 5 00 0 0 0 0 9 2 7 2 2 4 7 3 9 2 4 0 9 1 3 A E 0 1 1 4 5 A U T AU T R2 4 C A 20 2 4 0 9 1 3 0 3 0 8 0 3 01 A- 00 1 1 4 5 -00 8 -0-02-00 Page 4 of 5 Additional coverages The following policy coverages are also provided. Coverage Limits Deductible Premium Automobile Death Indemnity Insurance $4.08 • Named Insured • Spouse of Named Insured $15,000 benefit $15,000 benefit Not applicable Automobile Disability Income Protection Not purchased* Identity Theft Expenses $25,000 per premium period Not applicable $15.00 Total $19.08 * This coverage can provide you with valuable protection. To help you stay current with your insurance needs, contact your Allstate agent to discuss coverage options and other products and services that can help protect you. Your policy documents Your automobile policy consists of this Policy Declarations and the documents in the following list. Please keep these together. •Allstate Automobile Policy – AU104-3 •California Paperless Disclosure – AU14943 •Amendment of Policy Provisions – AU14626-1 •Identity Theft Expenses-Coverage IT – AU14256 •California Amendatory Endorsement – AU14629-3 Important payment and coverage information Here is some additional, helpful information related to your coverage and paying your bill: uYour rate is lower because you are insuring multiple cars. uYour bill will be sent to you in a separate mailing and will list any payment option(s) available to you. If you are eligible to pay your premium in installments, your first bill will reflect your available payment options, including the option to pay in full or to pay in monthly installments. Please note that any amounts payable for the first renewal bill will not include an installment fee (unless you have an unpaid balance from a previous policy period, in which case the Minimum Amount Due will include an installment fee, or unless you are participating in the Allstate Easy Pay Plan). The following applies to installment payments made after your first renewal bill. If you decide to pay your premium in installments, there will be a $3.50 installment fee charge for each payment due. If you make 5 installment payments during the policy period, and do not change your payment plan method, then the total amount of installment fees during the policy period will be $17.50. If you are on the Allstate® Easy Pay Plan, there will be a $1.00 installment fee charge for each payment due. If you make 5 installment payments during the policy period, and remain on the Allstate® Easy Pay Plan, then the total amount of installment fees during the policy period will be $5.00. If you change payment plan methods or make additional payments, your installment fee charge for each payment due and the total amount of installment fees during the policy period may change or even increase. Please note that the Allstate® Easy Pay Plan allows you to have your insurance payments automatically deducted from your checking or savings account. Renewal auto policy declarations Policy number: 927 224 739 Policy effective date:November 4, 2024 CA 0 1 0 R B D Page 5 of 5 Allstate Northbrook Indemnity Company's Secretary and President have signed this policy with legal authority at Northbrook, Illinois. Phil Telgenhoff President Courtney Welton Secretary Important notices Policy number: 927 224 739 Policy effective date:November 4, 2024 X2 1 01 0 07 4 24 0 9 1 3 A E 0 1 1 4 5 00 0 0 0 0 9 2 7 2 2 4 7 3 9 2 4 0 9 1 3 A E 0 1 1 4 5 A U T AU T R2 4 C A 20 2 4 0 9 1 3 0 3 0 8 0 3 01 A- 00 1 1 4 5 -00 9 -0-02-00 Page 1 of 3 Reasons for Extension, Cancellation or Nonrenewal California law requires Allstate to provide you with reasons why your policy may be extended, canceled or nonrenewed or your premium increased. Allstate may cancel or nonrenew your policy for one or more of the following reasons: Ñ Nonpayment of premium; Ñ Fraud or material misrepresentation affecting the policy or the insured; or Ñ Substantial increase in the hazard we insure against. In addition, your policy may be nonrenewed or your premium may be increased for any of the following reasons: Ñ Accident involvement by an insured and whether the insured is at fault in the accident; Ñ A change in, or addition of, an insured vehicle; Ñ A change in, or addition of, an insured under the policy; Ñ A change in the location of garaging of an insured vehicle; Ñ A change in the use of an insured vehicle; Ñ Conviction for violating any provision of the Vehicle Code or Penal Code relating to the operation of a motor vehicle; Ñ The payment made by an insurer due to a claim filed by an insured or a third party; Ñ Any other reason that is lawful and not unfairly discriminatory. Accidents and convictions for violating any provision of the Vehicle Code or Penal code relating to the operation of a motor vehicle that occur within the 36-month period ending on the effective date of the policy may lead to an increase of your premium. You have the right to be informed, upon your request, of any increase in premium, in whole or in part, charged to you because of an accident or conviction. Under certain circumstances, if we fail to send your renewal offer at least 20 days prior to your renewal effective date or if we fail to send your nonrenewal notice at least 30 days prior to the nonrenewal effective date, California law requires us to extend your existing policy term for 30 days from the date the notice is mailed or delivered to you. Other Uninsured Motorist Coverage Options Your policy has been issued with the coverages and options you requested. Please refer to the enclosed Policy Declarations to verify that your policy has been issued according to your requests. However, please be aware that you still have options concerning coverage for damages to your insured auto that you are legally entitled to recover from the owner or operator of an uninsured motor vehicle. The following options are available for each vehicle under your policy. Please see your Policy Declarations to determine your current coverages for each of your vehicles. Ñ If your vehicle is insured for Auto Collision Insurance, we are offering a Waiver of your Collision Coverage Deductible to apply when the vehicle is damaged in an accident caused by an uninsured motor vehicle. Ñ If your vehicle is not insured for Auto Collision Insurance and is insured for Uninsured Motorists Insurance for bodily injury, we are offering you the opportunity to extend your Uninsured Motorists Insurance to cover property damage. Ñ You still have the option of rejecting either the Waiver of Collision Coverage Deductible or Uninsured Motorists Insurance for property damage, or both coverages. If a vehicle insured under your policy is damaged by an uninsured motor vehicle and you are legally entitled to recover damages, we will, depending on the coverage you purchase, either: Ñ Pay the collision deductible on the insured motor vehicle when you have purchased collision coverage, or Ñ Pay for the damage to the insured motor vehicle when you have not purchased collision coverage but have purchased Uninsured Motorists Insurance for property damage. Payment shall not include damage to personal property or loss of use of a motor vehicle and shall not exceed the smaller of: Ñ The amount of the collision deductible, Ñ The actual cash value of the insured motor vehicle, Ñ $3500. The law also permits you to reject these coverages completely. If you would like to purchase one of these coverages or make any other changes concerning these coverage options, please call your Allstate Agent. If You Have a Problem with Your Insurance Please contact your Allstate representative if you have any questions or concerns about your insurance. If a problem arises that you and your Allstate representative are unable to resolve satisfactorily, please call or write to: Allstate Customer Service PO Box 660598, Dallas, TX 75266-0598 1-800-ALLSTATE SM (1-800-255-7828) Page 2 of 3 Important notices Policy number: 927 224 739 Policy effective date:November 4, 2024 If the problem remains unresolved, you may contact the California Department of Insurance at: Consumer Services Division California Department of Insurance 300 South Spring Street, Los Angeles, CA 90013 Consumer Hotline: 1-800-927-4357 Website: http://www.insurance.ca.gov/01-consumers/101-help/index .cfm Please contact the Department of Insurance only if you have been unable to satisfactorily resolve the problem with your Allstate representative and with Allstate. X5126-4 Voluntary Provider Networks We want to let you know about a program that may be available to you. If you, or anyone covered under your policy, is injured in a loss covered under your auto policy, a Voluntary Provider Network may be available to you. A Voluntary Provider Network includes a variety of participating medical providers that can treat those injuries. Voluntary Provider Networks maintain lists of their participating providers. In the event that you experience a loss, your claims representative can provide you with contact information for any participating Allstate networks that may be available in your state at that time. You are under no obligation to use a medical provider who is a member of one of these networks, and you are free to seek medical services from a provider of your choice. There is no penalty if you choose a provider outside the network. If you are injured and treated by a provider who is a member of one of the participating networks, we may review their bills for covered medical services for re-pricing based on the approved rate for that provider’s network. You do not need to make a choice about these networks at this time. Please keep in mind that using a provider within a network should not be considered a confirmation that you have coverage. This notice is for informational purposes only. X73469 Notice of Right to Designate a Third Party We want you to know that you have the right to designate one additional individual to receive copies of any coverage termination notices that we may issue if you fail to pay the required premium when due. You also have the right to replace the individual you previously designated or terminate the third party designation entirely. This third party will not receive copies of your regular billing statements or any other documents for your policy. How to start, change or end a third party designation To add, change or remove a third party simply contact your Allstate Agent or representative to receive a copy of a Third Party Designation form. After you return the form with the name and address of the designee or any changes you wish to make, we will process your request. Additionally, we will notify you annually of your right to designate a third party. If you have already designated a third party and do not wish to make any changes, you do not need to do anything. If you have questions Please contact your Allstate Agent or representative, or call us at 1-800-ALLSTATE (1-800-255-7828) if you have any questions or would like more information. X73598 Important information about the Good Driver Discount The Good Driver Discount gives a driver the opportunity to receive a discount for having a good driving history. Depending on your driving experience and information in your driving record, (such as the number of traffic violation convictions or accidents), you could be eligible for a 20% discount on your auto insurance premiums. Please Note: If a driver is no longer eligible for a Good Driver Discount policy because of the driving safety record or years of driving experience of any other person, the good driver is eligible to purchase a Good Driver Discount policy which excludes such other persons from coverage. If you want to exclude such other persons from your auto policy so that Allstate can offer you the Good Driver Discount policy, please contact your Allstate agent or representative. This change may affect your premium and any discounts currently on your policy. Questions? Important notices Policy number: 927 224 739 Policy effective date:November 4, 2024 X2 1 01 0 07 4 24 0 9 1 3 A E 0 1 1 4 5 00 0 0 0 0 9 2 7 2 2 4 7 3 9 2 4 0 9 1 3 A E 0 1 1 4 5 A U T AU T R2 4 C A 20 2 4 0 9 1 3 0 3 0 8 0 3 01 A- 00 1 1 4 5 -01 0 -0-02-00 Page 3 of 3 If you think you may qualify, have any questions regarding the Good Driver Discount or your coverage in general, please feel free to contact your Allstate agent or representative. X73866 Page 1 of 2 Page 2 of 2Policy number: 927 224 739 Policy effective date:November 4, 2024 X2 1 01 0 07 4 24 1 2 1 1 C E 0 3 2 3 5 00 0 0 0 0 9 2 7 2 2 4 7 3 9 2 4 1 2 1 1 C E 0 3 2 3 5 A U T AU T R2 4 C A 20 2 4 1 2 1 1 0 4 0 2 4 6 01 A- 00 3 2 3 5 -00 1 -0-00-00 Your Insurance Coverage Checklist We’re happy to have you as an Allstate customer! This checklist outlines what’s in this package and provides answers to some basic questions, as well as any “next steps” you may need to take. A guide to your amended package £What’s in this package? See the guide below for the documents that are included. Next steps: review your Policy Declarations to confirm you have the coverages, coverage limits, premiums and savings that you requested and expected. Read any Endorsements or Important Notices to learn about new policy changes, topics of special interest, as well as required communications. Keep all of these documents with your other important insurance papers. £Am I getting all the discounts I should? Confirm with your Allstate Agent that you’re benefiting from all the discounts you’re eligible to receive. £What about my bill? Unless you’ve already paid your premium in full, we’ll send your bill separately. Next steps: please pay the minimum amount by the due date listed on it. You can also pay your bill online at Allstate.com/support or through the Allstate mobile app. If you’re enrolled in the Allstate® Easy Pay Plan, we’ll send you a statement detailing your payment withdrawal schedule. Para español, Ilamar al 1-800-979-4285. £What if I have questions? Visit Allstate.com/support to browse our list of frequently asked questions and find information regarding billing or policy documents. You can also create an online account to access and manage your policies. Para español, Ilamar al 1-800-979-4285. Policy Declarations* The Policy Declarations lists policy details, such as your specific drivers, vehicles and coverages. Policy Endorsements If changes are made to your policy, these documents will include your new contract language. Important Notices We use these notices to call attention to particularly important coverages, policy changes and discounts. Insurance Made Simple Insurance seem complicated? Our online guides explain coverage terms and features: www.allstate.com/ madesimple Espanol.allstate.com /facildeentender * To make it easier to see where you may have gaps in your protection, we’ve highlighted any coverages you do not have in the Coverage Detail section in the enclosed Policy Declarations. Page 1 of 6 Amended auto policy declarations Policy number: 927 224 739 Policy effective date:November 4, 2024 CA 0 1 0 A M D X2 1 01 0 07 4 24 1 2 1 1 C E 0 3 2 3 5 00 0 0 0 0 9 2 7 2 2 4 7 3 9 2 4 1 2 1 1 C E 0 3 2 3 5 A U T AU T R2 4 C A 20 2 4 1 2 1 1 0 4 0 2 4 6 01 A- 00 3 2 3 5 -00 2 -0-00-00 Page 2 of 6 Additional interested party A Certificate of Insurance was sent to: The City of Cupertno 10300 Torre Ave Cupertino, CA 95014-3202 Amended auto policy declarations Policy number: 927 224 739 Policy effective date:November 4, 2024 CA 0 1 0 A M D X2 1 01 0 07 4 24 1 2 1 1 C E 0 3 2 3 5 00 0 0 0 0 9 2 7 2 2 4 7 3 9 2 4 1 2 1 1 C E 0 3 2 3 5 A U T AU T R2 4 C A 20 2 4 1 2 1 1 0 4 0 2 4 6 01 A- 00 3 2 3 5 -00 3 -0-00-00 Page 4 of 6 Coverage detail for 2021 Tesla Y Coverage Limits Deductible Premium Automobile Liability Insurance Not applicable $268.07 • Bodily Injury $250,000 each person $500,000 each occurrence • Property Damage $100,000 each occurrence Auto Collision Insurance Actual cash value $1,000 $588.60 Waiver of deductible applies Auto Comprehensive Insurance Actual cash value $250 $186.86 Rental Reimbursement Not purchased* Towing and Labor Costs Not purchased* Uninsured Motorists Insurance for Bodily Injury $250,000 each person $500,000 each accident Not applicable $135.86 Automobile Medical Payments Not purchased* Coordinated Medical Protection Not purchased* Sound System Not purchased* Tape Not purchased* Total premium for 2021 Tesla Y $1,179.39 * This coverage can provide you with valuable protection. To help you stay current with your insurance needs, contact your Allstate agent to discuss coverage options and other products and services that can help protect you. VIN 5YJYGDEE3MF094621 Rating information Your premium is determined based on certain information, including the following: •This vehicle is driven 0-3 miles to work/school, married person licensed 48 years. Lienholder Digital Federal Credit Union Allstate uses mileage information as one factor to help determine your premium amount. Important Note: The annual mileage figure applicable to this vehicle for the expiring policy period was: 3,500 - 3,999. The annual mileage figure applicable to this vehicle for the current policy period is: 4,500 - 4,999. The following odometer information was used to determine your annual mileage for current policy period: Odometer Reading: 10,122 Odometer Reading: 14,523 Date : 08/07/2023 Date : 07/06/2024 If any of the information shown above is incorrect, missing or changes in the future, please contact your Allstate representative. Please keep in mind that a change in any of the information may result in an adjustment to your premium. Amended auto policy declarations Policy number: 927 224 739 Policy effective date:November 4, 2024 CA 0 1 0 A M D X2 1 01 0 07 4 24 1 2 1 1 C E 0 3 2 3 5 00 0 0 0 0 9 2 7 2 2 4 7 3 9 2 4 1 2 1 1 C E 0 3 2 3 5 A U T AU T R2 4 C A 20 2 4 1 2 1 1 0 4 0 2 4 6 01 A- 00 3 2 3 5 -00 4 -0-00-00 Page 6 of 6 Allstate Northbrook Indemnity Company's Secretary and President have signed this policy with legal authority at Northbrook, Illinois. Phil Telgenhoff President Courtney Welton Secretary Important notices Policy number: 927 224 739 Policy effective date:November 4, 2024 X2 1 01 0 07 4 24 1 2 1 1 C E 0 3 2 3 5 00 0 0 0 0 9 2 7 2 2 4 7 3 9 2 4 1 2 1 1 C E 0 3 2 3 5 A U T AU T R2 4 C A 20 2 4 1 2 1 1 0 4 0 2 4 6 01 A- 00 3 2 3 5 -00 5 -0-00-00 Page 1 of 1 You’ve recently made a change to your policy The State of California recently passed Assembly Bill 1511, which requires insurers to provide the following statement when you’ve made a change to your policy: “For your protection, California law requires the following to appear on this form: Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.” Have questions? Please contact us. If you have any questions regarding this information or your insurance coverage in general, please feel free to contact your Allstate Agent or representative. X74018 Leading and Managing Meetings Final Audit Report 2024-12-20 Created:2024-12-18 By:Webmaster Admin (webmaster@cupertino.org) Status:Signed Transaction ID:CBJCHBCAABAAb49MoyWsLV8eHAI5HG6TcJ2GG1Ltg_bF "Leading and Managing Meetings" History Document created by Webmaster Admin (webmaster@cupertino.org) 2024-12-18 - 7:33:27 PM GMT- IP address: 35.229.54.2 Document emailed to aracelia@cupertino.gov for approval 2024-12-18 - 7:36:49 PM GMT Email viewed by aracelia@cupertino.gov 2024-12-18 - 7:36:59 PM GMT- IP address: 52.202.236.132 Document approval delegated to Araceli Alejandre (aracelia@cupertino.org) by aracelia@cupertino.gov 2024-12-18 - 9:13:07 PM GMT- IP address: 64.165.34.3 Document approved by Araceli Alejandre (aracelia@cupertino.org) Approval Date: 2024-12-18 - 9:16:53 PM GMT - Time Source: server- IP address: 64.165.34.3 Document emailed to chappiejones@gmail.com for signature 2024-12-18 - 9:16:54 PM GMT Email viewed by chappiejones@gmail.com 2024-12-18 - 9:19:38 PM GMT- IP address: 172.226.212.3 Signer chappiejones@gmail.com entered name at signing as Charles E Jones Jr 2024-12-20 - 8:23:24 PM GMT- IP address: 99.189.239.53 Document e-signed by Charles E Jones Jr (chappiejones@gmail.com) Signature Date: 2024-12-20 - 8:23:26 PM GMT - Time Source: server- IP address: 99.189.239.53 Document emailed to christopherj@cupertino.gov for signature 2024-12-20 - 8:23:28 PM GMT Email viewed by christopherj@cupertino.gov 2024-12-20 - 8:23:35 PM GMT- IP address: 52.202.236.132 Signer christopherj@cupertino.gov entered name at signing as Christopher D. Jensen 2024-12-20 - 9:00:04 PM GMT- IP address: 104.1.88.56 Document e-signed by Christopher D. Jensen (christopherj@cupertino.gov) Signature Date: 2024-12-20 - 9:00:06 PM GMT - Time Source: server- IP address: 104.1.88.56 Document emailed to Pamela Wu (pamelaw@cupertino.org) for signature 2024-12-20 - 9:00:08 PM GMT Email viewed by Pamela Wu (pamelaw@cupertino.org) 2024-12-20 - 9:00:21 PM GMT- IP address: 52.202.236.132 Document e-signed by Pamela Wu (pamelaw@cupertino.org) Signature Date: 2024-12-20 - 9:05:02 PM GMT - Time Source: server- IP address: 64.165.34.3 Document emailed to kirstens@cupertino.gov for signature 2024-12-20 - 9:05:18 PM GMT Email viewed by kirstens@cupertino.gov 2024-12-20 - 9:05:26 PM GMT- IP address: 3.232.50.116 Signer kirstens@cupertino.gov entered name at signing as Kirsten Squarcia 2024-12-20 - 9:36:17 PM GMT- IP address: 174.194.201.107 Document e-signed by Kirsten Squarcia (kirstens@cupertino.gov) Signature Date: 2024-12-20 - 9:36:19 PM GMT - Time Source: server- IP address: 174.194.201.107 Agreement completed. 2024-12-20 - 9:36:19 PM GMT