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HomeMy WebLinkAbout25-177 General Fund Human Service Grants Program _Amendment #1 dated 10-12-26 for FY25_26 - Legal Services for Seniors1 FIRST AMENDMENT TO AGREEMENT 25-177 BETWEEN THE CITY OF CUPERTINO AND SENIOR ADULTS LEGAL ASSISTANCE FOR GENERAL FUND HUMAN SERVICE GRANT PROGRAM CITY/NON- PROFIT CONTRACT This First Amendment to Agreement 25-177 is by and between the City of Cupertino, a municipal corporation (hereinafter "City") and Senior Adults Legal Assistance, a (“Corporation”) whose address is 1425 Koll Circle, Suite 109, San Jose, CA 95112, and is made with reference to the following: RECITALS: A. On July 1, 2025 Agreement 25-177 (“Agreement”) was entered into by and between City and Corporation for the Program (as described below) to be operated within City for the benefit of low and very low-income households; 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 I, entitled Program, of the Agreement is modified to read as follows: For the period of July 1, 2025 to June 30, 2026, City agreed to allocate a portion of its current HSG funds to Corporation, in the sum of Eighteen Thousand Dollars ($18,000) (the “Grant”) for the purpose of implementing the Corporation’s program, as more particularly described in Exhibits A-E to the Contract (the “Program”), and said Exhibits set forth below, as they may be amended or modified, are attached to this Contract and incorporated herein by reference. Exhibit A: Program Description Exhibit B: Program Work Plan Exhibit C: Proposed Implementation Timeline Schedule Exhibit D: Program Budget Exhibit E: Basic Insurance and Bond Requirements for Non-Profit Contracts For the period of July 1, 2026 to June 30, 2027 City agrees to allocate portion of its current HSG Funds to Corporation, in the sum of Sixteen Thousand Nine Hundred Dollars ($16,900) (“the “Grant”) for the purpose of implementing the Corporation’s program. 2 Exhibits A-E of the Agreement are replaced with new Exhibits A-E attached hereto. 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. SIGNATURES CONTINUE ON THE FOLLOWING PAGE 3 IN WITNESS WHEREOF, the parties hereto have caused this modification of Agreement to be executed. CITY: CORPORATION: CITY OF CUPERTINO Benjamin Fu Date Director of Community Development SENIOR ADULTS LEGAL ASSISTANCE Georgia Bacil Date Chief Executive Officer APPROVED AS TO FORM ATTEST: Michael K. Woo Date Lauren Sapudar Date Senior Assistant City Attorney City Clerk EXPENDITURE DISTRIBUTION Item PO Number Amount Base Contract FY 26 $18,000 1st Amendment FY 27 $16,900 Total $34,900 Georgia Bacil 09/30/2026 Michael K Woo 10/12/2026 Benjamin Fu 10/12/2026 Lauren Sapudar 10/12/2026 4 EXHIBIT A PROGRAM DESCRIPTION FY 2026-27 Agency Name: Senior Adults Legal Assistance (SALA) DUNS #: Not Applicable (Only for CDBG) Chief Executive Officer: Georgia Bacil Program Manager: Georgia Bacil Program # (For Office Use Only) 100-72-712 600-623 Street Address: 1425 Koll Circle, Suite 109 City: San Jose State: CA Zip Code: 95112 Telephone number: 408-295-5991 Fax Number: Manager E-mail gbacil@sala.org Name of Program: Legal Assistance to Cupertino Elders Program Location: Cupertino Senior Center, 21251 Stevens Creek Blvd., Cupertino CA 95014 Program Description: SALA will continue our program of free Legal Services to Cupertino seniors 60 or older. During State/local health orders related to COVID, SALA will provide legal services through intake appointments and follow up legal work remotely and primarily by telephone. When, and if, in- person services can be reinstated at senior centers, SALA intake appointments for Cupertino seniors will be available at least monthly at the Cupertino Senior Center, as well as through SALA intake sites in other cities, at SALA’s Central Office, by telephone intake, or through home visits. Regardless of whether intake appointments are remote or in-person, follow up legal services will include advice, brief service/document preparation, and attorney representation. A minimum of 20 Cupertino seniors will be served, targeting clients that are low income or at risk of abuse, isolation, homelessness, or institutionalization. All references to seniors herein are persons 60 or older. 5 EXHIBIT B PROGRAM WORK PLAN FY 2026-27 AGENCY NAME: Senior Adults Legal Assistance PROGRAM NAME: Legal Assistance to Cupertino Elders Objectives Benchmarks for Each Quarter 1st 2nd 3rd 4th TOTAL Provide free legal service to Cupertino seniors 5 5 5 5 20 6 EXHIBIT C PROPOSED IMPLEMENTATION TIMELINE SCHEDULE FY 2026-27 AGENCY NAME: Senior Adults Legal Assistance (SALA) PROGRAM NAME: Legal Assistance to Cupertino Elders Activity Number and Description: Activity # Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 1. 2. 7 EXHIBIT D PROGRAM BUDGET FY 2026-27 AGENCY NAME: Senior Adults Legal Assistance (SALA) PROGRAM NAME: Legal Assistance to Cupertino Elders Proposed Program Expenses FY 2026-27 Salaries/Benefits/Payroll/Taxes $16,900 Office Supplies Communication Publications/Printing/Advertising Travel Rent/Lease/Mortgage Utilities Insurance Equipment Rental/Maintenance Audit/Legal/Professional Services (for CDBG portion only) IT Direct Services (Funding for specific service such as a meal, ride) Awards Indirect Cost/Administration Contracted Services Other Total Expenses $16,900 8 EXHIBIT E BASIC INSURANCE AND BOND REQUIREMENTS FOR NON-PROFIT CONTRACTS Definition of Contractor: The "Contractor" as the word is used in this Exhibit E is the party contracting with the City of Cupertino for the direct distribution of HSG funds. Indemnity The Contractor shall indemnify, defend, and hold harmless the City of Cupertino (hereinafter "City"), its officers, agents and employees from any loss, liability, claim, injury or damage arising out of, or in connection with performance of this Contract by Contractor and/or its agents, employees or subcontractors, excepting only loss, injury or damage caused solely by the acts or omissions of personnel employed by the City. It is the intent of the parties to this Contract to provide the broadest possible coverage for the City. The Contractor shall reimburse the City for all costs, attorneys' fees, expenses and liabilities incurred with respect to any litigation in which the Contractor is obligated to indemnify, defend and hold harmless the City under this Contract. Insurance Without limiting the Contractor's indemnification of the City, the Contractor shall provide and maintain at its own expense, during the term of this Contract, or as may be further required herein, the following insurance coverages and provisions: A. Evidence of Coverage Prior to commencement of this Contract, the Contractor shall provide on the City's own form or a form approved by the City's Insurance Manager an original plus one copy of a Certificate of Insurance certifying that coverage as required herein has been obtained and remains in force for the period required by this Contract. The contract number and program name must be stated on the Certificate of Insurance. The City's Special Endorsement form shall accompany the certificate. Individual endorsements executed by the insurance carrier may be substituted for the City's Special Endorsement form if they provide the coverage as required. In addition, a certified copy of the policy or policies shall be provided by the Contractor upon request. This verification of coverage shall be sent to the address as shown on the City's Certificate of Insurance form and to the Community Development Department at the address set forth in this Contract at Section VI. PROGRAM COORDINATION, Paragraph C., NOTICES. The Contractor shall not issue a Notice to Proceed with the work under this Contract until it has obtained all insurance required and such insurance has been approved by the City. This approval of insurance shall neither relieve nor decrease the liability of the Contractor. B. Notice of Cancellation of Reduction of Coverage All policies shall contain a special provision for thirty (30) days prior written notice of any cancellation or reduction in coverage to be sent to the Community Development Department, 10300 Torre Avenue, Cupertino, CA 95014. C. Qualifying Insurers 9 All policies shall be issued by companies which hold a current policy holder's alphabetic and financial size category rating of not less than A VIII, according to the current Best's Key Rating Guide, unless otherwise approved by the City's Insurance Manager. D. Insurance Required 1. Comprehensive General Liability Insurance - for bodily injury (including death) and property damage which provides limits of not less than one million dollars ($1,000,000) combined single limit (CSL) per occurrence. OR 2. Commercial General Liability Insurance - for bodily injury (including death) and property damage which provides limits as follows: a. General limit per occurrence - $1,000,000 b. General limit aggregate - $2,000,000 c. Products/Completed Operations- $1,000,000 aggregate d. Personal Injury limit - $1,000,000 If coverage is provided under a Commercial General Liability Insurance form, the carrier shall provide the City Insurance Manager with a quarterly report of the amount of aggregate limits expended to that date. If over 50% of the aggregate limits have been paid or reserved, the City may require additional coverage to be purchased by the Contractor to restore the required limits. 3. For either type of insurance, coverage shall include: a. Premises and Operations b. Products/Completed Operations with limits of one million dollars ($1,000,000) per occurrence/ aggregate to be maintained for two (2) years following acceptance of the work by the City. c. Contractual Liability expressly including liability assumed under this Contract. d. Personal Injury liability. e. Independent Contractors' (Protective) liability. f. Severability of Interest clause providing that the coverage applies separately to each insured except with respect to the limits of liability. 4. For either type of insurance, coverage shall include the following endorsements, copies of which shall be provided to the City: a. Additional Insured Endorsement: 10 Such insurance as is afforded by this policy shall also apply to the City of Cupertino, and members of the City Council, and the officers, agents and employees of the City of Cupertino, individually and collectively, as additional insureds. b. Primary Insurance Endorsement: Such insurance as is afforded by the additional insured endorsement shall apply as primary insurance, and other insurance maintained by the City of Cupertino, its officers, agents, and employees shall be excess only and not contributing with insurance provided under this policy. c. Notice of Cancellation or Change of Coverage Endorsement: This policy may not be cancelled nor the coverage reduced by the Company without 30 days prior written notice of such cancellation or reduction in coverage to the City of Cupertino at the address shown on the Certificate of Insurance. d. Contractual Liability Endorsement: This policy shall apply to liability assumed by the insured under written contract with the City of Cupertino. e. Personal Injury Endorsement: The provisions of this policy shall provide Personal Injury coverage. f. Severability of Interest Endorsement: The insurance afforded by this policy shall apply separately to each insured that is seeking coverage or against whom a claim is made or a suit is brought, except with respect to the Company's limit of liability. 5. Comprehensive Automobile Liability Insurance for bodily injury (including death) and property damage which provides total limits of not less than one million dollars ($1,000,000) combined single limit per occurrence applicable to all owned, non-owned and hired vehicles. 6. Worker's Compensation and Employer's Liability Insurance for: a. Statutory California Workers' Compensation coverage including a broad form all-states endorsement. b. Employer's Liability coverage for not less than one million dollars ($1,000,000) per occurrence for all employees engaged in services or operations under this Contract. c. Inclusion of the City and its governing board(s), officers, representatives, agents, and employees as additional insureds, or a waiver of subrogation. 7. Professional Errors and Omissions Liability Insurance This type of insurance should be provided by persons/entities you contract with to provide you with professional services. 11 a. Limits of not less than one million dollars ($1,000,000). b. If this policy contains a self retention limit, it shall not be greater than ten thousand dollars ($10,000) per occurrence/event. c. This coverage shall be maintained for a minimum of two (2) years following termination of this Contract. The City must first approve any exceptions to the above requirements. 8. Bond Requirements Fidelity Bond - Before receiving compensation under this Contract, Contractor will furnish City with evidence that all officials, employees, and agents handling or having access to funds received or disbursed under this Contract, or authorized to sign or countersign checks, are covered by a BLANKET FIDELITY BOND in an amount of AT LEAST fifteen percent (15%) of the maximum financial obligation of the City cited herein. If such bond is cancelled or reduced, Contractor will notify City immediately, and City may withhold further payment to Contractor until proper coverage has been obtained. Failure to give such notice may be cause for termination of this Contract, at the option of the City. 9. Special Provisions The following provisions shall apply to this Contract: a. The foregoing requirements as to the types and limits of insurance coverage to be maintained by the Contractor and any approval of said insurance by the City or its insurance consultant(s) are not intended to and shall not in any manner limit or qualify the liabilities and obligations otherwise assumed by the Contractor pursuant to this Contract, including but not limited to the provisions concerning indemnification. b. The City acknowledges that some insurance requirements contained in this Contract may be fulfilled by self-insurance on the part of the Contractor. However, this shall not in any way limit liabilities assumed by the Contractor under this Contract. The City shall approve any self-insurance in writing. c. The City reserves the right to withhold payments to the Contractor in the event of material noncompliance with the insurance requirements outlined above. d. If the Contractor fails to maintain such insurance as is called for herein, the City must order the Contractor to immediately suspend work at Contractor's expense until a new policy of insurance is in effect. 07/27/2026 ISU/San Francisco CA License #0778092 PO Box 512965 Los Angeles CA 90051-2965 Lori Lowe (415) 788-9810 (415) 248-3534 insurance@isusf.com Senior Adults Legal Assistance, DBA: SALA 1425 Koll Circle #109 San Jose CA 95112 Nonprofits Ins Alliance of CA Markel Insurance Company Philadelphia Indemnity Ins. Co 18058 CL2672728813 A Y Y 01-CP-0004545-01-20 06/30/2026 06/30/2027 1,000,000 500,000 20,000 EXCLUDED 2,000,000 2,000,000 Liquor Liability INCLUDED A Coll:$500 Comp:$500 Y Y 01-CP-0004545-01-20 06/30/2026 06/30/2027 1,000,000 Hired & Nonowned Auto 1,000,000 A 01-UB-0004545-01-09 06/30/2026 06/30/2027 2,000,000 2,000,000 B N Y MWC006622513 07/01/2026 07/01/2027 1,000,000 1,000,000 1,000,000 A Improper Sexual Conduct and Physical Abuse 01-CP-0004545-01-20 06/30/2026 06/30/2027 Each Claim $1,000,000 Aggregate $1,000,000 RE: Account#: 110-7406-7102 Certificate Holder is included as Additional Insured as respects to Liability as required by written contract only as pertains to the Insured's operations as per Form CG 2026. Waiver of Subrogation in favor of Additional Insured. Coverage is Primary & Non-contributory. 30 Days Prior Written Notice of Cancellation. City of Cupertino Community Development Dept. Account #110-7406-7102 10300 Torre Avenue Cupertino CA 95014 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. *LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE INCLUSIVE OF AMOUNTS REQUESTED BY THE CERTIFICATE HOLDER AND MAY NOT REFLECT POLICY LIMIT AMOUNTS IN EXCESS OF THOSE REQUESTED.*Not Applicable in WY $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2025/12)© 1988-2025 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY NIA-064 GL 10 12 Nonprofits Insurance Alliance™ and NONPROFITS OWN® are brands of Alliance Member Services™ (AMS). © AMS. All rights reserved. Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDED NOTICE OF CANCELLATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Cancellation: 30 Days Notice of Cancellation Person or Organization: City of Cupertino Community Development Dept. If we cancel this policy for any statutorily permitted reason other than nonpayment of premium, we will mail notice of cancellation to the person or organization shown above. We will mail such notice to the address shown at least the number of days shown for cancellation. NIA-061B GL 01 25 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY - PUBLIC ENTITIES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Any person or organization that you are required to include on this policy, under written contract or agreement currently in effect or becoming effective during the term of this policy, applicable under the terms and conditions of this endorsement, and consistent with the description below that the parties intend. A. SECTION II – WHO IS AN INSURED is amended to include: 4. Any public entity as an additional insured, and the officers, officials, employees, agents and/or volunteers of that public entity, as applicable, who may be named in the Schedule above, when you have agreed in a written contract or written agreement presently in effect or becoming effective during the term of this policy, that such public entity and/or its officers, officials, employees, agents and/or volunteers be added as an additional insured(s) on your policy, but only with respect to liability for “bodily injury”, “property damage” or “personal and advertising injury” caused, in whole or in part, by: a.Your negligent acts or omissions; or b.The negligent acts or omissions of those acting on your behalf; in the performance of your ongoing operations. No such public entity or individual is an additional insured for liability arising out of the sole negligence by that public entity or its designated individuals. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. B. SECTION III – LIMITS OF INSURANCE is amended to include: 8. The limits of insurance applicable to the public entity and applicable individuals identified as an additional insured(s) pursuant to Provision A.4. above, are those specified in the written contract between you and that public entity, or the limits available under this policy, whichever are less. These limits are part of and not in addition to the limits of insurance under this policy. C.With respect to the insurance provided to the additional insured(s), Condition 4. Other Insurance of SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Other Insurance a. Primary Insurance This insurance is primary if you have agreed in a written contract or written agreement: (1) That this insurance be primary. If other insurance is also primary, we will share with all that other insurance as described in c. below; or NIA-061B GL 01 25 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 2 of 2 (2) The coverage afforded by this insurance is primary and non-contributory with the additional insured(s)’ own insurance. Paragraphs (1) and (2) do not apply to other insurance to which the additional insured(s) has been added as an additional insured or to other insurance described in paragraph b. below. b. Excess Insurance This insurance is excess over: 1. Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder’s Risk, Installation Risk or similar coverage for “your work”; (b) That is fire, lightning, or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for “property damage” to premises temporarily occupied by you with permission of the owner; or (d) 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. (e) Any other insurance available to an additional insured(s) under this Endorsement covering liability for damages which are subject to this endorsement and for which the additional insured(s) has been added as an additional insured by that other insurance. (1) When this insurance is excess, we will have no duty under Coverages A or B to defend the additional insured(s) against any “suit” if any other insurer has a duty to defend the additional insured(s) against that “suit”. If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured(s)’ rights against all those other insurers. (2) 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. (3) 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. c. Methods of Sharing If all of the other insurance available to the additional insured(s) 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 other the other insurance available to the additional insured(s) 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. NIA-102 BA 01 25 Nonprofits Insurance Alliance™ and NONPROFITS OWN® are brands of Alliance Member Services™ (AMS). © AMS. All rights reserved. Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AI - PRIMARY AND NON-CONTRIBUTARY – DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM In consideration of the premium charged, it is understood and agreed that the following is added as an additional insured: Any person or organization that you are required to include on this policy, under written contract or agreement currently in effect or becoming effective during the term of this policy, applicable under the terms and conditions of this endorsement, and consistent with the description below that the parties intend. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) But only as respects a legally enforceable contractual agreement with the Named Insured and only for liability arising out of the Named Insured's negligence and only for occurrences of coverages not otherwise excluded in the policy to which this endorsement applies. It is further understood and agreed that irrespective of the number of entities named as insureds under this policy, in no event shall the company's limits of liability exceed the occurrence or aggregate limits as applicable by policy definition or endorsement. Such insurance as is afforded by this endorsement for the additional insured shall apply as primary insurance. Any other insurance maintained by the additional insured or its officers and employees shall be excess and non- contributing with the insurance afforded by this endorsement. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY MWC 1400 05 10 Includes copyrighted material of National Council on Compensation Insurance with its permission Copyright 1983 National Council on Compensation Insurance.Page2 of 2MWC14000510 BLANKETWAIVEROFOURRIGHTTORECOVERFROMOTHERSENDORSEMENT-CALIFORNIA 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 any person or organization named in the Schedule. (This agreement applies only to the extent that you performworkunderawrittencontractthatrequiresyoutoobtainthisagreementfromus.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. ThisagreementshallnotoperatedirectlyorindirectlytobenefitanyonenotnamedintheSchedule. Schedule This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Premium: The additional premium charge for this endorsement shall be 3 percent of the California Workers’ Compensation premium otherwise due subject to a minimum premium of $750 per policy. Endorsement Effective: 07/01/2026 EndorsementNo. InsuranceCompany:Markel Insurance Company Countersigned by __________________________________ Premium $(See Attached)Insured:SENIOR ADULTS LEGAL ASSISTANCE (a non profit) Policy No.MWC0066225-13 2. 1. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY MWC 1400 05 10 Includes copyrighted material of National Council on Compensation Insurance with its permission Copyright 1983 National Council on Compensation Insurance.Page2 of 2MWC14000510 POLICY NUMBER: 01-CP-0004545-01-20 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER 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:Senior Adults Legal Assistance Endorsement Effective Date:06/30/2026 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization as required under a written contract or agreement currently in effect, or becoming effective during the term of this policy. 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. NIA-026B GL 01 25 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Any person or organization as required under a written contract or agreement currently in effect, or becoming effective during the term of this policy Where you are so required in a written contract or agreement currently in effect or becoming effective during the term of this policy, we waive any right of recovery we may have against that person or organization, who may be named in the schedule above, because of payments we make for injury or damage. POLICY NUMBER: 01-CP-0004545-01-20 COMMERCIAL GENERAL LIABILITY CG 20 26 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 26 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 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): County of Santa Clara, and members of the Board of Supervisors of the County of Santa Clara, and the officers, agents, and employees of the County of 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY Cupertino, CA 95014 10300 Torre Avenue City of Cupertino Subject to all policy terms, limits, conditions, exclusions and endorsements of the policy. $100,000Limit of Liability6/1/20276/1/2026105937785 Commercial Crime Bond Employee Theft & ERISA FidelityA Travelers Casualty & Surety Company San Jose, CA 95112 1425 Koll Circle #109 Senior Adults Legal Assistance (SALA) (847)541-0444(847)541-0900 Lake Zurich, IL 60047 1190 Flex Court COMPLETE EQUITY MARKETS INC 5/21/2026 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY Cupertino, CA 95050 10300 Torre Avenue City of Cupertino Subject to all policy terms, conditions, exclusions and endorsements of the policy. The City of Cupertino is listed as an additional insured but only per the terms & conditions of the endorsement generated and subject to all policy terms, conditions, exclusions, and endorsements. 30-Day Notice of Cancellation applies. $2,000,000Aggregate $1,000,000Each Claim11/01/2611/01/25JQF933799XProfessional LiabilityA 22608National Specialty Insurance Company San Jose, CA 95112 1425 Koll Circle #109 Senior Adults Legal Assistance (SALA) (847)541-0444(847)541-0900 In CA dba Complete Equity Markets Insurance Agency, Inc. CASL#0D44077 Lake Zurich, IL 60047 1190 Flex Court COMPLETE EQUITY MARKETS INC 10/15/25 General Fund Human Service Grants Program FY25/26 - Legal Services for Seniors Final Audit Report 2026-10-12 Created:2026-09-22 By:Webmaster Admin (webmaster@cupertino.org) Status:Signed Transaction ID:CBJCHBCAABAAGcsWOTQTTz09PECCvqOGNihLNyaTsWLZ "General Fund Human Service Grants Program FY25/26 - Legal Services for Seniors" History Document created by Webmaster Admin (webmaster@cupertino.org) 2026-09-22 - 6:22:11 PM GMT- IP address: 35.229.54.2 Document emailed to aracelia@cupertino.org for approval 2026-09-22 - 6:24:13 PM GMT Email viewed by aracelia@cupertino.org 2026-09-22 - 6:24:22 PM GMT- IP address: 98.82.199.191 Document approval delegated to Araceli Alejandre (AraceliA@cupertino.gov) by aracelia@cupertino.org 2026-09-22 - 6:25:48 PM GMT- IP address: 71.202.76.156 Document approved by Araceli Alejandre (AraceliA@cupertino.gov) Approval Date: 2026-09-22 - 6:26:47 PM GMT - Time Source: server- IP address: 71.202.76.156 Document emailed to gbacil@sala.org for signature 2026-09-22 - 6:26:48 PM GMT Email viewed by gbacil@sala.org 2026-09-30 - 8:32:03 PM GMT- IP address: 104.47.58.126 New document URL requested by gbacil@sala.org 2026-09-30 - 8:32:07 PM GMT- IP address: 76.102.125.76 Signer gbacil@sala.org entered name at signing as Georgia Bacil 2026-09-30 - 9:39:20 PM GMT- IP address: 76.102.125.76 Document e-signed by Georgia Bacil (gbacil@sala.org) Signature Date: 2026-09-30 - 9:39:22 PM GMT - Time Source: server- IP address: 76.102.125.76 - Signature Appearance Selected: TYPE Document emailed to michaelw@cupertino.org for signature 2026-09-30 - 9:39:24 PM GMT Email viewed by michaelw@cupertino.org 2026-09-30 - 9:39:35 PM GMT- IP address: 3.239.230.194 Email viewed by michaelw@cupertino.org 2026-10-08 - 0:09:10 AM GMT- IP address: 98.93.5.185 Email viewed by michaelw@cupertino.org 2026-10-09 - 0:09:04 AM GMT- IP address: 3.80.167.201 Email viewed by michaelw@cupertino.org 2026-10-10 - 0:16:14 AM GMT- IP address: 3.82.5.227 Email viewed by michaelw@cupertino.org 2026-10-11 - 1:13:01 AM GMT- IP address: 3.88.248.33 Email viewed by michaelw@cupertino.org 2026-10-12 - 0:09:07 AM GMT- IP address: 34.236.145.173 Signer michaelw@cupertino.org entered name at signing as Michael K Woo 2026-10-12 - 3:51:15 PM GMT- IP address: 69.181.158.199 Document e-signed by Michael K Woo (michaelw@cupertino.org) Signature Date: 2026-10-12 - 3:51:17 PM GMT - Time Source: server- IP address: 69.181.158.199 - Signature Appearance Selected: TYPE Document emailed to Benjamin Fu (benjaminf@cupertino.org) for signature 2026-10-12 - 3:51:18 PM GMT Email viewed by Benjamin Fu (benjaminf@cupertino.org) 2026-10-12 - 3:51:25 PM GMT- IP address: 3.236.108.40 Document e-signed by Benjamin Fu (benjaminf@cupertino.org) Signature Date: 2026-10-12 - 4:27:47 PM GMT - Time Source: server- IP address: 64.165.34.3 - Signature Appearance Selected: TYPE Document emailed to laurens@cupertino.org for signature 2026-10-12 - 4:27:49 PM GMT Email viewed by laurens@cupertino.org 2026-10-12 - 4:27:56 PM GMT- IP address: 3.235.223.37 Signer laurens@cupertino.org entered name at signing as Lauren Sapudar 2026-10-12 - 4:58:57 PM GMT- IP address: 64.165.34.3 Document e-signed by Lauren Sapudar (laurens@cupertino.org) Signature Date: 2026-10-12 - 4:58:59 PM GMT - Time Source: server- IP address: 64.165.34.3 - Signature Appearance Selected: TYPE Agreement completed. 2026-10-12 - 4:58:59 PM GMT