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HomeMy WebLinkAbout25-001 World Cup Soccer Camps & Classes for Youth Sports ProgramsCITY OF CUPERTINO RECREATION SERVICES AGREEMENT No. FY2026 - 2029 1. Parties. This contract is made by and between the City of Cupertino, a municipal corporation ("City"), and World Cup Soccer Camps & Classes ("Contractor"), a Corporation for Youth Sports Programs and is effective on 01/01/2026 ("Effective Date"). 2. Services. Contractor agrees to provide the Services included in the Scope of Work and in accordance with the Schedule of Performance attached in Exhibit A. 3. Term. This contract begins on the Effective Date and ends on 12/31/2028 ("Contract Time"), unless extended or terminated as provided herein. Time is of the essence and Contractor must have sufficient time, resources, and qualified staff to deliver the Services as required. Contractor must promptly notify City of any actual or potential delays to afford the Parties adequate opportunity to address or mitigate such delays. The City's appropriate department head or the City Manager may extend the Contract Time through a written amendment to this Agreement, provided such extension does not include additional contract funds. Extensions requiring additional contract funds are subject to the City's purchasing policy. 4. Compensation. City will pay Contractor for satisfactory performance of the Services an amount that will be based upon actual costs but that will be capped so as not to exceed $99,000.00 ("Contract Price"), based upon the Scope of Services, performance schedule, and rates included in Exhibit A. The maximum compensation includes all costs, expenses, and reimbursements and will remain in place even if Contractor's actual costs exceed the capped amount. Contractor must submit invoices and the information required in Exhibit A in order to receive payment. City will compensate Contractor within thirty (30) days after approval of written invoices. Invoices are subject to review and audit by City during regular business hours upon 24 hours' notice. Contractor must maintain complete and accurate records of payrolls, expenditures, disbursements and other cost items charged to City or establishing the basis for an invoice, for a minimum of four (4) years from the date of the final payment. 5. Independent Contractor. 5.1 Contractor is an independent Contractor and not an employee, partner, or joint venture of City. Contractor is solely responsible for the means and methods of performing the Services and for the persons hired to work under this Agreement. No civil service status or other right of employment will be acquired by virtue of Contractor's performance of the Services. Contractor is not entitled to City's health benefits, worker's compensation or any other benefit. Contractor must have the skills and qualifications to perform the Services in a competent and professional manner. Recreation Services Agreement/ Rev. April 2025 Page 1 of 7 Contractor will supply all tools, materials, and equipment required to perform the Services under this Contract. Contractor is responsible for obtaining permits and licenses required by law and must obtain a City business license, if required by the Cupertino Municipal Code. 5.2 Contractor is solely responsible for the payment of employment taxes incurred under this Agreement and any similar federal or state taxes. Contractor and any of its employees, agents, and subcontractors shall not have any claim under this Agreement or otherwise against City for seniority, vacation time, vacation pay, sick leave, personal time off, overtime, health insurance, medical care, hospital care, insurance benefits, social security, disability, unemployment, workers compensation or employee benefits of any kind. Contractor shall be solely liable for and obligated to pay directly all applicable taxes, fees, contributions, or charges applicable to Contractor's business including, but not limited to, federal and state income taxes. City shall have no obligation whatsoever to pay or withhold any taxes or benefits on behalf of Contractor. In the event that Contractor or any employee, agent, or subcontractor of Contractor providing services under this Agreement is determined by a court of competent jurisdiction, arbitrator, or administrative authority, including but not limited to the California Public Employees Retirement System (PERs) to be eligible for enrollment in PERS as an employee of City, Contractor shall indemnify, defend, and hold harmless City for the payment of any employee and/or employer contributions for PERS benefits on behalf of Contractor or its employees, agents, or subcontractors, as well as for the payment of any penalties and interest on such contributions, which would otherwise be the responsibility of City, and actual attorney's fees incurred by City in connection with the above. 6. Proprietary/Confidential Information. To the extent Contractor may have access to private or confidential information owned or controlled by the City, Contractor agrees to treat it as confidential and use it solely to perform this Agreement. Contractor must exercise the same standard of care to protect City information as a reasonably prudent Contractor would use to protect its own proprietary data. 7. Ownership of Materials. To the extent Contractor prepares written material, drawings, or data in connection with this contract, City will have the property rights to those materials and all copyrights, if any, to such work product will, to the extent requested by City, constitute City property upon completion of the work to be performed hereunder or upon termination of this Agreement. 8. Records. Contractor must maintain complete, accurate, and detailed accounting records relating to its performance in accordance with generally accepted accounting principles and procedures. The records must include detailed information about Contractor's services, benchmarks, deliverables, and costs/fees, and must be made reasonably available to City. The records and supporting documents must be kept separate from other files and maintained for four (4) years from the date of City's final payment. Recreation Services Agreement/ Rev. April 2025 Page 2 of 7 9. Assignment. This Contract is not assignable. Contractor may not substitute another or transfer any rights or obligations under this Contract without prior written approval of City. Only those persons whose names are included in Exhibit A may perform the Services. 10. Publicity and Signs. Any publicity generated by Contractor related to this contract or the Services during the Contract Time and for one (1) year thereafter must reference City contributions. The words "City of Cupertino" shall be displayed in all pieces of publicity, including flyers, press releases, posters, brochures, public service announcements, interviews, and newspaper articles. No signs may be posted, exhibited, or displayed on or about City property, except signage required by law or under this Agreement, without prior written approval from City. 11. Indemnification. To the fullest extent allowed by law and except for losses caused by the sole and active negligence or willful misconduct of City personnel, Contractor agrees to indemnify, defend, and hold harmless the City, its City Council, boards and commissions, officers, officials, employees, agents, servants, volunteers, and contractors (collectively, "Indemnitees"), through legal counsel acceptable to City, from and against any liability for damages, claims, actions, causes of action, demands, charges, losses, costs, and expenses (including attorney fees, legal costs, and expenses related to litigation, arbitrations, administrative, and regulatory proceedings), of every nature, arising out of or in any way related to Contractor's or Contractor's agents performance of this contract or the Services. This includes but is not limited to Liability resulting in personal injury, death, property damage, or economic losses. Contractor must pay any costs City may incur in enforcing this provision and must accept a tender of defense upon receiving notice from City. Contractor's payments may be deducted or offset to cover any money the City lost due to a claim or counterclaim arising out of this Contract. This Section 11 shall survive termination of the Agreement. 12. Insurance. Contractor shall comply with the insurance requirements in Exhibit B. City will not execute the Agreement until it has received and approved satisfactory certificates of insurance and endorsements evidencing the type, amount, and dates of coverage. Alternatively, City in its sole discretion, may purchase insurance and deduct the costs from payments to Contractor, or terminate the Agreement. 13. Compliance with Laws and Other City Requirements. Requirements for all Contracts. This contract is subject to local, state and federal laws and regulations prohibiting discrimination, including Title VII of the Civil Rights Act of 1964, the California Fair Employment Practices Act, the Americans with Disabilities Act of 1990, and other laws that pertain to fair employment and anti -discrimination practices. Contractor agrees to provide records and documentation to the City on request necessary to monitor compliance with this provision. Contractor must comply with labor laws pertaining to prevailing wages, working hours, overtime, payroll records, and other requirements imposed by the Department of Industrial Relations. If Contractor does not have employees, it must sign the Affidavit of No Employees, attached as Exhibit C. Contractor is responsible for verifying employment eligibility of employees pursuant to the Immigration Reform and Control Act of 1986. Contractor must comply with conflict of interest laws and regulations applicable to this Agreement and avoid conflicts of interest. Contractor may be required to file a conflict of interest form for engaging in governmental decisions or serving in a staff Recreation Services Agreement/ Rev. April 2025 Page 3 of 7 capacity, and is hereby advised to review the requirements of California Political Reform Act and the California Code of Regulations. Services may only be performed by persons who are not employed by City and who do not have a contractual relationship with City other than this contract. Contractor agrees to abide by City policies and administrative rules prohibiting gifts to City officials and employees. Additional Requirements for Services Provided to Minors. Contractor and its employees who provide services under this Agreement must comply with these additional requirements: A. Undergo fingerprints and a criminal background and verify all employees providing services under this contract have met this requirement. B. Complete a Tuberculosis screening test as required by law and as set forth in Exhibit D. C. Comply with the Mandatory Reporting under California Penal Code 11164-11174.3 and with the protocols, reporting, and training required under California Health and Safety Code Section 124235, AB 2007, and other laws pertaining to concussion evaluation, removal from play, and return to play protocols. (Refer to Center for Disease Control & Prevention, httl2s://www.cdc.gov/headsul2/index.html). D. Submit required forms and acknowledgments included in Exhibit D, and ensure its each participant is provided with a concussion information sheet, signs and returns the forms to the City as required by Health and Safety Code Section 124235. Require coaches and administrators to successfully complete the concussion and head injury education at least once either online or in person, before supervising a participant. Contractor shall offer training, educational materials, or both to each Contractor administrator on a yearly basis. (Training resources are available at the Center for Disease Control & Prevention (link cited above). E. If providing instruction, Contractor must acknowledge and comply with all requirements set forth in the Parks & Recreation Services Instructor Manual. This contract requires services for children. 14. Coordination of Services. The Parties designate the following persons as Services Coordinators with the responsibility to oversee the delivery of Services in accordance with the terms of this Agreement. Contractor's designation and any substitution are subject to City approval. For City: For Contractor: Name: Alex Corbalis Name: Ruedi Graf Position: Recreation Manager Position: Founder & CEO Contact: alexc@cupertino.gov 15. Abandonment. City may abandon or postpone the Activity or Program and will notify Contractor as soon as possible. Contractor will be paid for satisfactory Services rendered through the date of abandonment upon submission of final invoices approved by City. 16. Termination. City may terminate this contract for cause or without cause at any time and will notify Contractor as soon as possible. Contractor will be paid for satisfactory services rendered through the date of termination upon submission of final invoices approved by City. Recreation Services Agreement/ Rev. April 2025 Page 4 of 7 17. Governing Law, Venue, and Dispute Resolution. This contract is governed by the laws of the State of California. Any legal actions or proceedings filed against City in connection with this contract must comply with the government claims filing requirements and must be filed with the Superior Court for the County of Santa Clara, State of California. At City's request, Contractor is required to continue to provide Services pending resolution of any dispute. If the Parties elect arbitration, the arbitrator's award must be supported by law and substantial evidence and include detailed written findings of law and fact. 18. Attorney Fees. If City is required to pursue litigation, arbitration or other administrative or regulatory proceeding to enforce its rights or the terms of this Agreement, the prevailing party will be entitled to reasonable attorney fees and costs. This Section 18 survives this Agreement. 19. Third Party Beneficiaries. There are no third party beneficiaries under this Contract. 20. Waiver. Neither acceptance of Services nor payment thereof constitutes a waiver of any contract provision. City waiver of a breach shall not constitute waiver of another term, provision, covenant, or condition, or a subsequent breach, whether the same or a different character. 21. Entire Agreement. This Agreement and all referenced Exhibits are hereby attached and incorporated into the Agreement by this reference and represent the full and complete understanding as to those matters contained herein, and supersede any other contract or understanding, either oral or written, between the Parties. This Agreement may not be modified or amended except in writing signed by both Parties. If there is any inconsistency between any term, clause, or provision of the main contract and any term, clause, or provision of the attachments or exhibits thereto, the terms of the main contract shall prevail and be controlling. 22. Inserted Provisions. Each provision or clause required by law or this contract is deemed to be included and will be inferred herein. Either party may request an amendment to cure any mistaken insertion or omission of a required provision. 23. Headings. The headings are for convenience only and are not a part of the contract or intended to affect, limit, or amplify the terms or provisions of this Agreement. 24. Severability/Partial Invalidity. If any contract term or provision, or their application to a particular situation, is found by the court to be void, invalid, illegal, or unenforceable, such term or provision shall remain in force and effect to the extent allowed by such ruling. All other contract terms and provisions and their application to specific situations will remain in full force and effect. 25. Survival. All provisions which by their nature must continue after the Agreement ends, including without limitation Indemnification, Insurance, Ownership of Materials, Records, Governing Law, and Attorney Fees, will survive the expiration or termination of this Agreement. 26. Notices. All notices and instruments pertaining to material provisions of this contract or significant disputes which are required by law or under this contract to be in writing must be sent to the persons listed below. The notices will be deemed effective on the date of personal delivery or the Recreation Services Agreement/ Rev. April 2025 Page 5 of 7 date confirmed by a reputable overnight delivery service, on the fifth (5th) calendar day after deposit in the United States Mail, postage prepaid, registered or certified, or the next business day following electronic submission. To City of Cupertino: To Contractor: World Cup Soccer Camps & Office of the City Manager Classes 10300 Torre Ave., Cupertino, CA 95014 27. Execution. The person executing this contract on behalf of Contractor represents and warrants that Contractor has full right, power, and authority to execute this contract and to carry out all actions and services required. This contract constitutes a legally binding obligation of Contractor, and may be executed in counterparts, each one of which is deemed an original and all of which, taken together, constitute a single binding instrument. SIGNATURES CONTINUE ON THE FOLLOWING PAGE Recreation Services Agreement/ Rev. April 2025 Page 6 of 7 IN WITNESS WHEREOF, the parties have caused this contract to be executed. CITY OF CUPERTINO A Municipal Corporation By Name Rachelle Sander Title Director of Parks and Recreation , Dec 18, 2025 APPROVED AS TO FORM: 7,a e uJaa MICHAEL K. WOO Senior Assistant City Attorney ATTEST: KIRSTEN SQUARCIA City Clerk Date Dec 18, 2025 CONTRACTOR By I c� Name Ruedi Graf Title Founder & CEO Date Dec 17, 2025 Tax I.D. No.: Refer to W9 Recreation Services Agreement/ Rev. April 2025 Page 7 of 7 I*A:611.10 .11 SCOPE OF WORK, PERFORMANCE AND PAYMENT SCHEDULES The CONTRACTOR will provide Youth Sports Programs in, but not limited to, the following: Youth Soccer Classes/Programs Location and Time of CONTRACTOR Services: Refer to the City's Publications for agreed upon dates, times, and locations of a class, camp, activity, program, or service ("class"). The City, at its sole discretion, may change the agreed dates, times and locations of a class, or may cancel a class. Compensation for CONTRACTOR Services: Contractor shall be compensated for services performed pursuant to this Agreement. For a class taught in person, 65% of resident fees. City and Contractor may mutually agree for Contractor to teach a class online rather than in person, provided that City and Contractor reach agreement for compensation for that online class. Compensation for that online class shall be specified in writing in a separate side agreement before online instruction for a class begins. Eligible Participant Minimum and Maximums for CONTRACTOR Services: Minimum: 5 Maximum: 12 If less than the required minimum number of participants enroll in and pay for a particular class as identified in the schedule before the class is scheduled to start, the City may cancel the particular class and/or terminate this Agreement without additional notice or payment to Contractor. Performance of CONTRACTOR Services: Class Cancellation Contractor will only receive compensation for a class that is performed. If performance of a class is cancelled by the City or Contractor before instruction begins, Contactor will not receive compensation for the class. If the City or Contractor cancels performance of certain meetings of a class, Contractor will only receive compensation for those meetings of the class that are performed. In the case Contractor unilaterally cancels performance of a class without City approval, City reserves the right to immediately and without notice cancel the remainder of classes offered and or performed by Contractor. Updated 04129125 Registration, Enrollment, and Supervision The Contractor shall follow all guidelines pertaining to registration procedures as listed in the quarterly recreation schedule. Participants may not take part in the program unless they are listed on the class roster or can show proof of enrollment. All participants and volunteers need to complete the City's Waiver of Liability form prior to taking part in the program. If applicable, contractors who are responsible for supervising minors must remain with the class until a parent or legal guardian has arrived and all minors are released to them. Injury of a Class Participant In the event of an injury occurring to a participant, the Contractor will notify the City within 1 hour and complete an Incident Report in the form approved by the City. The Incident Report must be submitted to the City within 24 hours of the injury occurring. Updated 04129125 Exhibit B Insurance Requirements for Recreation Contracts As required by the Agreement, Contractor shall procure prior to commencement of Services and maintain the following insurance for the duration of the Agreement, at its own cost and expense, the following insurance policies and coverage with companies doing business in California and acceptable to City. Minimum Scope and Limit of Insurance. Coverage shall be at least as broad as: Commercial General Liability (CGL): Coverage at least as broad as Insurance Services Office ("ISO") Form CG 00 01 with limits no less than $1,000,000 per occurrence and $2,000,000 general aggregate. The policy shall include a per project or per location general aggregate endorsement as broad as CG 25 03 or CG 24 04. If a per project/location endorsement is not available, the limit of the general aggregate shall be doubled. 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 (H) the broader coverage and maximum limits of coverage of any insurance policy, whichever is greater. b. Additional Insured coverage under Contractor's policy shall allow and be endorsed "primary and non-contributory," will not seek contribution from City's insurance/self-insurance, and shall be at least as broad as the most recent edition of ISO Form CG 20 01. c. The limits of insurance required may be satisfied by a combination of primary and umbrella or excess liability insurance, provided each policy follows form of the underlying policy and 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. The City's own insurance or self-insurance shall not be called upon. 2. Automobile Liability: Coverage shall be provided using ISO CA 00 01 covering Code 1 (any auto), or if Contractor has no owned autos, Code 8 (hired) and 9 (non -owned), with limits no less than $1,000,000 per accident for bodily injury and property damage. (Required if automobile is used to perform work under this contract.) LJ Not required. Contractor shall be fully remote and not use automobiles to provide the service. In the event Contractor uses an automobile or automobiles in the operation of its business to provide services under this Agreement, the Contractor shall, prior to such use, provide the City with evidence of Business Automobile Liability insurance coverage in the amount required under this Section 2 for owned, non -owned and hired autos (any auto -Symbol 1), or if Contractor does not own autos (hired autos -Symbol 8 and non -owned autos -Symbol 9). 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. XContractor has provided written confirmation that it does not own any autos. Contractor shall provide coverage for hired autos -Symbol 8 and non -owned autos -Symbol 9. Primary and Non - Contributory coverage and Waiver of Subrogation coverage is waived under the Automobile Liability hired and non -owned only coverage. In the event Contractor uses an owned automobile or automobiles in the operation of its business to provide services under this Agreement, the Contractor shall, prior to such use, provide the City with evidence of Business Automobile Liability insurance coverage in the amount required under this Section 2 for owned, non -owned and hired autos (any auto -Symbol 1). Exh. Y Insurance f tr Recreation Contracts Updated May 2025 F In lieu of Business Automobile Liability, Contractor shall maintain throughout the term of this Agreement and provide the City with evidence (including the policy Declarations Page) of personal automobile insurance coverage in accordance with the laws of the State of California. As available under the policy, evidence shall be provided with the 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. City approval of coverage is required prior to commencement of services. 3. Workers' Compensation: As required by the State of California, with Statutory and Employer's Liability Insurance limits of no less than $1,000,000 per accident/disease. - If no employees, Contractor must sign Affidavit of No Employees. 4. Sexual Abuse/Molestation. Insurance is required for activities/services involving minors, (i.e., after school activities, recreational programs, athletics, study/training events and transportation of minors) or vulnerable populations. Coverage shall include bodily injury sexual abuse and molestation coverage, personal injury, and property damage, including without limitation, blanket contractual liability. Sexual Abuse/Molestation coverage must be included under General Liability or obtained in separate policies with a limit of no less than $2,000,000 per occurrence and $4,000,000 aggregate. If a general aggregate limit applies, it must apply separately to this contract or be twice the required occurrence limit. F Not Required. Contract does not involve services to minors or vulnerable populations Insurance coverage required may be satisfied by a combination of Primary and Excess/Umbrella insurance. 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 Contractor's CGL and automobile liability policies. Endorsement of General Liability coverage shall be at least as broad as ISO Form CG 20 10 (11/ 85) or both CG 2010 and CG 20 37 forms, if later editions are used. Primary and Non -Contributory Coverage Except Workers' Compensation coverage, Contractor's insurance coverage shall allow and be endorsed primary coverage at least as broad as the most recent edition of ISO CG 20 01. Any insurance or self- insurance maintained by City, its officers, officials, employees, agents, or volunteers shall be excess of Contractor'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. If a carrier will not provide the required notice of cancellation or policy modification, the Contractor shall provide written notice to the City of a cancellation or policy modification no later than 30 business days in advance or 10 days in advance if due to non-payment of premiums. Waiver of Subrogation Contractor 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 General Liability, Automobile Liability and Workers' Compensation policies shall allow and be endorsed with a waiver of Exh. B Insurancefir it Recreation Contracts updated May 2025 2 subrogation in favor of City for all work performed by Contractor, its employees, agents, volunteers and subcontractors. 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 (Insert on the Certificate of Insurance, if .zero, insert "$0"). At City's option, either: the insurer must reduce or eliminate the deductible or self -insured retentions as respects the City/Additional Insureds; or Contractor 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 Contractor must furnish acceptable insurance certificates and amendatory endorsements (or copies of the policies effecting the coverage required by this Contract), including 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. Subcontractors Contractor shall require and verify that all subcontractors maintain insurance that meet the requirements of this Contract, including indemnification, defense, and naming the City as an additional insured on subcontractor's insurance policies. Higher Insurance Limits If Contractor 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 Contractor. Adequacy of Coverage City reserves the right to modify these insurance requirements/coverages based on the nature of the risk, prior experience, insurer or other special circumstances, with not less than ninety (90) days prior written notice. Exh. R Insurance f tr Recreation Contracts Updated May 2025 3 DATE (MMMONYYY) Ac"J?" CERTIFICATE OF LIABILITY INSURANCE 70511512025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: The Camp Team, LLC 351C Suit Wadsworth Parkway, Suite 3820, PHONE FAX 303-422-1276 Ho AIC No Ext : A90 ADDRESS: info@campteam.com PRODUCER Westminster, CO, 80021 CUSTOMERID : INSURERS AFFORDING COVERAGE NAIC# INSURED Sports Marketing Program Management Inc. INSURER A : Texas Insurance COmpany 16543 World Cup Soccer Camps & Clinics INSURER B : INSURER C : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: A-SP-SU-25-04-24-339636 E8 438443 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCVM E NT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSVE❑ OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUeJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POU YEFF POUCYEXP LIMITS AY GENERAL LIABILITY Y 05/15/2025 D511512026 EACH OCCURRENCE 5 1 coo 00G.00 FIRE DAMAGE TO PREMISES RENTED An one remises 5 3vo,vao.vv X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F-9 OCCUR MED EXP (any one person) 55,000.00 PERSONAL & ADV INJURY s 1,000,000.00 x NCLUDESATHLETIC PARTICIPANTS GENERAL AGGREGATE s 3 000 QQQ_Q PRODUCTS - COMPIOP AGG S 2 QQQ 000.00 G EN ERAL AGGREGATE LIMIT APPLIES PER: $ POLICY1-1 PROJECT LOC AUTOMOBILE LViBEJIY COMBINED SINGLE LIMIT ANY AUTO HIRED AUTOS (Ea accident) S BODILY INJURY (Per person) $ ALL OWNED NON -OWNED AUTO AUTOS BODILY INJURY (Per accident) 5 PROPERTY DAMAGE Par accident S SCHEDULED AUTOS A UMBRELLA UAB EXCESS LIAB X OCCUR CLAIMS -MADE Y y BESGLXTNV011301_ 2025 0511512026 EACH OCCURRENCE 5 4 vvo vvv.00 x AGGREGATE 5 4,000,000.00 DEDUCTIBLE S RETENTION $ $ WDRI ERSCCNPENSATICN WC STATU- OTH- ANDENPLOYERS'UAEI I YIMT ANY PRGPRETC IDARTNEREXECU [VE OIPFIC�EXCLLDED? lM ndeftrynW N I A E.L. EACH ACCIDENT S It yes, descrlbe under SPECIAL PROVISIONS below E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT S OTHER A AbusefMolestation Y Y SESGLPTNVOI1301_ OV1512026 Each Occurrence: $ 1,000,000.00 Aggregate: S 2,000,000.00 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more spaoe is required) Endorsed Date :Dec 4 2025 12:00AM EST Liability Policy Deductible: $0.00 Deductible for Bodily Injury and $ 1OW. 00 per Property Damage Claim. ISO Occurrence form CG 00 01 04 13 and company's specific forms. Coverage For Participant Legal Liability requires that every participant signs a waiverlrelease- City of Cupertino, its City Council, Boards and Commissions, Officers, (continued on next page) CERTIFICATE HOLDER CANCELLATION City of Cupertino SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 10185 N Stelling Rd. HATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Cupertino, CA, 95014 AUTHORIZED REPRESENTATIVE Mark Di Perno ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ©1988- 2009 ACORD CORPORATION. All rights reserved. AGENCY NAMED INSURED The Camp Team, LLC World Cup Soccer Camps & Clinics 3141 Stevens Creek Boulevard #3{]0 POLICY NUMBER Santa Clara, CA, 95051 CARRIER NAIC CODE Texas Insurance Company 16543 EFFECTIVE DATE: 05/15/2025 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Officials, Employees, Agents, Servants, Volunteers and Consultants are named as Additional Insured with respect to negligent acts or omissions of the Named Insured and only with respect to the Operations of the insured during the coverage period. Coverage is on a primary and non-contributory basis. RE: Registered Soccer participants: 05/15/2025 - 0511512026-1 ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Oct 988- 2009 ACORD CORPORATION. All rights reserved. POLICY NUMBER: CERTIFICATE#: A-SP-SU-25-04-24-339636 COMMERCIAL GENERAL LIABILITY NAMED INSURED: World Cup Soccer Camps & Clinics CG 20 26 04 13 POLICY PERIOD: May 15, 2025 to May 15, 2026 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization if required by an insured contract provided such contract was executed prior to the occurrence or offense. ity of Cupertino 0185 N Stelling Rd. upertino, CA, 95014 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: BESGLPTNVO11301 170012 02 CERTIFICATE#: A-5P-5U-25-04-24-339636E2 NAMED INSURED: World Cup Soccer Camps & Clinics POLICY PERIOD. May 15, 2025 to May 15, 2026 Insured Name: Policy Number: Policy Effective Date World Cup Soccer Camps & Clinics BESGLPTNVO11301 1, 2023 PRIMARY AND NON-CONTRIBUTORY AMENDATORY ENDORSEMENT Policy Amendment— Commercial General Liability This Endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name of Person Or Organization Any person or organization if required by an insured contract provided such contract was executed prior to the occurrence or offense. City of Cupertino 10185 N Stelling Rd. Cupertino, CA, 95014 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4. Other Insurance is hereby deleted and replaced with the following: 1. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in Paragraph c. below. However, with respect to any other valid and collectible insurance available to a person or organization as scheduled above, this insurance shall be primary to other available sources, except where the liability of such person or organization is caused by his, her, or its own negligence. Nothing herein shall be construed to make this Policy subject to the terms, definitions, conditions and limitation of any other insurance. b. Excess Insurance (1) This insurance is excess over: (a) any of the other insurance, whether primary, excess, contingent or on any other basis: (i) that is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; ES-40098A-NAC (10-2022) Page I oft POLICY NUMBER: CERTIFICATE#: A-SP-SU-25-04-24-339636 E2 NAMED INSURED: World Cup Soccer Camps & Clinics POLICY PERIOD: May 15, 2025 to May 15, 2026 Insured Name: Policy Number: Policy Effective Date World Cup Socccr Camps & Clinics November 1, 2023 (ii) that is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner; (iii) that is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; or (iv) if the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I — Coverage A — Bodily Injury And Property Damage Liability. (b) any other primary insurance available to you covering liability for damages arising out of the premises or operations, or the products and completed operations, for which you have been added as an additional insured by attachment of an endorsement. (2) When this insurance is excess, we will have no duty under Coverages A or S to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. c. Method Of Sharing In the instance where we are primary, we will be non-contributory. In any other instance, we will contribute as follows: If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. (1) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self -insured amounts under all that other insurance. (2) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. This Endorsement is otherwise subject to all the terms, conditions, exclusions, limitations, and provisions of the policy to which it is attached. ES-40098A-NAC (10-2022) Page 2 of 2 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CERTIFICATE#: A-SP-SU-25-04-24-339636_E8 CG 24 04 05 09 NAMED INSURED: World Cup Soccer Camps & Clinics POLICY PERIOD: May 15, 2025 to May 15, 2026 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or organization: Any person or organization if required by an insured contract provided such contract was executed prior to the occurrence or offense. City of Cupertino 0185 N Stelling Rd. :upertino, CA, 95014 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer of Rights Of Recovery Against Others To Us of Section IV —Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page I of I State Farm Mutual Automobile Insurance Company PO Box 2358 Bloomington IL 61702-2358 A State Farm AT2 A-6480 A Policy Number: 428 7356-F22.05A Policy Period: June 22, 2025 to December 22, 2025 Vehicle: 2018 VOLKSWAGEN TIGUAN Principal Driver: RUED] GRAF CONVENIENT PAYMENT OPTION: You may use one of State Farm's alternate payment plans which divides your present premium into two separate payments. You may pay one half of the amount due, $574.10 on J U N 222025. The remaining half will be due on AUG 212025, We'll send you a reminder notice. We also have available a plan to let you pay your premium In monthly installments. For details on this plan and to AMOUNT DUE: $1,148.21 Payment is due by June 22, 2025 Your State Farm Agent JOHN WHEELER INS AGENCY INC Office: 408-378-3403 Address: 2523 WINCHESTER BLVD STE G CAMPBELL, CA 95008-5337 lfyou have anewordif*ent car, have added anyddvers� orhave moved, please contact your agent. Thank you for choosing State Farm. determine if you qualify, please contact your State Farm agent. Notice of insurance information collection practices - personal, family, or household insurance transactions: We may collect customer information from persons other than the individual or individuals applying for coverage. Such customer information as well as other personal or privileged information subsequently colleted may, in certain (continued on next page) Policy Number: 428 7356-F22-05A Page number 1 of 5 Prepared April 30, 2025 1004583 ------------------------------------------------------------------- + Please fold and tear here + 143562 202 01-15.2018 Power To Pay Online Your Way El statefarm.comlpay Mobile Call Use the Automated Line:1-800-440-0998 State Farm mobile app Your agent: 408-378-3403 Mail Visit your Send us State Farm a check 13agent Key code: 1683840761 StateFarm insured: GRAF, RUEDI & ANIKA 0209507142 Policy Number: 428 7356-F22-05A State Farm Insurance Companies P.O. Box 680001 Amount Due: $1,148.21 Dallas, TX 75368-0001 Please Pay by June 22, 2025 Make payment to State Farm For Office Use Only AUTO REN $1,14&21 0714 3-A3 A 6480-FBOC AP OT 08-01-2025 MUTL VOL �IrI��fi"iti���-��-3itf1��FI�i[i["I ��ttl�•3r�f��I�i"t� �,�I-i3tiil�Ir� :• State Farm circumstances, be disclosed to third parties without your authorization as permitted by law. You have the right to submit a written request to access, correct, amend, or delete your personal information and the right to receive a response within 30 days of submitting your request. If we deny your request, you have the right to file a statement with us containing the information you feel is accurate and fair along with the reasons you disagree with our denial. Instructions on how to file such request and our full privacy notice can be found www.statefarm.com/customer-care/privacy-security/privacy or contact your State Farm Agent. Your auto insurance rates are impacted by the mileage your vehicle is driven. To ensure we've priced our insurance coverage accurately based on the number of miles you drive, we obtained valid mileage information forth is vehicle I►14 *1 1 [of 4:2l�lgo] :4Tj1eIIIIIIM01 through a third party provider and/or from you. Annual mileage was determined using this data and applied. Please contact your State Farm agent with questions within 30 days of your policy's renewal date. Location used to determine rate charged-2336 RUPERT OR, SAN JOSE CA 95124. When you provide a check as payment, you authorize us either to use information from your check to make a one-time electronic fund transfer from your account or to process the payment as a check transaction. When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day we receive your payment, and you will not receive your check back from your financial institution. Review your policy information carefully. If anything is incorrect, or if there are any changes to your vehicle information, please let us know right away. Vehicle Identification Vehicle Description Number (VIN) Who principally drives this vehicle? How is this vehicle normally used? 2018 VOLKSWAGEN 428 7356-F22-05A Page number 2 of 5 Prepared April 30, 2025 Thanks for being part of our neighborhood. You mean a lot to us. If you have any questions or need anything, please call State Farm° Agent JCHN WHEELER INS AGENCY INC at 408-378-3443. T P31 :. State Farm Other Household Vehicle(s) Your premium may be influenced by other State Farm policies that currently insure the following vehicles) in your household: The premium on the expiring policy term was based on 15,600 miles per year. The premium on the renewal policy term was based on 15,600 miles per year. Premium Adjustment Each year, we review our medical payments and personal injury protection coverages claim experience to determine the vehicle safety discount that is applied to each make and 111N1V1:111:111►1141.11',1_1111 111[a]►1 Assigned Driver(s) The following drivers) are assigned to the vehicles) on this policy. model. In addition, we review the comprehensive, collision, bodily injury and property damage claim experience annually to determine which makes and models have earned decreases or increases from State Farm's standard rates. If any changes result from our reviews, adjustments are reflected in the rates shown on this renewal notice. Driving Experience as of Marital Name June 22 2025 Status 7 years Single Principal Driver & Assigned Drivers For each automobile, the Principal Driver is the individual who most frequently drives it. Each driver is designated as an Assigned Driver on the household automobile that they most frequently drive. Your premium may be influenced by the information shown for these drivers. COVERAG E AN D LIMITS See your policy for an explanabbn of these coverages A Liability Bodily Injury 250,000/500,000 Property Damage 100,000 $472.46 C Medical Payments 5,000 $29.64 D 250 Deductible Comprehensive $105.04 G 500 Deductible Collision $355.92 H Emergency Road Service $6.14 R1 Car Rental & Travel Expense $16 Per Day, $400 Max $18.10 U Uninsured Motor Vehicle Bodily Injury 250,000/500,000 $153.57 111 Uninsured Motor Vehicle Property Damage $7.34 Amount Due $1.148.71 Policy Number: 428 7356-F22-05A Page number 3 of 5 Prepared April 30, 2025 CERTHOLDER COPY NA P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 05-15-2025 CITY OF CUPERTINO NA 10300 TORRE AVE CUPERTINO CA 95014-3202 GROUP: POLICY NUMBER; 9085591-2025 CERTIFICATE ID: 63 CERTIFICATE EXPIRES: 01-1 1-202B 01-11-2025/01-11-2026 THIS CERTIFICATE SUPERSEDES AND CORRECTS CERTIFICATE # 42 DATED 01-11-2025 This is t❑ certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term ❑r condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject t❑ all the terms, exclusions, and conditions. ❑f such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2025-01-11 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL INSURED: CITY OF CUPERTINO ENDORSEMENT #2O85 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-11-2025 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2025-01-11 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF CUPERTINO EMPLOYER WORLD CUP SOCCER CAMPS & CLINICS(A CORP) WORLD CUP SOCCER CAMPS & CLINICS 3141 STEVENS CREEK 7-2014} PRINTED : 05-15-2025 ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION HOME OFFICE SAN FRANCISCO EFFECTIVE JANUARY 11, 2025 AT 12.01 A.M. ALL EFFECTIVE HATES ARE AND EXPIRING JANUARY 11, 2026 AT 12.01 A.M. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME WORLD CUP SOCCER CAMPS & CLINICS ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, Niilr7iilatililaal y1Ni.Ct; WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY, WORLD CUP SOCCER CAMPS & CLINICS IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION OF EMPLOYEES WHILE ENGAGED IN WORE{ FOR THE ABOVE EMPLOYER. 9085591-25 RENEWAL NA 7-16-32-38 PAGE 4 OF IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH EMPLOYEES SHALL BE INCREASED BY 03%. NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: �]�� JANUARY 14, 2025 2570 AUTHORIZED REPRESENT IVE PRESIDENT AND CEO SCIF FORM 10217 SREV.4.20181 L OLD DP 217 71 Fenchurch Street London EC3M 4BS TeOhone: +44 (0)20 3037 8fl00 Fax: +4410)20 3037 8010 T Y S E R S www.tysers.com CLAIMS MADE SEXUAL MISCONDUCT AND MOLESTATION INSURANCE Form: Tysers SafeGuard 202t - primary Policy Number: MR244153 Unique Market Reference: B0572MR244153 Renewal of: MR234153 Named Insured: Name: City of Cupertino — Parks and Recreation Department, Public Works Department Address: 10300 Torre Avenue, Cupertino, CA 95014 Policy Period: From: 1st July 2024 To: I" July 2025 Both days at 12:01 a.m. Local Time at the Address specified above Limit of Liability: a) USD 5,000,000 in the aggregate during the policy period for all claims brought by or on behalf of each victim, and b) USD 5,000,000 in the aggregate during the policy period for all claims brought by or on behalf of all victims and separately: c) USD 75,000 in the aggregate during the policy period for all safeguard costs resulting from all circumstances Such Limit of Liability shall be in addition to the overall Limit of Liability stated in a) and b) above. Retention: USD 35,000 each Victim Optional Extension Period: 12 months Additional premium of 100% of the annual premium plus applicable taxes, provided no claims and/or circumstances have been reported to the insurance company. In the event any claims and/or circumstances have been reported to the insurance company, the additional premium for the 12 month optional extension period will be determined by the insurance company at the time this Policy is not renewed or replaced by the insurance company Premium: USD 34,650 to be paid within 30 days of inception Notification pursuant to Clause IX. Shall be given to: Beasley Group Attn: Claims Group 30 Batterson Park Road Farmington, CT 06032 claims ,beazley.com or Other Notices: To report a circumstance under the Safeguard Additional Coverage, Call +1 844 285 4700 where a service representative will be available 24 hours a day, seven days a week Retroactive Date: I` July 2018 Pending or Prior Litigation Date: 1" July 2018 Service of Suit: Service of process in any suit shall be made upon: Lloyd's America, Inc. Attention: Legal Department 280 Park Avenue, East Tower, 25th Floor New York, NY 10017 Governing Law: New York Conditions: Application Dated: 25" June 2024 California Surplus Lines Notice California Complaints Notice Nuclear Incident Exclusion Clause -Liability -Direct — NMA 1256 Radioactive Contamination Exclusion Clause -Liability - NMA 1477 War and Terrorism Exclusion — NMA 2919 US Terrorism Risk Insurance Act of 2002 as amended New & Renewal Business Endorsement — LMA5389 Several Liability Notice— LMA5096 Sanctions Limits Clause - LMA31 OOA Tysers SafeGuard 2021 - Risk Management & Response Solutions Cvber Acts Clarification U.S Classification: Surplus Lines Broker and State filed in: Risk Placement Services, 2850 Golf Road, Rolling Meadows, IL 60008 License Number: OC66724 State of Filing: CA Brokerage: 20% or same net equivalent downwards, plus taxes as applicable Information: Employees — 235 Contractors — 90 Exposure Units — 70,000 Nature of Business --- Municipality Cancellation by an Insured may result in a short rate calculation to determine the return premium, subject to 5% minimum earned of the total premium. Underwriting Security: 100% Lloyd's (Information About Lloyd's} EXHIBIT D Contractor's Mandated Reporter Declaration The undersigned does hereby certify that: 1. I am a representative of World Cup Soccer Camps & Classes; that I am familiar with the facts herein and am authorized and qualified to execute this declaration. 2. I declare that World Cup Soccer Camps & Classes has complied with fingerprinting and criminal background investigation requirements with respect to all Contractor's employees who may have contact with minors in the course of providing services pursuant to the Agreement, and the California Department of Justice has determined that none of those employees has been convicted of a felony, as that term is defined in California Penal Code Section 11105.3. 3. I declare that each coach and administrator shall be required to successfully complete concussion and head injury education at least once, either online or in person, before supervising a participant, as required by California Health and Safety Code Section 124235, et seq. 4. On a yearly basis, all participants shall be required to sign and return a concussion and head injury information sheet in compliance with California Health and Safety Code Section 124235, which may be in the form attached as D-1. 5. That a complete and accurate list of Contractor's employees, who may come in contact with minors during the course and scope of the Agreement, are included below. 6. All of the below mentioned employees have tested negative for TB, or X-ray results for TB, and have current documentation on file with Contractor. 7. All of the below mentioned employees have received training and understand their responsibilities under the Mandated Reporter laws of this state and are willing and able to comply. List of all Contractor Employees working for the City (if no Employees, identify "self'): See attached list of employees. 8. The Contractor will notify the City of Cupertino in writing of any new employees and will be added to the above list prior to beginning work at the City of Cupertino. I declare under penalty of perjury that the foregoing is true and correct. CONTRACTOR Y B � Y Name Ruedi Graf Title Founder & CEO , Dec 17, 2025 Updated 6123121 List of all Contractor Employees working for the City of Cupertino (if no Employees, identify "self'): Youth Sports Programs Final Audit Report 2025-12-18 Created: 2025-12-17 By: Webmaster Admin (webmaster@cupertino.org) Status: Signed Transaction ID: CBJCHBCAABAA6xcA7QegjgdVklyD4D5s391 pUQX-HR "Youth Sports Programs" History Document created by Webmaster Admin (webmaster@cupertino.org) 2025-12-17 - 0:52:54 AM GMT- IP address: 35.229.54.2 Document emailed to Araceli Alejandre (aracelia@cupertino.org) for approval 2025-12-17 - 0:55:09 AM GMT Email viewed by Araceli Alejandre (aracelia@cupertino.org) 2025-12-17 - 0:55:18 AM GMT- IP address: 54.160.94.88 Document approved by Araceli Alejandre (aracelia@cupertino.org) Approval Date: 2025-12-17 - 1:46:39 AM GMT - Time Source: server- IP address: 71.202.76.156 Document emailed to Ruedi Graf ( for signature 2025-12-17 - 1:46:43 AM GMT Email viewed by Ruedi Graf ( 2025-12-17 - 7:00:29 AM GMT- IP address: 74.125.209.137 Document e-signed by Ruedi Graf ( Signature Date: 2025-12-17 - 11:05:44 PM GMT - Time Source: server- IP address: 73.241.26.107 Document emailed to Michael Woo (michaelw@cupertino.org) for signature 2025-12-17 - 11:05:49 PM GMT Email viewed by Michael Woo (michaelw@cupertino.org) 2025-12-17 - 11:06:04 PM GMT- IP address: 35.153.202.166 Document e-signed by Michael Woo (michaelw@cupertino.org) Signature Date: 2025-12-18 - 2:15:26 AM GMT - Time Source: server- IP address: 98.33.114.31 Document emailed to Rachelle Sander (rachelles@cupertino.org) for signature 2025-12-18 - 2:15:29 AM GMT Powered by Adobe CVPERTIND Acrobat Sign Email viewed by Rachelle Sander (rachelles@cupertino.org) 2025-12-18 - 2:15:37 AM GMT- IP address: 98.86.170.169 Document e-signed by Rachelle Sander (rachelles@cupertino.org) Signature Date: 2025-12-18 - 4:40:30 PM GMT - Time Source: server- IP address: 64.165.34.3 Document emailed to Kirsten Squarcia (kirstens@cupertino.org) for signature 2025-12-18 - 4:40:34 PM GMT Email viewed by Kirsten Squarcia (kirstens@cupertino.org) 2025-12-18 - 4:40:44 PM GMT- IP address: 54.235.62.131 Document e-signed by Kirsten Squarcia (kirstens@cupertino.org) Signature Date: 2025-12-18 - 5:09:56 PM GMT - Time Source: server- IP address: 64.165.34.3 .. Agreement completed. 2025-12-18 - 5:09:56 PM GMT Powered by Adobe CVPERTINO Acrobat Sign