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13-077 The Segal Company, Consultant Services for Employee Benefits Analysis AGREEMENT BETWEEN THE CITY OF CUPERTINO AND / C���-ca 6 THE THE SEGAL COMPANY R CONSULTANT SERVICES FOR EMPLOYEE BENEFITS ANALYSIS VC THIS AGREEMENT, for reference dated ikkLCi . 7 , 2013, is by and between �,. CITY OF CUPERTINO, a municipal corporation(hereinafter referred to as "City"), and The Segal Company, a California corporation whose address is (hereinafter referred to as "Consultant"), and is made with reference to the following: RECITALS: A. City is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to carry on its business as it is now being conducted under the Constitution and the statutes of the State of California and the Cupertino Municipal Code. B. Consultant is specially trained, experienced and competent to perform the special services which will be required by this Agreement; and C. Consultant possesses the skill, experience, ability, background, certification and knowledge to provide the services described in this Agreement on the terms and conditions described herein. D. City and Consultant desire to enter into an agreement for upon the terms and conditions herein. NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows: 1. TERM: The term of this Agreement shall commence on April 1, 2013, and shall terminate on March 31, 2014, unless terminated earlier as set forth herein. 2. SERVICES TO BE PERFORMED: Consultant shall perform each and every service set forth in Exhibit "A" according to the project schedule set forth in Exhibit B, which exhibits are attached hereto and incorporated herein by this reference, in accordance with the terms and conditions set forth in this agreement. Consultant's Project Manager to represent consultant during the day-to-day work on the Project is Robert Mitchell. Consultant's Project Manager shall have supervisory responsibility for the performance, progress, and execution of the Services. If circumstances cause the substitution of the project director, project coordinator, or any other key personnel for any reason, the appointment of a substitute project director and the assignment of any key new or replacement personnel will be subject to the prior written approval of the City. Consultant, at CiLty's request, also agrees to promptly remove personnel who City finds do not perform the Services in an acceptable manner. 3. COMPENSATION TO CONSULTANT: Consultant shall be compensated for services performed pursuant to this Agreement in the amounts set forth in Exhibit "C" which is attached hereto and incorporated herein by this reference. Consultant shall submit monthly invoices to the City in accordance with the provisions set forth in Exhibit"C." 4. TIME IS OF THE ESSENCE: Consultant and City agree that time is of the essence regarding the performance of this Agreement. 5. STANDARD OF CARE: Consultant agrees to perform all services hereunder in a manner commensurate with the prevailing standards of like professionals in the San Francisco Bay Area and agrees that all services shall be performed by qualified and experienced personnel who are not employed by the City nor have any contractual relationship with City. 6. INDEPENDENT PARTIES: City and Consultant intend that the relationship between them created by this Agreement is that of employer-independent contractor. The manner and means of conducting the work are under the control of Consultant, except to the extent they are limited by statute, rule or regulation and the express terms of this Agreement. No civil service status or other right of employment will be acquired by virtue of Consultant's services. None of the benefits provided by City to its employees, including but not limited to, unemployment insurance, workers' compensation plans, vacation and sick leave are available from City to Consultant, its employees or agents. Deductions shall not be made for any state or federal taxes, FICA payments, PERS payments, or other purposes normally associated with an employer-employee relationship from any fees due Consultant. Payments of the above items, if required, are the responsibility of Consultant. 7. IMMIGRATION REFORM AND CONTROL ACT (IRCA): Consultant assumes any and all responsibility for verifying the identity and employment authorization of all of his/her employees performing work hereunder, pursuant to all applicable IRCA or other federal, or state rules and regulations. Consultant shall indemnify and hold City harmless from and against any loss, damage, liability, costs or expenses arising from any noncompliance of this provision by Consultant. 8. NON-DISCRIMINATION: Consistent with City's policy that harassment and discrimination are unacceptable employer/employee conduct, Consultant agrees that harassment or discrimination directed toward a job applicant, a City employee, or a citizen by Consultant or Consultant's employee or subcontractor on the basis of race, religious creed, color, national origin, ancestry, handicap, disability, marital status, pregnancy, sex, age, or sexual orientation will not be tolerated. Consultant agrees that any and all violations of this provision shall constitute a material breach of this Agreement. 9. HOLD HARMLESS: Consultant shall, to the fullest extent allowed by law, with respect to all services performed in connection with the Agreement, indemnify, defend, and hold harmless the City and its officers, officials, agents, employees and volunteers from and against any and all liability, claims, actions, causes of action or demands whatsoever against any of them, including any injury to or death of any person or damage to property or other liability of any nature, to the extent resulting from the willful misconduct or negligent performance of this Agreement by Consultant or Consultant's employees, officers, officials, agents or independent contractors. Such costs and expenses shall include reasonable attorneys' fees of counsel of City's choice, expert fees and all other costs and fees of litigation. 10. INSURANCE: On or before the commencement of the term of this Agreement, Consultant shall furnish City with certificates showing the type, amount, class of operations covered, effective dates and dates of expiration of insurance coverage in compliance with paragraphs 9A, B, C, D and E. Such certificates, which do not limit Consultant's indemnification, shall also contain substantially the following statement: "Should any of the above described insurance policies be canceled or coverage reduced before the expiration date thereof, notice will be delivered in accordance with the policy provisions to the attention of the City Manager." It is agreed that Consultant shall maintain in force at all times during the performance of this Agreement all appropriate coverage of insurance required by this Agreement with an insurance company that is acceptable to City and licensed to do insurance business in the State of California. Endorsements naming or evidencing that the City is an additional insured shall be submitted with the insurance certificates. A. COVERAGE: Consultant shall maintain the following insurance coverage: (1) Workers' Compensation: Statutory coverage as required by the State of California. (2) Liability: Commercial general liability coverage in the following minimum limits: Bodily Injury: $500,000 each occurrence $1,000,000 aggregate - all other Property Damage: $100,000 each occurrence $250,000 aggregate If submitted, combined single limit policy with aggregate limits in the amounts of$1,000,000 will be considered equivalent to the required minimum limits shown above. (3) Automotive: Comprehensive automotive liability coverage in the following minimum limits: Bodily Injury: $500,000 each occurrence Property Damage: $100,000 each occurrence or Combined Single Limit: $500,000 each occurrence (4) Professional Liability: Professional liability insurance which includes coverage for the professional acts, errors and omissions of Consultant in the amount of at least $1,000,000. B. SUBROGATION WAIVER: Consultant agrees that in the event of loss due to any of the perils for which he/she has agreed to provide comprehensive general and automotive liability insurance, Consultant shall look solely to his/her insurance for recovery. Consultant hereby grants to City, on behalf of any insurer providing comprehensive general and automotive liability insurance to either Consultant or City with respect to the services of Consultant herein, a waiver of any right to subrogation which any such insurer of said Consultant may acquire against City by virtue of the payment of any loss under such insurance. C. FAILURE TO SECURE: If Consultant at any time during the term hereof should fail to secure or maintain the foregoing insurance, City shall be permitted to obtain such insurance in the Consultant's name or as an agent of the Consultant and shall be compensated by the Consultant for the costs of the insurance premiums at the maximum rate permitted by law and computed from the date written notice is received that the premiums have not been paid. D. ADDITIONAL INSURED: City, its City Council, boards and commissions, officers, employees and volunteers shall be named as an additional insured under all insurance coverages, except any professional liability insurance, required by this Agreement. The naming of an additional insured shall not affect any recovery to which such additional insured would be entitled under this policy if not named as such additional insured. An additional insured named herein shall not be held liable for any premium, deductible portion of any loss, or expense of any nature on this policy or any extension thereof. Any other insurance held by an additional insured shall not be required to contribute anything toward any loss or expense covered by the insurance provided by this policy. E. SUFFICIENCY OF INSURANCE: The insurance limits required by City are not represented as being sufficient to protect Consultant. Consultant is advised to confer with Consultant's insurance broker to determine adequate coverage for Consultant. 11. CONFLICT OF INTEREST: Consultant warrants that it is not a conflict of interest for Consultant to perform the services required by this Agreement. Consultant may be required to fill out a conflict of interest form if the services provided under this Agreement require Consultant to make certain governmental decisions or serve in a staff capacity as defined in Title 2, Division 6, Section 18700 of the California Code of Regulations. 12. PROHIBITION AGAINST TRANSFERS: Consultant shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest therein, directly or indirectly, by operation of law or otherwise, without prior written consent of City. Any attempt to do so without said consent shall be null and void, and any assignee, sublessee, hypothecate or transferee shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. However, claims for money by Consultant from City under this Agreement may be assigned to a bank, trust company or other financial institution without prior written consent. Written notice of such assignment shall be promptly furnished to City by Consultant. The sale, assignment, transfer or other disposition of any of the issued and outstanding capital stock of Consultant, or of the interest of any general partner or joint venturer or syndicate member or cotenant, if Consultant is a partnership or joint venture or syndicate or cotenancy, which shall result in changing the control of Consultant, shall be construed as an assignment of this Agreement. Control means fifty percent(50%) or more of the voting power of the corporation. 13. SUBCONTRACTOR APPROVAL: Unless prior written consent from City is obtained, only those people and subcontractors whose names and resumes are attached to this Agreement shall be used in the performance of this Agreement. Consultant may change or add subcontractors only with the prior written approval of City. In the event that Consultant employs subcontractors, such subcontractors shall be required to furnish proof of workers' compensation insurance and shall also be required to carry general, automobile and professional liability insurance in reasonable conformity to the insurance carried by Consultant. In addition, any work or services subcontracted hereunder shall be subject to each provision of this Agreement. 14. PERMITS AND LICENSES: Consultant, at his/her sole expense, shall obtain and maintain during the term of this Agreement, all appropriate permits, certificates and licenses including, but not limited to, a City Business License, that may be required in connection with the performance of services hereunder. 15. DELIVERABLES AND REPORTS: A. Except to the extent that they incorporate Consultant's proprietary software, know-how, techniques, methodologies and report formats (collectively, "Consultant's Information"), all documents, data, and other tangible materials authored or prepared and delivered by Consultant to City under the terms of this Agreement (collectively,the "Deliverables"), are the sole and exclusive property of City, once paid for by City. To the extent that Consultant's Proprietary Information is incorporated into such Deliverables, City shall have a perpetual, nonexclusive, worldwide, royalty-free license to use, copy, and modify Consultant's Proprietary Information as part of the Deliverables. B. All Reports prepared by Consultant may be used by City in execution or implementation of: (1) The original Project for which Consultant was hired; (2) Completion of the original Project by others; (3) Subsequent additions to the original project; and/or (4) Other City projects as appropriate. C. Consultant shall, at such time and in such form as City may require, furnish reports concerning the status of services required under this Agreement. D. All Deliverables and reports required to be provided by this Agreement shall be printed on recycled paper. All Deliverables and reports shall be copied on both sides of the paper except for one original, which shall be single sided. E. No Report, information or other data given to or prepared or assembled by Consultant pursuant to this Agreement shall be made available to any individual or organization by Consultant without prior approval by City, except as may be required by law or legal process. 16. RECORDS: Consultant shall maintain complete and accurate records with respect to sales, costs, expenses, receipts and other such information required by City that relate to the performance of services under this Agreement. Consultant shall maintain adequate records of services provided in sufficient detail to permit an evaluation of services. All such records shall be maintained in accordance with generally accepted accounting principles and shall be clearly identified and readily accessible. Consultant shall provide free access to such books and records to the representatives of City or its designees at all proper times, and gives City the right to examine and audit same, and to make transcripts therefrom as necessary, and to allow inspection of all work, data, documents,proceedings and activities related to this Agreement. Such records, together with supporting documents, shall be kept separate from other documents and records and shall be maintained for a period of three (3) years after receipt of final payment. If supplemental examination or audit o f the records is necessary due to concerns raised by City's preliminary examination or audit of records, and the City's supplemental examination or audit of the records discloses a failure to adhere to appropriate internal financial controls, or failure to act in good faith, then Consultant shall reimburse City for all reasonable costs and expenses associated with the supplemental examination or audit. 17. NOTICES: All notices, demands, requests or approvals to be given under this Agreement shall be given in writing and conclusively shall be deemed served when delivered personally or on the second business day after the deposit thereof in the United States Mail,postage prepaid, registered or certified, addressed as hereinafter provided. All notices, demands, requests, or approvals from Consultant to City shall be addressed to City at: City of Cupertino 10300 Torre Ave. Cupertino CA 95014 Attention: City Manager All notices, demands, requests, or approvals from City to Consultant shall be addressed to Consultant at: The Segal Company 330 North Brand Blvd., Suite 1100 Glendale, CA 91203 Attention: Robert Mitchell 18. TERMINATION: In the event Consultant fails or refuses to perform any of the provisions hereof at the time and in the manner required hereunder, Consultant shall be deemed in default in the performance of this Agreement. If such default is not cured within within the time specified after receipt by Consultant from City of written notice of default, specifying the nature of such default and the steps necessary to cure such default, City may terminate the Agreement forthwith by giving to the Consultant written notice thereof. City shall have the option, at its sole discretion and without cause, of terminating this Agreement by giving seven(7) days' prior written notice to Consultant as provided herein. Upon termination of this Agreement, each party shall pay to the other party that portion of compensation specified in this Agreement that is earned and unpaid prior to the effective date of termination. 19. COMPLIANCES: Consultant shall comply with all state or federal laws and all ordinances, rules and regulations enacted or issued by City. 20. CONFLICT OF LAW: This Agreement shall be interpreted under, and enforced by the laws of the State of California excepting any choice of law rules which may direct the application of laws of another jurisdiction. The Agreement and obligations of the parties are subject to all valid laws, orders, rules, and regulations of the authorities having jurisdiction over this Agreement (or the successors of those authorities.) Any suits brought pursuant to this Agreement shall be filed with the courts of the County of Santa Clara, State of California. 21. ADVERTISEMENT: Consultant shall not post, exhibit, display or allow to be posted, exhibited, displayed any signs, advertising, show bills, lithographs, posters or cards of any kind pertaining to the services performed under this Agreement unless prior written approval has been secured from City to do otherwise. 22. WAIVER: A waiver by City of any breach of any term, covenant, or condition contained herein shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant, or condition contained herein, whether of the same or a different character. 23. INTEGRATED CONTRACT: This Agreement represents the full and complete understanding of every kind or nature whatsoever between the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or nature are merged herein. No verbal agreement or implied covenant shall be held to vary the provisions hereof. Any modification of this Agreement will be effective only by written execution signed by both City and Consultant. 24. INSERTED PROVISIONS: Each provision and clause required by law to be inserted into the Agreement shall be deemed to be enacted herein, and the Agreement shall be read and enforced as though each were included herein. If through mistake or otherwise, any such provision is not inserted or is not correctly inserted, the Agreement shall be amended to make such insertion on application by either party. 25. CAPTIONS: The captions in this Agreement are for convenience only, are not a part of the Agreement and in no way affect, limit or amplify the terms or provisions of this Agreement. IN WITNESS WHEREOF, the parties have caused the Agreement to be executed. CONSULTANT CITY OF CUPERTINO A Municipal Corporation The Seal Company /By .,���. . Title Senior Vice Preside° Title )/i AL ,71jJ V<<<'5 Date May 22, 2013 Date b - /3 RECOMMENDED F• ' APPROVAL: By Title APPROVED AS TO FORM: /�� B � (g2- ' ti-i'City Attorney ATTEST: City Clerk /, %o -- 70 / 92: /3 EXHIBIT A SCOPE OF SERVICES Consultant shall complete the tasks described in this exhibit as directed by City's project manager. Prior to commencing work on each task, Consultant shall provide City with a description of the activities necessary to complete that task, schedule, and anticipated maximum budget. 1. Review and evaluate the City's current active and retiree medical contribution structures: a. Make recommendations on options for different benefit structures that may create more flexibility in providing benefits to active employees and retirees; b. Identify benefit options to limit the City's retiree medical liability; and c. Identify alternative options for medical coverage and evaluate costs and the level of benefits related to those options. 2. Evaluate the City's medical plans to determine compliance with Federal and State law, including the Affordable Care Act(ACA): a. Provide analysis and timetables for future compliance requirements; b. Assist the City with determining and mitigating exposure to upcoming employer penalties regarding the ACA, and develop tools for City Staff to use to maintain ongoing compliance. 3. Assist City staff in education and outreach, including presentations to City Council and City employees regarding benefit options, alternatives, and requirements under federal and state law. City shall, to the extent reasonable and practicable, assist and cooperate with Consultant in the performance of Consultant's services under this agreement. To enable Consultant to perform the services contemplated herein, the City agrees to promptly provide (or cause its agents, vendors and other third parties to provide) Consultant with such data, materials and other information as Consultant reasonably requests and all data needed to perform these services. Upon receipt of data, Consultant will review it for basic reasonableness and consistency and notify the City of any concerns with the data. Subject to its obligations in the preceding sentence, Consultant may rely upon such data and other information provided to it by such parties as being accurate and complete. Consultant is not required to verify or audit any data or other information so provided, nor is it liable to the City or others if such information is inaccurate, misleading or false. EXHIBIT B SCHEDULE OF PERFORMANCE Consultant shall perform the Services within a.timeframe mutually agreed by the project managers for Consultant and City, so long as all work is completed within the term of the Agreement. EXHIBIT C COMPENSATION City shall compensate Consultant for professional services in accordance with the terms and conditions of this Agreement based on the rates and compensation schedule set forth below. Compensation shall be calculated based on the hourly rates set forth below up to the not to exceed budget amount set forth below. The compensation to be paid to Consultant under this Agreement for all services described in Exhibit"A" and reimbursable expenses shall not exceed a total amount of twenty-five thousand dollars ($25,000.00). Any work performed or expenses incurred for which payment would result in a total exceeding the maximum amount of compensation set forth herein shall be at no cost to the City. Hourly Rates Robert Mitchell, Consultant $350 Thomas M. Morrison, Senior Consultant, SVP $475 Gita Raghavan, Health Benefits Manager$370 Nancy Topping, Senior Health Benefits Advisor$370 Nancy Hakes, Compliance and Wellness Specialist $370 Daljit Johl, Pharmacy Benefits Consultant $375 Jessica Kuhlman, Senior Health Benefits Advisor $295 Mandy Chu and Joanna Yip, Health Benefits Advisor$295 Johnny Wu, Associate $205 Invoices In order to request payment, Consultant shall submit monthly invoices to the CITY describing the services performed and the applicable charges (including an identification of personnel who performed the services, hours worked, task(s) for which work was performed, hourly rates, and reimbursable expenses), based upon Consultant's billing rates. Reimbursable Expenses Administrative, overhead, secretarial time or overtime, word processing, photocopying, in house printing, insurance and other ordinary business expenses are included within the scope of payment for services and are not reimbursable expenses. City shall reimburse consultant for reasonable travel. Travel expenses are limited to the lesser of actual expenses or expenses that would be authorized for City employee travel pursuant to City policy. Additional Services Consultant shall provide additional services outside of the services identified in Exhibit A only by advance written authorization from the City's Project Manager prior to commencement of any additional services. Consultant shall submit, at the Project Manager's request, a detailed written proposal including a description of the scope of additional services, schedule, and proposed maximum compensation. �/ OFFICE OF THE CITY CLERK ' CITY HALL 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 �5S'i'ss TELEPHONE: (408) 777-3223• FAX: (408) 777-3366 CUP E RT I N O WEBSITE:www.cupertino.org June 17, 2013 The Segal Company 330 North Brand Blvd., Suite 1100 Glendale, CA 91203 Attn: Robert Mitchell Re: Agreement for Consultant Services for Employee Benefits Analysis Enclosed is a fully executed original copy of your agreement with the City of Cupertino. If you have any additional questions, please contact the Administrative Services department at (408) 777-3220. Sincerely, Brittany Carey' Senior Office Assistant Enclosure cc: Administrative Services Client#:3912 SEGACOMP ACORDr. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 6/14/2013 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: Jordan Graubard BWD Group LLC PHONE FAX ,Arc,No,Ext);516 327-2700 (ac,No): 516-327-2800 45 Executive Drive EMAIL ADDRESS: jgraubard@bwd.us Plainview,NY 11803 _ INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Great Northern Insurance Co. 20303 INSURED INSURER B:Federal Insurance Company 20281 The Segal Company(Western States),Inc. INSURER C:Pacific Indemnity Company 20346 330 North Brand Boulevard -- Suite 1100 INSURER D Glendale,CA 91203-2308 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 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. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS _ _ (MM/DD/YYYY) (MM/DD/YYYY) A GENERAL LIABILITY Y Y 35825562 02/28/2013 02/28/2014 EACH OCCUURRENCE $1,000,000 _ XI COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $1,000,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $10,000 General Aggregate PERSONAL&ADV INJURY $1,000,000 Cap-$30,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $Included POLICY PRO X LOC $ JECT B AUTOMOBILE LIABILITY Y 73526838 02/28/2013 02/28/2014 COMBINED INGLE LIMIT 000 (Ea accident) $1, ,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per $ AUTOS AUTOS er accident) X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ _ AUTOS (Per accident) $ B x UMBRELLA LIAB X OCCUR Y 79837923 02/28/2013 02/28/2014 EACH OCCURRENCE $20,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $20,000,000 DED X RETENTION$10,000 __ $ C WORKERS COMPENSATION 71738381 02/28/2013 02/28/2014 X TO STATUTS- OTH- AND EMPLOYERS'LIABILITY y/N TORY LIMI FR ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? N N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate Holder is an Additional Insured AIMA. CERTIFICATE HOLDER CANCELLATION City of Cupertino SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Liz Nunez ACCORDANCE WITH THE POLICY PROVISIONS. 10300 Torre Avenue _ Cupertino,CA 95014 ALTHORIZED REPRESENTATIVE I C,4 C 4t 7 . ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #5302783/M293271 DESIM