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HomeMy WebLinkAbout25-195 Rebuilding Together_Amendment #1 dated 7-7-26 Housing Repair & Rehabilitation Project FY261 FIRST AMENDMENT TO AGREEMENT 1183 BETWEEN THE CITY OF CUPERTINO AND REBUILDING TOGETHER SILICON VALLEY FOR HOUSING REPAIR & REHABILITATION PROJECT FY26 This First Amendment to Agreement 1183 is by and between the City of Cupertino, a municipal corporation (hereinafter "City") and Rebuilding Together Silicon Valley, a non-profit public benefit corporation (“Contractor”) whose address is 1701 S 7th St #10, San Jose, CA, 95112, and is made with reference to the following: RECITALS: A. On November 18, 2025 Agreement 1183 (“Agreement”) was entered into by and between City and Contractor for Housing Repair & Rehabilitation Project FY26. B. City and Contractor desire to continue Contractor’s services to the City under the Agreement, and hereby affirm their intent that it remain in full force and effect as amended and reinstated by this First Amendment. C. 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 II of the Agreement is modified to read as follows: II. TERM The initial term of this Contract (the "Term") will begin on July 1, 2025, and will end on August 31, 2026, unless otherwise amended or terminated earlier pursuant to Section VI or Section VII of this Contract. The Term of this Contract may be extended two (2) times, each for an additional one (1) year period, for a total Term of up to three (3) years; provided, however, neither party is obligated to extend the initial Term. If the Term is extended, the subsequent Term shall commence on 12:00 am on the first day immediately following the last day of the current Term provided that the CITY and the CORPORATION have entered into a written amendment to this Contract providing for: (i) such extension of the Term, (ii) the amount of CDBG Funds allocated for such extended Term; and (iii) an update to the Project Budget, Project Workplan, and Project Scope of Work (as applicable), in accordance with Article XVI of this Contract. Notwithstanding anything to the contrary in this Contract, CORPORATION acknowledges that CITY has only committed the funding of CDBG Funds for the initial Term, and CITY's obligation to enter into an amendment extending the Term or to fund any subsequent CDBG funds to the CORPORATION in any subsequent year is wholly contingent on the satisfaction of the following conditions precedent for each subsequent year: (i) the allocation and appropriation by the City Council of the CITY for the funding of the Grant in any subsequent year, in accordance with the CITY's standard process and procedure 2 for approving the annual budget of the CITY; and (ii) the allocation and delivery of funds by HUD to the CITY, pursuant to the CDBG Program, for the funding of the CDBG Funds. If either of such conditions precedent are not satisfied for any reason prior to the expiration of the then existing Term, then this Agreement shall automatically terminate upon the expiration of the Term. Upon such termination, CITY shall have no further obligation to fund any portion of the CDBG Funds, and the CORPORATION releases CITY for any and all claims related to such termination. In no event shall the failure to enter into any amendment extending the Term of this Contract, be considered a breach or default by CITY under this Contract. In the event of any conflict between the terms of this provision and any other provision in this Contract, the terms of this provision shall control 2. 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. REMAINDER OF PAGE INTENTIONALLY LEFT BLANK SIGNATURES CONTINUE ON THE FOLLOWING PAGE 3 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 Senior Assistant City Attorney ATTEST: City Clerk Date REBUILDING TOGETHER SILICON VALLEY By Title Date EXPENDITURE DISTRIBUTION Item PO Number Amount Base 2026-353 $107,500 1st Amendment $0 Total $107,500 Executive Director 07/06/2026 Michael K Woo Luke T Connolly Asst Director Community Development 07/07/2026 Lauren Sapudar 07/07/2026 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE Lockton Companies, LLC DBA Lockton Insurance Brokers, LLC in CA CA license #0F15767 444 W. 47th St., Ste. 900 Kansas City MO 64112-1906 (816) 960-9000 kcasu@lockton.com REBUILDING TOGETHER, INC. 999 N. CAPITOL STREET, NE, SUITE 330 WASHINGTON DC 20002 Navigators Specialty Insurance Company 36056 Philadelphia Indemnity Insurance Company 18058 Tokio Marine Specialty Insurance Company 23850 X 1,000,000 1,000,000 5,000 1,000,000 2,000,000 2,000,000 X X X 1,000,000 XXXXXXX XXXXXXX XXXXXXX XXXXXXX X X X 10,000 10,000,000 10,000,000 XXXXXXX XXXXXXX XXXXXXX XXXXXXX PROFESSIONAL & POLLUTION LIABILITY $2,000,000 PER CLAIM $2,000,000 AGGREGATE A PHPK2662813 3/15/2026 3/15/2027 A PHPK2662813 3/15/2026 3/15/2027 B PPK2665994 3/15/2026 3/15/2027 A PHUB903162 3/15/2026 3/15/2027 C PT26EXCZ0NX34IC 3/15/2026 3/15/2027 NOT APPLICABLE 3/15/2027 1550924 Y Y Y N N N 6/29/2026 N N 21472584 21472584 XXXXXXX CITY OF CUPERTINO ATTN: HOUSING MANAGER COMMUNITY DEVELOPMENT DEPARTMENT 10300 TORRE AVENUE CUPERTINO CA 95014 THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED. NAVIGATORS $5MX$5M POLICY EXCLUDES RESIDENTIAL CONSTRUCTION OPERATIONS IN COLORADO. TOKIO MARINE SPECIALTY INSURANCE COMPANY, EFFECTIVE 3/15/2025-3/15/2026, POLICY #: PSD1862324, EMPLOYEE THEFT LIMIT: $500,000. *** SEE ATTACHED *** X See Attachments CONTINUATION DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS (Use only if more space is required) ACORD 25 (2016/03) THE CITY OF CUPERTINO, ITS OFFICERS, AGENTS & EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED/FUNDING SOURCE WITH RESPECT TO GENERAL LIABILITY AND AUTO LIABILITY IF REQUIRED BY WRITTEN CONTRACT. THE INSURANCE PROVIDED IN THE GENERAL LIABILITY AND AUTO LIABILITY POLICY IS PRIMARY AND ANY OTHER INSURANCE SHALL BE EXCESS ONLY, AND NOT CONTRIBUTING. WAIVER OF SUBROGATION IN FAVOR OF THE ADDITIONAL INSURED APPLIES ON GENERAL LIABILITY AND AUTO LIABILITY, IF REQUIRED BY WRITTEN CONTRACT AND WHERE ALLOWED BY LAW. 30 DAY NOTICE OF CANCELLATION EXCEPT 10 DAYS NON-PAYMENT OF PREMIUM. CITY OF CUPERTINO IS LOSS PAYEE WITH RESPECT TO THE CRIME COVERAGES AS THEIR INTERESTS MAY APPEAR. DEDUCTIBLES: GENERAL LIABILITY: $N/A; AUTO COMPREHENSIVE: $1,000; AUTO COLLISION: $1,000; PROFESSIONAL LIABILITY: $50,000. Certificate Holder ID: 21472584 Named Insured Schedule Policy Number: PHPK2662813, PHUB903162, and PT26EXCZ0NX34IC Rebuilding Together, Inc. Rebuilding Together Anne Arundel County Rebuilding Together Arlington, Fairfax, Falls Church, Inc. Rebuilding Together Atlanta Rebuilding Together Aurora Rebuilding Together Austin Rebuilding Together Baltimore Rebuilding Together Boston Rebuilding Together Broward County Rebuilding Together Bryan/College Station Rebuilding Together Central Alabama Rebuilding Together Charles County Rebuilding Together Charleston Rebuilding Together Colorado Rebuilding Together Dayton Rebuilding Together Duneland Rebuilding Together Hudson County Rebuilding Together East Bay Network Rebuilding Together Eastern Shore, Inc. Rebuilding Together El Paso Rebuilding Together Fargo-Moorhead Area, Inc. Rebuilding Together Fox Valley Rebuilding Together Greater Bismarck-Mandan Area Inc. Rebuilding Together Greater Burlington Rebuilding Together Greater Des Moines Rebuilding Together Greater Harrisburg Rebuilding Together Greater Haverhill Rebuilding Together Hartford Rebuilding Together Hebron Rebuilding Together Henry County Rebuilding Together Houston Rebuilding Together Howard County Rebuilding Together Indianapolis PAGE 1 of 3 Attachment Code: D657014 Master ID: 1550924, Certificate ID: 21472584 Rebuilding Together Jersey City Rebuilding Together Kansas City Rebuilding Together Kern County Rebuilding Together Knoxville Rebuilding Together Lewiston-Auburn Rebuilding Together Lincoln County Rebuilding Together Litchfield County Rebuilding Together Long Beach Rebuilding Together Long Island Rebuilding Together Manchester Rebuilding Together Metro Chicago Rebuilding Together Miami-Dade Rebuilding Together Montgomery County Rebuilding Together Mountain Communities Rebuilding Together Muscatine County Rebuilding Together Nashville Rebuilding Together New York City Rebuilding Together North Central Florida Rebuilding Together North Jersey Rebuilding Together North Suburban Chicago Rebuilding Together North Texas Rebuilding Together Northeast Ohio Rebuilding Together of Greater Charlotte Rebuilding Together of Greater Green Bay Rebuilding Together of Hampton Roads Rebuilding Together of South Alabama Rebuilding Together of the City of Angels Rebuilding Together of the Palm Beaches Rebuilding Together Oklahoma City Rebuilding Together Olean Rebuilding Together Pacific County Rebuilding Together Peninsula Rebuilding Together Peoria Rebuilding Together Petaluma Rebuilding Together Philadelphia Rebuilding Together Pitt County Rebuilding Together Pittsburgh Rebuilding Together Platte Valley East Rebuilding Together Pacific Northwest PAGE 2 of 3 Attachment Code: D657014 Master ID: 1550924, Certificate ID: 21472584 Rebuilding Together Richmond Rebuilding Together Rogue Valley Rebuilding Together Sacramento Rebuilding Together San Diego Rebuilding Together San Francisco Rebuilding Together San Gabriel Valley Foothills Rebuilding Together Sandoval County Rebuilding Together Santa Cruz County Rebuilding Together Saratoga County Rebuilding Together Seattle Rebuilding Together Sebastopol Rebuilding Together Shawnee-Johnson County Rebuilding Together Sheboygan County Rebuilding Together Silicon Valley Rebuilding Together Solano County Inc. Rebuilding Together South Lake County Rebuilding Together South Sound Rebuilding Together Southern Tier, Inc. Rebuilding Together SouthWest Illinois Rebuilding Together Spartanburg Rebuilding Together St. Joseph County Rebuilding Together St. Louis Rebuilding Together Stephenson County Rebuilding Together Thurston County Rebuilding Together Tri-County Rebuilding Together Twin Cities Rebuilding Together Valley of the Sun Rebuilding Together Warner Robins Rebuilding Together Waycross PAGE 3 of 3 Attachment Code: D657014 Master ID: 1550924, Certificate ID: 21472584 POLICY NUMBER: PHPK2662813 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED – DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): When Required by Written Contract 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 04 13 Attachment Code: D657348 Certificate ID: 21472584 POLICY NUMBER: PHPK2662813 PI-GL-005 (07/12) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Effective Date: 03/15/2024 Name of Person or Organization (Additional Insured): Blanket where required by written contract Blanket where required by written contract SECTION II – WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the endorsement Schedule, but only with respect to liability for “bodily injury,” “property damage” or “personal and advertising injury” arising out of or relating to your negligence in the performance of “your work” for such person(s) or organization(s) that occurs on or after the effective date shown in the endorsement Schedule. This insurance is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or ”occurrence” we cover for this Additional Insured. The Additional Insured’s limits of insurance do not increase our limits of insurance, as described in SECTION III – LIMITS OF INSURANCE. All other terms, conditions, and exclusions under the policy are applicable to this endorsement and remain unchanged. Attachment Code: D657351 Certificate ID: 21472584 POLICY NUMBER: PHPK2662813 PI-CA-003 (04/14) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. SECTION II – COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured is amended by adding the following: The following are also "insureds": Any person or organization for whom you are required by an “insured contract” to procure “bodily injury” or “property damage” liability insurance arising out of the operation of a covered "auto" with your permission. However, this additional insurance does not apply to: 1. The owner or anyone else from whom you hire or borrow a covered "auto." This exception does not apply if the covered "auto" is a "trailer” connected to a covered "auto” you own; 2. Your "employee” if the covered “auto" is owned by that "employee” or a member of his or her household; 3. Anyone using a covered "auto” while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is yours; 4. Anyone other than your "employees," partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employees," while moving property to or from a covered "auto"; or 5. A partner (if you are a partnership), or a member (if you are a limited liability company) for covered "auto” owned by him or her or a member of his or her household. B. The “insured contract” must be in effect during the policy period shown in the Declarations and must have been executed prior to the “bodily injury” or “property damage”. C. This person or organization is an “insured” only to the extent you are liable due to your ongoing operations for that “insured”, whether the work is performed by you or for you, and only to the extent you are held liable for an “accident” occurring while a covered “auto” is being driven by you or one of your employees. D. There is no coverage provided to this person or organization for “bodily injury” to its employees or for “property damage” to its property. E. Coverage for this person or organization shall be limited to the extent of your negligence or fault according to the applicable principles of comparative negligence or fault. F. The defense of any claim or “suit” must be tendered by this person or organization as soon as practicable to all other insurers which potentially provide insurance for such claim or “suit”. G. A person’s or organization’s status as an “insured” under this endorsement ends when your operations for that “insured” are completed. Page 1 of 2 Attachment Code: D657352 Certificate ID: 21472584 PI-CA-003 (04/14) H. The coverage extended to any additional insured by this endorsement is limited to, and subject to all terms, conditions, and exclusions of the Coverage Part to which this endorsement is attached. In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written agreement to add any “insured,” or to procure insurance. I. The following additional exclusions apply: The insurance afforded to any person or organization as an “insured” under this endorsement does not apply to “loss”: 1. Which occurs prior to the date your contract is effective with such person or organization; 2. Arising out of the sole negligence of any person or organization that would not be an “insured” except for this endorsement; or 3. Which occurs after you returned the leased or rented “auto” to the lessor or the policy period ends, whichever occurs first. Page 2 of 2 Attachment Code: D657352 Certificate ID: 21472584 POLICY NUMBER: PHPK2662813 PI-CA-004 10/14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY CLAUSE ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The following is added to SECTION IV-BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance: The insurance provided by this policy for any additional insured endorsement attached to this policy is primary when primary coverage is required in a written contract. In addition, we will not seek contribution from any insurer when insurance on a non-contributing basis is required in a written contract for any additional insured endorsement attached to this policy. For coverage to apply, the written contract must have been executed prior to the occurrence of "loss." This endorsement supersedes anything to the contrary. Page 1 of 1 ©2014 Philadelphia Consolidated Holding Corp. Attachment Code: D662743 Certificate ID: 21472584 POLICY NUMBER: PHPK2662813 COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Rebuilding Together, Inc.(Affiliate Endorsement Effective Date: 03/15/2024 SCHEDULE Name(s) Of Person(s) Or Organization(s): Blanket per written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 03 10 © Insurance Services Office, Inc., 2009 Page 4 of 6 Attachment Code: D657731 Certificate ID: 21472584 © 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER ACORD 25 (2016/03) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER E-MAIL ADDRESS: FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Acct#:2895333 10/14/2025 LOCKTON COMPANIES, LLC 888-828-83653657 Briarpark Dr., Suite 700 Houston, TX 77042 Indemnity Insurance Company of North America 43575 REBUILDING TOGETHER SILICON VALLEY 1701 S 7TH ST STE 10 SAN JOSE, CA 95112-6000 NA X C73988391 10/01/2025 10/01/2026 X 1,000,000 1,000,000 1,000,000 WAIVER OF SUBROGATION IN FAVOR OF CERTIFICATE HOLDER WHERE REQUIRED BY WRITTEN CONTRACT. 30 DAY NOTICE OF CANCELLATION APPLIES insperitycerts@locktonaffinity.com City of Cupertino Community Development Dept. Cupertino CA 95014 10300 Torre Avenue WC 90 03 75 (05/18) Workers' Compensation a nd Employers' Li ability Pol icy Named Insured Endorsement Number Policy Number Symbol: Number: Policy Period TO Effective Date of Endorsement Issued By (Name of Insurance Company) Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM O THERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1.( X ) Specific WaiverName of person or organization: ( ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2.Operations: 3.Premium: The premium charge for this endorsement shall be INCLUDED percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4.Minimum Premium: INCLUDED Authorized Agent 10/01/2025 10/01/2026 C73988391 City of Cupertino Community Development Dept. 10300 Torre Avenue Cupertino, CA 95014 WLR REBUILDING TOGETHER SILICON VALLEY SAN JOSE, CA 95112-6000 1701 S 7TH ST STE 10 Indemnity Insurance Company of North America 10/14/2025 Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Nu mber Policy Number Symbol: Number: Policy Period TO Effective Date of E ndorsement Is s ued By (Name of Insurance C ompany) Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. NOTICE TO OTHERS ENDORSEMENT - SPECIFIC PARTIES A.If we cancel this Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium, we will endeavor, as set out below, to send written notice of cancellation, via such electronic or other form of notification as we determine, to the persons or organizations listed in the schedule set out below {the "Schedule"). You or your representative must provide us with both the physical and e -mail address of such persons or organizations, and we will utilize such e -mail address or physical address that you or your representative provided to us on such Schedule . B.We will endeavor to send or deliver such notice to the e-mail address or physical address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. C.The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). Our failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule shall impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. D.We are not responsible for verifying any information provided to us in any Schedule, nor are we responsible for any incorrect information that you or your representative provide to us. If you or your representative does not provide us with the information necessary to complete the Schedule, we have no responsibility for taking any action under this endorsement. In addition, if neither you nor your representative provides us with e-mail and physical address information with respect to a particular person or organization, then we shall have no responsibility for taking action with regard to such person or entity under this endorsement. E.We may arrange with your representative to send such notice in the event of any such cancellation. F.You will cooperate with us in providing, or in causing your representative to provide, the e -mail address and physical address of the persons or organizations listed in the Schedule. G.This endorsement does not apply in the event that you cancel the Policy. SCHEDULE Name of Certificate Holder E-Mail Address Physical Address All other terms and conditions of this Policy remain unchanged. This endorsement is not applicable in the states of AZ, FL, ID, ME, NC, NJ, NM, TX and WI. Authorized Representative REBUILDING TOGETHER SILICON VALLEY SAN JOSE, CA 95112-60001701 S 7TH ST STE 10 10/01/2025 10/01/2026 10/14/2025 C73988391 City of Cupertino Community Development Dept.10300 Torre Avenue Cupertino, CA 95014 WLR Indemnity Insurance Company of North America Housing Repair & Rehabilitation Project FY26 Final Audit Report 2026-07-08 Created:2026-07-02 By:Webmaster Admin (webmaster@cupertino.org) Status:Signed Transaction ID:CBJCHBCAABAAVxgMa4O3yi9kbyKqkk9CkJRvzw5fUtqZ "Housing Repair & Rehabilitation Project FY26" History Document created by Webmaster Admin (webmaster@cupertino.org) 2026-07-02 - 3:55:12 AM GMT- IP address: 35.229.54.2 Document emailed to aracelia@cupertino.org for approval 2026-07-02 - 3:59:40 AM GMT Email viewed by aracelia@cupertino.org 2026-07-02 - 3:59:49 AM GMT- IP address: 3.238.31.33 Signer aracelia@cupertino.org entered name at signing as Araceli Alejandre 2026-07-02 - 7:47:03 PM GMT- IP address: 71.202.76.156 Document approved by Araceli Alejandre (aracelia@cupertino.org) Approval Date: 2026-07-02 - 7:47:05 PM GMT - Time Source: server- IP address: 71.202.76.156 Document emailed to Deanne Everton (deanne@rtsv.org) for signature 2026-07-02 - 7:47:09 PM GMT Email viewed by Deanne Everton (deanne@rtsv.org) 2026-07-03 - 6:23:46 AM GMT- IP address: 146.75.154.1 Document e-signed by Deanne Everton (deanne@rtsv.org) Signature Date: 2026-07-06 - 11:25:21 PM GMT - Time Source: server- IP address: 76.210.140.146 - Signature Appearance Selected: IMAGE Document emailed to michaelw@cupertino.org for signature 2026-07-06 - 11:25:26 PM GMT Email viewed by michaelw@cupertino.org 2026-07-06 - 11:25:35 PM GMT- IP address: 98.92.106.249 Signer michaelw@cupertino.org entered name at signing as Michael K Woo 2026-07-08 - 1:03:52 AM GMT- IP address: 73.15.27.240 Document e-signed by Michael K Woo (michaelw@cupertino.org) Signature Date: 2026-07-08 - 1:03:54 AM GMT - Time Source: server- IP address: 73.15.27.240 - Signature Appearance Selected: TYPE Document emailed to lukec@cupertino.org for signature 2026-07-08 - 1:03:58 AM GMT Email viewed by lukec@cupertino.org 2026-07-08 - 1:04:07 AM GMT- IP address: 54.90.23.143 Signer lukec@cupertino.org entered name at signing as Luke T Connolly 2026-07-08 - 4:30:00 AM GMT- IP address: 73.63.184.35 Document e-signed by Luke T Connolly (lukec@cupertino.org) Signature Date: 2026-07-08 - 4:30:02 AM GMT - Time Source: server- IP address: 73.63.184.35 - Signature Appearance Selected: TYPE Document emailed to laurens@cupertino.org for signature 2026-07-08 - 4:30:05 AM GMT Email viewed by laurens@cupertino.org 2026-07-08 - 4:30:22 AM GMT- IP address: 3.239.74.209 Signer laurens@cupertino.org entered name at signing as Lauren Sapudar 2026-07-08 - 4:33:16 AM GMT- IP address: 64.165.34.3 Document e-signed by Lauren Sapudar (laurens@cupertino.org) Signature Date: 2026-07-08 - 4:33:18 AM GMT - Time Source: server- IP address: 64.165.34.3 - Signature Appearance Selected: TYPE Agreement completed. 2026-07-08 - 4:33:18 AM GMT