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15-206 Professional Turf Management; Blackberry Farm Golf Course Maintenance (Original Contract and Amendments 1-4)1
FIFTH AMENDMENT TO AGREEMENT 15-206
BETWEEN THE CITY OF CUPERTINO AND
PROFESSIONAL TURF MANAGEMENT FOR
BLACKBERRY FARM GOLF COURSE
MAINTENANCE
This Fifth Amendment to Agreement 15-206 between the City of Cupertino and
Professional Turf Management, for reference dated 5/4/2020, is by and between the CITY OF
CUPERTINO, a municipal corporation (hereinafter "City") and Professional Turf
Management, a California Corporation (“Contractor”) whose address is P.O. Box 700142,
San Jose, Ca. 95170, and is made with reference to the following:
RECITALS:
A. On 12/3/2015, Agreement 15-206 (“Agreement”) was entered into by and
between City and Contractor for Blackberry Farm Golf Course Maintenance and soil
sample collection and testing.
B. On 7/1/2016, City and Contractor agreed to the First Amendment for
Blackberry Farm Golf Course Maintenance and soil sample collection and testing.
C. On 7/1/2017, City and Contractor agreed to the Second Amendment for
Blackberry Farm Golf Course Maintenance and soil sample collection and testing
D. On 7/1/2018, City and Contractor agreed to the Third Amendment for
Blackberry Farm Golf Course Maintenance and soil sample collection and testing
E. On 7/1/2019, City and Contractor agreed to the Fourth Amendment for
Blackberry Farm Golf Course Maintenance and soil sample collection and testing
F. The Agreement and the First, Second, Third, and Fourth Amendments are
collectively referred to as the “Agreement” unless otherwise indicated.
G. 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 and undersigned parties
as follows:
1. TERM.
Paragraph 1 of the Agreement is modified to read as follows: The Contractor shall
continue work through June 30, 2021, and shall diligently prosecute the work. The
term of the Agreement shall terminate on June 30, 2021, unless terminated earlier as
2
set forth herein.
2. SERVICES TO BE PERFORMED.
Contractor agrees, at its own cost and expense, to furnish all labor, tools, equipment,
materials, except as otherwise specified, and to do all work strictly in accordance
with the Scope of Work (see Exhibit A). The General and Special Conditions,
Technical Provisions and Special Environmental Conditions are hereby referred to
and expressly made a part hereof with the same force and effect as if the same were
fully incorporated herein. Contractor further agrees to carry out its work in
compliance with the City’s Shelter In Place and Social Distancing Requirements,
attached here and incorporated as Exhibit A-A.
3. Exhibit A-A, attached hereto, is added to the Agreement.
4. COMPENSATION TO CONTRACTOR.
Paragraph 3 of the Agreement is modified to read as follows: Contractor shall be
compensated for services performed pursuant to this Agreement in the amount and
manner set forth in Contractor’s bid, which is attached hereto as Exhibit B-3 and
incorporated herein by reference.
5. Exhibit B-2 of the Agreement is replaced with new Exhibit B-3 attached hereto.
6. 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.
IN WITNESS WHEREOF, the parties hereto have caused this modification of
Agreement to be executed.
CONTRACTOR
By
Title
Date________________________________
CITY OF CUPERTINO
By
Title
Date________________________________
APPROVED AS TO FORM
City Attorney
ATTEST:
City Clerk
Michael Basile
Owner
Jun 16, 2020
Heather M. Minner
Deborah L. Feng
Jun 21, 2020
City Manager
Kirsten Squarcia 6/22/20
3
EXPENDITURE DISTRIBUTION
PO #2016-398 560-63-616 700-702
Original $99,600.00
Amendment #1: $205,200.00
Amendment #2: $205,200.00
Amendment #3: $205,200.00
Amendment #4: $205,200.00
Amendment #5: $205,200.00
Total: $1,125,600
Revised: June 5, 2020 – Public Works Contracts
1
Exhibit A-A – SHELTER IN PLACE AND SOCIAL DISTANCING REQUIREMENTS
A. Health Laws Acknowledged. It is acknowledged that Consultant’s/Contractor’s
(“Contractor”) duty to comply with Laws, as defined in Section 13 of the Contract/Agreement
(“Contract”), includes immediate compliance by Contractor and its subcontractors with the
restrictions on travel and the Social Distancing Requirements set forth in the most recent health
order issued by the County of Santa Clara Health Department in response to the COVID-19
pandemic, and any subsequent amendments or superseding orders thereto (the “Health
Order”), and any other local, state, or federal laws that have been or may be enacted in
response to the COVID-19 pandemic (collectively, “Health Laws”).
B. Health Order Compliance. Contractor shall comply with any restrictions on travel and social
distancing requirements in the Health Order when preforming work under this Contract. If a
scope of work item, notice to proceed, or work order under this Contract specifies work that
cannot be performed in compliance with the Health Order or other Health Laws, Contractor
shall refrain from conducting the work and immediately inform the City.
C. Individuals at High Risk of Severe Illness. Nothing in this Contract shall be interpreted to
require any person at high risk of severe illness from COVID-19 to leave their residence to
perform work under the Contract. Contractor will inform the City if other arrangements for the
work must be made, and City will do so, with no penalty to Contractor, although Contractor will
not be compensated for work performed by the City or third parties. Information from the
Center for Disease Control ("CDC") on "high risk" categories is available at the CDC's website at:
https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/people-at-higher-risk.html.
D. Health Order Requirements and Best Practices. Contractor will immediately undertake all
appropriate measures to ensure compliance with the Social Distancing Requirements in the
Health Order by all individuals on any project site or work area performing work under this
Contract, including Contractor's or any subcontractor's workers, employees, representatives,
vendors, or suppliers (collectively, "workers"), and shall maintain these measures for as long as
required by the Health Order or other Health Laws. In particular, Contractor must comply with
the provisions of Appendix B-1 or B-2 (attached hereto) to the Health Order, as applicable.
Further, as long as required by the operative Health Order including Appendix B-1 or B-2, or
other Health Laws, these measures shall include, but are not limited to, the following best
practices:
1. Information. Inform all workers of the Social Distancing Requirements and these best
practices, including any updates or modifications, and require compliance as a condition
to being present on the project site or work area.
2. Sick Workers. Prohibit any individuals who have been tentatively or conclusively
diagnosed with COVID-19 or who have any symptoms of illness, including the following,
from entering or remaining on the project site or work area: fever, cough, shortness of
Revised: June 5, 2020 – Public Works Contracts
2
breath, sore throat, body aches, chills, sudden loss of smell or taste or other flu-like
symptoms. Encourage sick workers to get immediate medical attention.
a. Daily Screening. A supervisor must ask the following questions of each worker
before the worker is permitted to enter the project site or work area each day,
and a worker who responds "yes" to any one of the following questions must be
asked to leave immediately and will not be permitted back on the project site or
work area until cleared based on meeting the applicable requirements set forth
in the CDC's Interim Guidance on Discontinuation of Home Isolation for Persons
with COVID-19 (https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-in-
home-patients.html):
(1) Have you had any of the following symptoms within the past 14 days:
fever, cough, shortness of breath, sore throat, body aches, chills, sudden
loss or smell or taste, or any other flu-like symptoms?
(2) Have you or anyone in your household been in contact with a person
that has been diagnosed with, has symptoms of, or is being tested for
COVID-19?
(3) Have you been medically directed to self-quarantine due to possible
exposure to COVID-19?
3. Signage/Posters. In compliance with the Health Order, post a Social Distancing
Protocol, substantially in the form attached to the Health Order as Appendix A, at all
project site or work area entry points, and in other areas where they are likely to be
seen (e.g., project trailers, sanitary facilities, break areas). The Social Distancing Protocol
must explain how Contractor is achieving compliance with social distancing
requirements. Resources for this purpose are available from the CDC at:
https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-
response.html A copy of the Social Distancing Protocol must also be provided to each
employee performing work at the project site or work area.
4. Sanitary Facilities. Ensure adequate handwashing and/or hand-sanitizing facilities are
available at all times and encourage frequent handwashing and/or hand-sanitizing
throughout the day as specified below. Portable sanitary facilities must be serviced and
cleaned on a daily basis. Provide hand sanitizer in or around all toilet facilities and
common areas, including project trailers.
a. Handwashing. Wash hands using soap and water for at least 20 seconds.
b. Hand-sanitizer. Use a hand sanitizer that contains at least 60-95% alcohol
when handwashing is not immediately available.
Revised: June 5, 2020 – Public Works Contracts
3
c. Paper Products. Ensure that toilet paper, tissues, and paper towels are
available as appropriate, with designated receptacles for disposal.
5. Distancing. Prohibit workers from being less than six feet apart, unless and only to
the extent that would compromise worker safety or violate safety Laws for specific
operations. Prohibit handshaking or any physical contact among workers, with the sole
and limited exception of any physical contact required for worker safety or to comply
with safety Laws. Avoid sharing tools to the extent possible. Require workers to provide
their own transportation where possible and to avoid having more than two workers in
a vehicle.
6. Groups/Meetings/Site Access. Avoid any group gatherings of 10 or more people. Use
electronic alternatives to in person meetings, e.g., conference calls, video-conferencing,
etc., to the greatest extent possible. Limit access to the project site or any work area to
workers who are necessary to perform the work at that time. Allow non-essential
personnel to work from home to the extent possible. Avoid all non-essential travel. Do
not stack trades if possible.
7. Frequent Cleaning. Provide for regular and appropriate cleaning of all high touch
surfaces at a project site or work area, including, but not limited to, shared tools or
equipment, doorknobs and handles, toolboxes, sanitary facilities, common break areas,
keypads, touch screens, project trailer surfaces and equipment, light or power switches,
workstations, countertops, break areas, and the like. Clean and/or disinfect any reusable
items or equipment. Clean surfaces of shared vehicles, including steering wheels, gear
shifts, handles, instrument panels, etc. Ensure that cleaning products are used correctly
and safely, and avoid cleaning techniques, such as use of pressurized air or water sprays,
that may generate bioaerosols.
8. Personal Protective Equipment. When workers cannot avoid close proximity or
physical contact, e.g., based on applicable safety laws, or are otherwise at risk for
exposure to COVID-19, ensure that the affected workers are provided with appropriate
personal protective equipment ("PPE"), which may include disposable gloves and/or
other PPE. Instruct workers to wash or sanitize hands after removing gloves or other
PPE. Ensure that all personal protective equipment is disposed of properly.
9. Water and Food. Prohibit shared or communal food or common water coolers.
Provide individual water bottles for workers or instruct workers to bring their own.
10. Enforcement. Immediately eject any worker who fails or refuses to comply with the
Health Laws, Social Distancing Requirements, or these best practices from the project
site until or unless the Project Manager issues a written authorization for the worker to
return, subject to full compliance.
Revised: June 5, 2020 – Public Works Contracts
4
F. Proof of Compliance. If Contractor is subject to Appendix B-1 of the Health Order, Contractor
must provide to the City the name and contact information for its designated site-specific
COVID-19 supervisor(s). If Contractor is subject to Appendix B-2 of the Health Order, Contractor
must provide to the City a copy of its Site-Specific Health and Safety Plan. Any changes to the
COVID-19 supervisor or the Site-Specific Health and Safety Plan must be reported to the City
immediately.
E. Oversight. In other to ensure that all workers comply with the Social Distancing
Requirements to the extent possible, Contractor shall designate a named individual to have
primary responsibility for implementation and enforcement of the Social Distancing
Requirements and these best practices, and to serve as the primary point of contact with the
City in this regard. Contractor shall promptly inform the City of the name of this individual.
F. Changed Requirements. It is understood and acknowledged that circumstances pertaining to
the COVID-19 pandemic are evolving rapidly and that new local, state, or federal requirements
may modify the requirements under this Exhibit. Contractor agrees to work cooperatively with
the City to implement new or changed requirements as quickly as possible.
G. Subcontracts. Contractor shall include the terms of this Exhibit in all subcontracts and
require any agents, subcontractors, or subconsultants to comply with its provisions.
Attachments to Exhibit A-A
Appendix B-1 to June 5, 2020 Health Order
Appendix B-2 to June 5, 2020 Health Order
1228578.4
Appendix B-1
(Effective June 5, 2020)
1
Small Construction Project Safety Protocol
1. Any construction project meeting any of the following specifications is subject to this Small
Construction Project Safety Protocol (“SCP Protocol”), including public works projects unless
otherwise specified by the Health Officer:
a. For residential projects, any single-family, multi-family, senior, student, or other residential
construction, renovation, or remodel project consisting of 10 units or less. This SCP Protocol
does not apply to construction projects where a person is performing construction on their
current residence either alone or solely with members of their own household.
b. For commercial projects, any construction, renovation, or tenant improvement project
consisting of 20,000 square feet of floor area or less.
c. For mixed-use projects, any project that meets both of the specifications in subsection 1.a and
1.b.
d. All other construction projects not subject to the Large Construction Project Safety Protocol
set forth in Appendix B-2.
2. The following restrictions and requirements must be in place at all construction job sites subject to
this SCP Protocol:
a. Comply with all applicable and current laws and regulations including but not limited to
OSHA and Cal-OSHA. If there is any conflict, difference, or discrepancy between or among
applicable laws and regulations and/or this SCP Protocol, the stricter standard shall apply.
b. Designate a site-specific COVID-19 supervisor or supervisors to enforce this guidance. A
designated COVID-19 supervisor must be present on the construction site at all times during
construction activities. A COVID-19 supervisor may be an on-site worker who is designated
to serve in this role.
c. The COVID-19 supervisor must review this SCP Protocol with all workers and visitors to the
construction site.
d. Establish a daily screening protocol for arriving staff to ensure that potentially infected staff
do not enter the construction site. If workers leave the jobsite and return the same day,
establish a cleaning and decontamination protocol prior to entry and exit of the jobsite. Post
the daily screening protocol at all entrances and exits to the jobsite. More information on
screening can be found online at: https://www.cdc.gov/coronavirus/2019-
ncov/community/index.html.
e. Practice social distancing by maintaining a minimum six-foot distance between workers at all
times, except as strictly necessary to carry out a task associated with the construction project.
Appendix B-1
(Effective June 5, 2020)
2
f. Where construction work occurs within an occupied residential unit, separate work areas
must be sealed off from the remainder of the unit with physical barriers such as plastic
sheeting or closed doors sealed with tape to the extent feasible. If possible, workers must
access the work area from an alternative entry/exit door to the entry/exit door used by
residents. Available windows and exhaust fans must be used to ventilate the work area. If
residents have access to the work area between workdays, the work area must be cleaned and
sanitized at the beginning and at the end of workdays. Every effort must be taken to
minimize contact between workers and residents, including maintaining a minimum of six
feet of social distancing at all times.
g. Where construction work occurs within common areas of an occupied residential or
commercial building or a mixed-use building in use by on-site employees or residents,
separate work areas must be sealed off from the rest of the common areas with physical
barriers such as plastic sheeting or closed doors sealed with tape to the extent feasible. If
possible, workers must access the work area from an alternative building entry/exit door to
the building entry/exit door used by residents or other users of the building. Every effort must
be taken to minimize contact between worker and building residents and users, including
maintaining a minimum of six feet of social distancing at all times.
h. Prohibit gatherings of any size on the jobsite, including gatherings for breaks or eating,
except for meetings regarding compliance with this protocol or as strictly necessary to carry
out a task associated with the construction project.
i. Cal-OSHA requires employers to provide water, which should be provided in single-serve
containers. Sharing of any of any food or beverage is strictly prohibited and if sharing is
observed, the worker must be sent home for the day.
j. Provide personal protective equipment (PPE) specifically for use in construction, including
gloves, goggles, face shields, and face coverings as appropriate for the activity being
performed. At no time may a contractor secure or use medical-grade PPE unless required
due to the medical nature of a jobsite. Face coverings must be worn in compliance with the
April 17, 2020 Guidance from the County of Santa Clara Public Health Department,
available at: https://www.sccgov.org/sites/covid19/Pages/learn-what-to-do.aspx#howto.
k. Strictly control “choke points” and “high-risk areas” where workers are unable to maintain
six-foot social distancing and prohibit or limit use to ensure that six-foot distance can easily
be maintained between individuals.
l. Minimize interactions and maintain social distancing with all site visitors, including delivery
workers, design professional and other project consultants, government agency
representatives, including building and fire inspectors, and residents at residential
construction sites.
m. Stagger trades as necessary to reduce density and allow for easy maintenance of minimum
six-foot separation.
Appendix B-1
(Effective June 5, 2020)
3
n. Discourage workers from using others’ desks, work tools, and equipment. If more than one
worker uses these items, the items must be cleaned and disinfected with disinfectants that are
effective against COVID-19 in between use by each new worker. Prohibit sharing of PPE.
o. If hand washing facilities are not available at the jobsite, place portable wash stations or hand
sanitizers that are effective against COVID-19 at entrances to the jobsite and in multiple
locations dispersed throughout the jobsite as warranted.
p. Clean and sanitize any hand washing facilities, portable wash stations, jobsite restroom areas,
or other enclosed spaces daily with disinfectants that are effective against COVID-19.
Frequently clean and disinfect all high touch areas, including entry and exit areas, high traffic
areas, rest rooms, hand washing areas, high touch surfaces, tools, and equipment
q. Maintain a daily attendance log of all workers and visitors that includes contact information,
including name, phone number, address, and email.
r. Post a notice in an area visible to all workers and visitors instructing workers and visitors to
do the following:
i. Do not touch your face with unwashed hands or with gloves.
ii. Frequently wash your hands with soap and water for at least 20 seconds or use hand
sanitizer with at least 60% alcohol.
iii. Clean and disinfect frequently touched objects and surfaces such as work stations,
keyboards, telephones, handrails, machines, shared tools, elevator control buttons,
and doorknobs.
iv. Cover your mouth and nose when coughing or sneezing, or cough or sneeze into the
crook of your arm at your elbow/sleeve.
v. Do not enter the jobsite if you have a fever, cough, or other COVID-19 symptoms. If
you feel sick, or have been exposed to anyone who is sick, stay at home.
vi. Constantly observe your work distances in relation to other staff. Maintain the
recommended minimum six feet at all times when not wearing the necessary PPE for
working in close proximity to another person.
vii. Do not carpool to and from the jobsite with anyone except members of your own
household unit, or as necessary for workers who have no alternative means of
transportation.
viii. Do not share phones or PPE.
s. In the event of a confirmed case of COVID-19 at any jobsite, the following must take place:
i. Immediately remove the infected individual from the jobsite with directions to seek medical
care.
ii. Each location the infected worker was at must be decontaminated and sanitized by an outside
vendor certified in hazmat clean ups, and work in these locations must cease until
decontamination and sanitization is complete.
iii. The County Public Health Department must be notified immediately by both telephone (by
calling 408.885.4214) and by email (by sending an email to coronavirus@phd.sccgov.org).
Any requirements specified by the County health officials must be completed, including full
compliance with any tracing efforts by the County.
Appendix B-2
(Effective June 5, 2020)
1
Large Construction Project Safety Protocol
1. Any construction project meeting any of the following specifications is subject to this
Large Construction Project Safety Protocol (“LCP Protocol”), including public works
projects unless otherwise specified by the Health Officer:
a. For residential construction projects, any single-family, multi-family, senior,
student, or other residential construction, renovation, or remodel project consisting
of more than 10 units.
b. For commercial construction projects, any construction, renovation, or tenant
improvement project consisting of more than 20,000 square feet of floor area.
c. For construction of Essential Infrastructure, as defined in section 16.c of the Order,
any project that requires 20 or more workers at the jobsite at any one time.
2. The following restrictions and requirements must be in place at all construction job sites
subject to this LCP Protocol:
a. Comply with all applicable and current laws and regulations including but not
limited to OSHA and Cal-OSHA. If there is any conflict, difference or discrepancy
between or among applicable laws and regulations and/or this LCP Protocol, the
stricter standard will apply.
b. Prepare a new or updated Site-Specific Health and Safety Plan to address COVID-
19-related issues, post the Plan on-site at all entrances and exits, and produce a
copy of the Plan to County governmental authorities upon request. The Plan must
be translated as necessary to ensure that all non-English speaking workers are able
to understand the Plan.
c. Provide personal protective equipment (PPE) specifically for use in construction,
including gloves, goggles, face shields, and face coverings as appropriate for the
activity being performed. At no time may a contractor secure or use medical-grade
PPE, unless required due to the medical nature of a job site. Face coverings must
be worn in compliance with the April 17, 2020 Guidance from the County of Santa
Clara Public Health Department, available at:
https://www.sccgov.org/sites/covid19/Pages/learn-what-to-do.aspx#howto.
d. Ensure that employees are trained in the use of PPE. Maintain and make available
a log of all PPE training provided to employees and monitor all employees to
ensure proper use of the PPE.
e. Prohibit sharing of PPE.
Appendix B-2
(Effective June 5, 2020)
2
f. Implement social distancing requirements including, at minimum:
i. Stagger stop- and start-times for shift schedules to reduce the quantity of
workers at the jobsite at any one time to the extent feasible.
ii. Stagger trade-specific work to minimize the quantity of workers at the
jobsite at any one time.
iii. Require social distancing by maintaining a minimum six-foot distance
between workers at all times, except as strictly necessary to carry out a task
associated with the project.
iv. Prohibit gatherings of any size on the jobsite, except for safety meetings or
as strictly necessary to carry out a task associated with the project.
v. Strictly control “choke points” and “high-risk areas” where workers are
unable to maintain minimum six-foot social distancing and prohibit or limit
use to ensure that minimum six-foot distancing can easily be maintained
between workers.
vi. Minimize interactions and maintain social distancing with all site visitors,
including delivery workers, design professional and other project
consultants, government agency representatives, including building and fire
inspectors, and residents at residential construction sites.
vii. Prohibit workers from using others’ phones or desks. Any work tools or
equipment that must be used by more than one worker must be cleaned with
disinfectants that are effective against COVID-19 before use by a new
worker.
viii. Place wash stations or hand sanitizers that are effective against COVID-19
at entrances to the jobsite and in multiple locations dispersed throughout the
jobsite as warranted.
ix. Maintain a daily attendance log of all workers and visitors that includes
contact information, including name, address, phone number, and email.
x. Post a notice in an area visible to all workers and visitors instructing
workers and visitors to do the following:
1. Do not touch your face with unwashed hands or with gloves.
2. Frequently wash your hands with soap and water for at least 20
seconds or use hand sanitizer with at least 60% alcohol.
3. Clean and disinfect frequently touched objects and surfaces such as
workstations, keyboards, telephones, handrails, machines, shared
tools, elevator control buttons, and doorknobs.
4. Cover your mouth and nose when coughing or sneezing or cough or
sneeze into the crook of your arm at your elbow/sleeve.
5. Do not enter the jobsite if you have a fever, cough, or other COVID-
19 symptoms. If you feel sick, or have been exposed to anyone who
is sick, stay at home.
6. Constantly observe your work distances in relation to other staff.
Maintain the recommended minimum six-feet distancing at all times
when not wearing the necessary PPE for working in close proximity
to another person.
7. Do not share phones or PPE.
Appendix B-2
(Effective June 5, 2020)
3
xi. The notice in section 2.f.x must be translated as necessary to ensure that all
non-English speaking workers are able to understand the notice.
g. Implement cleaning and sanitization practices in accordance with the following:
i. Frequently clean and sanitize, in accordance with CDC guidelines, all high-traffic and
high-touch areas including, at a minimum: meeting areas, jobsite lunch and break
areas, entrances and exits to the jobsite, jobsite trailers, hand-washing areas, tools,
equipment, jobsite restroom areas, stairs, elevators, and lifts.
ii. Establish a cleaning and decontamination protocol prior to entry and exit of the
jobsite and post the protocol at entrances and exits of jobsite.
iii. Supply all personnel performing cleaning and sanitization with proper PPE to prevent
them from contracting COVID-19. Employees must not share PPE.
iv. Establish adequate time in the workday to allow for proper cleaning and
decontamination including prior to starting at or leaving the jobsite for the day.
h. Implement a COVID-19 community spread reduction plan as part of the Site-Specific Health
and Safety Plan that includes, at minimum, the following restrictions and requirements:
i. Prohibit all carpooling to and from the jobsite except by workers living within the
same household unit, or as necessary for workers who have no alternative means of
transportation.
ii. Cal-OSHA requires employers to provide water, which should be provided in single-
serve containers. Prohibit any sharing of any food or beverage and if sharing is
observed, the worker must be sent home for the day.
iii. Prohibit use of microwaves, water coolers, and other similar shared equipment.
i. Assign a COVID-19 Safety Compliance Officer (SCO) to the jobsite and ensure the SCO’s
name is posted on the Site-Specific Health and Safety Plan. The SCO must:
i. Ensure implementation of all recommended safety and sanitation requirements
regarding the COVID-19 virus at the jobsite.
ii. Compile daily written verification that each jobsite is compliant with the components
of this LCP Protocol. Each written verification form must be copied, stored, and
made immediately available upon request by any County official.
iii. Establish a daily screening protocol for arriving staff, to ensure that potentially
infected staff do not enter the construction site. If workers leave the jobsite and
return the same day, establish a cleaning and decontamination protocol prior to entry
and exit of the jobsite. Post the daily screening protocol at all entrances and exit to
the jobsite. More information on screening can be found online
at: https://www.cdc.gov/coronavirus/2019-ncov/community/index.html.
iv. Conduct daily briefings in person or by teleconference that must cover the following
topics:
1. New jobsite rules and pre-job site travel restrictions for the prevention of
COVID-19 community spread.
2. Review of sanitation and hygiene procedures.
3. Solicitation of worker feedback on improving safety and sanitation.
4. Coordination of construction site daily cleaning/sanitation requirements.
5. Conveying updated information regarding COVID-19.
Appendix B-2
(Effective June 5, 2020)
4
6. Emergency protocols in the event of an exposure or suspected exposure to
COVID-19.
v. Develop and ensure implementation of a remediation plan to address any non-
compliance with this LCP Protocol and post remediation plan at entrance and exit of
jobsite during remediation period. The remediation plan must be translated as
necessary to ensure that all non-English speaking workers are able to understand the
document.
vi. The SCO must not permit any construction activity to continue without bringing such
activity into compliance with these requirements.
vii. Report repeated non-compliance with this LCP Protocol to the appropriate jobsite
supervisors and a designated County official.
j. Assign a COVID-19 Third-Party Jobsite Safety Accountability Supervisor (JSAS) for the
jobsite, who at a minimum holds an OSHA-30 certificate and first-aid training within the past
two years, who must be trained in the protocols herein and verify compliance, including by
visual inspection and random interviews with workers, with this LCP Protocol.
i. Within seven calendar days of each jobsite visit, the JSAS must complete a written
assessment identifying any failure to comply with this LCP Protocol. The written
assessment must be copied, stored, and, upon request by the County, sent to a
designated County official.
ii. If the JSAS discovers that a jobsite is not in compliance with this LCP Protocol, the
JSAS must work with the SCO to develop and implement a remediation plan.
iii. The JSAS must coordinate with the SCO to prohibit continuation of any work activity
not in compliance with rules stated herein until addressed and the continuing work is
compliant.
iv. The remediation plan must be sent to a designated County official within five
calendar days of the JSAS’s discovery of the failure to comply.
k. In the event of a confirmed case of COVID-19 at any jobsite, the following must take place:
i. Immediately remove the infected individual from the jobsite with directions to seek
medical care.
ii. Each location the infected worker was at must be decontaminated and sanitized by an
outside vendor certified in hazmat clean ups, and work in these locations must cease
until decontamination and sanitization is complete.
iii. The County Public Health Department must be notified immediately by both
telephone (by calling 408.885.4214) and by email (by sending an email to
coronavirus@phd.sccgov.org). Any requirements specified by the County health
officials must be completed, including full compliance with any tracing efforts by the
County.
l. Where construction work occurs within an occupied residential unit, any separate work area
must be sealed off from the remainder of the unit with physical barriers such as plastic
sheeting or closed doors sealed with tape to the extent feasible. If possible, workers must
access the work area from an alternative entry/exit door to the entry/exit door used by
Appendix B-2
(Effective June 5, 2020)
5
residents. Available windows and exhaust fans must be used to ventilate the work area. If
residents have access to the work area between workdays, the work area must be cleaned and
sanitized at the beginning and at the end of workdays. Every effort must be taken to
minimize contact between workers and residents, including maintaining a minimum of six
feet of social distancing at all times.
m. Where construction work occurs within common areas of an occupied residential or
commercial building or a mixed-use building in use by on-site employees or residents, any
separate work area must be sealed off from the rest of the common areas with physical
barriers such as plastic sheeting or closed doors sealed with tape to the extent feasible. If
possible, workers must access the work area from an alternative building entry/exit door to
the building entry/exit door used by residents or other users of the building. Every effort
must be taken to minimize contact between worker and building residents and users,
including maintaining a minimum of six feet of social distancing at all times.
EXHIBIT B-3
COMPENSATION
COMPENSATION
Payment for services to be performed in Fiscal Year 2020-21 From July 1, 2020 to June
30, 2021 shall be $17,000.00 per month for maintenance activities as described in Exhibit
A, plus $100.00 per each soil sample and testing with a maximum Quantity of 12.
Payment for services to be performed in Fiscal Year 2020-21 shall not exceed $205,200 as
noted below.
Item Unit Qty Unit Price Total Cost
Blackberry Farm Month 12 $17,000.00 $204,000.00
Golf Course Maintenance
Soil Sampling Collection Each 12 $100.00 $1200.00
TOTAL FEE for services, Fiscal Year 2020-21, Not to Exceed: $205,200.00
Ple as e fold a nd tea r here
Policy Number: 191 4357-D04-05J
Prepared January 22, 2020
Page number 1 of 5
1004583 143562 202 01-15-2018
AT2
State Farm Mutual Automobile Insurance Company
PO Box 853922 Richardson, TX 75085-3922
A-0264 A
BASILE, MICHAEL
DBA PROFESSIONAL TURF MGT
1310 SADDLE RACK ST APT 302
SAN JOSE CA 95126-5105
AUTO RENEWAL
AMOUNT DUE: $517.17
Payment is due by April 04, 2020
You r State Fa rm Ag en t
JOSEPH FRANGIEH INS AGY INC
Office: 408-793-8303
Add ress: 120 W CAMPBELL AVE STE A
CAMPBELL, CA 95008-1044
If you have a new or different car, have added any drivers, or have moved,
please contact your agent.
Th an k y ou for c ho os ing State Fa rm.
Policy Number: 191 4357-D04-05J
Policy Period: April 4, 2020 to October 4, 2020
Ve hic le:
2013 FORD EDGE
Prin cip al Driv er:
MICHAEL BASILE
CONVENIENT PAYMENT OPTION: You may use one of
State Farm’s alternate payment plans which divides your
present premium into two separate payments.
You may pay one half of the amount due, $258.58, plus a
handling charge of $2.00. The amount due on APR 04 2020
will be $260.58.
The remaining half will be due on JUN 03 2020. We’ll send
you a reminder notice.
When you provide a check as payment, you authorize us
either to use information from your check to make a
one-time electronic fund transfer from your account or to
process the payment as a check transaction. When we use
information from your check to make an electronic fund
transfer, funds may be withdrawn from your account as soon
as the same day we receive your payment, and you will not
receive your check back from your financial institution.
Insured: BASILE, MICHAEL
Policy Number: 191 4357-D04-05J
Amount Due: $517.17
Please pay by April 04, 2020
Make payment to State Farm
For Offic e Us e Only AUTO REN $517.17 0426
3-A3 A 0264-FB0C
APP DT 05-14-2020 MUTL VOL
10026058 359009500051717 805200191435711102>
0209004267
State Farm Insurance Companies
P.O. Box 680001
Dallas, TX 75368-0001
Power To Pay
You r Way
Online
statefarm.com/pay
Mobile
Use the
State Farm m obile app
Call
Automated Line: 1-800-440-0998
Your agent: 408-793-8303
Mail
Send us
a check
Visit your
State Farm
agent
Key code: 1682102759
Policy Number: 191 4357-D04-05J
Prepared January 22, 2020
Page number 2 of 5
V EH IC L E IN F OR MAT I ON
Re vie w yo ur p olic y in form atio n c are fully . If an yth in g i s i ncorre ct, o r if th ere are an y cha ng es to you r ve hi cl e i nfo rma tio n, p le as e
l et u s k no w rig ht a way.
Vehicle Descri ption
Veh icl e I den tificatio n
Nu mber (VIN)Who principally drives this vehicle?How is this vehicle normally used ?
2013 FORD EDGE 2FMDK3JC1DBA83377 MICHAEL BASILE, a divorced individual,
who will have 41 years of driving
experience as of April 04, 2020.
Business.
Oth er Ho us eh old Veh icle (s)
Yo ur p remiu m m ay be in flu en ce d b y o the r State Fa rm
p ol ic ie s th at c urre ntl y i ns ure the fol lo win g v eh ic le (s)
i n y ou r ho useh ol d:
2019 FORD F150
The premium on the expiring policy term was based on
15,900 miles per year.
The premium on the renewal policy term was based on
15,900 miles per year.
The premium for this renewal was determined using an
annual mileage this vehicle is expected to be driven that
was developed from information we obtained or was
provided by you. Please contact us if you expect your
annual mileage to change over the next year.
Premium Adjustment
Each year, we review our medical payments and personal
injury protection coverages claim experience to determine
the vehicle safety discount that is applied to each make and
model. In addition, we review the comprehensive, collision,
bodily injury and property damage claim experience
annually to determine which makes and models have
earned decreases or increases from State Farm’s standard
rates. If any changes result from our reviews, adjustments
are reflected in the rates shown on this renewal notice.
We’ve taken the hassl e out of onl ine
bill payment.
Go to statefarm.com/pay to ma ke a payment.
We’re here to help life go rightfi with secu re, sim pler way to pay.
A s secu re as it
is co nvenient.
Policy Number: 191 4357-D04-05J
Prepared January 22, 2020
Page number 3 of 5
D RI VE R IN F OR M AT I ON
As sig ne d Driv er(s )
T he fol lo win g d river(s) are as si gn ed to th e v eh ic le (s) o n th is po li cy.
Name Driving Experience as of
April 04, 2020
M arital
Statu s
MICHAEL BASILE 41 years Divorced
Principal Driver & Assigned Drivers
For each automobile, the Principal Driver is the individual
who most frequently drives it.
Each driver is designated as an Assigned Driver on the
household automobile that they most frequently drive. Your
premium may be influenced by the information shown for
these drivers.
C OV ER AG E AN D L IM I T S See your policy for an explanat ion of these coverages.
A Liability 1,000,000
Bodily Injury & Property Damage $274.74
C Medical Payments 10,000 $14.06
D 250 Deductible Comprehensive $36.26
G 500 Deductible Collision $135.18
H Emergency Road Service $4.23
U Uninsured Motor Vehicle
Bodily Injury 250,000/500,000 $50.05
U1 Uninsured Motor Vehicle
Property Damage $2.65
Amount Due $517.17
If any coverage you carry is changed to give broader
protection with no additional premium charge, we will give
you the broader protection without issuing a new policy,
starting on the date we adopt the broader protection.
D IS CO UN T S These adjustments have already been applied to your premium.
Discou nt Name
Multiple Line P
Multicar P
Vehicle Safety P
Driving Safety Record P
California Good Driver P
Loyalty P
Total Discounts $2,076.36
Oth er Av aila ble Disc ou nt(s )
Yo u m ay be el ig ib le for a dd iti on al di scou nts
Se e th e e nclo se d i nsert fo r mo re i nfo rma tio n.
Mature Driver
Please fold and tear here
Policy Number: 273 4810-A07-05E
Prepared April 24, 2020
Page number 1 of 5
1004583 143562 202 01-15-2018
AT2
State Farm Mutual Automobile Insurance Company
PO Box 853919
Richardson, TX 75085-3919
A-0264 A
BASILE, MICHAEL
DBA PROFESSIONAL TURF MGT
1310 SADDLE RACK ST APT 302
SAN JOSE CA 95126-5105
AUTO RENEWAL
AMOUNT DUE: $706.90
Payment is due by July 07, 2020
Your State Farm Agent
JOSEPH FRANGIEH INS AGY INC
Office: 408-793-8303
Address: 120 W CAMPBELL AVE STE A
CAMPBELL, CA 95008-1044
Ifyouhaveanewordifferentcar,haveaddedanydrivers,orhavemoved,
pleasecontactyouragent.
Thank you for choosing State Farm.
Policy Number: 273 4810-A07-05E
Policy Period: July 7, 2020 to January 7, 2021
Vehicle:
2019 FORD F150
Principal Driver:
MICHAEL BASILE
CONVENIENT PAYMENT OPTION: You may use one of
State Farm's alternate payment plans which divides your
present premium into two separate payments.
You may pay one half of the amount due, $353.45, plus a
handling charge of $2.00. The amount due on JUL 07 2020
will be $355.45.
The remaining half will be due on SEP 05 2020. We'll send
you a reminder notice.
Your auto insurance rates are impacted by the mileage your
vehicle is driven. To ensure we've priced our insurance
coverage accurately based on the number of miles you
drive, we obtained valid mileage information for this vehicle
through a third party provider and/or from you. Annual
mileage was determined using this data and applied. Please
contact your State Farm agent with questions within 30 days
of your policy's renewal date.
(continued on next page )
Insured: BASILE, MICHAEL
Policy Number: 273 4810-A07-05E
Amount Due: $706.90
Please pay by July 07, 2020
Make payment to State Farm
For Office Use Only AUTO REN $706.90 0729
3-A3 A 0264-FB0C
APP DT 08-16-2020 MUTL VOL
40035545 059018900070690 905200273481011102>
0209007291
State Farm Insurance CompaniesP.O. Box 680001Dallas, TX 75368-0001
Power To Pay
Your Way
Online
statefarm.com/pay
Mobile
Use the
State Farm mobile app
Call
Automated Line: 1-800-440-0998
Your agent: 408-793-8303
Mail
Send us
a check
Visit your
State Farm
agent
Key code: 1684007625
Policy Number: 273 4810-A07-05E
Prepared April 24, 2020
Page number 2 of 5
When you provide a check as payment, you authorize us
either to use information from your check to make a
one-time electronic fund transfer from your account or to
process the payment as a check transaction. When we use
information from your check to make an electronic fund
transfer, funds may be withdrawn from your account as soon
as the same day we receive your payment, and you will not
receive your check back from your financial institution.
VEHICLE INFORMATION
Review your policy information carefully.If anything is incorrect, or if there are any changes to your vehicle information, please
let us know right away.
Vehicle Description
Vehicle Identification
Number (VIN) Who principally drives this vehicle? How is this vehicle normally used?
2019 FORD F150 1FTEW1C43KKD28593 MICHAEL BASILE, a divorced individual,
who will have 41 years of driving
experience as of July 07, 2020.
To Work, School or Pleasure.
Other Household Vehicle(s)
Your premium may be influenced by other State Farm
policies that currently insure the following vehicle(s)
in your household:
2013 FORD EDGE
The premium on the expiring policy term was based on
10,600 miles per year.
The premium on the renewal policy term was based on
14,100 miles per year.
The premium for this renewal was determined using an
annual mileage this vehicle is expected to be driven that
was developed from information we obtained or was
provided by you. The national average is more than 12,000
miles driven annually according to the U.S. Department of
Transportation. Please contact us if you expect your annual
mileage to change over the next year.
(continued on next page)
We've taken the hassle out of online
bill payment.
Go to statefarm.com/pay to make a payment.
We're here to help life go right
®with secure, simpler way to pay.
As secure as it
is convenient.
Policy Number: 273 4810-A07-05E
Prepared April 24, 2020
Page number 3 of 5
VEHICLE INFORMATION continued
Premium Adjustment
Each year, we review our medical payments and personal
injury protection coverages claim experience to determine
the vehicle safety discount that is applied to each make and
model. In addition, we review the comprehensive, collision,
bodily injury and property damage claim experience
annually to determine which makes and models have
earned decreases or increases from State Farm's standard
rates. If any changes result from our reviews, adjustments
are reflected in the rates shown on this renewal notice.
DRIVER INFORMATION
Principal Driver & Assigned Drivers
For each automobile, the Principal Driver is the individual
who most frequently drives it.
Each driver is designated as an Assigned Driver on the
household automobile that they most frequently drive. Your
premium may be influenced by the information shown for
these drivers.
COVERAGE AND LIMITS See your policy for an explanation of these coverages.
A Liability
Bodily Injury 1,000,000/1,000,000
Property Damage 1,000,000 $287.14
C Medical Payments 10,000 $16.22
D 250 Deductible Comprehensive $81.43
G 500 Deductible Collision $263.82
H Emergency Road Service $4.23
U Uninsured Motor Vehicle
Bodily Injury 250,000/500,000 $51.34
U1 Uninsured Motor Vehicle
Property Damage $2.72
Amount Due $706.90
If any coverage you carry is changed to give broader
protection with no additional premium charge, we will give
you the broader protection without issuing a new policy,
starting on the date we adopt the broader protection.
DISCOUNTS These adjustments have already been applied to your premium.
Multiple Line P
Multicar P
Vehicle Safety P
Driving Safety Record P
California Good Driver P
Loyalty P
Total Discounts $2,786.98
PTM 5th Amendment to Agreement for BBF
Golf Course Maintenance
Final Audit Report 2020-06-22
Created:2020-06-09
By:Kevin Khuu (KevinK@cupertino.org)
Status:Signed
Transaction ID:CBJCHBCAABAAsnfNTyYRwE3RKYo0yM5uXpTo6wR2BTmJ
"PTM 5th Amendment to Agreement for BBF Golf Course Mainte
nance" History
Document created by Kevin Khuu (KevinK@cupertino.org)
2020-06-09 - 9:53:06 PM GMT- IP address: 73.158.53.147
Document emailed to Araceli Alejandre (aracelia@cupertino.org) for approval
2020-06-09 - 9:57:28 PM GMT
Document approved by Araceli Alejandre (aracelia@cupertino.org)
Approval Date: 2020-06-11 - 2:49:35 PM GMT - Time Source: server- IP address: 24.23.184.82
Document emailed to m_basile@hotmail.com for signature
2020-06-11 - 2:49:39 PM GMT
Kevin Khuu (KevinK@cupertino.org) replaced signer m_basile@hotmail.com with Michael Basile
(mike_basile@hotmail.com)
2020-06-12 - 1:45:36 PM GMT- IP address: 73.158.53.147
Document emailed to Michael Basile (mike_basile@hotmail.com) for signature
2020-06-12 - 1:45:36 PM GMT
Email viewed by Michael Basile (mike_basile@hotmail.com)
2020-06-12 - 1:55:28 PM GMT- IP address: 174.194.194.170
Document e-signed by Michael Basile (mike_basile@hotmail.com)
Signature Date: 2020-06-16 - 10:15:46 PM GMT - Time Source: server- IP address: 98.210.121.198
Document emailed to Heather M. Minner (minner@smwlaw.com) for signature
2020-06-16 - 10:15:47 PM GMT
Email viewed by Heather M. Minner (minner@smwlaw.com)
2020-06-20 - 10:59:40 PM GMT- IP address: 45.41.142.183
Document e-signed by Heather M. Minner (minner@smwlaw.com)
Signature Date: 2020-06-20 - 11:00:24 PM GMT - Time Source: server- IP address: 52.39.49.65
Document emailed to Deborah L. Feng (debf@cupertino.org) for signature
2020-06-20 - 11:00:26 PM GMT
Email viewed by Deborah L. Feng (debf@cupertino.org)
2020-06-22 - 4:58:56 AM GMT- IP address: 104.47.44.254
Document e-signed by Deborah L. Feng (debf@cupertino.org)
Signature Date: 2020-06-22 - 4:59:20 AM GMT - Time Source: server- IP address: 24.6.12.22
Document emailed to Kirsten Squarcia 6/22/20 (kirstens@cupertino.org) for signature
2020-06-22 - 4:59:23 AM GMT
Email viewed by Kirsten Squarcia 6/22/20 (kirstens@cupertino.org)
2020-06-22 - 3:35:43 PM GMT- IP address: 104.47.45.254
Document e-signed by Kirsten Squarcia 6/22/20 (kirstens@cupertino.org)
Signature Date: 2020-06-22 - 3:36:15 PM GMT - Time Source: server- IP address: 148.64.105.190
Signed document emailed to Araceli Alejandre (aracelia@cupertino.org), Kevin Khuu (KevinK@cupertino.org),
Kirsten Squarcia 6/22/20 (kirstens@cupertino.org), Michael Basile (mike_basile@hotmail.com), and 4 more
2020-06-22 - 3:36:15 PM GMT
FOURTH AMENDMENT TO AGREEMENT 15-206
BETWEEN THE CITY OF CUPERTINO AND
PROFESSIONAL TURF MANAGEMENT FOR
BLACKBERRY FARM GOLF COURSE MAINTENANCE
This Fourth Amendment to Agreement 15-206 between the City of Cupertino and
Professional Turf Management, for reference dated 5/16/2019, is by and between the CITY
OF CUPERTINO, a municipal corporation (hereinafter "City") and Professional Turf
Management, a California corporation ("Consultant") whose address is P.O. Box 700142,
San Jose, CA 95170, and is made with reference to the following:
RECITALS:
A. On 12/3/2015, an agreement was entered into by and between City and
Consultant (hereinafter "Agreement") for Contract Services for Blackberry Farm Golf
Course Maintenance and soil sample collection and testing. The agreement will
expire on 6/30/2016.
B. On 7/1/2016, City and Consultant agreed to the First Amendment for Contract
Services for Blackberry Farm Golf Course Maintenance and soil sample collection
and testing.
C. On 7/1/2017, City and Consultant agreed to the Second Amendment for
Contract Services for Blackberry Farm Golf Course Maintenance and soil sample
collection and testing.
D. On 7/1/2018, City and Consultant agreed to the Third Amendment for
Contract Services for Blackberry Farm Golf Course Maintenance and soil sample
collection and testing.
E. The Agreement and the First, Second, and Third Amendments are collectively
referred to as the "Agreement" unless otherwise indicated.
F. City and Consultant desire to modify the Agreement on the terms and
conditions set forth herein.
NOW, THEREFORE, it is mutually agreed by and between and undersigned parties
as follows:
1. TERM
Paragraph 1 of the Agreement is modified to read as follows:
The contractor shall continue work through June 30, 2020, and shall diligently
prosecute the work. This Agreement may be renewed annually for additional one-
year terms commencing July 1, 2020, at the City's sole discretion and subject to
appropriation, for up to one (1) additional one-year terms. The term of the Agreement
shall terminate on June 30, 2020, unless terminated earlier as set for herein.
2. COMPENSATION TO CONTRACTOR
Paragraph 3 of the Agreement is modified to read as follows:
Contractor shall be compensated for services performed pursuant to this Agreement
in the amount and manner set forth in Contractor's bid, which is attached hereto as
Exhibit "13-2" and incorporated herein by reference.
3. The following Exhibits to the Agreement, are amended and replaced to read as
shown in the attachments to this Amendment:
a. Exhibit B-2
4. 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.
IN WITNESS WHEREOF, the parties hereto have caused this modification of
Agreement to be executed.
CONSULTANT CITY OF CUPERTINO
1V
By BY
C-'-
Title Title
I
RECOMMENDED FOR APPROVAL APPROVED AS TO FORM
By
Title A�tl -.1A t? City Attorney"
ATTEST:
City Clerk
EXPENDITURE DISTRIBUTION
PO #2016-398 560-63-616 700-702
Original $99,600.00
Amendment #1: $205,200.00
Amendment #2: $205,200.00
Amendment #3: $205,200.00
Amendment #4: $205,200.00
Total: $920,400.00
EXHIBIT B-2
COMPENSATION
COMPENSATION
Payment for services to be performed in Fiscal Year 2019-20 From July 1, 2019 to June
30, 2020 shall be $17,000.00 per month for maintenance activities as described in Exhibit
A, plus $100.00 per each soil sample and testing with a maximum Quantity of 12.
Payment for services to be performed in Fiscal Year 2019-20 shall not exceed $205,200 as
noted below.
Item Unit Qty Unit Price Total Cost
Blackberry Farm Month 12 $17,000.00 $204,000.00
Golf Course Maintenance
Soil Sampling Collection Each 12 $100.00 $1200.00
TOTAL FEE for services, Fiscal Year 2019-20, Not to Exceed; $205,200.00
-rly��7y�—
CERTIFICATE BILI OF LIATY INSURANCE 05/06/19
THIS CERTIFICATE IS ISSUED AS A MA"FrER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDtwR, TIft
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EX'rEND OR ALTER THE COVERAGE AFFORDED BY TFW, POLICIES
BELOW" THIS CER11MCATE OF INMJRANCK:I DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING Ro1SURER(8), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND 111E CERTIFICATE F-10"DEM
@R05 RTANT� If tho cortifleako Wder Is a"ADMTIONAL.INSUREE� =Ut FS LT 5�16�7"FA Wil 7ft;T.
the terms and rondftlons of 0w pWIey,Carta in polickra may requIro an endorsement A statownent cm Ws ear0ficate does nat confer rlWibi to the
war
PRODLICER N
VOLPATTI INSURANCE SERVICES INC PHONE �92r)2430133 VA-9-------------......
11MLN2)S.225)243-0132
511 Leisure Street ADr)RESfi,:.R.'ick@"%rolp,a"t'ti.com
Livermore, CA 94553, ------
LINSURM(S) AFFORDFNG COYCRAOU. NAWN
W.cense#:OE40809
INSURERA:Saotts dal e Insurance Co
........... -------
Professional Turf Management, Inc, I SUREREj:Scottsdale Insurance Company
----------
INSURERC:Technology Insurance C'ompany
PO Box 700142 Cry.TijfCa_,r_._n1_a" Capital 'Ensurance Company,
San Jose, CA 95170 WSURER E:
------------- -------
INSURER F:
'�OV I-FIS 1`67LWA (".*RTWICATE NUMBER: REVISION NUMBER:
TIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED To'rHE WWRIED, NAMED ABOVE FOR THE POLICY PEMOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR 0111ER DOCOMEN'r WITH RESPEari,o WHICH THIS
CEIRTIFICATE MAY BE ISSUED OR WkY PERTAIN, THE INSURANCE AFFORDED BY 'THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONSAND CONDITIONS OF'SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TrAFL.�Lr,INSURANCE POLICY N LIMITS
m. vwv
GENERAL 1JA8ILITY _11___ EACH OCCURRENCE
X COMMERCIAL GENERAL LIABILHI(
CLAIMS-AIADE OCCUR MED a person) 5,000
A CPS2971848 04/01/2019 04/01/2020 PERSONAL,A ADV INJURY 1. 000,000
y ------
IA�EL 0 0 0,0 0 0
GERL AGGREGATr LIMIT APPLIES FIER: _P.R(DUCTS-COMPIOP A(a�, 0
L f--h ...... OPP—
�ny I 0C $
AUTOMOBILE LIABILITY
ANYAUTO DODILY INJURY(Per peroon) $
ALL"OWNED SCHEDULED
AUTOS AUTOS
NON-OWNED DA k:
MIRED AUT08 AUT0$ $
JEA jt
UMBRELLA [JAH OCCUR 04/01/2019 04/01/2020
B RF EXCE88 LIAO CIAIMS-MADE XBS0107007 AGGREGNT E 3p. 000 000
1) NTION$
WORI 1_Wd3�1Arkj.-' D11'
]DRY LIM1111117,
AND EMPLOYERVIJAWLIW Y/N
ANY PRCVRtrrT()RIPPJTrNERA�XECtn'tVE
C OFFIMIMENSER EXCLU 1--y I NIA y TWC3784198 04/01/19 04/01/20
N") DIf EES_1 Lk LS±. L)Y 0
Ifv29,descrIlLm under
IL E.JDISEASE-POLICY 1.
'___'J.L
Conmercial Inland Contractors Equip.
D Marine 3-MIA-1-026769 6/23/20-1.8 6/23/201.9 $224,082
Deductible $500
(AHZ;FaF(;M,77o_i, —SPU-W 19 rflqUlmd)
The Ci-by of Cupertino, its directors, officers, agents, con,sul,taxi ts and employees are nameIj as
additional insured in regard to General Linshility and. Primary/ onContxibu toxjr wording, is
attached to this poliqy. Waiver of Stair, ogation in rec ard to workers compensation Jm favor of
C.ity of Cupertino
The issuing insuirer wJ11 endeavor to mail 30 days written notice of canrmllation,
CERTIFICATE HOI.DER CANCELJ_KTION
SHOULD ANY OF THE AKWE DIR"SCRIFLED POLICIES BE CANCELLED BEFORE
City of Cupertino THE F"XNRfi,7'I0N DATE rHEREOF, NOrBGE WILL BE DELIVERED IN
10300 Torre Avenue ACCORDANCE WITH THE POLMY PROVISIONS.
C11perdt I= CA 95014
ALII14ORWED REPRESENrAI'VE
@ 198iRb i—ts r e"—se n—m(J,
ACORD25(2010/06) The ACORD v,mme atid bgo are registered I,narks of ACORD
ENDORSEMEN'r
._�...��...�a.*...n._.__....m_. _....._.._v_.......�......_w_....�..�.. ._._.,�.�_.__.__�.�.,__.._.__.._..�.��ts���ra IIu�tFa��:�..._� ..v___.w__....._..a.....____.°..._. .W,..._rac��:�a�__,.,_ __n
'I°r ¢'w&Va rJ T,0 AND r�dR�a7F4�ICWHL°N I"G:6��^�G,'F9V E DA,rE
C`'a S2971.848 04/01/2019 1:�Fr.Cmrl°r:?,�°i�a:rwe.1 'tal" ':[°CJ1.t+ tw�ANA('�1rd1"r�,1,r INC., Cr�t0A
w.6rmS ENDORSEIVIENTCHANGES THE pOUC Y.Fit„tofu k L-.``fit VT CA EFL9&..i Y,
BLANKET ADDITIONAL INSURED ENDORSEMENT
-this endorsement raacadifres.a insurance provided Under the following:
COMMERCIAL GENERAL LIAB11.17Y COVERAGE PART'
With resj.,m;t to this endorsement, SECTION it - WHO IS . Al work, incipcling materials, psrts or eqUip-
AN INSURED ls amended to lrWude as an addldonM in- meet furnished in rconnecalon wfth such wark,
soured any person or organization whom you are required on the project: (other than service, rnaminte-
to add as an additional ire tired on this policy Iuruder,aa writ- nonce or repairs)to be per"f r'rrasd by or on be,
ten contract, written aaCgreernermt or written perrnit which ha f of the addltlonW in su..ured(s) at the location
raar.ust be: of the covered calaeraatlorws has, beers corn-
a,. C:urm".r'°atly In effect or becoming effective during
pieteda or
the terra of the poHc,y;aruc.l b. °C°laaat por°don caf° our work"crest of which the in.
b. Executed prior to the"bodily inilur"ayo," x"propearty jury or d rnaagge arises has been pert to its in-
" ", tended use by any person oror organization
staauamaucdel, or"personal sand advertising irgiaury.," rather than aanratl"aer contractor or Subcontractor
The imsraar°r e provided to these additional insureds is line- engaged in performing operations Star as princk
iced as follows; pawl as as part of the same prejecct.
,i ..I..haat person or organisation is an aadditicanW in- 3. "ffie llmlts of insurance applicable to the-additional
srured only with respect to liability for "beadily inSUred rare those spec.i'lc d in tl°ae written contract,
W¢°uiaury""property dsr°rmspe"or""personal and sdarer- written agreement or written permit or In the ecl,tam
tgaringg injury"c°ca.ar~se*d"in whole or in part,by: rations for tl°ais poHc y,whiclmver is less, These Hrrl-
a. of ins ra;recce are incckisuvice of",Brad net In additlon
Your acts or,e:a alssicans�or to, the Ur°aa6 s of Insurance shown in the Decclaara-
b. The acts or or issbrm of those aaccfirap on your tlsaums for t1°a6s pcuiic:y"
behalf, 4. Coverage t s not providec.N for"bodfly injury,""prep.
person's or or" anizaatgora"s status as an audditior°raal erty darrlam e," or"personal and aadvc,-ttisintg injury"
insured [under this endorsement ends when arising out of the scale negligence of the additional
yeaeur operations for that addidonai insured are insured.
completed, . `sae insurance provided to the aaddi'honaal lrauserred
2. With respect to the insurance afforded to these ad- asses not apply ilaYl" to ""beadily inia.ury," "property darer.,,
ditionaal insureds, the following exclusions are age," or "personal and advertising injcury" aarisirag
added to itern 2. Exclusions of SECTION l - ,mart of an architects, engineers or surveyor's rc-ties..
COVERAGES;"t'r derinrd of or fa"allmure to render any professional sear"^ i
"Mi s irmsaur"aanceu does rot apply to 'bofflly lraieury"
ie°wes incalrsdlntg.
U fro e,t:ydan"ia e" or"personal and advertising l"i°
iIrra "
"
occc':aurr'n g after:
rredudes copyrighted m tr°dzd of ISO Properties,Inc—Wth b r.man sslr°n.
e:r"r r'Io,A,60 PropeuVes,Inc.„700r
GI.s°150s(7.06) Page"I of 2
CNSCT.rt,ED
�
a. The preparing,.approving or failing to prepare
or approve maps, shop drawings,opinions, re- ance be primary, �
ports, surveys, field onjas, change orders or
�
dra*�Osand spac�cadonqand `~' ~"=="" "^^`^^+ �= =" ..",= nvu
ty under SECTION I - COVERAGES to defend
b. Supervisory, inspection, architectural orongi- ~ additional insured against any"suk"if any otherh+
neehngoctivihes. suner has o duty to defend the additional insued
against that "suit," |f no other insurer defends,
�e
6. Any coverage provided hereunder will be excess '
will undertake to do so' bu� mavvi|| be entitled
to
over any other valid and co||ecdb!e �susnceavail-
the additional insumd's rightsagoins�aUthooeo�h Y
able to the additional insured whether primary, ex- ,
cess, contingent or or on any other basis unless m -
'
'
|
/ |
' |
AUTHORIZED REPRESENTATIVE DATE
Includes copyrighted material ur ISO Properties,mc,with Its permission.
Copyright,ISO Properties,mc..z004 !
!
oLs-1os(7-0e) Page 2«ra
dP'
CPS2971848
COMMERCIAL GENERAL.LIABILITY
CG 20 01 0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance Condi- (2) You have agreed in writing in a contract or
tion and supersedes any provision to the contrary: agreement that this insurance would be pri-
Primary And Noncontributory Insurance mary and would not seek contribution from
any other insurance available to the additional
This insurance is primary to and will not seek con- insured.
tribution from any other insurance available to an
additional insured under your policy provided that:
(1) The additional insured is a Named Insured
under such other insurance; and
CG 20 01 0413 Copyright, Insurance Services Office, Inc„2012 Page 1 of 1
INSURED
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 O6
(Ed.04-84)
WAIVER Of OUR RIGHT To RECOVER FROM OTHERS ENDORSEMENT-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 the person Or organization named In the Schedule. (This agreement applies only To the extent that you perform work
under a written contract that requires you To obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration Of your employees While engaged In the work
described In the Schedule.
The additional premium For this endorsement shall be 5%Of the California workers'compensation premium otherwise due on
such remuneration.
Schedule
Person or Organization Job Description
City of Cupertino 10300 Torre Avenue Cupertino, CA Specific Waiver per written contract
95014
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 pelicy.)
Endorsement Effective 4I1/2019 Policy No. TWC3784198 Endorsement No, 4
insured Professlonal Turf Management,Inc.(A Corp) Premium$ 8,851
Insurance Company Technology Insurance Company,Inc.
Countersigned by—
WC 04 03 06
(Ed.04-84)
i
I
I
ACCAR" VEHICLE OR EQUIPMENT CERTIFICATE ®F INSURANCE DATE(MM/DD/YYYY)
05/10/2019
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.
This form is used to report coverages provided to a single specific vehicle or equipment.Do not use this form to report liability coverage
provided to multiple vehicles under a single policy.Use ACORD 25 for that purpose.
PRODUCER CONTACT
NAME; CHRIS LEE
HONE
All
StateF rm JOE FRANGIEH STATE FARM AGENT P FAX
A/C No Ext: 408-793-8303 A/c No: 408-793-8304
120 W CAMPBELL AVE STE A ADDRESS: CHRISTOPHER.LEE.PHOQ@STATEFARM.COM
CAMPBELL,CA 95008 PRODUCER
CUSTOMER ID#:
INSURER(S)AFFORDING COVERAGE NAIC#
INSURED -INSURER A: State Farm Mutual Automobile Insurance Company 25178
BASILE,MICHAEL DBA PROFESSIONAL TURF MGT INSURER B
1310 SADDLE RACK ST APT 302 INSURER C
SAN JOSE CA 95126-5105 INSURER D:
INSURER E:
DESCRIPTION OF VEHICLE OR EQUIPMENT
YEAR MAKE/MANUFACTURER MODEL BODY TYPE VEHICLE IDENTIFICATION NUMBER
2019 FORD E350 F150 1FDSE35L35HB47643
DESCRIPTION SERIAL NUMBER
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICY(IES)OF INSURANCE LISTED BELOW HAS/HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
PERIOD(S)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 POLICY(IES)DESCRIBED HEREIN IS/ARE SUBJECT TO
ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICY(IES).
INSR ADD•L POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YYYY) DATE(MM/DD/YYYY) LIMITS
X VEHICLE LIABILITY COMBINED SINGLE LIMIT $
Y 273 4810-A07-05E 01/07/2019 07/07/2019 BODILY INJURY(Per person) $ 1,000,000
BODILY INJURY(Per accident) $ 1,000,000
PROPERTY DAMAGE $ 1,000,000
GENERAL LIABILITY EACH OCCURENCE $
OCCURRENCE GENERAL AGGREGATE $
CLAIMS MADE
INSR LOSS POLICY EFFECTIVE POLICY EXPIRATION
LTR PAYEE TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YYYY) DATE(MMIDD/YYYY) LIMITS I DEDUCTIBLE
X VEH COLLISION LOSS ACV ❑AGREED AMT $ LIMIT
❑ ❑STATED AMT $250 DED
X VEH COMP VEH OTC •❑ACV ❑AGREED AMT $ LIMIT
❑ ❑STATED AMT $500 DED
PROPERTY ❑ACV ❑AGREED AMT
BASIC H BROAD ❑RC ❑STATED AMT $ LIMIT
SPECIAL ❑ $ DED
REMARKS(INCLUDING SPECIAL CONDITIONS I OTHER COVERAGES)(Attach ACORD 101,Additional Remarks Schedule,if more space is required)
ALL CALIFORNIA OPERATIONS
ADDITIONAL INTEREST CANCELLATION
Select one of the following: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
X The additional interest described below has been added to the policy(ies)listed herein by policy number(s). BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE
A request has been submitted to add the additional interest described below to the policy(ies) DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
I
listed herein by policynumbers.
VEHICLE/EQUIPMENT INTEREST: LEASED FINANCED DESCRIPTION OF THE ADDITIONAL INTEREST
NAME AND ADDRESS OF ADDITIONAL INTEREST X ADDITIONAL INSURED LOSS PAYEE
BLACKBERRY FARM GOLF COURSE LENDER'S LOSS PAYEE PRIMARY WORDING APPLIES
22100 STEVENS CREEK BLVD LOAN I LEASE NUMBER
CUPERTINO CA 95014-1037
AUTHORIZED REPPRgEpS�E� y�
REPRESENTC�HIZISTATIVE
) EE
@ 1997-2010 ACORD CORPORATION.All rights reserved.
ACORD 23(2010/05) The ACORD name and logo are registered marks of ACORD
1004361 142987.2 01-28-2013
Ac"Ra VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE DATE(MM/DD/YYYY)
05/10/2019
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.
This form is used to report coverages provided to a single specific vehicle or equipment.Do not use this form to report liability coverage
provided to multiple vehicles under a single policy.Use ACORD 25 for that purpose.
PRODUCER CONTACT
NAME; CHRIS LEE
tateF f"n JOE FRANGIEH STATE FARM AGENT a�No EXt: 408 793-8303 qAX No): 408-793-8304
120 W CAMPBELL AVE STE A E-MAIL
t4,',„ ADDRESS: CHRISTOPHER.LEE.PHOQ@STATEFARM.COM
CAMPBELL,CA 95008 PRODUCER
CUSTOMER ID#:
INSURER(S)AFFORDING COVERAGE NAIC#
INSURED INSURER A: State Farm Mutual Automobile Insurance Company 25178
BASILE,MICHAEL DBA PROFESSIONAL TURF MGT INSURER B:
1310 SADDLE RACK ST APT 302 INSURER C:
SAN JOSE CA 95126-5105 INSURER D:
INSURER E:
DESCRIPTION OF VEHICLE OR EQUIPMENT
YEAR MAKE/MANUFACTURER MODEL BODY TYPE VEHICLE IDENTIFICATION NUMBER
2013 FORD T
350 EDGE 2FMDK3JC1DBA83377
DESCRIPTION SERIAL NUMBER
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICY(IES)OF INSURANCE LISTED BELOW HAS/HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
PERIOD(S)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 POLICY(IES)DESCRIBED HEREIN IS/ARE SUBJECT TO
ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICY(IES).
INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YYYY) DATE(MM/DD/YYYY) LIMITS
X VEHICLE LIABILITY COMBINED SINGLE LIMIT $ 1000000
Y 191 4357-D04-05J 04/04l2019 10/04/2019 BODILY INJURY(Per person) $
BODILY INJURY(Per accident) $
PROPERTY DAMAGE $
GENERAL LIABILITY EACH OCCURENCE $
OCCURRENCE GENERAL AGGREGATE $
CLAIMS MADE $
INSR LOSS POLICY EFFECTIVE POLICY EXPIRATION
LTR PAYEE TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YYYY) DATE(MM/DD/YYYY) LIMITS/DEDUCTIBLE
X VEH COLLISION LOSS 0 ACV ❑AGREED AMT $ LIMIT
❑ ❑ STATED AMT $250 DED
X VEH COMP VEH OTC 0 ACV ❑AGREED AMT $ LIMIT
❑ ❑STATED AMT $500 DED
PROPERTY ❑ACV ❑AGREED AMT
BASIC R BROAD ❑ RC ❑STATED AMT $ LIMIT
SPECIAL ❑ $ DED
REMARKS(INCLUDING SPECIAL CONDITIONS/OTHER COVERAGES)(Attach ACORD 101,Additional Remarks Schedule,if more space is required)
ALL CALIFORNIA OPERATIONS
ADDITIONAL INTEREST CANCELLATION
Select one of the following: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
X The additional interest described below has been added to the policy(ies)listed herein by policy number(s). BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE
A request has been submitted to add the additional interest described below to the policy(es) DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
I listed herein by policynumbers.
VEHICLE/EQUIPMENT INTEREST: LEASED FINANCED DESCRIPTION OF THE ADDITIONAL INTEREST
NAME AND ADDRESS OF ADDITIONAL INTEREST X ADDITIONAL INSURED LOSS PAYEE
BLACKBERRY FARM GOLF COURSE LENDER'S LOSS PAYEE PRIMARY WORDING APPLIES
22100 STEVENS CREEK BLVD LOAN/LEASE NUMBER
CUPERTINO CA 95014-1037
AUTHORIZED REPRESENTATIVE
HRIST HER,, LEA"
@ 1997-2010 ACORD CORPORATION.All rights reserved.
ACORD 23(2010/05) The ACORD name and logo are registered marks of ACORD
1004361 142987.2 01-28-2013
THIRD AMENDMENT TO AGREEMENT 15-206
BETWEEN THE CITY OF CUPERTINO AND
PROFESSIONAL TURF MANAGEMENT FOR
BLACKBERRY FARM GOLF COURSE MAINTENANCE
This Third Amendment to Agreement 15-206 between the City of Cupertino and Professional
Turf Management, for reference dated April 17, 2018, is by and between the CITY OF
CUPERTINO, a municipal corporation(hereinafter "City") and Professional Turf Management, a
California corporation("Consultant") whose address is P.O. Box 700142, San Jose, Ca., 95170, and
is made with reference to the following:
RECITALS:
A. On December 3, 2015, an agreement was entered into by and between City and
Consultant(hereinafter "Agreement") for Contract Services for Blackberry Farm Golf Course
Maintenance and soil sample collection and testing. The agreement will expire on 6/30/2016.
B. On July 1, 2016, City and Consultant agreed to the First Amendment for Contract
Services for Blackberry Fann Golf Course Maintenance and soil sample collection and
testing.
C. On July 1, 2017, City and Consultant agreed to the Second Amendment for Contract
Services for Blackberry Farm Golf Course Maintenance and soil sample collection and
testing.
D. The Agreement and the First and Second Amendments are collectively referred to as
the "Agreement"unless otherwise indicated.
E. City and Consultant desire to modify the Agreement on the teens and conditions set
forth herein.
NOW, THEREFORE, it is mutually agreed by and between and undersigned parties as
follows:
1. TERM
Paragraph I (Section 1) of the Agreement is modified to read as follows:
The Consultant shall continue work through June 30, 2019, and shall diligently prosecute the
work. This Agreement may be renewed arnivally for additional one-year teens commencing
July 1, 2019, at the City's sole discretion and subject to appropriation, for up to two (2)
additional one-year teens. The term of this Agreement shall terminate on June 30, 2019, unless
terminated earlier as set for herein.
2. COMPENSATION
Paragraph 2 (Section 2) of the Agreement is modified to read as follows:
Consultant shall be compensated for services performed pursuant to this Agreement in the
arnount and manner set forth in Consultant's bid, which is attached hereto as Exhibit B-3 and
incorporated herein by reference.
3. The following Exhibits to the Agreement, are amended and replaced to read as shown in the
attachments to this Amendment:
a. Exhibit B and Exhibit B-2
b. Insurance requirements are updated as provided in the attached documents,
Exhibit C.
4. 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.
IN WITNESS WHEREOF,the parties hereto have caused this modification of
Agreement to be executed.
CONSULTAN CI OF PERTINO
By By /
Title (9�m--e v- Title
RECOMMENDED FOR APPROVAL AP VED AS T RM By
Title City Attorney
ATTEST:
City Clerk
EXPENDITURE DISTRIBUTION
PO #2016-398 560-63-616-700-702
Original Contract: $99,600.00 560-63-616-700-702
Amendment#1: $205,200.00 560-63-616-700-702
Amendment#2: $205,200.00 560-63-616-700-702
Amendment#3: $205,200.00 560-63-616-700-702
Total: $715,200.00
EXHIBIT B-2
COMPENSATION
COMPENSATION
Payment for services to be performed in Fiscal Year 2018-19 from July 1, 2018 to June 30, 2019 shall
be $17,000.00 per month for maintenance activities as described in Exhibit A,plus$100.00 per each
soil sample and testing with a maximum quantity of 12.
Payment for services to be performed in Fiscal Year 2018-19 shall not exceed$205,200.00 as noted
below.
Item Unit Qty Unit Price Total Cost
Blackberry Farm Golf month 12 $17,000.00 $204,000.00
Course Maintenance
Soil Sampling Collection each 12 $100.00 $1,200.00
TOTAL FEE for services, Fiscal Year 2018-19,Not to Exceed: $205,200.00
nature, arising out of, pertaining to, or related to the performance of this Agreement by Contractor
or Contractor's employees, officers, officials, agents or independent contractors. Contractor shall
not be obligated under this Agreement to indemnify City to the extent that the damage is caused by
the sole or active negligence or willful misconduct of City,its agents or employees. 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.
Contractor agrees to obtain executed indemnity agreements with provisions identical to
those set forth here in these sections horn each and every subcontractor or any other person or ,
entity involved by, for, with, or on behalf of Contractor in the performance of this agreement. If
Contractor fails to obtain such indemnity obligations from others as required here, Contractor
agrees to be fully responsible according to the terms of this section.
10. INSURANCE:
On or before the commencement of the terms of this Agreement, Contractor 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 paragraph 10A; B, C and D. Such
certificates, which do not limit Contractor's indemnification, shall also contain substantially the
following statement: "Should any of the above insurance covered by this certificate be canceled or
coverage reduced before the expiration date thereof, the insurer affording coverage shall provide
thirty (30) days' advance written notice to the City of Cupertino by certified mail, "Attention.: City
Manager."It is agreed that Contractor 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 the City as additional insured shall be submitted with the
insurance certificates. Contractor to complete the attached Document 00530 Insurance Fortes,
A. COVERAGE:
Contractor shall maintain the following insurance coverage:
(1) Workers'Compensation: -
St-atutory coverage as required by the State of California;Employers'Liability
$1,000,000 per occurrence
(2) General.Liabifity:
Commercial general liability coverage in the following minimum limits:
Bodily' jury: $500,000 z j/i � �j�a
<ad-L
rrence
Pnil�i D�)-all.other
Property Dames occuurenceaggregate
If subnlitt combined su1g�1 .1' vt of$1,000,000�� occurrence; 000 in
the a negate iIl be ssidered quivale 1- o�fhe re wired a nim�M is
sho vn above.
Contractor Ag'eement Page 3 of 17
Blackberry Farm Golf Course Maintenmee 2016
i
(3) Automotive:
Comprehensive automobile liability coverage in the �� G
following minunum limits: ( o"
9odiLy , $, 50,0 Q each ocenrrP
Pa:oiae�t�-D.arx�a.g�--$�59(�,09©-eaeli-eecrarrerti�'
-TT--
Combined Single Limit: $1,000,000 each occurrence
B. SUBROGATION WAIVER:
Contractor agrees that in the event of loss due to any of the perils for which it has agreed to
provide comprehensive general and automotive liability insurance, Contractor shall look solely to
its insurance for recovery. Contractor hereby grants to City, on behalf of any insurer providing
comprehensive general and automotive liability insurance to either Contractor or City with respect
to the services of Contractor herein,a waiver of any right to subrogation which any such insurer of
said Contractor may acquire against City by virtue of the 'payment of any loss under such
insurance.
C. )FAILURE TO SECURE:
If Contractor 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 Contractor's name or as
an agent of the Contractor and shall be compensated by the Contractor 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 tinder all insurance coverages, except worker's compensation
insurance, The naming of an additional insured shall riot 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,anytHri- 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
Contractor. Contractor is advised to consult Contractor's insurance broker to determine adequate
coverage for Contractor.
1:1. BONDS: - - - - -
Not applicable.
Contractor Agreement Page 4 of 17
Blackberry Farm Golf Course Maintenance 2016
® DATE(MM/DDIYYYY)
ACORU CERTIFICATE OF LIABILITY INSURANCE 05/08/18
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($), 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
VOLPATTI INSURANCE SERVICES INC PHONE FAX
511 Leisure Street E MAIL EXt: (925)243-0131 Arc Ne:(925)243-0132
Livermore, CA 94551 ADDRESS:rick@volpatti.com
INSURER(a)AFFORDING COVERAGE NAIL#
License#: OE40809 INSURER A:Scottsdale Insurance Com any 41297
INSURED professional Turf Management, Inc.. INSURER B:Technology Insurance Company, Inc. 42376
INSURER C:California Capital Insurance Company 13544
PO Box 700142 INSURER D:
San Jose, CA 95170 INSURERE:
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.
Te TYPE OF INSURANCE ADDL su R P IC FF E P
INSR WVD POLICY NUMBER MW/DD MM/DDIYYYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 2 OOO 0OO
X COMMERCIAL GENERAL LIABILITY ILD
PREMISESEe c�ccurranco $ 100,000
CLAIMS-MADE I -"I OCCUR MED EXP(Any one person) $ 5,000
A CPS2807423 04/01/2018 04/01/2019 PERSONAL&ADVINJURY $ 2,000,000
y
GENERAL AGGREGATE $ 4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000
1
POLICY X j O- LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Ea accident $
ANYAUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED
AUTOS AUTOS BODILY INJURY(Per accident) $
NON-OWNED PROPERTY D G
HIRED AUTOS AUTOS Per accident $
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS'LIABILITY YIN X TO Y LI ITS ER
ANY PROPRIETORIPARTNER/EXECUTIVE TKC 37 0 94 0 9 E.L.EACH ACCIDENT $ 1,000,000
B OFFICER/MEMBER EXCLUDED? ® NIA X 04/01/1B 04/01/19
(Mandatary In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000
If yes describe under
DESG�RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,000
Commercial Inland Contractors Equip.
C Marine 3-MIA-1-026769 6/23/2017 6/23/2018 $224,082
Deductible 500
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required)
The City of Cupertino, its directors, officers, agents, consultants and employees are named as
additional insured in regard to General Liability and Primary/Non--Contributory wording is
attached to this policy. Waiver of Subrogation in regard to workers compensation in favor of
City of Cupertino.
The issuing insurer will endeavor to mail 30 days written notice of cancellation.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Cupertino THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
10300 Torre Avenue ACCORDANCE WITH THE POLICY PROVISIONS.
Cupertino, CA 95014
AUTHORIZED RE R ENTATIVE t )
01988-2010 ACORD CORPORATION. All rights'reserved.
ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD j
StateFarm
State Farm Mutual Automobile Insurance Company 53534-3-P MATCH 00148 MUTL VOL
PRichar ,OBoxS853TX750853922 DECLARATIONS PAGE
NAMED INSURED 00148
05-0264-3 P A POLICY NUMBER 191 4357-DO4-D5J
0
0
0
1
48 ooss POLICY PERIOD APR 06 2018 to OCT 04 2018
DBA PROFESSIONAL TURF MST
BASILE, L 12:01 A.M.Standard Time
1310 SADDLE RACK ST APT 302
SAN JOSE CA 95126-5105
AGENT _
JOSEPH FRANGIEH INS AGY INC —
120 W CAMPBELL AVE STE A
CAMPBELL,CA 95008-1044
PHONE:(408)793-8303
DO NOT PAY PREMIUMS SHOWN ON THIS PAGE.
IF AN AMOUNT IS DUE,THEN A SEPARATE STATEMENT IS ENCLOSED.
YOUR CAR
YEAT3 1V1AKl= , _MODEL a:�.� BQDYSILE I�EHICLEID T�lUN1BF_fi CLASS y, -
2013 FORD EDGE SPORT WG 2FMDK3JC1 DBAS3377 603HCV1 H
Limit-Each Accident
C Medical Payments Coverage _ $19 42
$10,000
G Collision Coverage $500 Deductible $191 68
e -ioad.
. - _- N: �,
U Uninsured Motor Vehicle Coverage $44 09
Each Person, Each Accident
Ui Uninsured Motor Vehicle Property Damage Coverage $2.22
Replaced policy number 1914357-051. _
Your total renewal premium for APR 04 2018 to OCT 04 2018 is$631.20.
F_XCEPTiL3NS�FOLIC�YBOtOKLET&..ENDORSEMENTS{See poi[oy�T3ookTe#&in<TivaduaT endorseinentsTorcouerage de#axis,) 3�
FOR80YNDSYSNRSNSLTAIAPPAGILUDGLOEOSSUERM 95B AANEDOEMETHTLY, NCINTHSII D TO YOU
WIT ANY SI'IBSEQUENT RENEWAL NOTICE.
CREDITOR- FORD
ADDIITIONAL INSUURED-CCITYNO� PALOOALTO,7PD'BOXL10250 GA, PALLO ALTO CA
94303-0862.
02 6028BU ADDITIONAL INSURED-BLACKBERRY FARM GOLF COURSE, 22100 STEVENS.
CREEK BLVD, CUPERTINO CA 95014-1037.
6126MD EXCESS COVERAGE FOR PERSONAL VEHICLE SHARING.
6128AC AMENDATORY ENDORSEMENT.
6289DW SINGLE LIMIT LIABILITY COVERAGE.
Agent: JOSEPH FRANGIEH INS AGY INC
Telephone: (408)793-8303
04139102086 See Reverse Side Prepared MAY 03 2018 0264-BOO
2002 (o1e025ic)
148XON (o11 e025W) (o1e0254c)
SWeFami
State Farm Mutual Automobile Insurance Company 53485.3-P MATCH 00035 MUTL VOL
•® kedA93Ba s� l C 311 DECLARATIONS PAGE
NAMED INSURED 00035
05-0264-3 P A POLICY NUMBER 273 4810-AO7.05D —
000035 0058
BASI LE, MICHAEL POLICY PERIOD APR 06 2018 to JAN 07 2019
DBA PROFESSIONAL TURF MOT 12:01 A.M.Standard Time
1310 SADDLE RACK ST APT 302
SAN JOSE CA 95126-5105
AGENT
JOSEPH FRANGIEH INS AGY INC
120 W CAMPBELL AVE STE A
CAMPBELL,CA 95008-1044 —
PHONE:(408)793-8303
DO NOT PAY PREMIUMS SHOWN ON THIS PAGE.
IF AN AMOUNT IS DUE,THEN A SEPARATE STATEMENT IS ENCLOSED.
YOUR CAR
,m,�EAFt �� MAKT= �` �VIODE� �� BODY�TYLE�_ iTEHiCLEli3�lUMBEFi = CLASS„ s
2012 FORD F150 PICKUP 1 FTFW1 CF70FB95742 303HCV1 H
YlNBOT_S COVEi4GE€c LIMITS - r` `� Q -PI?EMIUIi+IS
u ,
Bodily Injury Limits
r- ..Ad_._- 1=ah PEsbn, Each Accide>�tt n- =
$1,D00 000 $1 OOD 000 r
Each Accident _
C Medical Paymf�e-�nts Coverage $33 10
10,000 h
G Collision Coverage $500 Deductible $383 95
n
,. emsmeTgency ::aarU Setaeouer. ge .x. : - _ _ -- . $6`3 .
U Uninsured Motor Vehicle Coverage $78 49
'y
fly�n)uEt=imLts�
Each Person Each Accident
U1 Uninsured Motor Vehicle Property Damage Coverage $3 95
o#al reii�um#ar ApFi.D&201 8n BAN 07 201'a _ ., 3 2I�15 5$. Ttjs is nnf a bill
Replaced policy number 2734810-05C.
Your total renewal premium for JUL 07 2018 to JAN 07 2019 is$800,52.
EXCEPTIONS,POLICY 60t3Ki=_E�&sENt�ORSER1lENTS(See psitcy borltiet�c(rtclivrdnaT a dorserrfents#ar coves a details
YOUR POLICY CONSISTS OF THIS DECLARATIONS PAGE THE POLICY BOOKLET FOR 9805B AND ANY ENDORSEMENTS THAT APPLY, INCLUDING THOSE ISSUED TO YOU
WITH ANY SOBSEffNT RENEWAL NOTICE.
6028BU ADDITIOINvAL INSURED-BLACKBERRY FARM GOLF COURSE, 22100 STEVENS CREEK
BLVD, CUPERTINO CA 95014-1037.
6126MD EXCESS COVERAGE FOR PERSONAL VEHICLE SHARING.
6128AC AMENDATORY ENDORSEMENT.
Agent: JOSEPH FRANGIEH INS AGY INC
Telephone: (408)793-8303
0 068 1/0041 2 See Reverse Side Prepared MAY 03 2018 0264-BOC
155-3866 CA.2 05-2002(o1e025fc) (0.0254)
14SXON (ote025te) -
I(evin Khuu
From: Joseph Costamagna <jcostamagna@bickmore.net>
Sent: Wednesday, June 13, 2018 4:12 PM
To: Kevin Khuu
Cc: Jenny Koverman
Subject: Re: FW:Insurance Coverage Questions PTM Auto
Actually I had not seen the insurance. This is a commercial policy with sufficient limits, and is acceptable.
Thank you!
Joe Costamagna, ARM
Litigation Management
Risk Control Services
Bickmore
415.407.4157 cell
Notes and suggestions contained in this communication are made by Bickmore staff for the propose of reconunending best risk management practices and enhancing
the risk management decisions made by Bickmore clients and member agencies.NOTHING CONTAINED IN THIS EMAIL IS INTENDED TO BE,NOR SHOULD
BE CONSTRUED AS,LEGAL ADVICE.Bickmore clients and member agencies are encouraged to seek appropriate counsel with legal professionals to address legal
questions.
On Wed, Jun 13, 2018 at 3:48 PM Kevin Khuu<KevinKkcupertino.org> wrote:
Hi Joe,
Just in case, have you seen the insurance in question?Jenny asked me to send it to you just in case.
i
The contractor is claiming that this is his commercial auto insurance and had highlighted the line that says"DBA
Professional Turf Management". Would this work?
Thank you.
Regards,
1
ENDORSEMENT
SCOTTSDALE INSURANCE COMPAA NO.
ATTACH130 TO AND HNDORSEMkNT OPPECTIVa DATE
PORMIN43 APART OP tY1toYA.M.ETANDARDTIME) NAMED INSURED AaBNTNo,
POLICY NUMaER
CPS2807423
04/01/2018 PROFESSIONAL TURF MWAGEMENx, INC. 040AO
i
THIS ENDORSEMENT CHANGES THE POLICY,PLEASE READ IT CAREFULLY,
BLANKET ADDITIONAL INSURED ENDORSEMENT
This endorsement modifies Insurance provided under the following:
COMMERCIAL.GENERAL LiA131LiTY COVERAGE PART
With respect to this endorsement, SECTION II • WHO IS a. All work, including materials, parts or equip-
AN INSURED Is amended to Include as an additional In- ment furnished in connection with such work,
sured any person or organization whom you are required on the project (other than service, mainte-
to add as an additional insured on this policy under a writ- nance or repairs)to be performed by or on be.
ten contract, written agreement or written permit which half of the additional Insured(s) at the location
must be: of the covered operations has been com-
a. Currently In effector becoming effective during plated;or
the term of the policy;and b, That portion of"your work"out of which the In-
b. Executed prior to the"bodily Injury," "property jury or damage arises has been put to Its in-
damage,"or"personal and advertising Injury," tended use by any person or organization
other than another contractor or subcontractor
The Insurance provided to these additional insureds is Ilm- engaged In performing operations for a princi-
ited as follows; pal as a part of the same project.
1. That person or organization Is an additional In- 3. The limits of Insurance applicable to the additional
sured only with respect to liability for "bodily insured are those specified In the written contract,
Injury,""property damage"or"personal and adver- written agreement or written permit or in the Decla-
tlsing injury"caused,in whole or in part,by: rations for this policy,whichever is less.These lim-
Its of insurance are inclusive of,and not in addition
a, Your acts or omissions;or to, the Limits of Insurance shown in the Declara-
b, The acts or omissions of those acting on your dons for this policy,
behalf. 4, Coverage Is not provided for"bodily injury,""prop-
A person's or organization's status as an additional erty damage," or"personal and advertising Injury"
insured under this endorsement ends when arising out of the sole negligence of the additional
your operations for that addltlorial Insured are insured.
completed. S. The Insurance provided to the additional Insured
2. With respect to the insurance afforded to these ad- does not apply to "bodily injury," "property dam-
ditlonal Insureds, the following exclusions are age," or "personal and advertising Injury" arising
added to item 2. Exclusions of SECTION I out of an architect`s, engineer's or surveyor's ren.
COVERAGES: during of or failure to render any professional serv-
This Insurance does not apply to "bodily Injury," ices Including:
"property damage"or"personal and advertising In-
jury"occurring after;
Includes copyrighted material of ISO Properties,Inc„with its permission,
Copyright,iSO Propertles,Inc,,200
GhS-1 SOS(7-06) Page 1 of 2 °
.X�.GENT
a. The preparing, approving or failing to prepare written contract specifically requires that this insu
or approve maps,shop drawings,opinions,re- ante be primary.
ports, surveys, field orders, change orders or drawings and specifications;and When this insurance is excess, we will have no du-
ty under SECTION I-COVERAGES to defend the
b. Supervisory, Inspection, architectural or engi- additional Insured against any"suit"If any other In-
neering activities, surer has a duty to defend the additional Insured
6. Any coverage provided hereunder will be excess against that"suit." If no other Insurer defends, we
over any other valid and collectible Insurance avail- will undertake to do so, but we will be entitled to
able to the additional Insured whether primary, ex- the additional Insured's rights against all those oth-
c6ss, contingent or an any other basis unless a er Insurers.
AUTHORIZED REPRESENTATIVE DATE
Includes copyrighted material of ISO Properties,Inc.,with Its permission.
Copyright,ISO Properties,Inc.,2004
GLS-150s(7-06) Paga 2 of 2
COMMERCIAL GENERAL LIA>31LITY
4
CG 20 0104 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY
OTHER INSURANCE CONDITION
This endorsement modifies Insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance Condl- (2) You have agreed In writing in a contract or
tion and supersedes any provision to the contrary: agreement that this Insurance would be prl-
PrlmaryAnd Noncontributory Insurance mary and would not seek contribution from
any other Insurance available to the additional
This Insurance Is primary to and will not seek con- Insured,
tributlon from any other Insurance available to an
additional insured under your policy provided that:
(`I) The additional Insured is a Named Insured
under such other Insurance;and
CG 20 01 0.4'13 Copyright,Insurance services Of i e,Inc„2012 Page 1 of`i
MENT
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06
(Ed.04-84)
WAIVER Of OUR RIGHT To RECOVER FROM OTHERS ENDORSEMENT-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 the person Or organization named In the Schedule.(This agreement applies only To the extent that you perform work
under a written contract that requires you To obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration Of your employees While engaged In the work
described In the Schedule.
The additional premium For this endorsement shall be 5%Of the California workers'compensation premium otherwise due on
such remuneration.
Schedule
Person or Organization Job Description
City of Cupertino/Blackberry Farm Golf Course 10300 Specific waiver per written contract j
Torre Avenue Cupertino, j
i
i
i
i
i
i
i
i
I
j
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.)
Endorsement Effective 4/1/2018 Policy No. TWC3709409 Endorsement No. 1
Insured Professional Turf Management,Inc.(A Corp) Premium$ 14375
Insurance Company Technology Insurance Company,Inc. 11
Countersigned by
I
WC 04 03 06
I
(Ed.04-84)
I
SECOND AMENDMENT TO THE AGREEMENT BETWEEN THE CITY
CUPERTINO AND PROFESSIONAL TURF MANAGEMENT FOR CONTRACT
SERVICES FOR BLACKBERRY FARM GOLF COURSE MAINTENANCE
This Second Amendment to the Contract between the City of Cupertino and Professional
Turf Management, for reference dated June 14, 2017, is by and between the CITY OF
CUPERTINO, a municipal corporation (hereinafter "City") and Professional Turf Management,
A California corporation whose address is P.O. Box 700142, San Jose, California, 95170,
(hereinafter"CONTRACTOR"), and is made with reference to the following:
RECITALS:
A. On December 3, 2015, an agreement was entered into by and between the City and
Contractor(hereinafter"Agreement") for Contract Services for Blackberry Farm Golf
Course maintenance and soil sample collection and testing.
B. City and Contractor desire to modify the Agreement on the terms and conditions
set forth herein.
NOW, THEREFORE, it is mutually agreed by and between and undersigned parties as
follows:
1. Section 1, "TERM" is modified to read as follows:
The Contractor shall continue work through June 30, 2018, and shall diligently
prosecute the work. This Agreement may be renewed annually for additional one-
year terms commencing July 1, 2018, at the City's sole discretion and subject to
appropriation, for up to three (3) additional one-year terms. The term of the
Agreement shall terminate on June 30, 2018, unless terminated earlier as set for
herein.
2. Section 3, "COMPENSATION TO CONTRACTOR', Sentence 1, is modified to read
as follows:
Contractor shall be compensated for services performed pursuant to this
Agreement in the amount and manner set forth in Contractor's bid, which is attached
hereto as Exhibit`B" and incorporated herein by reference.
3. Except as expressly modified herein, all other terms and covenants set forth in the
Agreement shall remain the same and shall be in full force and effect.
IN WITNESS WHEREOF, the parties hereto have caused this modification of
Agreement to be executed.
Contractor CITY OF CUPERTINO
Professional Turf Management A � ip 1 Co orati0� �"�_
By
By City Managers David Brandt
4-5,A,7- Date 4/z 2/Z0l
Title
RECOMMENDED
-h g /� FOR APPROVAL:
Date By
Director of Recreation and
Community Services, Jeff Milkes
APPROVED AS TO FORM:
13Y &)--A
el City C-44 Attorney,
ATTEST: �k&jff
4'�L
City Clerk,
Amendment Amount$205,200.00
Account No. 560-63-616-700-702
CERTIFICATE OF LIABILITY INSURANCE 6/l/(2017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER NAME:
VOLPATTI INSURANCE SERVICES INC P O No (925)243-0131 !uc No:(925)243-0132
511 Leisure Street ADORESS:ra Gk@volpatta .com
Livermore, CA 94551 INauRERta)Ar-FORQM COVERPOF NAKStl
License#:OE40809 INSURER A:Scottsdale Insurance Company 41297
INSURED Professional 'Turf Management, Inc. INSURER 0:Falls Lake Fire & Casualty Company 24538
INSURER C:balifornia. Capital Insurance Company 13544
PO HOX 700142 INSURER D:
San Jose, CA 95170 INSURERE:
INSURER F.
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER;
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INBR ADUL POLICY EXP
TYPE OF INSURANCE LIMIT$
LTR o POLICY NUMBER MM/DOUBIR n� MMIDD
GENERAL LIABILITY EACH OCCURRENCE s 1,000 000
X COMMERCIAL GENERAL LIABILITY PREMISES Ea=Wane s 100,000
CLAIMS-MADE ®OCCUR MED EXP(Any one person) $ 5,000
A y CPS2609259 09/O1J201? 09/Ol/2018 PERSONAL&ADV INJURY s 1,000,000
GENERAL AGGREGATE s 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG s 2,000,000
POLICY I X J CTEl LOG $
AUTOMOBILE LIABILITY Ea accident
ANYAUTO
BODILY INJURY(Per Perron) $
AUT OWNED SCHEDULED BODILY INJURY(Par acddent) $
PRO E
HIRED AUTOS AUTOSWNEo Per accdent $
S
UMBRELLA LIAB OCCUR EACH OCCURRENCE s
EXCESS LIAB CLAIMS.MADE AGGREGATE $ _
DED J I RETENTION$ $
WORKERS COMPENSATION X T YT T E -
AND EMPLOYERS'LIABILITY
ANY PROPRIETORIPARTNEMXECUTIVE YIN NIA y E.L.EACH ACCIDENT $ 1,000,000
B (MandaMtoNH) EXCLUOEA? PLA005003�-00 04/01/17 04�01�18 E.L,DISEASE-EA EMPLOYS-$ 1,000,000
(Mandatory to NH)
I(yyeesdescribeunder E.L.DISEASE-POLICY LIMIT $ 1,000,000
pENIPTION OF OPERATIONS Below +
Commercial Inland Contractors Equip.
C Marine 3--MIA-1-026769 6/23/2016 6/23/2017 $213,275
Deductible 500
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is requUed)
The City of Cupertino, its directors, officers, agents, consultants and employees are named as
additional insured in regard to General Liability and Primary/Non-Contributory wording is
attached to this policy. Waiver of Subrogata,on in regard to workers compensation in favor of
City of Cupertino.
The issuing insurer will endeavor to mail 30 days written notice of cancellation.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Cupertino THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
10300 Torre Avenue ACCORDANCE WITH THE POLICY PROVISIONS.
Cupertino, CA 95014
AUTHORIZED REPRESENTATIVE
0 988-20 0 D CORP T[ON. All rights reserved.
ACORD26(2010/06) The ACORD name and logo are registered marks of ACORD
FIRST AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF
CUPERTINO AND PROFESSIONAL TURF ANAL ENT FOR CONTRACT
SERVICES FOR BLACKBERRY FARM GOLF COURSE MAINTENANCE
This First Amendment to the Agreement between the City of Cupertino and
Professional Turf Management, for reference dated June 22, 2016, is by and between the
CITY OF CUPERTINO, a municipal corporation (hereinafter "CITY") and Professional
Turf Management, a California Corporation, whose address is P.O. Box 700142, San
Jose, California, 95170, (hereinafter referred to as "Contractor"), and is made with
reference to the following:
RECITALS:
A. On December 3, 2015, an agreement was entered into by and between City
and Contractor (hereinafter "Agreement") for Contract Services for Blackberry
Farm Golf Course maintenance and soil sample collection and testing.
B. City and Consultant desire to modify the Agreement on the terms and
conditions set forth herein.
NOW, THEREFORE, it is mutually agreed by and between and undersigned
parties as follows:
1. Section 1, "TERM" is modified to read as follows:
The Contractor shall continue work through June 30, 2017, and shall
diligently prosecute the work. This Agreement may be renewed annually for
additional one-year terms commencing July 1, 2017, at the City's sole
discretion and subject to appropriation, for up to four (4) additional one-year
terms. The term of this Agreement shall terminate on June 30, 2017, unless
terminated earlier as set for herein.
2. Section 3, "COMPENSATION TO CONTRACTOR", sentence 1, is modified
to read as follows:
Contractor shall be compensated for services performed pursuant to
Page I of 2
First Amendment
Professional Turf Management Contract,Blackberry Farm Golf Course
this Agreement in the amount and manner set forth in Contractor's bid,
which is attached hereto as Exhibit "B" and incorporated herein by reference.
3. Except as expressly modified herein, all other terms and covenants set forth
in the Agreement shall remain the same and shall be in full force and effect.
IN WITNESS WHEREOF, the parties hereto have caused this modification of
Agreement to be executed.
Professional Turf Management CITY OF WPERTINO
AMu ip Corporan
B By
City Manager, David Brandt
Title
Date a J 3 LFC' Date
RECOMMENDED 111-1 OR APPROVAL
By
Acting b-ir-e"ctor of Recreation and
Community Services, Christine M.
Hanel
APP OVED AS TO FORM:
By
City Attorney, Randolph Stevenson Horn
ATTEST:
City Clerk, Grace Schmidt
Amendment Amount$205,200.00
Account No. 560-63-616-700-702
Page 2 of 2
First Amendment
Professional Turf Management Contract,Blackberry Farm Golf Course
CONTRACT
AGREEMENT BETWEEN THE CITY OF CUPERTINO AND
PROFESSIONAL TURF MANAGEMENT FOR
BLACKBERRY FARM GOLF COURSE MAINTENANCE
THIS AGREEMENT, for reference dated December 3, 2015, is by and between CITY OF
CUPERTE\TO,, a municipal corporation (hereinafter referred to as "City"), and Professional Turf
Management, a California corporation, whose address is P.O. Box 700142, San Jose, CA 95170,
hereinafter called the Contractor, 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. City and Contractor desire to enter into an agreement for Blackberry Farm Golf
Course Maintenance, in accordance with the Technical Provisions, General and Special Conditions,
and Special Environmental Conditions.
NOW, ITIEREFORE, it is mutually agreed by and between the undersigned parties as
follows:
1. TERM:
The Contractor shall begin work on January 1, 2016 and continue work through June 30,
2016, and shall diligently prosecute the work. This Agreement may be renewed annually for one-
year terms commencing July 1, 2016 through June 30, 2017, at the City's sole discretion and subject
to appropriation, for up to five (5) one-year terms (possible total term 5.5 years).
2. SERVICES TO BE PERFORMED:
Contractor agrees, at its own cost and expense, to furnish all labor, tools, equipment,
materials, except as otherwise specified, and to do all work strictly in accordance with the Scope of
Work (see Exhibit A). The General and Special Conditions, Technical Provisions and Special
Environmental Conditions are hereby referred to and expressly made a part hereof with the same
force and effect as if the same were fully incorporated herein,
3. COMPENSATION TO CONTRACTOR:
Contractor shall be compensated for services performed pursuant to this Agreement in the
amount and manner set forth in Contractor's bid, which is attached hereto as Exhibit "A" and
incorporated herein by this reference. 'Payment will be made in the same manner that claims of a
like character are paid by the City, with checks drawn on the treasury of the City, to be taken from
the fund as indicated in the city's adopted budget.
Contractor Agreement Page I of 17
Blackberry Farm Golf Course Maintenance 2016
4. TIME IS OF THE ESSENCE:
Conti-actor and City agree that time is of the essence regarding the performance of this
Agreement.
5. STANDARD OF CARE:
Contractor 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 Contractor intend that the relationship between them created by this Agreement is
that of an independent contractor. The manner and means of conducting the work are under the ,
control of Contractor, 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 Contractor'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 Contractor, 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 Contractor. Payments of the
above items,if required, are the responsibility of Contractor.
7. IMMIGRATION REFORM AND CONTROL ACT(IRCA):
Contractor assumes any and all responsibility for verifying the identity and employment
authorization of all of its employees performing work hereunder, pursuant to all applicable IRCA
or other federal or state rules and regulations. Contractor shall indemnify and hold City harmless
from and against any loss, damage, liability, costs or expenses arising from any noncompliance of
this provision by Contractor.
S. NON-DISCRIMINATION:
Consistent with City's policy that harassment and discrimination are unacceptable
employer/employee conduct, Contractor agrees that harassment or discrimination directed toward
a job applicant, a City employee, or a citizen by Contractor or Contractor's employee 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, Contractor agrees that any and all violations of
this provision shall constitute a material breach of this Agreement,
9. HOLD HARMLESS:
Contractor shall, to the fullest extent allowed by law,indemnify, defend, and hold harmless
the City and its officers, officials, agents, employees and volunteers against any and all liability,
claims,stop notices, actions, causes of action or demands whatsoever from and against any of them,
including any injury to or death of any person or damage to property or other liability of any
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Blackberry Farm Golf Course Maintenance 201.6
nature, arising out of, pertaining to, or related to the performance of this Agreement by Contractor
or Contractor's employees, officers, officials, agents or independent contractors. Contractor shall
not be obligated under this Agreement to indemnify City to the extent that the damage is caused by
the sole or active negligence or willful misconduct of City,its agents or employees. 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.
Contractor agrees to obtain executed indemnity agreements with provisions identical to
those set forth here in these sections from each and every subcontractor or any other person or
entity involved by, for, with, or on behalf of Contractor in th"e performance of this agreement. If
Contractor fails to obtain such indemnity obligations from others as required here, Contractor
agrees to be fully responsible according to the terms of this section.
10, INSURANCE:
On or before the commencement of the terms of this Agreement, Contractor 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 paragraph 10A, B, C and D. Such
certificates, which do not limit Contractor's indemnification, shall also contain substantially the
fallowing statement: "Should any of the above insurance covered by this certificate be canceled or
coverage reduced before the expiration date thereof, the insurer affording coverage shall provide
thirty (30) days' advance written notice to the City of Cupertino by certified mail, "Attention: City
Manager."It is agreed that Contractor shall maintain in force at all tunes 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 the City as additional insured shall be submitted with the
insurance certificates. Contractor to complete the attached Document 00530 Insurance Forms.
A. COVERAGE:
Contractor shall maintain the following insurance coverage:
(1) Workers' Compensation;
Statutory coverage as required by the State of California;Employers' Liability
$1,000,000 per occurrence
(2) General Liability:
Commercial general liability coverage in the following minimum limits:
Bodily Injury: $500,000
each occurrence
$1,000,000
aggregate- all other
Property Damage: $500,000 each occurrence
1 $1,000,000 aggregate
If submitted, combined single limit of$1,000,000 per occurrence;$2,000,000 in
the aggregate will be considered equivalent to the required minimum limits
shown above.
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(3) Automotive:
Comprehensive automobile liability coverage in the
following minimum limits:
Bodily injury: $500,000 each occurrence
Property Damage: $500,000 each occurrence
or
Combined Single Limit: $1,000,000 each occurrence
B. SUBROGATION WAIVER:
Contractor agrees that in the event of loss due to any of the perils for which it has agreed to
provide comprehensive general and automotive liability insurance, Contractor shall look solely to
its insurance for recovery. Contractor hereby grants to City, on behalf of any insurer providing
comprehensive general and automotive liability insurance to either Contractor or City with respect
to the services of Contractor herein, a waiver of any right to subrogation which any such insurer of
said Contractor may acquire against City by virtue of the payment of any loss under such
insurance.
C. FAILURE TO SECURE:
If Contractor 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 Contractor's name or as
an agent of the Contractor and shall be compensated by the Contractor for the costs of the insurance
premiums at the maxi-i-num 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 vol-ur-iteers shall be
named as an additional insured under all insurance coverages, except worker's compensation
insurance. 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
Contractor. Contractor is advised to consult Contractor's insurance broker to determine adequate
coverage for Contractor.
11. BONDS:
Not applicable.
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12. PROHIBITION AGAINST TRANSFERS:
Contractor 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 assignirient, hypothecation or transfer. However, claims for money by Contractor 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 Contractor.
The sale, assignment, transfer or other disposition of any of the issued and outstanding
capital stock of Contractor, or of the interest of any general partner or joint venturer or syndicate
member or cotenant,if Contractor is a partnership or joint venture or syndicate or cotenancy, which
shall result in changing the control of Contractor, shall be construed as an assigninent 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 are listed iri Contractor's bid shall be used in the performance of this Agreement.
Requests for additional subcontracting shall be submitted in writing, describing the scope of
work to be subcontracted and the name of the proposed subcontractor. Such request shall set forth
the total price or hourly rates used in preparing estimated costs for the subcontractor's services.
Approval of the subcontractor may, at the option of City,be issued in the form of a Work Order.
In the event that Contractor employs subcontractors, such subcontractors shall be required
to furnish proof of workers' compensation insurance and shall also be required to carry general and
automobile liability insurance in reasonable conformity to the.insurance carried by Contractor. In
addition, any work or services subcontracted hereunder shall be subject to each provision of this
Agreement,
14. PERMITS AND LICENSES:
Contractor, at its sole expense, shall obtain and maintain during the term of this Agreement,
all appropriate permits, certificates and licenses, including a City Business License, that may be
required in connection with the performance of services hereunder.
15. REPORTS:
Each and every report, draft, work product, map, record and other document reproduced,
prepared or caused to be prepared by Contractor pursuant to or in connection with this Agreement
shall be the exclusive property of City. Consultant may retain a copy of any report furnished to the
City pursuant to this Agreement.
No report information nor other data given to or prepared or assembled by Contractor
pursuant to this Agreement shall be made available to any individual or organization by Contractor
without prior approval by City.
Contractor shall, at such time and in such form as City may require, furnish reports
concerning the status of services required under this Agreement.
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16. RECORDS:
Contractor 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 Mulder this Agreement.
Contractor 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. Contractor
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 of the records is necessary due to concerns raised by
City's preffi-ninary 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 other
breach of contract or failure to act in good faith, then Contractor shall reimburse City for all
reasonable costs and expenses associated with the suppleAlental 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 Contractor to City shall be addressed to
City at:
City of Cupertino
10300 Torre Avenue
Cupertino CA 9501.4
Attention: Carol Atwood,Director of Recreation and Community Services
All notices, demands, requests, or approvals from City to Contractor shall be addressed to
Contractor at:
Professional Turf Management
P.O.Box 700142
San Jose, CA 951,70
Attention:Michael Basile,President
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18. URBAN RUNOFF MANAGEMENT:
The Contractor shall avoid creating excess dust when breaking asphalt or concrete and
during excavation and grading or other activities that may create dust or erosion. If water is used
for dust control, contractor shall use as little as necessary. Contractor shall take all steps necessary
to keep wash water out of the streets, gutters and storm drains,
The Contractor shall develop and implement erosion and sediment control to prevent
pollution of storm drains. Such control includes but is not limited to:
A. Use storm drain inlet protection devices such as sand bag barriers, filter fabric
fences, block and gravel filters. (Block storm drain inlets prior to the start of the rainy season
(October 15), in site de-watering activities and saw-cutting activities; shovel or vacuum saw-cut
slurry and remove from the site).
B. Cover exposed piles of soil or construction material with plastic sheeting. All
construction materials must be stored in containers,
C. Sweep and remove all materials from paved surfaces that drain to streets, gutters
and storm drains prior to rain as well as at the end of the each work day. At the completion of the
project, the street shall be washed and the wash water shall be collected and disposed of offsite in
an appropriate location.
D. After breaking old pavement, Contractor shall remove all debris to avoid contact
with rainfall or runoff,
E. Contractor shall maintain. a clean work area by removing trash, litter, and debris at
the end of each work day. Contractor shall also clean up any leaks, drips, and other spills as they
occur.
The objective is to ensure that the City and County of Santa Clara County-Wide Clean
Water Program is adequately enforced. These controls should be implemented prior to the start of
construction, up-graded as required, maintained during construction phases to provide adequate
protection, and removed at the end of construction.
These recorru-nendations are intended to be used in conjunction with the State's Best
Management Practices Municipal and Construction Handbooks, local program guidance materials
from municipalities, Section 7.1.01 of the Standard Specifications and any other appropriate
documents on storm water quality controls for construction.
Failure to comply with this program will result in the issuance of noncompliance notices,
citations, project stop orders or fines. The fine for noncompliance of the above program is two
hundred and. fifty dollars ($250.00) per occurrence per day. The State under the Federal Clean
Water Act can also impose a fine on the contractor,pursuant to Cal.Water Code '13385.
19. TERMINATION:
In the event Contractor fails or refuses to perform any of the provisions hereof at the time
and in the mamier required hereunder, Contractor shall be deemed in default in the performance of
this Agreement. If such default is not cured within a period of two (2) days after receipt by
Contractor 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
Contractor written notice thereof.
City sball have the option, at its sole discretion and without cause, of terminating this
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Blackberry Farm Golf Course Maintenance 2016
Agreement by giving seven (7) days' prior written notice to Contractor 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 carried and unpaid prior to the effective date of termination.
20. COMPLIANCES:
Contractor shall comply with all state or federal laws and all ordinances,rules and
regulations enacted or issued by City. Specifically, and without limitation, Contractor shall comply
with all state,federal,or local regulation regarding the removal and disposal of hazardous waste,
A. PREVAILING WAGES: To the extent applicable,Contr actor shall comply with the
City's Labor Compliance Program and all other requirements set forth in Labor Code section 1770
et seq. Contractor shall pay prevailing wages. Contractor will submit monthly certified payroll
records to the City for all employees and subcontractors in a preapproved format or a City
provided form. Any delay in remitting certified payroll reports to the City upon request from the
City will result in either delay and/or forfeit of outstanding payment to Contractor.
B. WORKING DAY: Contractor shall comply with California Labor Code Section
1810, et seq. which provides that work performed by employees of contractors in excess of 8 hours
per day, and 40 hours during any one week, must be compensated as overtime, at not less than 1 1/2
times the basic rate of pay, to the extent applicable,
C. PAYROLL RECORDS: Contractor shall comply with California Labor Code Section
1776 which requires certified payroll records be maintained with the name, address, social Security
number, work classification, straight time and overtime hours worked each day and week, and the
actual per diern wages paid to each journeyman, apprentice,worker, or other employee employed
by him or her in connection with this Agreement, to the extent applicable, The Payroll Records
shall be made available for inspection as provided in California Labor Code Sect-loll 1776.
D. APPRENTICES: Contractor shall comply with California Labor Code Section 1777.5
regarding apprentices, to the extent applicable,
21. 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.
22. ADVERTISEMENT:
Contractor 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
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Blackberry Farm Golf Course Maintenance 2016
performed under this Agreement tmless prior written approval has been secured frorn City to do
otherwise.
23, 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.
24. INTEGRATED CONTRACT:
This Agreement consists of this document as well as the following documents, including all
changes, addenda,and modifications thereof which are incorporated herein by reference:
Document 00400,Bid Form
Document 00430,Subcontractors List
Document 00450,Statement of Qualifications
Document 00481, Non-Collusion Affadavit
Document 00482,Bidder Certifications
Document 00530,Insurance Forms
Document 00660,Substitution Request Form
Document 00700, General Conditions
Document 00800, Special Conditions
Document 00820,Special Environmental Conditions
Document 00821,lrisuranc6
Document 00822,Apprenticeship Program
Technical Provisions
Addenda(No. I and 2)
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 Contractor.
25. 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.
26. 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.
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Blackberry Farm Golf Course Maintenance 2016
P.O.No.: 10(�-3� 9
IN WITNESS WHEREOF, the parties have caused the Agreement to be executed on the day
and year first above written,
CONTRACTOR CITY OF CUPERTINO
Professional Turf Management A Municipal Corporation
7
By /B 4&
David Brandt
Name City Manager
Title—61,I),1 e r 1l es()C'l
Date Date
Address: RECOMMENDED FOR APPROVAL:
P.O. Box 700142
San Jose, CA 95170 By 4, 1
Carol Atwood
Director of Recreation&Community Services
APPROVED AS TO FORM:
By
Col een Winchester,Acting City Attorney
ATTEST:
Grace Schmidt,City Clerk
Contract Amount: $99,600.00
Account No. :
7 0
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Blackberry Farm Golf Course Maintenance 2016
EXI-11BIT A
SCOPE OF WORK
BLACKBERRY FARM GOLF COURSE MAINTENANCE
Work to provide maintenance of Blackberry Farm Golf Course
1. PUTTING GREENS
1.01 SCOPE: Greens shall be maintained disease and weed free. Complete renovation of
any green is not included in this maintenance project.
1.02 MOWING FREQUENCY': Winter—six times per week. Spring/Summer/Fall—six
times per week. Contractor to recycle grass trimmings.
1.03 CHANGING CUPS: Contractor shall change the cup location daily year-round.
Placement is to be at least 8 feet from edge of green on level surface. When
requested,use the 1/3 rule— 1/3 of the pins back, 1/3 pins middle, 1/3 pins up.
1.04 HEIGHT OF CUT: Is to be 0.135 of an inch
1.05 FERTILIZATION: Contractor to collect soil samples yearly to determine
recommended nutrients, rates of application and frequency of application, with the
goal of a sustainable fertility program. Use organic fertilizers, i.e. Earthworks or
approved equivalent. The City shall determine which of the greens are to be tested.
Contractor to use Logan Laboratories or City approved equal for soils testing and
recorninendations. All fertilizer shall be applied in accordance with all applicable
laws, codes, specifications and policies and at minimum rates that are consistent with
healthy turf.
1.06 AE RIFICATION/TOP DRESS/VERTI-CUTTING: Contractor is to perform
Dryfect aerification or equal twice a year in March/April and September/October, and
overseed with Pencross bentgrass in September. Perform a DryJcct Maximus
aerification.or equal in July. Verti-cut greens monthly during the growing season.
Top-dress with TD320 from TMT enterprises or City approved equal.
1.07 PESTICIDE APPLICATION: All pesticide application shall be completed by a
qualified person in accordance with all applicable laws, codes, specifications and
policies. Greens to be maintained disease and weed free. Apply all chemicals
sparingly. Applications shall be as per EPA regulations. Contractor must possess
SDS (safety data sheets) for all materials. All posting and re-entry requirements must
be followed. Contractor to submit montl-Ay a written report of all pesticide
applications. A recommendation by a licensed Pest Control Advisor(PCA) that is
familiar with Blackberry Farm Golf Course and with its setting and protected natural
resources is required for applications, and a licensed staffer with a current Qualified
Applicator License(QAL) or is a Qualified Applicator Certificate holder(QAC) shall
be on site and provide oversight during applications is required. All work shall
adhere to all laws, regulations and applicable guidelines for all pesticide applications.
Contractor may be required to obtain a Restricted Materials Use Permit and Notice of
Intent prior to any applications.
1.08 PROTECTION OF CREEK AND PONDS: No runoff from fertilizer,pesticide or
chemical applications shall flow into creeks or ponds nor to drainage hilets that
discharge to creeks or ponds.
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1.09 INTERSEEDING: Contractor shall interseed greens with City approved mix of
creeping bentgrass two times per year, in the spring and fall at a rate of 2 lbs.per
1,000 sq. fect unless otherwise directed.
2. COLLAR MAINTENANCE
2.01 MONNTfNG FREQUENCY: Twice weekly in spring/summer/fall and once a week in
winter,
2.02 HEIGHT OF CUT: to be 1/2 inch all year
2.03 FERTILIZATION: to be fertilized the same as greens
2.04 NVE ED CONTROL: to be applied the same as greens
3. TEE MAINTENANCE
3.01 MOWING FREQUENCY: Two to three times per week in spring/suminer/fall and
one to two times a week in winter.
3.02 HEIGHT OF CUT: to be 1/2 inch all year
3.03 FERTILIZATION: Contractor to collect at least one soil sample yearly to
determine the recommended complete fertilizer to use. Contractor to use Logan
Laboratories or City approved equal for soils testing and recommendations. Fertilizer
to be applied four times a year in March, May, late August and October. The
application rate shall be at the manufacturer's recommended rate. All fertilizer shall
be applied in accordance with all applicable laws, codes, specification and policies
and at mij.-i_muni rates consistent with healthy turf. Special care shall be taken to
prevent-fertilizer or fertilizer-containing runoff from getting into creek areas or ponds.
3.04 AERIFICATION: Contractor to aerate four tunes per year in May and October and
as needed.
3.05 OVERSEEDING: Contractor to overseed four times per year with peremlial rye
grass, at 8 lbs. per 1,000 sq. feet unless otherwise directed. Contractor to use
seeder/slicer(verti-cutting)unit.
3.06 TEE AIIARKE RS: Contractor shall move and rotate daily. Keep 10 feet apart and 8
feet from back of tee(except where markers do not allow).
3.07 PERMANENT YARDAGE, MARKERS: Contractor to keel) visible at all times,
3.08 NVE ED CONTROL: Contractor to apply two broadleaf weed control in the spring
and fall. Broadleaf weed control is for,but not limited to, English Daisy, clover,
spurge and chickweed. Contractor to apply one Crabgrass control in spring. All
weed controls shall be applied in accordance with all applicable laws, codes,
specification and policies.
3.09 PROTECTION OF CREEK AND PONDS: No runoff from fertilizer,pesticide or
chemical applications shall flow into creek areas or ponds nor to drain inlets that
discharge to creek areas or ponds.
3.10 SEED AND TOPSOIL TEES: Contractor to place seeds and sand/organic compost
mix on.tees daily to repair divots.
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4. FAIRWAY MAINTENANCE
4.01 MOWING FREQUENCY: two to three times per week in growing season, and
one to two times per week in winter
4.02 HEIGHT OF CUT: 3/ inch all year
4.03 FERTILIZATION: Contractor to collect one soil sample yearly to determine the
recommended complete fertilizer to use. Contractor to use Logan Laboratories or
City approved equal for soils testing and recommendations. Fertilizer to be applied
four times a year in March, May,late August and October. The application rate shall
be at the manufacturer's recommended rate. All fertilizer shall be applied in
accordance with all applicable laws, codes, specifications and policies and at
minimum rates consistent with healthy turf.
4.04 AERIFICATION: VE RTI-CUTTING: Contractor to aerate, verti-cut once per
year in April/May.
4.05 OVERSEEDING: Contractor shall overseed with Perennial Rye one time per year,
8 lbs. per 1,000 sq. feet unless otherwise directed. Use seeder/slicer for distribution.
Perform spot-overseeding as needed with Perennial Rye.
4.06 WEED CONTROL: Contractor to apply broadleaf weed control twice per year, in
the spring and fall. Broadleaf weed control is for,but not limited to, English Daisy,
clover, spurge and chickweed. Contractor to apply one Crabgrass control in spring,
All weed controls shall be applied in accordance with all applicable laws, codes,
specification and policies,
4.07 PROTECTION OF CREED AND PONDS: No runoff from chemical applications
shall flow into creek areas or ponds. Contractor shall cover the drain inlets and
drainage structures that discharge to the creek for one week after the application of
any chemicals.
5. ROUGH MAINTENANCE
5.01 MOWING FREQUENCY: twice per week all year
5.02 HEIGHT OF CUT: I to I V2inches all year
5.03 FERTILIZATION:Same as Fairway Maintenance
5.04 AERIFICATION: Same as Fairway Maintenance
5.05 WEED CONTROL:Contractor to apply two broadleaf weed control in the spring
and fall. Broadleaf weed control is for,but not limited to,English Daisy, clover,
spurge and checkweed. Contractor to apply one Crabgrass control in spring. All
weed controls shall be applied in accordance with all applicable, laws, codes,
specification and policies.
5.06 PROTECTION OF CREED AND PONDS:No runoff from chemical applications
shall flow into creeks or ponds.
7. EQUIPMENT AND EQUIPMENT STORAGE
7.01 GREEN EQUIPMENT: The City encourages the Contractor to use
Environmentally Friendly or Green equipment and supplies for this contract.
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Blackberry Farm Golf Course Maintenance 2016
7.02 SCOPE: All mowing equipment shall be on a regular preventive maintenance
schedule for hydraulic and oil lines so as to minin-dze damage to turf and protect the
creek and wildlife habitat from leaks. Hydraulic hoses shall be changed off site every
six months.
7.03 GREENS: Mowing equipment shall be 9 or more bladed,reel-type mower with a
frequency of out at a minimum of.25 at 3.6 mph.
7.04 TEES: Mowing equipment shall be 7 or more bladed,reel-type mower with a
frequency of cut at a minimum of.53 at 4.2 mph.
7.05 FAIRWAYS: Mowing equipment shall be 6 or more bladed, reel-type mower with a
frequency of cut at a minirnum,of.67 at 5.0 mph.
10. PARKING LOT AT GOLF COURSE ENTRANCE
10.01 SWEEPING: Contractor shall sweep monthly. Manually using a blower is
acceptable during the hours of 7:00 am to 8:00 pm on week days and 9:00 am to 6:00
pm on weekend, and in accordance with the City's noise ordinance.
10.02 LOOSE TRASH AND GARBAGE CANS: Contractor shall pick up trash and
check area daily.
10.03 BROKEN GLASS/BOTTLES: Contractor shall pick up and dispose of broken
glass or similar potentially harmful materials immediately.
11. CLUBHOUSE &MAINTENANCE BUILDING
11.01 REST ROOMS AT INIAI"NTTENANCE BUILDING: Public restroorns for golfers
exist on the golf-facing side of the golf maintenance building. The public rest rooms
will be cleaned and maintained by the City or City's designee.
11.02 PATIO: Contractor shall sweep daily.
11.03 RECYCLED CARDBOARD CONTAINERS: Shall be emptied at least once per
week.
12. ENTRY AREA/CLUBHOUSE GROUNDS
12.01. FLOWER BEDS: Contractor shall weed,mulch,water and replenish as needed.
12.02 TRASH: Contractor shall pick up daily,
12.03 FOOT BRUSHES: Contractor shall clean and check weekly and replace when
worn.
12.04 WALKWAYS: Contractor shall S IA7eep daily when weather permits,
12.05 TRASH AND CIGARETTE CANS: Contractor shall empty cans daily and comply
with City's recycling standards.
12.06 LEAKS FROM GOLF CARTS: Contractor shall clean inunediately.
12.07 LANDSCAPE SHRUBBERY: Contractor shall trim monthly and as needed.
12.08 ANNUAL PLANTINGS: Contractor shall remove and re-plant minimum 2 times
per year the two planter boxes located at the clubhouse. The planter box on number
one tee measuring roughly 4.5 ft.by 35.5 ft. (160 S.F.)and the planter box to the left
Conti-actor Agreement Page 14 of 17
Blackberry Ferret Golf Course Mavitenarice 2016
of the building along the restroom walkway measuring roughly 8 ft. by 34 ft. (272
S.F.).
12.09 DRIVING RANGE: Contractor shall cut grass weekly and fertilize and aerate the
same as fairways.
12.10 WEED CONTROL(NON-SELECTIVE): Conti-actor shall use mechanical method
of trimming or removing undesirable vegetation in tree wells,perimeter and interior
fence lines,barriers, railroad ties, delineators, and along edges of golf play areas that
are along the creek or associated native planting areas.
12.11 LITTER: Contractor shall remove daily,
12.12 TRASH AND DEBRIS (FROM MAINTENANCE): Contractor shall remove as it
occurs and dispose of it in a safe and legal manner.
12.13 SOIL,WATER SAMPLES: Contractor shall take samples annually or more often
if unusual growth habits develop,
12.14 RODENT CONTROL: Contractor shall begin i-ininediate eradication action
following local, state and federal guidelines when gopher or ground squirrel activity
occurs. Contractor is not allowed to use rodemicides nor any chemicals to control.
rodents. Acceptable methods may include carbon dioxide use, trapping, exclusion, or
burrow sealing/removal, or using other techniques as acceptable to City.
12.15 SAND TRAPS: Complete renovation of any sand trap is not included in this
maintenance project. Contractor shall rake daily. Contractor shall keep sand at 4
inches in depth minimum and keep clean of all weeds. When using power rake, stay
about one foot from edge of trap. When hand-raking edge of trap,put sand inward on
low side and pull outward on high side. Contractor to edge traps monthly and as
needed. Do not drag sand out of trap when exiting trap with power rake,
12.16 TREES: Any tree removal or tree replacement must be approved by the City and
any expenditures incurred will be outside the standard scope of work, Contractor
shall keep all trees trimmed at least 6 feet from the ground to prevent damage to golf
cart tops and maintenance equipment, except for trees and shrubs along the creek
which shall only be trimmed as acceptable to the City Naturalist. Contractor shall
maintain trees in a safe,healthy, and aesthetically pleasing condition at all times,
Contractor shall mow,weed and/or mulch tree wells as needed. Contractors shall
iminediately remove any broken tree limbs. Downed blush shall be removed as soon
as possible, All trimmings or debris shall be removed from the course,unless they
are chipped, and used for mulch on site. Contractor shall not be responsible for
removal of dead or fallen trees; such removal shall be at the City's expense unless it
is determined that the condition was caused by the Contractor's negligence.
12.17 USDA GREEN SECTION VISIT: Contractor shall have a USGA staff agronomist
visit the course yearly on the following schedule: first year in the spring, second year
in the sumnier,third year in the fall, no winter visits. Contractor shall act on all
appropriate recoininendations that result from these visits.
12.18 LEAF PICKUP: Contractor shall remove leaves daily or as necessary.
12.19 VANDALISAI/GRAFFITT: Contractor shall correct vandalism immediately and
remove graffiti within 24 hours.
Contractor Agreement Page 15 of 17
Blackberry Farm Golf Course Maintenance 2016
14. OTHER AREAS
14.01 TEE MARKERS: Contractor shall have two sets each hole. Missing or broken
markers shall be replaced immediately.
14.02 BENCHES/TEE SIGNS: Contractor shall immediately remove any damaged bench,
and notify supervisor so that City can replace it. Any damaged tee sip shall be
removed as soon as possible, and notify supervisor so that City can replace it.
14.03 YARD MARKERS: Contractor shall replace as needed any yard markers.
14.04 GREENS FLAGS, POLE, CUPS: Contractor shall replace flags, poles and cups
when they are discolored, frayed or damaged in any way,
14.05 BALL WASHERS: Contractor shall check for water/soap daily. Contractor shall
replace tee towels monthly or more often if towel is frayed, discolored, or
aesthetically unpleasing.
14.06 SAND TRAP RAKES: Contractor shall keep two rakes per trap or more as needed,
and replace any missing or broken rake immediately.
14.07 OUT-OF-BOUNDS/HAZARD STAKES: Contractor shall replace white our-of-
bounds stakes immediately if missing or broken.
14.08 OVERSEEDING: Contractor shall spot-overseed with Perennial Rye when needed.
14.09 PONDS: Contractor shall keep the ponds free from algae and excessive growth of
plant material.
14.10 BRIDGE: Contractor shall inspect bridge daily for safe conditions and repair
structures immediately when necessary.
14.11 FOOT GOLF: Contractor shall maintain 9 hole foot golf course, with all tee
markers,holes, cups, flagpoles, and flags. Edging around the cups shall be done
weekly.
15. IRRIGATION
15.01 SCOPE: Irrigation system shall be maintained in a maniier to provide proper
watering. Any major irrigation system repairs or improvements are not included in
this maintenance project.
15.02 MAINTENANCE: Contractor shall maintain system, including lateral lines,
sprinkler heads, and controllers in good operating repair, functioning properly, and
conforming to related laws, codes and regulations. No valves or water main repairs
are included in this maintenance project. Contractor shall notify the City immediately
when valve or water main repairs are necessary for proper operation.
15.03 FREQUENCY: Contractor is to irrigate as required to maintain adequate moisture
for growth rate and appearance. Contractor is to hand-water as needed any and all
portions of the course that do not receive adequate water from the irrigation system,
15.04 TESTING FOR ADEQUATE SOIL MOISTURE: Contractor shall determine by
visual observation,plant resiliency,turgidity, examining cores removed by soil probe,
and moisture sensor devices.
15.05 WATER CONSERVATION: Irrigation controllers shall be programmed to
maintain course appearance and health of vegetation while maximizing water
conservation. '
Contractor Agreement Page 16 of 17
Blackberry Farin Golf Course Maintenance 2016
15.06 WIND PROBLEMS: In areas where wind creates problems of spraying onto private
property or road rights of way, operation shall occur during period of lowest wind
velocity.
15.07 MONITORING: Contractor shall make corrections for coverage, adjustment,
clogging of lines, and removal of obstacles, tilting of heads, and management of
plant materials that obstruct the spray as they occur.
15.08 SYSTEM CHECK: Contractor shall check the system daily during months of
operation.
15.09 PUMPING PLANT: Pumping plant shall be maintained the City.
15.10 WATER COST: Water costs shall be paid for by the City.
Contractor Agreement Page 17 of 17
Blackberry Farm Golf Course Maintenance 2016
EXHIBIT B - 1
SCHEDULE OF BID PRICES
Conti-actor's Name: -fad, 4nQ,� ul,
SCHEDULE OF BID PRICES
All Bid items,including lump sums and unit prices,must be filled in completely, Allowances and Alternative Bid items
if applicable are described in Document 00800(Special Conditions). Quote in figures only,unless words are specifically
requested.
ITEM SPEC DESCRIPTION UNIT EST UNIT TOTAL
REF QTY PRICE (Qty x Unit Price)
1 Technical Provide one month of maintenance at
Provisions Blackberry Farm Golf Course,Jan.—June month 6
&00800 2016
2 Technical
—Provisions Soil Sample Collection&Testing EA 6 ( OJ
200,
TOTAL BASE BID V11
Total Bid: N t M 9 _ VJ_S ' Itit IP2X1
(words)
SCHEDULE OF ALTERNATES
ALTERNATES
ITEM SPEC DESCRIPTION UNIT EST UNIT TOTAL
I REF QTY. PRICE (Qty x Unit Price)
BID ALTERNATE 1: Provide Maintenance at Blackberry Farm
Golf Course,Jul 2016-June 2017
Technical Provide maintenance,each month,July IQ
3 Provisions 2016-June 2017 month 12 2-oq oo(D
&00800
4
Technical Soil Sample Collection and Testing EA 12
Provisions 00
BID ALTERNATE 1,TOTAL,ITEMS 3+4 z o,5, zoo,
BID ALTERNATE 2:Provide Maintenance at.Blackberry Farm
Golf Course,July 2017-June 2018
Technical Provide maintenance,each month,July
5 Provisions 2017-June 2018 month 12 %&00800 11000 2-DI4, Dou
Technical
6 Provisions Soil Sample Collection and Testing EA 12
BID ALTERNATE 2,TOTAL,ITEMS 5+6 -2-0
Unit Legend
LS=Lump Sum AL=Allowance
EA=Each SF=Square Feet
LF=Linear Feet
TON=Ton or 2,000 Pounds
CY=Cubic Yards
LB=Pounds
City 017cupertillo Bid Form
Blackberry Farm Golf Course Maintenance 2016 00400-3
Amendment 1,Agmt.between City of Cupertino Exhibit B,Page I Exhibit B
&Professional Turf Management
EXHIBIT B - 1
SCHEDULE OF BID PRICES, continued
Contractor's Name:N 54L LA�
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUMS
Bidder herby acknowledges receipt and examination of all Contract Documents and the following Addenda:
Addendum No. Addendum Datp
1 11 /S OwNeup,
Z_
Bidder proposes and agrees to fully perform the Work within the time stated and in strict accordance with the Contract
Documents for the sums of money listed in this Bid Form.
NAME OF BIDDER:.---.PA,0�6 S(t,jJ A Julu �q,4A
v
licensed in accordance lvithlan act for the registration of Contractors,and with license number:
Expiration Date: i U 1(311110 1-7
N I '
Where incorporated,if applicable
Principals
I certify(or declare)under penalty of perjury under the laws of the State of California that the foregoing is true
and correct.
Signature of Bidder
NOTE: If Bidder is a corporation,set forth the legal name of the corporation,state where incorporated,together with the
signature of the officer or officers authorized to sign contracts on behalf of the corporation.If Bidder is a partnership,set
forth the name of the firm together with the signature of the partner or partners authorized to sign contracts on behalf of
the partnership. n I
Business Address: 0, -7 00 1
Sals;� rA
Officers authorized to sign contracts:
Ty d Fu l Name:
Telephone Number(s): rq(�)�'I S- 3?61
Fax N urn ber(s): CI- d g 9�- L oq q-
'
E-Mail Address: M I ke kfts I
END OF DOCUMENT
City of Cupertino Bid Form
Blackberry Farm Golf Course Maintenance 2016 00400-4
Amendment 1,Agmt.between City of Cupertino Exhibit B,Page 2 Exhibit B
&Professional Turf Management
EXHIBIT B-2
COMPENSATION
COMPENSATION
Payment for services to be performed in Fiscal Year 2016-17 from July 1, 2016 to June 30,
2017 shall be $17,000.00 per month for maintenance activities as described in Exhibit A,
plus $100.00 per each soil sample and testing with a maximum quantity of 12.
Payment for services to be performed in Fiscal Year 2016-17 shall not exceed$205,200.00
as noted below.
Item Unit Oty Unit Price Total Cost
Blackberry Farm Golf Course month 12 $17,000.00 $204,000.00
Course Maintenance
Soil Sample Collection each 12 $100.00 $1,200.00
& Testing
TOTAL FEE for services, fiscal year 2016-17, Not to Exceed: $205,200.00
Amendment 1,Agnit.between City of Cupertino Exhibit B,Page 3 Exhibit B
&Professional Turf Management
1
CONTRACT
AGREEMENT BETWEEN THE CITY OF CUPERTINO AND
PROFESSIONAL TURF MANAGEMENT FOR
BLACKBERRY FARM GOLF COURSE MAINTENANCE
THIS AGREEMENT, for reference dated December 3, 2015, is by and between CITY OF
CUPERTINO, a municipal corporation (hereinafter referred to as "City"), and Professional Turf
Management, a California corporation, whose address is P.O. Box 700142, San Jose, CA 95170,
hereinafter called the Contractor, 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. City and Contractor desire to enter into an agreement for Blackberry Farm Golf
Course Maintenance, in accordance with the Technical Provisions, General and Special Conditions,
and Special Environmental Conditions.
NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as
follows:
1. TERM:
The Contractor shall begin work on January 1, 2016 and continue work through June 30,
2016, and shall diligently prosecute the work. This Agreement may be renewed annually for one-
year terms commencing July 1, 2016 through June 30, 2017, at the City's sole discretion and subject
to appropriation,for up to five(5) one-year terms (possible total term 5.5 years).
2. SERVICES TO BE PERFORMED:
Contractor agrees, at its own cost and expense, to furnish all labor, tools, equipment,
materials, except as otherwise specified, and to do all work strictly in accordance with the Scope of
Work (see Exhibit A). The General and Special Conditions, Technical Provisions and Special
Environmental Conditions are hereby referred to and expressly made a part hereof with the same
force and effect as if the same were fully incorporated herein.
3. COMPENSATION TO CONTRACTOR:
Contractor shall be compensated for services performed pursuant to this Agreement in the
amount and manner set forth in Contractor's bid, which is attached hereto as Exhibit "A" and
incorporated herein by this reference. Payment will be made in the same manner that claims of a
like character are paid by the City, with checks drawn on the treasury of the City, to be taken from
the fund as indicated in the city's adopted budget.
Contractor Agreement Page 1 of 17
Blackberry Farm Golf Course Maintenance 2016
4. TIME IS OF THE ESSENCE:
Contractor and City agree that time is of the essence regarding the performance of this
Agreement.
5. STANDARD OF CARE:
Contractor 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 Contractor intend that the relationship between them created by this Agreement is
that of an independent contractor. The manner and means of conducting the work are under the
control of Contractor, 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 Contractor'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 Contractor, 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 Contractor. Payments of the
above items,if required, are the responsibility of Contractor.
7. IMMIGRATION REFORM AND CONTROL ACT (IRCA):
Contractor assumes any and all responsibility for verifying the identity and employment
authorization of all of its employees performing work hereunder, pursuant to all applicable IRCA
or other federal or state rules and regulations. Contractor shall indemnify and hold City harmless
from and against any loss, damage, liability, costs or expenses arising from any noncompliance of
this provision by Contractor.
8. NON-DISCRIMINATION:
Consistent with City's policy that harassment and discrimination are unacceptable
employer/employee conduct, Contractor agrees that harassment or discrimination directed toward
a job applicant, a City employee, or a citizen by Contractor or Contractor's employee 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. Contractor agrees that any and all violations of
this provision shall constitute a material breach of this Agreement.
9. HOLD HARMLESS:
Contractor shall, to the fullest extent allowed by law,indemnify, defend, and hold harmless
the City and its officers, officials, agents, employees and volunteers against any and all liability,
claims, stop notices, actions, causes of action or demands whatsoever from and against any of them,
including any injury to or death of any person or damage to property or other liability of any
Contractor Agreement Page 2 of 17
Blackberry Farm Golf Course Maintenance 2016
nature, arising out of, pertaining to, or related to the performance of this Agreement by Contractor
or Contractor's employees, officers, officials, agents or independent contractors. Contractor shall
not be obligated under this Agreement to indemnify City to the extent that the damage is caused by
the sole or active negligence or willful misconduct of City, its agents or employees. 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.
Contractor agrees to obtain executed indemnity agreements with provisions identical to
those set forth here in these sections from each and every subcontractor or any other person or
entity involved by, for, with, or on behalf of Contractor in the performance of this agreement. If
Contractor fails to obtain such indemnity obligations from others as required here, Contractor
agrees to be fully responsible according to the terms of this section.
10. INSURANCE:
On or before the commencement of the terms of this Agreement, Contractor 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 paragraph 10A; B, C and D. Such
certificates, which do not limit Contractor's indemnification, shall also contain substantially the
following statement: "Should any of the above insurance covered by this certificate be canceled or
coverage reduced before the expiration date thereof, the insurer affording coverage shall provide
thirty (30) days' advance written notice to the City of Cupertino by certified mail, "Attention: City
Manager."It is agreed that Contractor 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 the City as additional insured shall be submitted with the
insurance certificates. Contractor to complete the attached Document 00530 Insurance Forms.
A. COVERAGE:
Contractor shall maintain the following insurance coverage:
(1) Workers' Compensation:
Statutory coverage as required by the State of California;Employers'Liability
$1,000,000 per occurrence
(2) General Liability:
Commercial general liability coverage in the following minimum limits:
Bodily Injury: $500,000
each occurrence
$1,000,000
aggregate-all other
Property Damage: $500,000 each occurrence
$1,000,000 aggregate
If submitted, combined single limit of$1,000,000 per occurrence;$2,000,000 in
the aggregate will be considered equivalent to the required minimum limits
shown above.
Contractor Agreement Page 3 of 17
Blackberry Farm Golf Course Maintenance 2016
(3) Automotive:
Comprehensive automobile liability coverage in the
following minimum limits:
Bodily injury: $500,000 each occurrence
Property Damage: $500,000 each occurrence
or
Combined Single Limit: $1,000,000 each occurrence
B. SUBROGATION WAIVER:
Contractor agrees that in the event of loss due to any of the perils for which it has agreed to
provide comprehensive general and automotive liability insurance, Contractor shall look solely to
its insurance for recovery. Contractor hereby grants to City, on behalf of any insurer providing
comprehensive general and automotive liability insurance to either Contractor or City with respect
to the services of Contractor herein, a waiver of any right to subrogation which any such insurer of
said Contractor may acquire against City by virtue of the payment of any loss under such
insurance.
C. FAILURE TO SECURE:
If Contractor 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 Contractor's name or as
an agent of the Contractor and shall be compensated by the Contractor 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 worker's compensation
insurance. 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
Contractor. Contractor is advised to consult Contractor's insurance broker to determine adequate
coverage for Contractor.
11. BONDS:
Not applicable.
Contractor Agreement Page 4 of 17
Blackberry Farm Golf Course Maintenance 2016
12. PROHIBITION AGAINST TRANSFERS:
Contractor 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 Contractor 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 Contractor.
The sale, assignment, transfer or other disposition of any of the issued and outstanding
capital stock of Contractor, or of the interest of any general partner or joint venturer or syndicate
member or cotenant,if Contractor is a partnership or joint venture or syndicate or cotenancy, which
shall result in changing the control of Contractor, 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 are listed in Contractor's bid shall be used in the performance of this Agreement.
Requests for additional subcontracting shall be submitted in writing, describing the scope of
work to be subcontracted and the name of the proposed subcontractor. Such request shall set forth
the total price or hourly rates used in preparing estimated costs for the subcontractor's services.
Approval of the subcontractor may,at the option of City,be issued in the form of a Work Order.
In the event that Contractor employs subcontractors, such subcontractors shall be required
to furnish proof of workers' compensation insurance and shall also be required to carry general and
automobile liability insurance in reasonable conformity to the.insurance carried by Contractor. In
addition, any work or services subcontracted hereunder shall be subject to each provision of this
Agreement.
14. PERMITS AND LICENSES:
Contractor, at its sole expense, shall obtain and maintain during the term of this Agreement,
all appropriate permits, certificates and licenses, including a City Business License, that may be
required in connection with the performance of services hereunder.
15. REPORTS:
Each and every report, draft, work product, map, record and other document reproduced,
prepared or caused to be prepared by Contractor pursuant to or in connection with this Agreement
shall be the exclusive property of City. Consultant may retain a copy of any report furnished to the
City pursuant to this Agreement.
No report, information nor other data given to or prepared or assembled by Contractor
pursuant to this Agreement shall be made available to any individual or organization by Contractor
without prior approval by City.
Contractor shall, at such time and in such form as City may require, furnish reports
concerning the status of services required under this Agreement.
Contractor Agreement Page 5 of 17
Blackberry Farm Golf Course Maintenance 2016
16. RECORDS:
Contractor 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.
Contractor 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. Contractor
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 of 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 other
breach of contract or failure to act in good faith, then Contractor 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 Contractor to City shall be addressed to
City at:
City of Cupertino
10300 Torre Avenue
Cupertino CA 95014
Attention: Carol Atwood,Director of Recreation and Community Services
All notices, demands, requests, or approvals from City to Contractor shall be addressed to
Contractor at:
Professional Turf Management
P.O.Box 700142
San Jose, CA 95170
Attention:Michael Basile,President
Contractor Agreement Page 6 of 17
Blackberry Farm Golf Course Maintenance 2016
18. URBAN RUNOFF MANAGEMENT:
The Contractor shall avoid creating excess dust when breaking asphalt or concrete and
during excavation and grading or other activities that may create dust or erosion. If water is used
for dust control, contractor shall use as little as necessary. Contractor shall take all steps necessary
to keep wash water out of the streets, gutters and storm drains.
The Contractor shall develop and implement erosion and sediment control to prevent
pollution of storm drains. Such control includes but is not limited to:
A. Use storm drain inlet protection devices such as sand bag barriers, filter fabric
fences, block and gravel filters. (Block storm drain inlets prior to the start of the rainy season
(October 15), in site de-watering activities and saw-cutting activities shovel or vacuum saw-cut
slurry and remove from the site).
B. Cover exposed piles of soil or construction material with plastic sheeting. All
construction materials must be stored in containers.
C. Sweep and remove all materials from paved surfaces that drain to streets, gutters
and storm drains prior to rain as well as at the end of the each work day. At the completion of the
project, the street shall be washed and the wash water shall be collected and disposed of offsite in
an appropriate location.
D. After breaking old pavement, Contractor shall remove all debris to avoid contact
with rainfall or runoff.
E. Contractor shall maintain a clean work area by removing trash, litter, and debris at
the end of each work day. Contractor shall also clean up any leaks, drips, and other spills as they
occur.
The objective is to ensure that the City and County of Santa Clara County-Wide Clean
Water Program is adequately enforced. These controls should be implemented prior to the start of
construction, up-graded as required, maintained during construction phases to provide adequate
protection, and removed at the end of construction.
These recommendations are intended to be used in conjunction with the State's Best
Management Practices Municipal and Construction Handbooks, local program guidance materials
from municipalities, Section 7.1.01 of the Standard Specifications and any other appropriate
documents on storm water quality controls for construction.
Failure to comply with this program will result in the issuance of noncompliance notices,
citations, project stop orders or fines. The fine for noncompliance of the above program is two
hundred and fifty dollars ($250.00) per occurrence per day. The State under the Federal Clean
Water Act can also impose a fine on the contractor,pursuant to Cal.Water Code '13385.
19. TERMINATION:
In the event Contractor fails or refuses to perform any of the provisions hereof at the time
and in the manner required hereunder, Contractor shall be deemed in default in the performance of
this Agreement. If such default is not cured within a period of two (2) days after receipt by
Contractor 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
Contractor written notice thereof.
City shall have the option, at its sole discretion and without cause, of terminating this
Contractor Agreement Page 7 of 17
Blackberry Farm Golf Course Maintenance 2016
Agreement by giving seven (7) days' prior written notice to Contractor 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.
20. COMPLIANCES:
Contractor shall comply with all state or federal laws and all ordinances,rules and
regulations enacted or issued by City. Specifically,and without limitation, Contractor shall comply
with all state,federal, or local regulation regarding the removal and disposal of hazardous waste.
A. PREVAILING WAGES: To the extent applicable,Contractor shall comply with the
City's Labor Compliance Program and all other requirements set forth in Labor Code section 1770
et seq. Contractor shall pay prevailing wages. Contractor will submit monthly certified payroll
records to the City for all employees and subcontractors in a preapproved format or a City
provided form. Any delay in remitting certified payroll reports to the City upon request from the
City will result in either delay and/or forfeit of outstanding payment to Contractor.
B. WORKING DAY: Contractor shall comply with California Labor Code Section
1810, et seq. which provides that work performed by employees of contractors in excess of 8 hours
per day, and 40 hours during any one week, must be compensated as overtime, at not less than 1 1/2
times the basic rate of pay, to the extent applicable.
C. PAYROLL RECORDS: Contractor shall comply with California Labor Code Section
1776 which requires certified payroll records be maintained with the name, address, social security
number, work classification, straight time and overtime hours worked each day and week, and the
actual per diem.wages paid to each.journeyman, apprentice, worker, or other employee employed
by him or her in connection with this Agreement, to the extent applicable. The Payroll Records
shall be made available for inspection as provided in California Labor Code Section 1776.
D. APPRENTICES: Contractor shall comply with California Labor Code Section 1777.5
regarding apprentices,to the extent applicable.
21. 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.
22. ADVERTISEMENT:
Contractor 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
Contractor Agreement Page 8 of 17
Blackberry Farm Golf Course Maintenance 2016
performed under this Agreement unless prior written approval has been secured from City to do
otherwise.
23. 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.
24. INTEGRATED CONTRACT:
This Agreement consists of this document as well as the following documents, including all
changes, addenda,and modifications thereof which are incorporated herein by reference:
Document 00400,Bid Form
Document 00430,Subcontractors List
Document 00450,Statement of Qualifications
Document 00481,Non-Collusion Affadavit
Document 00482,Bidder Certifications
Document 00530,Insurance Forms
Document 00660,Substitution Request Form
Document 00700, General Conditions
Document 00800, Special Conditions
Document 00820,Special Environmental Conditions
Document 00821,Insurance
Document 00822,Apprenticeship Program
Technical Provisions
Addenda(No. 1 and 2)
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 Contractor.
25. 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.
26. 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.
Contractor Agreement Page 9 of 17
Blackberry Farm Golf Course Maintenance 2016
P.O.No.: 7i01
IN WITNESS WHEREOF, the parties have caused the Agreement to be executed on the day
and year first above written.
CONTRACTOR CITY OF CUPERTINO
Professional Turf Management A Municipal Corporation
By By
/ David Brandt
Name/�r e. � r/ City Manager
Title 64)n e r; &5()C"'?1`
Date/ l Dater/ /�
Address: RECOMMENDED FOR APPROVAL:
P.O. Box 700142
San Jose, CA 95170
By_ ®—
Carol Atwood
Director of Recreation&Community Services
APPROVED AS TO FORM:
By
Col een Winchester,Acting City Attorney
ATTEST: r
Grace Schmidt, City Clerk
Contract Amount: $99,600.00
Account No. : SCvo--(v 3-(01 G
Tom-'70�--
Contractor Agreement Page 10 of 17
Blackberry Farm Golf Course Maintenance 2016
EXHIBIT A
SCOPE OF WORIC
BLACKBERRY FARM GOLF COURSE MAINTENANCE
Work to provide maintenance of Blackberry Farm Golf Course
1. PUTTING GREENS
1.01 SCOPE: Greens shall be maintained disease and weed free. Complete renovation of
any green is not included in this maintenance project.
1.02 MOWING FREQUENCY: Winter—six times per week. Spring/Summer/Fall—six
times per week. Contractor to recycle grass trimmings.
1.03 CHANGING CUPS: Contractor shall change the cup location daily year-round.
Placement is to be at least 8 feet from edge of green on level surface. When
requested,use the 1/3 rule— 1/3 of the pins back, 1/3 pins middle, 1/3 pins up.
1.04 HEIGHT OF CUT: Is to be 0.135 of an inch
1.05 FERTILIZATION: Contractor to collect soil samples yearly to determine
recommended nutrients,rates of application and frequency of application, with the
goal of a sustainable fertility program. Use organic fertilizers, i.e. Earthworks or
approved equivalent. The City shall determine which of the greens are to be tested.
Contractor to use Logan Laboratories or City approved equal for soils testing and
recommendations. All fertilizer shall be applied in accordance with all applicable
laws, codes, specifications and policies and at minimum rates that are consistent with
healthy turf.
1.06 AERIFICATION/TOP DRESS/VERTI-CUTTING: Contractor is to perform
DryJect aerification or equal twice a year in March/April and September/October, and
overseed with Pencross bentgrass in September. Perform a DryJect Maximus
aerification or equal in July. Verti-cut greens monthly during the growing season.
Top-dress with TD320 from TMT enterprises or City approved equal.
1.07 PESTICIDE APPLICATION: All pesticide application shall be completed by a
qualified person in accordance with all applicable laws, codes, specifications and
policies. Greens to be maintained disease and weed free. Apply all chemicals
sparingly. Applications shall be as per EPA regulations. Contractor must possess
SDS (safety data sheets) for all materials. All posting and re-entry requirements must
be followed. Contractor to submit monthly a written report of all pesticide
applications. A recommendation by a licensed Pest Control Advisor(PCA)that is
familiar with Blackberry Farm Golf Course and with its setting and protected natural
resources is required for applications, and a licensed staffer with a current Qualified
Applicator License(QAL) or is a Qualified Applicator Certificate holder(QAC) shall
be on site and provide oversight during applications is required. All work shall
adhere to all laws, regulations and applicable guidelines for all pesticide applications.
Contractor may be required to obtain a Restricted Materials Use Permit and Notice of
Intent prior to any applications.
1.08 PROTECTION OF CREEK AND PONDS: No runoff from fertilizer,pesticide or
chemical applications shall flow into creeks or ponds nor to drainage inlets that
discharge to creeks or ponds.
Contractor Agreement Page 11 of 17
Blackberry Farm Golf Course Maintenance 2016
i
1.09 INTERSEEDING: Contractor shall interseed greens with City approved mix of
creeping bentgrass two times per year, in the spring and fall at a rate of 2 lbs.per
1,000 sq. feet unless otherwise directed.
2. COLLAR MAINTENANCE
2.01 MOWING FREQUENCY: Twice weekly in spring/summer/fall and once a week in
winter.
2.02 HEIGHT OF CUT: to be %2 inch all year
2.03 FERTILIZATION: to be fertilized the same as greens
2.04 WEED CONTROL: to be applied the same as greens
3. TEE MAINTENANCE
3.01 MOWING FREQUENCY: Two to three times per week in spring/summer/fall and
one to two times a week in winter.
3.02 HEIGHT OF CUT: to be 1/2 inch all year
3.03 FERTILIZATION: Contractor to collect at least one soil sample yearly to
determine the recommended complete fertilizer to use. Contractor to use Logan
Laboratories or City approved equal for soils testing and recommendations. Fertilizer
to be applied four times a year in March, May, late August and October. The
application rate shall be at the manufacturer's recommended rate. All fertilizer shall
be applied in accordance with all applicable laws, codes, specification and policies
and at minimum rates consistent with healthy turf. Special care shall be taken to
prevent fertilizer or fertilizer-containing runoff from getting into creek areas or ponds.
3.04 AERIFICATION: Contractor to aerate four times per year in May and October and
as needed.
3.05 OVERSEEDING: Contractor to overseed four times per year with perennial rye
grass, at 8 lbs.per 1,000 sq. feet unless otherwise directed. Contractor to use
seeder/slicer(verti-cutting)unit.
3.06 TEE MARKERS: Contractor shall move and rotate daily. Keep 10 feet apart and 8
feet from back of tee(except where markers do not allow).
3.07 PERMANENT YARDAGE MARKERS: Contractor to keep visible at all times.
3.08 WEED CONTROL: Contractor to apply two broadleaf weed control in the spring
and fall. Broadleaf weed control is for,but not limited to, English Daisy, clover,
spurge and chickweed. Contractor to apply one Crabgrass control in spring. All
weed controls shall be applied in accordance with all applicable laws, codes,
specification and policies.
3.09 PROTECTION OF CREEK AND PONDS: No runoff from fertilizer,pesticide or
chemical applications shall flow into creek areas or ponds nor to drain inlets that
discharge to creek areas or ponds.
3.10 SEED AND TOPSOIL TEES: Contractor to place seeds and sand/organic compost
mix on tees daily to repair divots.
Contractor Agreement Page 12 of 17
Blackberry Farm Golf Course Maintenance 2016
4. FAIRWAY MAINTENANCE
4.01 MOWING FREQUENCY: two to three times per week in growing season, and
one to two times per week in winter
4.02 HEIGHT OF CUT: 3/ inch all year
4.03 FERTILIZATION: Contractor to collect one soil sample yearly to determine the
recommended complete fertilizer to use. Contractor to use Logan Laboratories or
City approved equal for soils testing and recommendations. Fertilizer to be applied
four times a year in March, May, late August and October. The application rate shall
be at the manufacturer's recommended rate. All fertilizer shall be applied in
accordance with all applicable laws, codes, specifications and policies and at
minimum rates consistent with healthy turf.
4.04 AERIFICATION: VERTI-CUTTING: Contractor to aerate, verti-cut once per
year in April/May.
4.05 OVERSEEDING: Contractor shall overseed with Perennial Rye one time per year,
8 lbs. per 1,000 sq. feet unless otherwise directed. Use seeder/slicer for distribution.
Perform spot-overseeding as needed with Perennial Rye.
4.06 WEED CONTROL: Contractor to apply broadleaf weed control twice per year, in
the spring and fall. Broadleaf weed control is for,but not limited to, English Daisy,
clover, spurge and chickweed. Contractor to apply one Crabgrass control in spring.
All weed controls shall be applied in accordance with all applicable laws, codes,
specification and policies.
4.07 PROTECTION OF CREEK AND PONDS: No runoff from chemical applications
shall flow into creek areas or ponds. Contractor shall cover the drain inlets and
drainage structures that discharge to the creek for one week after the application of
any chemicals.
5. ROUGH MAINTENANCE
5.01 MOWING FREQUENCY: twice per week all year
5.02 HEIGHT OF CUT: 1 to 1 %2 inches all year
5.03 FERTILIZATION:Same as Fairway Maintenance
5.04 AERIFICATION: Same as Fairway Maintenance
5.05 WEED CONTROL:Contractor to apply two broadleaf weed control in the spring
and fall. Broadleaf weed control is for,but not limited to, English Daisy, clover,
spurge and checkweed. Contractor to apply one Crabgrass control in spring. All
weed controls shall be applied in accordance with all applicable, laws, codes,
specification and policies.
5.06 PROTECTION OF CREEK AND PONDS:No runoff from chemical applications
shall flow into creeks or ponds.
7. EQUIPMENT AND EQUIPMENT STORAGE
7.01 GREEN EQUIPMENT: The City encourages the Contractor to use
Environmentally Friendly or Green equipment and supplies for this contract.
Contractor Agreement Page 13 of 17
Blackberry Farm Golf Course Maintenance 2016
i
7.02 SCOPE: All mowing equipment shall be on a regular preventive maintenance
schedule for hydraulic and oil lines so as to minimize damage to turf and protect the
creek and wildlife habitat from leaks. Hydraulic hoses shall be changed off site every
six months.
7.03 GREENS: Mowing equipment shall be 9 or more bladed,reel-type mower with a
frequency of cut at a minimum of.25 at 3.6 mph.
7.04 TEES: Mowing equipment shall be 7 or more bladed,reel-type mower with a
frequency of cut at a minimum of.53 at 4.2 mph.
7.05 FAIRWAYS: Mowing equipment shall be 6 or more bladed, reel-type mower with a
frequency of cut at a minimum of.67 at 5.0 mph.
10. PARKING LOT AT GOLF COURSE ENTRANCE
10.01 SWEEPING: Contractor shall sweep monthly. Manually using a blower is
acceptable during the hours of 7:00 am to 8:00 pm on week days and 9:00 am to 6:00
pm on weekend, and in accordance with the City's noise ordinance.
10.02 LOOSE TRASH AND GARBAGE CANS: Contractor shall pick up trash and
check area daily.
10.03 BROKEN GLASS/BOTTLES: Contractor shall pick up and dispose of broken
glass or similar potentially harmful materials immediately.
11. CLUBHOUSE &MAINTENANCE BUILDING
11.01 REST ROOMS AT MAINTENANCE BUILDING: Public restrooms for golfers
exist on the golf-facing side of the golf maintenance building. The public rest rooms
will be cleaned and maintained by the City or City's designee.
11.02 PATIO: Contractor shall sweep daily.
11.03 RECYCLED CARDBOARD CONTAINERS: Shall be emptied at least once per
week.
12. ENTRY AREA/CLUBHOUSE GROUNDS
12.01 FLOWER BEDS: Contractor shall weed,mulch,water and replenish as needed.
12.02 TRASH: Contractor shall pick up daily.
12.03 FOOT BRUSHES: Contractor shall clean and check weekly and replace when
worn.
12.04 WALKWAYS: Contractor shall sweep daily when weather permits.
12.05 TRASH AND CIGARETTE CANS: Contractor shall empty cans daily and comply
with City's recycling standards.
12.06 LEAKS FROM GOLF CARTS: Contractor shall clean immediately.
12.07 LANDSCAPE SHRUBBERY: Contractor shall trim monthly and as needed.
12.08 ANNUAL PLANTINGS: Contractor shall remove and re-plant minimum 2 times
per year the two planter boxes located at the clubhouse. The planter box on number
one tee measuring roughly 4.5 ft. by 35.5 ft. (160 S.F.) and the planter box to the left
Contractor Agreement Page 14 of 17
Blackberry Farm Golf Course Maintenance 2016
of the building along the restroom walkway measuring roughly 8 ft. by 34 ft. (272
S.F.).
12.09 DRIVING RANGE: Contractor shall cut grass weekly and fertilize and aerate the
same as fairways.
12.10 WEED CONTROL(NON-SELECTIVE): Contractor shall use mechanical method
of trimming or removing undesirable vegetation in tree wells,perimeter and interior
fence lines,barriers, railroad ties, delineators, and along edges of golf play areas that
are along the creek or associated native planting areas.
12.11 LITTER: Contractor shall remove daily.
12.12 TRASH AND DEBRIS (FROM MAINTENANCE): Contractor shall remove as it
occurs and dispose of it in a safe and legal manner.
12.13 SOIL,WATER SAMPLES: Contractor shall take samples annually or more often
if unusual growth habits develop.
12.14 RODENT CONTROL: Contractor shall begin immediate eradication action
following local, state and federal guidelines when gopher or ground squirrel activity
occurs. Contractor is not allowed to use rodenticides nor any chemicals to control
rodents. Acceptable methods may include carbon dioxide use, trapping, exclusion, or
burrow sealing/removal, or using other techniques as acceptable to City.
12.15 SAND TRAPS: Complete renovation of any sand trap is not included in this
maintenance project. Contractor shall rake daily. Contractor shall keep sand at 4
inches in depth minimum and keep clean of all weeds. When using power rake, stay
about one foot from edge of trap. When hand-raking edge of trap,put sand inward on
low side and pull outward on high side. Contractor to edge traps monthly and as
needed. Do not drag sand out of trap when exiting trap with power rake.
12.16 TREES: Any tree removal or tree replacement must be approved by the City and
any expenditures incurred will be outside the standard scope of work. Contractor
shall keep all trees trimmed at least 6 feet from the ground to prevent damage to golf
cart tops and maintenance equipment, except for trees and shrubs along the creek
which shall only be trimmed as acceptable to the City Naturalist. Contractor shall
maintain trees in a safe,healthy, and aesthetically pleasing condition at all times.
Contractor shall mow,weed and/or mulch tree wells as needed. Contractors shall
immediately remove any broken tree limbs. Downed brush shall be removed as soon
as possible. All trimmings or debris shall be removed from the course,unless they
are chipped, and used for mulch on site. Contractor shall not be responsible for
removal of dead or fallen trees; such removal shall be at the City's expense unless it
is determined that the condition was caused by the Contractor's negligence.
12,17 USGA GREEN SECTION VISIT: Contractor shall have a USGA staff agronomist
visit the course yearly on the following schedule: first year in the spring, second year
in the summer,third year in the fall, no winter visits. Contractor shall act on all
appropriate recommendations that result from these visits.
12.18 LEAF PICKUP: Contractor shall remove leaves daily or as necessary.
12.19 VANDALISM/GRAFFITI: Contractor shall correct vandalism immediately and
remove graffiti within 24 hours.
Contractor Agreement Page 15 of 17
Blackberry Farm Golf Course Maintenance 2016
I
14. OTHER AREAS
14.01 TEE MARKERS: Contractor shall have two sets each hole. Missing or broken
markers shall be replaced immediately.
14.02 BENCHES/TEE SIGNS: Contractor shall immediately remove any damaged bench,
and notify supervisor so that City can replace it. Any damaged tee sign shall be
removed as soon as possible, and notify supervisor so that City can replace it.
14.03 YARD MARKERS: Contractor shall replace as needed any yard markers.
14.04 GREENS FLAGS, POLE, CUPS: Contractor shall replace flags, poles and cups
when they are discolored, frayed or damaged in any way.
14.05 BALL WASHERS: Contractor shall check for water/soap daily. Contractor shall
replace tee towels monthly or more often if towel is frayed, discolored, or
aesthetically unpleasing.
14.06 SAND TRAP RAKES: Contractor shall keep two rakes per trap or more as needed,
and replace any missing or broken rake immediately.
14.07 OUT-OF-BOUNDS/HAZARD STAKES: Contractor shall replace white our-of-
bounds stakes immediately if missing or broken.
14.08 OVERSEEDING: Contractor shall spot-overseed with Perennial Rye when needed.
14.09 PONDS: Contractor shall keep the ponds free from algae and excessive growth of
plant material.
14.10 BRIDGE: Contractor shall inspect bridge daily for safe conditions and repair
structures immediately when necessary.
14.11 FOOT GOLF: Contractor shall maintain 9 hole foot golf course,with all tee
markers, holes, cups, flagpoles, and flags. Edging around the cups shall be done
weekly.
15. IRRIGATION
15.01 SCOPE: Irrigation system shall be maintained in a manner to provide proper
watering. Any major irrigation system repairs or improvements are not included in
this maintenance project.
15.02 MAINTENANCE: Contractor shall maintain system, including lateral lines,
sprinkler heads, and controllers in good operating repair, functioning properly, and
conforming to related laws, codes and regulations. No valves or water main repairs
are included in this maintenance project. Contractor shall notify the City immediately
when valve or water main repairs are necessary for proper operation.
15.03 FREQUENCY: Contractor is to irrigate as required to maintain adequate moisture
for growth rate and appearance. Contractor is to hand-water as needed any and all
portions of the course that do not receive adequate water from the irrigation system.
15.04 TESTING FOR ADEQUATE SOIL MOISTURE: Contractor shall determine by
visual observation,plant resiliency,turgidity, examining cores removed by soil probe,
and moisture sensor devices.
15.05 WATER CONSERVATION: Irrigation controllers shall be programmed to
maintain course appearance and health of vegetation while maximizing water
conservation.
Contractor Agreement Page 16 of 17
Blackberry Farm Golf Course Maintenance 2016
15.06 WIND PROBLEMS: In areas where wind creates problems of spraying onto private
property or road rights of way, operation shall occur during period of lowest wind
velocity.
15.07 MONITORING: Contractor shall make corrections for coverage, adjustment,
clogging of lines, and removal of obstacles, tilting of heads, and management of
plant materials that obstruct the spray as they occur.
15.08 SYSTEM CHECK: Contractor shall check the system daily during months of
operation.
15.09 PUMPING PLANT: Pumping plant shall be maintained the City.
15.10 WATER COST: Water costs shall be paid for by the City.
Contractor Agreement Page 17 of 17
Blackberry Farm Golf Course Maintenance 2016
DOCUMENT 00530
INSURANCE FORMS
INSURANCE FORMS INSTRUCTIONS
FOR ITEMS 3, 4 AND 5, THE FORMS PROVIDED BY THE CITY OF CUPERTINO
MUST BE USED. FORMS OTHER THAN THESE WILL NOT BE ACCEPTED.
ALL DOCUMENTS MUST BE ORIGINALS -SUBMIT IN TRIPLICATE
1. Insurance Agreement -Must be signed by Contractor.
2. Certificate of Insurance to the City of Cupertino - must be completed by the insurance
agent or must provide a certificate on the company's form. They must contain the same
information.
3. Endorsement of Additional Insured and Primary Insurance and Notice of Cancellation - must be
signed by the insurance agent for general liability and automobile liability only.
4. Comprehensive general liability/commercial general liability endorsement of aggregate limits of
insurance per project- must be signed by the insurance agent for general liability only.
5. Waiver of subrogation endorsement worker's compensation insurance - must be signed by the
insurance agent for worker's compensation only.
City of Cupertino 00530-1 Insurance Forms
Blackberry Farm Golf Course Maintenance 2016
i
CITY OF
CUPERTINO
INSURANCE AGREEMENT
A. Contractor is aware of the provisions of Section 3700 of the Labor Code, which requires
every employer to be insured against liability for worker's compensation or undertake self-
insurance in accordance with the provisions of that Code, and will comply with such provisions
before commencing the performance of the work of this Contract.
B. Contractor and all subcontractors will carry worker's compensation insurance for the
protection of its employees during the progress of the work. The insurer shall waive its rights of
subrogation against the City, the City's officers, agents and employees and shall issue an
endorsement to the policy evidencing same.
C. Contractor shall carry at all times, on all operations hereunder, commercial general liability
insurance, and automobile liability insurance. All insurance coverage shall be in amounts required
by the City and shall be evidenced by the issuance of a certificate in a form prescribed by the City
and shall be underwritten by insurance companies satisfactory to the City for all operations, sub-
contract work, contractual obligations, product or completed operations, all owned vehicles and
non-owned vehicles. Said insurance coverage obtained by the Contractor, excepting worker's
compensation coverage, shall name the City, its engineer, and each of its directors, officers, agents
and employees, as determined by the City, as additional insureds on said policies. Insurers must be
licensed to do business in the State of California. The Insurers must also have an "A"
policyholder's rating and a financial rating of at least Class VII in accordance with the current
Best's Guide Rating or that is otherwise acceptable to the City.
D. Before Contractor performs any work at, or prepares or delivers materials to, the site of
construction, Contractor shall furnish certificates of insurance evidencing the foregoing insurance
coverages and such certificates shall provide the name and policy number of each carrier and policy
and that the insurance is in force and will not be canceled or modified without thirty (30) days
written notice to the City. Contractor shall maintain all of the foregoing insurance coverages in
force until the work under this Contract is fully completed. The requirement for carrying the
foregoing insurance shall not derogate from the provisions for indemnification of the City by
Contractor under this Contract and for the duration of the warranty period. Notwithstanding nor
diminishing the obligations of Contractor with respect to the foregoing, Contractor shall maintain in
full force and effect during the life of this Contract,the following insurance in amounts not less than
the amounts specified and having a Best's Guide Rating of A, Class VII or better or that is
otherwise acceptable to the City.
City of Cupertino 00530-2 Insurance Forms
Blackberry Farm Golf Course Maintenance 2016
LIMITS
Worker's Compensation In accordance with the Worker's Compensation
&Employers' Liability Act of the State of California—Worker's comp
"statutory"per CA Law;Employers' Liability
$1,000,000 per occurrence.
General Liability- commercial general liability; Combined single limit of$1.0 million per
including provisions for contractual liability, occurrence; $2.0 million in the aggregate
personal injury, independent contractors and
products-completed operations hazard.
Automobile Liability- comprehensive covering Combined single limit of$1.0 million per
owned,non-owned and hired automobiles. occurrence.
b19,ro41,55tV',tcr i / ,r-1//,,ageme4 By:_AZZ 41111eaae,Z_
(Contractor's Name) -
City of Cupertino 00530-3 Insurance Forms
Blackberry Farm Golf Course Maintenance 2016
CITY OF
CUPERTINO
CERTIFICATE OF INSURANCE TO THE CITY OF CUPERTINO
This certifies to the City of Cupertino that the following described policies have been issued to the
insured named below and are in force at this time.
Insured:
Address:
Description of operations/locations/products insured(show contract name and/or number, if any):
---------------------------------------------------------------------
---------------------------------------------------------------------
WORKER'S COMPENSATION * Statutory Min.
* Employer's
Liability
(name of insurer)
Insurance Company's State License No.
-------------------------------------------------------------------
-------------------------------------------------------------------
Check Policy Type: Each Occurrence $
COMPREHENSIVE GENERAL
LIABILITY
[ ] Premises/Operations - General Aggregate $
(if applicable)
[ ] Owners& Contractors
Protective Aggregate $
[ ] Contractual for Specific
Contract Personal Injury $
[ ] Products Liability
[ ] XCU Hazards
[ ] Broad Form P.D. Fire Damage (any one fire) $
[ ] Severability of Interest
Clause
[ ] Personal Injury with Medical Expense $
Employee Exclusion Removed (any one person)
or Self-Insured
COMMERCIAL GENERAL LIABILITY Retention $
(name of insurer)
Policy No. Expiration Date
City of Cupertino 00530-4 Insurance Forms
Blackberry Farm Golf Course Maintenance 2016
CITY OF
I.[a
CUPERTINO INSURANCE AGREEMENT
A. Contractor is aware of the provisions of Section 3700 of the Labor Code, which requires every employer
to be insured against liability for worker's compensation or undertake self-insurance in accordance with the
provisions of that Code,and will comply with such provisions before commencing the performance of the work of
this Contract.
B. . Contractor and all subcontractors will carry worker's compensation insurance for the protection of its
employees during the progress of the work. The insurer shall waive its rights of subrogation against the City,the
City's officers,agents and employees and shall issue an endorsement to the policy evidencing same.
C. Contractor shall carry at all times, on all operations hereunder, commercial general liability insurance,
and automobile liability insurance. All insurance coverage shall be in amounts required by the City and shall be
evidenced by the issuance of a certificate in a form prescribed by the City and shall be underwritten by insurance
companies satisfactory to the City for all operations, sub-contract work, contractual obligations, product or
completed operations, all owned vehicles and non-owned vehicles. Said insurance coverage obtained by the
Contractor,excepting worker's compensation coverage,shall name the City,its engineer,and each of its directors,
officers,agents and employees, as determined by the City, as additional insureds on said policies. Insurers must
be licensed to do business in the State of California. The Insurers must also have an"A"policyholder's rating and
a financial rating of at least Class VII in accordance with the current Best's Guide Rating or that is otherwise
acceptable to the City.
D. Before Contractor performs any work at, or prepares or delivers materials to, the site of construction,
Contractor shall furnish certificates of insurance evidencing the foregoing insurance coverages and such
certificates shall provide the name and policy number of each carrier and policy and that the insurance is in force
and will not be canceled or modified without thirty(30)days written notice to the City. Contractor shall maintain
all of the foregoing insurance coverages in force until the work under this Contract is fully completed. The
requirement for carrying the foregoing insurance shall not derogate from the provisions for indemnification of the
City by Contractor under this Contract and for the duration of the warranty period. Notwithstanding nor
diminishing the obligations of Contractor with respect to the foregoing,Contractor shall maintain in full force and
effect during the life of this Contract,the following insurance in amounts not less than the amounts specified and
having a Best's Guide Rating of A,Class VII or better or that is otherwise acceptable to the City.
LIMITS
Worker's Compensation In accordance with the Worker's Compensation
&Employers' Liability Act of the State of California—Worker's comp
"statutory"per CA Law;Employers' Liability
$1,000,000 per occurrence.
General Liability'-commercial general liability; Combined single limit of$1.0 million per occurrence;
including provisions for contractual liability,personal $2.0 million in the aggregate
injury,independent contractors and products—
completed operations hazard.
Automobile Liability-comprehensive covering owned, Combined single limit of$1.0 million per occurrence.
non-owned and hired automobiles.
C
ew
aPIg 6 t'sxtvld By: i
(Contractor's Name)
Dated: 20/6--
City of Cupertino 00530-2 Insurance Forms
Blackberry Farm Golf Course Maintenance 2016
P.
CITY Or-
CUPERTINO
CERTIFICATE OF INSURANCE TO THE CITY OF CUPEETINO
This certifies to the City of Cupertino that the following described policies have beets issued to the
insured named below and are in force at this time.
Insured: JD�'L' ldnGl tY� 1`hl1Hfif�l�`GI'
Address:
.5/ 7
Description of operations/locations/products insur d (show contract name and/or number, if any):
6 (1-(ik b f1y-y\,1 k-r-m �c l ou� � Vila 4 a
WORKER'S COMYE%TiON *Statutory Min.
j� (�i7C1�q +? <s<d rIC * Employer's
At��,l�c.�G/)111o,OV a vs ► S. Liability
(name of insurer) 6lao No
Insurance Company's State License No. Ay5 3 81
Check Policy Type: Each Occurrence_.____.�___�.$
COMPREHENSIVE GENERAL
Premises/Operations General Aggregate $ e0o,6160
(if applicable)
] Owners & Contractors
Protective Aggregate $
[ ] Contractual for Specific
Contract Personal Injury $ 11.000_1__e)L70
] Products Liability
] XCU Hazards
[ ] Broad Form I'_D, Hire Damage (any one tire) $ .(�0, 00C�
[ ] Severability of Interest
Clause
Personal Injury with Medical Expense $ d0
Employee Exclusion Removed (any one person)
or Self-Insured
CON1 MERCIAL GENERAL LIABILITY Retention
___. (name of insurer)policy No.�So� `71G 7 Expiration Date
City of Cupertilto 00530-3 Insurance Forms
Slaokberry Pam Coif Course Maintenance 2016
I
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CITY OF
ADDITIONAL INSURED ENDORSEMENT
and
CUR` INO ENDORSEMENT OF PI2 MARY INSURANCE
and
NOTICE OF POLICY CANCELLATION ENJDORSEiY ENT
Project Title and Number:�R/ar
In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this
Endorsement is attached or any other Endorsement attached thereto, it is agreed as follows:
The City of Cupertino("City")and its directors,officers,engineers,agents and employees,and all public
agencies from whom permits will be obtained and their directors, officers, engineers,agents acid employees, and
the State of California,and its officers,agents and employees,are:Hereby declared to be additional insureds under
the terms of this policy,but only with respect to the operations of the Contractor at or upon any of the premises of
the City in connection with the Contract with the City, or acts or omissions of the additional insureds in
connection with,but limited to its general supervision or inspection of said operations.
The insurance afforded by this policy is primary insurance,and no additional insurance held or owned by
the designated additional insured(s)shall be called upon to cover a loss under said additional policy.
Cancellation Notice. The insurance afforded by this policy shall not be suspended, voided, canceled,
reduced in coverage or in limits, or materially altered, except after thirty (30) days' prior written notice by
certified mail, return receipt requested, has been ,given to the City of Cupertino ("City"). Such notice shall be
addressed to the City as indicated below.
POLICY INFORMATION
1. insurance Company: 560q-561e, t;,6 CM
7
2. Insurance Policy Number:
13. Effective Date of this Endorsement: i , j 20�
4. Insured:
Ali notices herein provided to be given by the Insurance Company to the City in connection with this policy
and these Endorsoments,shall be mailed to or delivered to the City at 10300`Torre Avenue; Cupertino, California
95014,
I, (print/type name)
warrant that I hav 1 t' o d e below ed Insurance Company and by arty signature hereon do so bind
this Company,
Signature of Authorized Representative:_ { '
(Original signature required on all Endorsemen s furnislwV M the District)
Names of ,,JJ
Agent/Agency:W�Vgsp l',ff 6;W11 J4e5 Title:—_640 LAY
Address: 6 14,5#0 �'!�
1rr r�d11'l�r ° J Facsimile: al,5 d Y3 e13d-
City of Cupertino 00530-S Insurance Foilns
Blackberry Farm Golf Course Maintenance 2016
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* CITY OF
IRI COMPREHENSIVE GENERAL LIABILITY
COMMERCIAL GENES{AL LIABILITY
ENDORSEMENT OF AGGREGATE LIMIT'S OF
CUPER"CINO INSURANCE PER PROJECT
Project Title and Number: &ac kL'e,
In consideration of the policy preiniutn and notwithstanding any inconsistent statement in the policy
to Which this Endorsement is attached or any other Endorsement attached thereto, it is as follows:
This Endorsement modifies the insurance provided under the General Liability Coverage part of the
below-referenced policy of insurance_
The general aggregate limit under LIMITS OF INSURANCE applies separately to the project
described as
POLICY JNFORMATION
1. Insurance Company:
2. Insurance Policy Number: (� P s of IMi g 7
3. Effective Date of this Endorsement- k 20_L6
4. 1llsured: f y^04�5-51 U✓l(, b Tlir--( r la mageol ey)-f-
5. Additional insured: City of Cupertino, its directors,officers, agents and employees.
All notices herein provided to be given by the Insurance Company to the City in connection with
this policy and this Endorsement, shall be mailed to or delivered to the City at 10300 Torre Avenue;
Cupertino, California
alifornia 95014. ! ,/
1, k-t I/L/ V 0 t ' f' 11 (print/type name)
warrant that I have authority to bind the below listed Insurance Company and by my signature hereon do
so bind this Company. '
Signature of Authorized Representative:
(Original signature required on all Endorsement furni-A&W the District)
Names of y�
Agent/Agency: U0�� ,_t"nSrf lai?L' , rV1C� Title:^ /7Iw -
Address: 5/1 G /S 41 r"e S IV ee—t" Telephone: qA5 03 3�
Gil yey/W 6y(' r (-a Facsimile: qAJ ,i D/ '
VOLPA►` 'TI INSURANCE
SERVICES INC.
511 LEISURE STREET
LIVERMOW CA 94551
City of Cuperthlo 00530-6 Insurance Forms
131ao1,bcrry Farm Golf Course Maintenance 2016
I
COMMERCIAL GENERAL LIABILITY
CG 20 33 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWN.ERS, LESSEES OR
CONTRACTORS - AUTOMATIC STATUS WHEN
REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU
This endorsement modifies insurance provided under the following*
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section 11 - Who Is An Insured Is amended to B. With respect to the insurance afforded to these ad-
include as an additional Insured any person or or- ditional Insureds, the following additional exclu-
ganization for whom you are performing opera- sions apply:
tions when you and such per-son or organization This insurance does not apply to:
have agreed In writing in a contract or agreement
that such person or organization be added as an- I• "Bodily injury","property damage"or"personal
additional insured on your policy. Such person or and advertising Injury" arising out of the ren-
organization is an additional insured only with re-- dering of, or the failure to render, any profes-
spect to liability for "bodily injury", "property dam- slonal architectural, engineering or surveying
age"or"personal and advertising injury"Caused,In services, including;
whole or in part,by: a. The preparing, approving, or failing to
1. Your acts or omissions;or prepare or approve, rnaps, shop draw-
ings, opinions, reports, surveys, field or-
2. The acts or omissions of those acting on your ders, change orders or drawings and
behalf, specifications;or
in the performance of your ongoing operations for h. Supervisory, inspection, architectural or
(lie additional Insured, engineering activities.
However,the Insurance afforded to such additional This exclusion applies even if the claims against
insured: any Insured allege negligence or other wrongdoing
1. Only applies to the extent permitted by law; in the supervision, hiring, employment, training or,
and monitoring of others by that Insured, if the "occur_
2. Will not be broader than that which You are re- rence" which caused the "bodily injury" or "prop-
quired by the contract or agreement to provide erty damage", or the offense which caused the
for such additional insured. "personal and advertising injury", involved the ren-
dering of or the failure to render any professional
A person's or organization's status as an addi- architectural,engineering or surveying services.
tional Insured under this endorsement ends when
your operations for that additional Insured are
completed.
CG 20 33 04 13 Copyright, Insurance Services Office, Inc.,2012 Page I of 2
TNSURED
2. "Bodily injury"or"property damage"occurring C. With respect to the insurance afforded to these
after: additional Insureds, the following is added to Sec-
a. All work, including materials, parts or tion III-Limits Of Insurance:
equipment furnished in connection with The most we will pay on behalf of the additional In-
such work,on the project(other than serv- sured is the amount of insurance:
ice, maintenance or repairs) to be per- I. Required by the contract or agreement you
formed by or on behalf of the additional have entered into with the additional insured;
insured(s) at the location of the covered or
operations has been completed;or
2. Available under the applicable Limits of Insur
� b. That portion of "your work" out of which anae shown in the Declarations;
the injury or damage arises has been put
to Its intended use by any person or or- whichever is less.
ganization other than another contractor This endorsement shall not increase the applicable
or subcontractor engaged in performing Limits of Insurance shown In the Declarations.
operations for a principal as a part of the
same project.
I
Page 2 of 2 Copyright, Insurance Services Office, Inc.,2012 CG 20 33 04 13
+ 0 DATE(MIND D/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 12/18/201.5
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 hl lieu of such endorsement(s).
PRODUCER
NAME:
VOLPATTI INSURANCE SERVICES INC PHONE FAX Ext: (925)243-0t Arc No:(925)243-0132
511 Leisure Street ADDRI�ss:rick@volpatta .com
Livermore, CAp94551
License#:OE40809 INSURER(S) AFFORDWO COVERAGE HAICM
INSURERA:Scottsdale Insurance Company 41297
INSURED Rep zo Underwriters Insurance Company 24538
Professional Turd Management, Inc. INSURER B:
INSURER C:Cali orzria Capital Insurance Company 13544
PO Box 700142 INSURERD:
San Jose, CA 95170 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.
INSR ADDL SUER POUCY EFF P L C EXP
LrR TYPE OF INSURANCE INSR 1'!VD POLICY NUMBER A4PA/DD IAP.'I/DDIYYYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
x COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000
CLAIMS-MADE I "-1 OCCUR MED EXP(Any one person) $ 5,000
A y CPS2189797 04/01/2015 04/01/2016 PERSONAL&ADVINJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COIAP/OP AGG $ 2,000,000
1 POLICY R PE 0 LOC $
AUTOMOBILE LIABILITY Ea accident)SINGLE LIMIT
$
ANYAUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per accidenl) $
AUTOS AUTOS
NON-OWNED PROP RTY DAA GE $
HIRED AUTOS AUTOS Peraccident
! UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LPABH CLAIMS-MADE AGGREGATE $
DED I I RETENTIONS S
WORKERS COMPENSATION X WCSTATU- 07H-
AND EMPLOYERS'LIABILITY Y/NTORY LIPAITSI ER _
g ANY OFF1C P,i�E+IFTO�ABERPAR NEReLUDED ECUTM — NIA E.L.EACH ACCIDENT- $ 1,000,000
(6londato7inNN) ATW 004386-01. 04/01/15 04/01/16 E DISEASE-EAEMPLOYE $ 1,000,000
beuMer
DE$CRIPTI ON OF OPERATIONS bettry E.L.1 00
Commercial Inland Contractors Equip.
C Marine 3--MIA-1--026769 6/23/2015 6/23/201(5 $213,275
Deductible $500
DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (Attach ACORD got,Add-Monat Remarks Schedule,if more space Is required])
The City of Cupertino, its directors, officers, agents, consultants and employees are named as
additional insured in regard to General Liability and Primary/Pion-Contributory wording is
attached to this policy. Waiver of Subrogation in regard to workers compensation in favor of
City of Cupertino.
The issuing insurer will endeavor to mail 30 days written notice of cancellation,
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Cupertino THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
10300 Torre Avenue ACCORDANCE WITH THE POLICY PROVISIONS.
Cupertino, CA 95014 J
AUTHORIZED EPRESENTATIVE � A l
O 1988-'A O CORD CORPORATION. All r1ghts reserved.
ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD
I
I
Dec 141E 05:58p
p.2
C D VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE DATE(MMIDDNYYY)
lk. 11211412015
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 INSURERIS), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND TIME CERTIFICATE HOLDER.
This form is used to report coverages provided to a single specific vehicle or equipment,Do not use this form to report liability coverage
provided to multiple vehicles under a single policy,Use ACORD 25 for that purpose.
PRODUCER CONTACT
NAMF- Elena Rivera
5tateili rm JOE FRANGIEH ON . x40793-8303 -793-8304NC a Et:
120 W CAMPBELL AVE STE A ADMDRESS: alana.rivera.fhvp@statefarrn.Corn
CAMPBELL,CA 96008 PRODUCER
CUSTOMER ID9:
INSURER(S)AFFORDING COVERAGE NAIC A
INSURED INSURER A: State Farm Mutual Automobile insurance Company 25178
Basile,Michael INSURER B:
OBA Professional Turf MG_T INSURER C:
1310 Saddle Rack St Apt 302. INSURER D:
San Jose,CA 9.5126 INSURERE.
DESCRIPTION OF VEHICLE OR EQUIPMENT
YEAR MAKE 1 MANUFACTURER MODEL BODY TYPE VEHICLE IDENTIFICATION NUMBER
2012 Ford F150 Pickup 1FTFW1CF7CF695742
DESCRIPTION SERIAL NUMBER
COVER AC+ES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICY(IES)OF INSURANCE LISTED BELOW HASIHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
PERIOD(S)INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY-CONTRACT OR OTHER DOCUMENT YwTH RESPECT TO
WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICY(IES)DESCRIBED HEREIN ISIARE SUBJECT TO
ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICY(IES).
INSR ADOL POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRD TYPEOFINSURANCE POLICYNUMBER DATE(MIAI)DIYYYYI DATE(MWDDiYYYY) LIMITS
Oe VEHICLE LIABILITY COMBINED SINGLE LIMIT $
A 273 4810-A07-05A 01/07/2016 07/07/2016 BODILY INJURY(Per person) S 1,000,000-
BODILY INJURY(Per-accident) $ 1,000,000 -
PROPERTYDAMACE $ 1,000,000
GENERAL LIABILITY EACH OCCURENCE $
OCCURRENCE GENERAL AGGREGATE S '
CLAIMS MADE MEDICAL PMNTS is 10,000
INSR LOSS- POLICYEFFECTIVE PODCYEXPIRATION LINtITSrOEDUC7IBLE
LTR PAYEE TYPE OF INSURANCE POLICY NUMBER DATE(UrAIDDIYYYY) DATE IMMIDDIYYYY)
K VEH COLLISION LOSS ❑. ACV ❑AGREED AMT S LIMIT"
G 273 4810-A07-05A 01/07/2016 07107/2018
❑ ❑STATED AMT $50O DEO
VEH COMP VEH OTC ❑" ACV ❑AGREED AMT S LIMIT
C1 273 4610-A07-05A 0110712016 07107/2016
© ❑STATED MAT S 290 DIED
PROPERTY ❑ACV L1 AGREED AMT
• -5 LIMIT
BASIC BROAD ClRC ❑STATED WAT
5 DED
SPECIAL n' ❑
REMARKS(INCLUDING SPECIAL CONDITK)NS/OTHER COVERAGES)(AHach ACORD 101,Additional Remarks Schedule,if more space As required)
ADDITIONAL INTEREST CANCELLATION
Select one of the following:- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE-CANCELLED
Tie additional Interest dasc dried below has been added to the poticy(les)listed herein by PoNcy nurmerm. BEFORE THE EXPIRATION DATE THEIREOF,NOTICE WILL BE
•A request has been submitted to add`headdiGsna.Inmest described below to the poliey(les) DELIVERED IN ACCORDANCE INITH THE POLICY PROVLSIONS.
Used herein w.,Poicy numb@_fflS)_
VEHIOLEI EQUIPMENT INTEREST-. LEASED FINANCED DESCRIPTION OF THE ADDITIONAL INTEREST
NACAE AND ADDRESS OF ADDITIONAL INTER£ST ADDIYIDNALINSURED LOSS PAYEE
LENDER'S LOSS PAYEE
LOAN[LEASE NUMBER
UTHORIZE.D REPRESENTVE
at�tlle C�osv�TI�9Vj „ �
• ,/ MII;iC YfR P19A1'IIa000�� j
©1997-2010 ACORD CORPORATION,All rights reserved.
ACORD 23 201010E The ACORD name and logo are registered marks of ACORD
1004361 142987.2 01-28-2013
Dec 1415 05:58p P 3
A 0 VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE DATE(MPAIDOmYY)
112/1412015
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.
This form is used to report coverages provided to a single.specific vehicle or equipment.Do not use this form to report liability coverage
provided to multiple vehicles under a single policy.Use ACORD 25 forthatpurpose.
PRODUCER NAMEACT Elans Rivera
StatBFarm JOE FRANGIEH w�No Exc: 408-793-8303 ac No: 448-793-8304
120 W CAMP13ELL AVE STE A AEOnRIE st elona.rivera.fhvp@statefarm.com
CAMPBELL,CA 95008 PRODUCER
cusronlER ID K:
• I
INSURERS)AFFORDING COVERAGE NAIC P
INSURED INSURER A; Stale Fart Mutual Automobile Insurance Company 25178
Basile,Michael INSURER 13
DBA Professional Turf MGT INSURER C:
1310 Saddle Rack St Apt 302 INSURER D-
San Jose,CA 95126 1 INSURERE:
DESCRIPTION OF VEHICLE OR EQUIPMENT
YEAR MAKE 1 rAANUFACTURER N)DEL BODY TYPE VEHICLE IDENTIFICATION NUMBER
20,13 Ford Edgy SportWG 2FMU1(3JC1D18A83577
DESCRIPTION SERIAL NUMBER
COVERAGES. CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICY(IES)OF INSURANCE LISTED BELOW HAS/HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
PERIOD(S)INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECTTO
WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICY(IES)DESCRIBED HEREIN ISIARE SUBJECT TO
ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICY(IES).
INSR ADDL POLICY EFFECTIVE POLICY EXPIRATION
LTR %N5RD TYPE OF INSURANCE FOUCY NUMBER DATE(rA11D131YYYY) DATE(MMIDONYYY) LIMITS
VEHICLE LIABILITY COMBINEU SINGLE LIMIT 3 1,000,000
A 1914357-DO4-05G 10/04/2015 04104/2016 BOOILY INJURY(Per person) 5
BODILYINJURY(Peraxident) S
PROPERTY DAMAGE -
GENERAL LIABILITY EACH OCCURRENCE S
OCCURRENCE GENERAL AGGREGATE s
C'-AIMSMADE MEDICAL PMNTS s 10,000
IN SR LDsS POLICY EFFECTIVE POLICY EXPIRATION
LTR PAYEE TYPE OF INSURANCE POLICY NUMBER DATE(MM/DDIYYYY) DATE(MMIDDIYYYY) LIMITS!DEDUCTIBLE
G V_H COLLISION LOSS 191 4357-D04-05G 10/04/2015 04/04/2016 0 ACV" C3 AGREZDAMT s- LIMIT
1:1 ❑STATED MAT $500 DED
D VEHCOh1P VET:OTC 1914357-D04-05G - 10/04/2015 04/04/2016 ❑` ACV -❑AGREED AMT -S LIMIT
© • ❑SrATEDAMT $250 DED
PROPERTY ❑ACV ❑AGREEDAMT
$ LIMIT
BASIC BROAD ❑RC ❑STATED AMT
S DED
SPECIAL ❑
REMARKS(INCLUDING SPECIAL CONDITIONS/OTHER COVERAGES)[Attach ACORn 101,Additional Remarks SchedUe,rf mare apace Is required)
ADDITIONAL INTEREST CANCELLATION --
Selectone of the following: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
-1 RThe additional interest described balm has been added to the policypes)listed herelr.by policy ntonber(sl. BEFORE THE EXPIRATION DATE THEREOF,NOTICE WALL.BE
Arequest has been subm:l:ed to add the addl9onalinlerest descrioed below to the poliay(ies) DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
lisisd herein b"'Illcy number s.
VEHICLE I EQUIPMENT INTEREST; LEASED FINANCEp DESCRIPTION OF'THE ADDITIONAL INTEREST
NAMEAND ADDRESS OF ADDITIONAL INTEREST ADDITIONAL INSURED LOSS PAYEE
LENDER'S LOSS RRYEE
LOAN!LEASE NUMBER
AUTHORIZED REP ESENTATIVE
Car�aile ��vuley
oi.:rarsm.0 roaes,tew
01997-2010 ACORD CORPORATION.All rights reserved.
AGGRO 23(2010106) The ACORD name and logo are registered marks of ACORD
1004361 142987.2 01-28-2013
• i
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crrY or
-
WAIVE,R OF SUBROGATION ENDORSEMENT
WORKER'S COMPENSATION INSURANCE
CUPER'rINO
Project Title and Nurnber: 91(zc `&AV rorrA Q-(Gev✓se RofelT vtah r e.
In consideration of the policy premium and notwithstanding any inconsistent statement in the policy
to which this Endorsement is attached or any other Endorsement attached thereto, it is agreed as follows;
It is agreed that with respect to such insurance as is afforded by the policy, the Insurance Company
waives any right of subrogation against the City of Cupertino, and each of its directors, officers, agents,
consultants and employees by reason of any payrnent made on account of injury, including death
resulting therefrom, sustained by any employee of the insured, arising out of the perforniance of the
above-referenced Contract.
;POLICY INFORMATION
t. Insurance Company: f 11Ppu' &I U u-eeGrw''i lei--s -�'t l o ¢r�F�C:e—
2. Insurance Policy Number: A IT-14/ Co y� �& '-0 1
3. Effective Date of this Endorsement, -- -dal) 20 Je,
4. Insured:_^&0
All notices herein provided to be given by the Insurance Company to the City in connection with
this policy and this Endorsement, shall be mailed to or delivered to the City at 10300 Torre Avenue;
Cupertino, California 950I4. ,
',T V 0 t �6 - J (print/typo name)
warrant that I hav authority to-biiAd the below listed Insurance Company and by my signature hercon do
so bind this Company.
Signature of Authorized Representative:
(Original signature required on all Endorsement furnis e W the District)
Names of
AgentlAgency;� t' JfJUCe JlailrG�L''�` Title: 6 '-d
Address: /f 1(%sa Ir(? Telephoner 0/3 r
Co'1 d"Mdv"'f co facsimile:p
0
VOLPATTI INSURANCE
SERVICES INC. END OF DOCUMENT
511 LEISURE STREET
LIVERMORE, CAS. 94551
City nor Cupertino 00530-7 Insurance Forms
Blookberry Farm Golf Course A4ainteuance 7.01 G
I
i
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06
(Ed.4-841
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-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 the person or organization named in the Schedule. (This agreement applies only to the extent that
you perform work under a written contract that requires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the
work described in the Schedule.
The additional premium for this endorsement shall be 5% of the California workers'compensation premium otherwise
due on such reurtuneration.
Schedule
Person or Organization Job Description
The City of Cupertino; Blackberry Farm Oolf Course 22100 Stevens Creek Blvd.
10300 Torre Ave Cupertino, CA 95014
Cupertino,CA 95014
general maintenance on the golf course
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.)
Endorsement Effective 04-01-2015 Policy No. ATV 004386-01 Endorsement No. 1
Insured Insurance Company
Professional Turf Management,W.(A Corp) Republic Underwriters Insurance Company
Countersigned By
