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16-069 Colleen Lopez for General Affordable Housing Consulting ServicesSECOND Al\1ENDMENT TO AGREEMENT BETWEEN THE CITY OF CUPERTINO
AND COLLEEN LOPEZ FOR AFFORDABLE HOUSING CONSULTING SERVICES
This Second Amendment to the Agreement between the City of Cupe11ino and Colleen
Lopez, for reference dated October 17, 2017 , is by and between the CITY OF CUPERTINO , a
municipal corporation (hereinafter "City") and Colleen Lopez a California individual
("Consultant") whose address is and is made with
reference to the following:
RECITALS:
A. On May 17, 2016, an agreement was entered into by and between City and
Consultant for affordable housing consulting services.
B. On December 14, 2016, a first amendment was entered into by and between City
and Consultant for affordable housing consulting services. The Agreement and the First
Amendment are collectively refeITed to as the "Agreement."
C. City and Consultant desire to modify the Agreement on the tenns and conditions
set forth herein.
NOW, THEREFORE, it is mutually agreed by and between and undersigned pai1ies as
follows:
1. Paragraph 1 of the Agreement is modified to read as follows:
The tenn of this agreement shall commence on May 17, 2016 and shall te1minate on
June 30, 2018, unless tenninated earlier as set f011h herein.
2 . Paragraph 3 of the Agreement is modified to read as follows:
Consultant shall be compensated for services perfo1med pursuant to this agreement in
an additional amount not to exceed FIFTY-FOUR THOUSAND AND SIX
HUNDRED AND FIFTY dollars ($54 ,650.00) for a total amount not to exceed ONE
HUNDRED AND TWENTY-THREE THOUSAND AND NINE HUNDRED AND
FIFTY dollars ($123,950 .00) based on the rates and terms set fo11h in Exhibit "A".
3. The following Exhibits to the Agreement, are amended and replaced to read as shown
in the attachments to this Amendment:
a. Exhibit "A,"-Scope of Services and Compensation
4. Except as expressly modified herein, all other tenns and covenants set f011h 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.
RECOMfVE1':J"Dqp FO~ APPROVAL:
By ~~
Title ~'0/~'J ~
APP~RM:
City ey
PO #2016-555 Account: 265-72-711 700-702
Original Contract: $34,650.00
Amendment #1 : $34,650.00
Amendment #2 : $54,650.00
Total: $123,950.00
Exhibit D
Insurance Requirements and Proof of Insurance
Proof of insurance coverage desclibed below is attached to this Exhibit, with City named
as additional insured.
Consultant shall maintain the following minimum insurance coverage:
A. COVERAGE:
(1)
(2)
(3)
D (4)
Workers' Compensation:
Statutory coverage as required by the State of California.
Liability:
Commercial general liability coverage in the following minimum limits:
Bodily Injury: $500,000 each occurrence
$1,000,000 aggregate -all other
Property Damage: $100,000 each occurrence
$250,000 aggregate
If submitted, combined single limit policy with aggregate limits in the
amounts of $1,000,000 will be considered equivalent to the required
minimum limits shown above.
Automotive:
Comprehensive automotive liability coverage in the following minimum limits:
Bodily Injury: $500,000 each occurrence
Property Damage: $100,000 each occurrence
or
Combined Single Limit: $500,000 each occurrence
Professional Liability
Professional liability insurance which includes coverage for the professional acts,
errors and omissions of Consultant in the amount of at least $1,000,000.
~ COLLLOP OP ID· TP
ACORD" CERTIFICATE OF LIABILITY INSURANCE I OATE (MMIOD/YYYY)
~ 02/17/2018
THIS CERTIFICATE IS ISSUED AS A MATIER 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 lNSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on
this certificate does not confer riahts to the certificate holder in lieu of such endorsementtsl.
PRODUCE:R 408-395-7900 ~21:ii~cT Julian Rodriguez
INB Insurance Services Corp.
License #0680989 rAJ8,N~' eJ<tl: 408-395-7900 j f..{t NoJ :408-395-3711
P.O. Box 699 E·MAIL liDDRES:S•
Los Gatos, CA 95031 INSURER/SI AFFORDING COVERAGE NAIC# Julian Rodriguez
INSURER A, The Hartford 19682
INSURED COLLEEN M. LOPEZ INSURER B:
COLLEEN M. LOPEZ
INSURERC:
INSURER D:
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 FDR 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 .
l~J: TYPE OF INSURANCE ~J'J>J-~JI POUCY NUMBER POLICY EFF .f.!:JUCYEXP LIMITS
A COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE s 1,000,000 -D CLAIMS,MADE D OCCUR ~!fGE TO RENTEO 1,000,000 y 57SBABC9349 05/28/2017 05/28/2018 M!SES.{Ea s x Business Owners MED EXP IAnv ona oersonl s 10,000 --PERSONAL & ADV INJURY s 1,000,000
2,000,000 H'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
POLICY O ~~8-f O LOG PRODUCTS -COMP/OP AGG s 2,000,000
nTHER: s
A AUTOMOBILE LIABILITY c---
fi,~1~~~.,~~,f INGLE LIMIT $
ANY AUTO 57SBABC9349 05/28/2017 05/28/2018 BODILY INJURY !Per oersonl s -OWNED -SCHEDULED
-AUTOS ONLY .__ AUTOS BODILY INJURY IPer accidenll S
X ~/WWs ONLY X ~8¥oi"&ir.~ I f ~9~&~d1J.1?AMAGE s -s
UMBRELLA LIAB H OCCUR I EACH OCCURRENCE s ,___
EXCESS LIAB CLAIMS -MADE AGGREGATE $
OED I I RETENTION s Is
WORKE:RS COMPENSATION I ~~~Tl ITJ: I I .PJH-AND EMPLOYERS ' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE D NIA E.L. EAf-H ACCIDENT s OFFICER/MEMBER EXCLUDED? [Mandalory In NH) E.L. 01SEAS£:: -E.A EMPLOYEE S
If yes . describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE· POLICY LIMIT I i
PROPERTY 5,900
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES {ACORD 101, Addlllonal Remarks Schodule, may be atrachcd If more space ls n,qulrcdl
City of Cupertino its officers, officials, emplodees, agents, servants and
volunteers are included as Additional Insure per form SS 00 08 04 05-
Business Liability Coverage Form which includes Primary Wording and Waiver
of Subrof(ation
Except: 0 Days Notice of Cancellation for Non Payment of Premium.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Cupertino
Attn Building Dept.
10300 Torre Avenue
Cupertino, CA 95014
I
ACORD 25 (2016/03)
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS .
AUTHORIZED REPRESENTATIVE
4~~
© 1988-2015 ACORD CORPORATION. All rights reserved-
The ACORD name and logo are registered marks of ACORD
QUICK REFERENCE
BUSINESS LIABILITY COVERAGE FORM
READ YOUR POLICY CAREFULLY
BUSINESS LIABILITY COVERAGE FORM
A. COVERAGES
Business Liability
Medical Expenses
Coverage Extension -Supplemenlary Payments
8. EXCLUSIONS
C. WHO IS AN INSURED
D. LIABILITY AND MEDICAL EXPENSES
Beginning on Page
1
1
2
2
3
10
LIMITS OF INSURANCE 14
E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS 15
1. Bankruptcy
2. Duties In The Event Of Occurrence, Offense, Glaim Or Sult
3. Rnancial Responsibility Laws
4. legal Action Against Us
5. SeparaUon Of Insureds
6. Representations
7. Other Insurance
B. Transfer Of Rights Of Recovery Against Others To Us
F. OPTIONAL ADDITIONAL INSURED COVERAGES
Additional Insureds
G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS
Form SS 00 DB 04 05
15
15
16
16
16
16
16
17
18
18
20
l
BUSINESS LIABILITY COVERAGE FORM
Various provisions in this policy restrict coverage. Read the entire policy carefully to determine righls, dulies and what
is and Js not covered.
Throughout this poltcy lhe wards "you" and "your" refer lo the Named Insured shown in lhe Declaralions. The words
"we", "us" and "our" refer to the slack insurance company member ofThe Hartford providing this insurance.
The word "lnswed" mec!llS any pe19on or organ!~aUon qualifying as such under Section C. -Who Is An Insured.
Other words and phrases that appear In quotation marks have special meaning. Refer to Section G. -Liebillly And
Medlcal Expenses Definitions.
A. COVERAGES
1. BUSINESS LIABILITY COVERAGE (BODILY
INJURY, PROPERTY DAMAGE, PERSONAL
AND ADVERTISING INJURY)
Insuring Agreement
a. We wlll pay those sums that the insured
becomes legally obligated lo pay as
damages because of "bodily injury",
"properly damage" or "personal and
advertising injury" to which this insurance
applies. We wlll have the right and duty to
defend the Insured against any "suit"
seeking those damages. However, we will
have no duty to defend the Insured against
any "suit" seeking damages for "bodily
injury", "property damage" or "peraonal and
adverUsing Injury" to . which this Insurance
does not apply.
We may, at our discretion, investigate any
"occurrence" or offense and settle any claim
·or "suit" that may resull But
(1) The amount we will pay for damages is
limited as described In Section D. -
Liability And Medical Expenses Limits
Of Insurance; and
(2) Our right and duty to defend ends when
we have used up the applicable limlt of
Insurance in lhe payment of judgments,
set1lements or medical expenses to which
this Insurance applies.
No other obligation or liability to pay sums or
perform acls or services is covered unless
expllclUy provided for under Coverage
Extension -Supplementary Payments.
b. This Insurance applies:
(1) To "bodily injury" and "property
damage" only If:
Form SS 00 08 04 05
(a) The "bodily injury" or "property
damage" Is caused by an
"occurrence" that takes place in the
"coverage territory";
(b) The "bodily injury" or "property
damage" occurs during the policy
periad;and
(c) Prior to the policy period, no Insured
listed under Paragraph 1. of Section
C. -Who Is An Insured and no
"employee" authorized by you to give
or receive notice of an "occurrence"
or claim, knew that the "bodlly Injury"
or "property damage" had occurred,
in whole or In part. If such a listed
Insured or authorized "employee"
knew, prior to the policy period, that
the "bodily Injury" or "property
damage" occurred, then any
continuation, change or resumption
of such "bodily Injury" or "property
damage" during or after the policy
period will be deemed to have been
known prior lo lhe policy period.
(2) To "personal end advertising Injury"
caused by an offense arising out of your
business, but only If U,e offense was
committed in the "coverage territory"
during the policy period.
c. "Bodily injury" or "property damage" will be
deemed lo have been known to have
occurred at lhe earliest time when any
insured listed under Paragraph 1. of Section
C. -Who Is An Insured or any "employee"
authorized by you to give or receive notice
of an "occurrence" or claim:
(1) Reports all, or any part, of the "bodily
injury" or "property damage" to us or
any other insurer;
Page 1 of 24
© 2005, The Hartford
BUSINESS LIABJLITY COVERAGE FORM
(2) Receives a written or verbal demand or
claim for damages because of the "bodily
injury" or "property damage"; or
(3) Becomes aware by any other means that
"bodily injury" or "property damage" has
occurred or has begun lo occur.
d. Damages because of "bodily injury" include
damages claimed by any person or
organization for care, loss of services or
death resulting at any time from the "bodily
injury".
e. Incidental Medical Malpractice
(1) 'Bodily injury" arising out of lhe
rendering of or failure to render
professional health care services as a
physician, dentist, nurse, emergency
medical technician or paramedic shall
be deemed ta be caused by an
noccurrence", but only if:
(a) The physician, dentist, nurse,
emergency medical technician or
paramedic Is employed by you to
provide such services; and
(b) You are not engaged In the
business or occupaUon of providing
such services.
(2) For the purpose of determining the
lfmits of Insurance for incidental medical
malpracUce, any act or omission
together with all related acts or
omissions In the furnishing of these
services to any one person will be
considered one "occurrence".
2. MEDICAL EXPENSES
Insuring Agreement
a. We wlll pay medical expenses as described
below for "bodily injury" caused by an
accident:
(1) On premises you own or rent;
(2) On ways next to premises you own or
rent; or
(3) Because of your operations;
pravfded U,at
(1) The accidenL takes place fn the
"coverage territory" and during the
policy period;
(2) The expenses are incurred and reported
to us within three years of lhe date of
the accident; and
(3) The Injured person submits lo
Page 2 of 24
examination: at'· our expense, by
physicians of our choice as often as we
reasonably require.
b. We will make these payments regardless of
fau!L These payments will not exceed lhe
applicable limit of insurance. We will pay
reasonable expenses for:
(1) First aid administered at the lime of an
accident;
(2) Necessary medical, surgical, x-ray and
dental services, Including prosthetic
devices; and
{3) Necessary
professional
services.
ambulance,
nursing and
3. COVERAGE EXTENSION -
SUPPLEMENTARY PAYMENTS
hospital,
funeral
a. We will pay,· with respect to any claim or
"suit" we Investigate or settle, or any "suit"
against an insured we defend:
(1) All expenses we incur.
(2) Up lo $1,000 for the cost of ball bands
required because of accidents or traffic
law violations arising out of the use of
any vehicle to which Business Liablllty
Coverage for "bodUy lnjuryn applies. We
do not have lo furnish these bonds.
(3} The cost of appeal bonds or bands lo
release attachments, but only for bond
amounts wlU,ln the applfcable limit of
Insurance. We do not have lo furnish
U,ese bonds.
(4) All reasonable expenses Incurred by the
Insured at our request lo assist us in the
lnvestlgaUon or defense of the claim or
"suit", including actual loss of earnings
up to $500 a day because of time off
from work.
(5) All costs taxed against the insured in
the "suit".
(6) Prejudgment interest awarded against
U,e insured on that part of the judgment
we pay. If we make an offer lo pay the
applicable limit of insurance, we will not
pay any prejudgment Interest based on
lhat period of time after lhe offer.
(7) All interest on the full amount of any
judgment that accrues after entry of the
judgment and before we have paid,
offered to pay, or deposited in court the
part of the judgment that Is within U,e
applicable limit of insurance.
Any amounts paid under (1) through (7)
above wlll not reduce the limits of insurance.
,;; ··:
Form SS 00 08 04 05
b. If we defend an insured against a "suit"
and an lndemnilee of the Insured Is also
named as a party lo lhe "suil", we will
defend that indemnitee If all of lhe
following condlllons are mel:
(1) The "suit" against the !ndemnitee
seeks damages for which the insured
has assumed the liability of the
indemnitee in a contract or agreement
that is an "insured contract";
(2) This insurance applies to such llabillty
assumed by the insured;
(3) The obligation to defend, or the cost of
the defense of, that indemnltee, · has
also been assumed by the insured in
the same "Insured contract";
(4) The allegations In the "suit" and lhe
information we know about the
"occurrence" are such that no conflict
appears to exist between the interests
of the Insured and the interest of the
indemnitee;
(5) The indemnitee and the insured ask
us to conduct and control the defense
of that lndemnltee against such "suie'
and agree that we can assign the
same counsel to defend the Insured
and the lndemnllee; and
(6) The indemnltee:
(a) Agrees In writing to:
(i) Cooperate with us in the
Investigation, settlement or
defense of the "suit";
(ii) Immediately send us copies of
any demands, notices,
summonses or legal papers
received [n connection with
the ''.suit";
· (il!) Notify any other Insurer whose
coverage is available lo lhe
indemnltee; and
(Iv) Cooperale with us with
respect lo coordinating other
applicable insurance available
to the indemnltee; and
(b) Pmvides us with written
authorization to:
(i) Obtain records and other
Information related la lhe
"suit"; and
(I!) Conduct and contra[ lhe
defense of the indernnitee in
such "suit''.
Form SS DO OB 04 05
BUSINESS LIABILITY COVERAGE FORM
So long as the above conditions are met,
attorneys' fees Incurred by us in the
defense of lhal indemnitee, necessary
litigation expenses incurred by us and
necessary litlgatlon expenses incurred
by the indemnilee at our 11:quest will be
paid as Supplementary Payments.
Notwithstanding the provisions of
Paragraph 1.b.(b) of Section 8. -
Exclusions, such payments wnl not be
deemed . to b.e .. darnage.s. Jgr "!JqdOY
injury" .and "property damage" and will
not reduce the Limits of Insurance.
Our obligation to defend an insured's
. indemn!tee and to pay for attorneys' fees
and necessary litigation expenses as
Supplementary Payments ends when:
(1} We have used up lhe applicable limit
of Insurance in the payment of
judgments or setUements; or
(2) The conditions set forth above, or the
terms of the agreement described in
Paragraph (6) above, are no longer met
B. EXCLUSIONS
1. Applicable To Business Liability Coverage
This insurance does not apply to:
a. Expected Or Intended Injury
(1) "Bodfly injury" or "property damege"
expected or Intended from the
standpoint of the Insured. This
exclusion does not apply to "bodily
injury" or "property damage" resulting
from the use of reasonable force lo
protect persons or property; or
(2) "Personal and advertising Injury" arising
out of an offense committed by, at Ille
direction of or with the consent or
acquiescence of the Insured wi\h the
expectation of inflicting "personal and
advertising injury".
b. Contractual Liability
( 1) "Bodily injury" or "property damage"; or
(2) "Personal and advertising Injury"
for which the Insured Is obligated lo pay
damages by reason of the assumption of
liability in a conlracl or agreemenL
This exclusion does nol apply lo liability
for damages because of:
{a) "Bodily injury", "property damage" or
"personal and advertising lnjucy" lhat
the insured woulp have · in lhe .
absence of the contract or
agreement; or
Page 3 of 24
BUSINESS LIABILITY COVERAGE FORM
(b) "Bodily Injury" or "property damage"
assumed in a contract or agreement
Uiat is an "Insured contract",
provided the "bodily injury" or
"property damage" occura
subsequent lo U,e execution of the
contract or agreement. Solely for
the purpose of liability assumed ln
an "insured con\racl", reasonable
attorneys' fees and necessary
llUgation expenses Incurred by or for
a party otlief . Uiari ati insured are
deemed to be damages because of
"bodfly injury" or "property damage"
provided:
(i) Liability to such party for, or for
the cost of, thal party's defense
has also been assumed ln the
same "Insured contract", and
(ll) Such attorneys' fees and
llt!gation expenses ara for
defense of that party against a
civil or alternative dispute
resolution proceeding In which
damages to which this
insurance applies ara alleged.
c. Liquor Liability
"Bodily injury" or "property damage" for
which any Insured may be held liable by
reason of:
(1) causing or contributing to the
Intoxication of any person;
{2) The furnishing of alcoholtc beverages lo
a person under the legal drinking age or
undarthe Influence of alcohol; or
(3) Any statute, ordinance or regulation
relating to the sale, gift, dlstribullon or
use of alcohollc beverages.
This exclusion applies only if you are In !he
business of manufacturing, distributing,
selling, serving or furnishing alcoholic
beverages.
d. Workers' Compensation And Similar
Laws
Any obligation of the insured under a
workers' compensation, disability benefits
or unemployment compensation law or
any slmllar law.
e. Employer's Liability
"Bodily injury" to :
(1) An "employee" of !he insured arising
out of and in lhe course of: ·
(a) Employment by lhe insured; or
Page 4 of24
(b) Perfomilng duties relaled lo U,e
conduct of the lnsured's business, or
(2) The spouse, ch!ld, paren~ brotller or
sister of that "employee" as a
consequence of (1) above.
This exclusion applies:
(1) Whether the Insured may be liable as
an employer or in any other capacity;
and
(2) To any obligallon to share damages
with or repay someone _else wlio must
pay damages because of the injury.
This exclusion does not apply to liability
assumed by the Insured· under an "Insured
contract".
f. Pollution
(11 "Bodily injury", "property carnage" or
"personal and advertising ·injury"
arising out of the actual, alleged or
threatened discharge, dispersal,
seepage, migration, release or escape
of "pollutants":
(a) Al or from any premises, slte or
location which Is or was at any
time awned or occupied by, or
rented ar loaned to any Insured.
However, this s!.Jbparagraph does
not apply to:
(l} "Bodily Injury'' if suslained wtthin
a bu!ld!ng and caused by
smoke, fumes, vapor or soot
produced by or originating from
equipment that is used lo heal,
cool or dehumidify lhe building,
or equipment that Is used lo
heat water for personal use, by
the building's occupants or their
guests;
(ii) "Bodily injury" or "property
damage" for which you may be
held liable, If you are a
contractor and U,e owner or
lessee of such premises, sile or
location has been added to your
policy as an additional insured
with mspect to your ongoing
operations performad for Uiat
additional insured at that
premises, site or location and
such premises, site or location
is not and never was owned or
occupied by, or rented or
loaned to, any insured, other
than !hat additional insured; or
Form SS 00 OB 04 05
(iii) "Bodily injury" or "property
damage" arising oul of heal,
smoke or fumes from a
"hostile fire";
(bl Al or from any premises, site or
location which is or was at any
lime used by or for any insured or
others for lhe handling, storage,
disposal, processing or treatment
ofwas\e;
(c) Which are or were at any lime
transported, handled, stored,
treated, disposed of, or processed
as waste by or for:
(I) Any Insured; or
(Ii) Any person or organization for
whom you may be legally
responsible;
(d) At or from any premises, site or
location on which any Insured or
any contractors or subcontractors
working directly or Indirectly on
any lnsured's behalf are
performing operations if lhe
"pollutants" are brought on or to
the premises, site or location ln
connection with such operaUons
by such Insured, contractor or
subcontractor. However, !his
subparagraph does not apply 1o:
(i) "Bodlly Injury" or uproperty
Form SS 00 OB 04 05
damage" arising out of !he
escape of fuels, lubricants or
other operating fluids which are
needed to perform the normal
electrical, hydraulic or
mechanical functions
necessary for the operation of
"moblle equipment" or its parts,
if such fuels, lubricants or other
operating fluids escape from a
vehic le part designed to hold,
store or receive !hem. This
exception does not apply if the
"bodlly injury" or "property
damage" arises out of the
lntentlonal discharge, dlspersal
or release of the fuels,
lubricants or other operating
nuids, or if such fuels,
lubricants or other opera\ing
fluids are brought on or lo !he
premises, site or location with
the . intent . that they be
discharged, dispersed or
BUSINESS LIABILITY COVERAGE FORM
released as part of Uie
operations being performed
by such insured, contraclor or
subcontractor;
(ii) "Bodily injury" or "pruperty
damage" sustained wilhin a
building and caused by the
release of gases, fumes or
vapors from materials brought
into that building in cannecUan
wtth operations being performed
by you or on your behalf by a
contractor or subc.ontraclor; or
(ill) "Bodlly injury" or "property
damage" arising out of heat,
smoke . or fumes from a
"hostile fire"; or
(e) At or from any premises, site or
location on which any insured or any
contractors or subcontractors
working direcUy or Indirectly on any
insured's behalf are perfoITT1ing
operations if the operations are lo
test for, monitor, clean up, remove,
contain, treat detoxify or neutralize,
or In any way respond lo, or assess
U,e effects of, "pollutants".
(2) Any loss, cost or expense arising out
of any:
(a) Reques~ demand, orderorstatutory
or regulatory requirement that any
insured or others test for, monitor,
clean up, remove, contain, !real,
detoxify or neutralize, or in any way
respond to, er assess U,e elfects of,
"pollutants"; or
(b) Claim ar suit by or on behalf of a
governmental authority for
damages because of !esUng for,
monitoring, cleaning up, removing,
containing, treating, detoxifying or
neutralizing, or in any way
responding to, or assessing !he
effects of, "pollutants".
However, this paragraph does not
apply lo ![ability for damages because
of "property damage" that the insured
would have in !he absence of such
request. demand~ order or statulory or
regulatory requirement, or such claim
or "suit" by or on behalf of a
governmental authority.
Page 5 of 24
BUSINESS LIABILITY COVERAGE FORM
g. Aircraft, Auto Or Watercraft
"Bodily Injury" or "property damage" arising
oul of the ownership, maintenance, use or
entrustmenl to olhers of any aircraft., "auto"
or watercraft. owned or operated by or rented
or loaned lo any i nsured . Use includes
operaUon and "loading or unloading".
This exclusion applies even if the claims
against any insured allege negligence or
other wrongdoing in the supervision, hiring,
employmen~·training or monitoring of oU,ers
by lhal insured, if the "occurrence" which
caused the "bodily injury" or "property
. damage" Involved the ownership,
maintenance, use or entrustment to others of
any aircraft, "auto" or watercraft that rs
owned or operated by or rented or loaned lo
any insured .
This e:><cluslon does not app ly to:
(1) A wate rcraft while ashore on premises
you own or rent;
(2) A watercraft you do not own that rs:
(a) less than 51 feet longj and
(b) Not bei ng used to carry persons
for a cha rge;
{3} Park[ng an "auto" on, or on the ways
next to, premises you own or rent,
provided the "auto" ls not owned by or
rented or loaned to you or the ins ured;
(4) Liablllty assumed under any "insure:tl
contract" for the ownership,
maintenance or use of aircraft or
watercraft;
(5) "Bodily Injury" or "property damage"
arising out of the operation of any of
lhe equipment listed In Paragraph f.(2)
or f.(3) of the delinltlon of "mobile
equipment''; or
(6) An aircraft that is no t owned by any
insured and is hired , chartered or loaned
with a paid crew. However, lhis
e:><cepHon does not apply If the insured
has any otlier insurance for such "bodily
Injury" or "property damage", whether
the oliler insurance ls primary, excess,
contingent or on any other basis .
h . Mobile Equipment
"Bodlly injury" or "property damage"
arising out of:
(1) The transportation of "mobile equipment"
by an "auln" owned or operaled by or
rented or loaned to any lnsu~d; or
Page 6 of 24
(2) The use of "mobile equipment" in , or
while In practice or preparaUon for, a
prearranged racing, speed or
demoll lion con test or in any stunllng
activi ty .
i. War
"Bodily Injury", "property damage" or
"personal and . advertising injury", however
caused, arising , directly or ind irectly, out of;
{1) ~.%Jnclu~i f!g undeclared Of civil war;
(2) Warlike action by a milllary force,
including E)clion in . hindering or
defending against an actual or
expected attack, by any government,
sovereign or other authority using ·
· milllary personnel or other agents; or
(3) lnsurrecUon, rebellion, revolution,
usurped power, or action taken .by
governmental authority In hindering or
defending agai nst any of these.
j. Professional Services
"Bodily injury", "property damage" or
"personal and advertising lnJury" arislng
out of the rendering of or failure to render
any professional service. This Includes
but is nol limited to:
(1) legal, accounting or advertising
services;
(2) Preparing, approving, or falling la
prepare o r approve maps, shop
drawings, opinions, reports, surveys,
field orders, change orders, designs or
drawings and specifications;
(3) Supervisory, Inspection, arch!leclural
or engineering activities;
(4) fu1~dlcal , surgical, dental, x-ray or
nursi'n.9 servlces treatment, advice or
instruclloi;>:
(5) Any health a/' therapeutic service
treatment, advice or lnstr11ct)[ln;
(6) Any service, lrealment, adv ice or
instruclion for the purpose of
appearance or skin enhancement, hair
removal or replacement or personal
grooming;
(7) Optical or hearing aid services
Including the prescribing, preparation,
fitting, demonstration or distribution of
ophthalmic lenses and similar
products or hearing aid devices;
Fo r m SS OD 08 04 05
(B) Optomehy or optometric services
including but not llmlted to examination
of lhe eyes and lhe prsscnblng,
preparation, litting,demonstration or
dislribulion of ophthalmic lenses and
simltar products;
(9) Any:
(a) Body piercing {not Including ear
piercing);
(b) Tattooing, including but not limited
tci 11ie· hisertfon . of ·µlgmenls inio or
under lhe skin; and
(c) Similar services_;
(10) qervices in the pracUce of pham,acy;
and
(11) Computer consulting, design or
programming services, including web
site design.
Paragraphs (4) and (5) of this exclusion do
not apply to the Incidental Medical
Malpractice coverage afforded under
Paragraph 1.e. in Section A. -Coverages.
k. Damage To Property
"Property damage" to:
(1) Property you own, rent or occupy,
Including any costs or expenses
Incurred by you, or any other person,
organization or entity, for repair,
replacement, enhancement,
restoration or maintenance of such
property for any reason, Including
prevention of injury lo a person or
damage to another's property;
(2) Premises you sell, give away or
abandon, if lhe "property damage" arises
out of any part of those premises;
(3) Property loaned t(! you;
(4) Personal property in lhf'.! care, custody
or control of the Insured;
(5) That particular part of real property on
which you or any contractors or
subcontractors working direcUy or
· indirectly on your behalf are performing
operations, if the "property damage•
arises out of those operations; or
(6) That particular part of any property
that must be restored, repaired or
replaced because "your work" was
lncorreclly performed on il
Fann SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
Paragraphs (1 ), (3) and (4) of \his
exclusion do nol apply kl "property
damage" (other than damage by fire) lo
premises, including lhe conlalls of such
premises, rented lo you for a period of 7 or
fewer consecutive days. A separate Limit
of Insurance applies to Damage To
Premises Rented To You as described in
Section D. -Limits Of Insurance..
Paragraph (2) of this exclusim does not
apply -If-the -premises· are ~your work~ and
were never occupied, rented or held for
rental by you.
Paragraphs (3) and (4) of this exclusion do
not apply to the use of eleval015. ·
Paragraphs (3), (4), (5) and (6) of this
exclusion do not apply to liability assumed
under a sidetrack agreement.
Paragraphs (3) and (4) of lhls exclusion do
not apply to "property damage" to
borrowed equipment while not being used
lo perform operations at a job site.
Paragraph (6) of this exclusion does not
apply lo "property damage" Included In the
"products-completed op~rations hazard".
I. Damage To Your Product
"Property damage" to "your product''
arising out of It or any part of It.
m. Damage To Your Work
"Property damage" to "your work" arising
out of it or any part or ll and Included In the
"producls-rmrnpleted operations hazard".
Thls exclusion does not apply if the
damaged work or the work out of which
lhe damage arises was pe,iormed on your
behalf by a subcontractor.
n. Damage To Impaired Property Or
Property Not Physically Injured
"Property damage" to "Impaired property"
or property that has not been physically
injured, arising out of:
(1) A defect, deficiency, Inadequacy or
dangerous condition In "your producf
or "your work''; or
(2) A delay or failure by you or anyone
acllng on your behalf to perform a
contract or agreement in accordance
with its terms.
This exclusion does nol apply lo the toss
of use of other property arising out of
sudden and accidental physical Injury to
"your product'' or "your wcirk" after it has
been put lo its Intended use .
Page 7 of 24
t::SU!::ilNES5 LIABILITY COVERAGE FORM
o, Recall Of Products, Work Dr Impaired
Property
Damages claimed for any loss, cost or
expense Incurred by you or others for the
loss of use, withdrawal, recall, inspection ,
repair, replacement, adjustment, removal
or disposal of:
(1} "Your product";
(2) "Your work"; or
(3) "Impaired property";
If such pttfducr, Work or ·pmperfy is
withdrawn or recalled from the market or
from use by any person or organizatlon
because of a known or suspectea defect,
deliciency, inadequacy or dangerous
condition in iL
p. Personal And Advertis!ng Injury
"Personal and advertising injury":
(1) Arising out of oral, written or electronic
publication of material, !f done by or at
the dlrsctlon of the Insured with
knowledge ofits falsity;
(2) Arising out of oral, written or electronic
pubficatlon of n-iaterial whose first
publlc:atlon took plcice before the
beginning of the policy pe11od;
(3) Arising out of a criminal act co,rnmitted
by or at the direction of the rnsured;
(4) Arising out of any breach of contraci,
except an Implied contract lo use
another's "advertlsing Idea" in your
"advertisement'';
(5) Arising oul of the failure of goods,
products or services lo conform with
any statement of quallly or
performance made ln your
"advertisement";
(6) Arising out of the wrong descripllon of
the price of goods, products or services;
(7) Arising out of any violation of any
intellectual property rights such as
copyright, patent, trademark, trade
name, trade secret, service mark or
other designation of origin or
authenucity.
Page 8 of 24
However, this exclusion does not
apply to infringement, in your
"advertisement", of
(a) Copyright;
(b) Slogan, unless Iha slogan is also
a trademark, trade name, servlce
mark or olhi:fr designation of origin
or authenticity; o~
(c) Tille or any literary or artistlc work;
(B) Arising cul of an offense committed by
an Insured whose business is:
(a} Advertising, broadcasUng,
publishing or telecasting;
(b) Designing or determining content
of web sites for others; or
(c) An Internet search , access,
content or service provider.
However, this exclusion does nol
appT{ ti:i Paragraphs i. b. and c.
under the definition of "personal and
advertising Injury" in Section G. -
Liability And Medical Experises
Definitions.
For the purposes of this exclusion,
placing an "advertisement" for or
!inking to others on your web site, by
itself, is not considered the business
of advertising, broadcasting,
publishing or te!ecaslfng;
(9) Arising out of en electronic chat room
or bulletin board the Insured hosts,
owns, or over which the Insured
exercises control;
(10) Arising out of U,e unauthorized use of
another's name or product In your e-mail
address, domain name or melatags, or
any other sim!Jar tactics lo mfslead
anoU,er's potential customers;
(11) Arising out of the violation of a
person's right of privacy created by
any stale or federal acl
However, lhls exclusion does not
apply to liability for damages that the
lnsured would have ln the absence of
such state or federal act;
(12) Arising out of:
(a) An "advertJsement" for others on
your web site;
(b) Placing a link to a web site of
others on your web site;
(c) Content from a web slte of others
displayed within a frame or border
on your web site. Contenl includes
Information, code, sounds, text,
graphics or images; or
(d) Computer code, software or
programming used to enable:
(!) Your web site; or
(ii) The presentation or functionality·
of an "advertisement" or other
content on your web site;
Form SS 00 OB 04 05
(13) Arising out of a violation of any anti-
trust Jaw;
(14) Arising out of the fluctuation In price or
value of any stocks, bonds or other
securities; or
(15) Arising oul of discrlmlnation or
humiliation committed by or at the
direction of any "executive officer",
director, stockholder, partner or
member of the insured.
q. Ele·ctrofiic Data
Damages arising out of the lass of, loss of
use of, damage to, corruption of, Inability
to access, or inability to manipulate
"electronic. data".
r. Employment-Related Practices
"Bodliy Injury" or "personal and advertising
injury" to:
(1) A person arising out of any:
(a) Refusal to employ that person;
(b) Tennlnation of that person's
employment; or
(c} Employment-related practices,
policies, acts or omissions, such as
coercion, demotion, evaluatlon,
reassignmen~ discipline,
defamation, harassmen~ humliiation
or discrimination directed pt that
person; or
(2} The spouse, chlid, paren~ brother or
sister of that person as a
consequence of "bodlly injury" or
"personal and advertising Injury" to the
person at whom any of the
employment*related practices
described In Paragraphs (a), {b), or (c}
above Is directed.
This exclusion applies:
{1} Whether the Insured may be liable as
an employer or In any other capacity;
and
(2) To any obligation to share damages
with or repay someone else who must
pay damages because of the injury.
s. Asbestos
(1) "Bodily injury", "property damage" or
"personal and advertlslng Injury"
arising out of lhe "asbestos hazard".
{2} Any damages, Judgments, settlements,
loss, costs or expenses that
Form SS 00 OB 04 05
BUSINESS LIABILITY COVERAGE FORM
(a) May be awarded or incurred by
reason of any claim ar suit
alleging actual or threatened injury
or damage of any nalure or kind lo
persons or property which would
not have occurred ln whole or in
part but for the "asbeslos hazard";
(b) Arise out of any request, demand,
order or s!alutory or regulatory
requirement lhat any insured or
oJb~J.S _ l~~t fo.r,. m QII]lQ[, _ i,lea rum,
remove, . encapsulate, contain,
treat, detoxify or neutralize or In
any way respontj to or assess the
effects of an "asbeslos hazard'~ or
(c) Arise out of any claim or suit for
damages because of testing for,
monlloring, cleaning up, removing,
encapsulating, containing, trealing,
detoxifying or neutralizing or in any
way responding to or assessing the
effects of an "asbestos hazard".
L Violation Of Statutes That Govern E-
Malls, Fax, Phone Calls Or Other
Methods Of Sending Material · Or
Information
"Bodily injury", "property damage", or
"personal and advertising Injury" arising
directly or indirectly out of any action or
omission that violates or is alleged to
violate:
(1) The Telephone Consumer Protection
Act (TCPA), Including any amendment
of or add!Uon to such Jaw;
(2) The CAN-SPAM Act of 2003, including
any amendment of or addition to such
11'lw;or
(3) Any .atalute, ordinance or regulation,
other lhar1 the TCPA or CAN..SPAM Act
of 2003, that prohibits or limits lhe
sending, lransmllting, communicating or
distribution of material or lnfonnatlon.
Damage To Premises Rented To You -
Exception For Damage By Fire, Lightning
or Exploslon
Exclusions c. through h. and k. through o. do
not apply to damage by fire, lightning or
explosion lo premises rented to you or
tempqrarily occupied by you wiU1 permission of
the owner. A separate Limit of Insurance
applies to this coverage as described in
Section D. -Liability And Medical Expenses
Limits or Insurance.
Page 9 of 24
uu,;,1('11 t:~u 1-lr\CJLI J T l.UVl::KAGI:: rDRM
2. Applicable To Medical Expenses Coverage
We will not pay expenses for "bodily injury":
a. Any Insured
To any insured, except "volunteer workers".
b. Hired Person
To a person hired to do work for or on behalf
of any insured or a tenant of any insured.
c. Injury On Normally Occupied Premises
To a person Injured on that part of
p remls.es you. own or rent that the person
normally occupies.
d. Workers' Compensation And Similar
Laws ·
To a person, whether or not an
"employee" of any insured, If benefits for
the "bodily Injury" are payable or must be
provided under a workers' compensation
or dlsabllity benefits law or a similar law.
e. Athletics Activities
To a person injured wh!le practicing,
instructing or participating In any physlcal
exercises or games, sports or athletic
contests.
f. Products.Completed Operations Hazard
Included with the "products-completed
operations hazard".
g. Business Uabfllty Exclusions
Excluded under Business Liability Coverage.
C. WHO IS AN INSURED
1. If you are designated in U,e Declarations as:
a. An lndlvfdual, you and your spouse are
insureds, but only with respect to the
conduct of a business of which you are the
sole owner.
b. A partnership or joint venture, you are an
insured. Your membe1S, your partners, and
their spouses are also insureds, but only with
respecl to the conduct of your business.
c. A limited llability company, you are an
insured. Your members are also insureds,
but only with respecl to the conduct of your
business. Your managers are insureds, but
only with respect to their duties as your
managers.
d. An organization other than a partnership,
joint venture or limited Jiabilfty company, you
are an insured. Your "executive officers" and
directors are Insureds, but only with respect
to their dull~ a~ your officers or directors.
Your slockholders are also Insureds, but only
with respect la their llab!ITty as stockholders.
Page 10 of24
e. A trust, you are an insured. Your trustees
are also Insureds, but only with respect lo
their du lies as trustees.
2. Each of the following ls also an insured:
a. Employees And Volunteer Workers
Your "volunteer workers" only while
performing duties related to the conduct of
your business, or your "employees", other
than either your "executive officers• {if you
are an organization other than a
partnership; jointventure or ·limited liabflity
company) or your managers (if you are a
limited liabillty company), but only far act;;
within the scope of their employment by
you or while performing duties related to
the conduct of your business.
However, none of these "employees" or
"volunteer workers" are insureds for.
(1) "Bodily Injury" or "personal and
advertising Injury":
(a) To you, to your partners or
members (if you are a partnership
or joint venture), to your members
(if you are a limited liability
company), or to a co-"employee"
while In the course of his or her
employment or performing duties
related to the conduct of your
business, or to your other
"volunteer workers" whlle
performing duties related to the
conduct of your business;
(b) To the spouse, child, parent,
brother or sister of thal co-
"employee" or that "volunteer
worker'' as a consequence of
Paragraph (1)(a) above; ·
(c) For which there is any obllgation
to share damages with or repay
someone else who must pay
damages because of the Injury
described in Paragraphs (1)(a) or
(b) above; or
(d) Arising out of his or her providing
or failing to provide professional
health care services.
If you are not in the business of
providing professional health care
services, Paragraph (d) does nol apply
lo any nurse, emergency medical
lechnician or paramedic employed by
you to provide such services.
(2) "Property damage"·to p"roperty:
(a) Owned, occupied or used by,
Form 55 00 08 04 05
(bl Rented lo, In the care, custody or
control of, or over which physical
control is being exercised for any
purpose by you, any of your
"employees", "volunteer workers",
any partner or member (if you are
a partnership or joint venture), or
any member (If you are a limited
liability company).
b. Real Estate Manager
Any person (other-than.your ~·employee"-or
"volunteer worker"), or any organization
while actjng as your real estate manager.
c. Temporary Custodians Of Your
Property
Any person or organlzallon having proper
temporary custody of your property if you
die, but only:
(1) With respect to llablllty arising out of lhe
maintenance or use of that property; and
(2) Until your legal representative has
been appointed.
d. Legal Representative If You Die
Your legal representative If you dle, but
only with respect lo duties as such. That
representative wllf have all your rights and
duties under this insurance.
e. Unnamed Subsidiary
Any subsidiary and subsidiary thereof, of
yours which Is a legally Incorporated entity
of which you own a financial Interest of
more than 50% of the voting stock on the
effective date oflhls Coverage Part.
The insurance afforded herein for any
subsidiary not shown tn the Declarations
as a named Insured does not apply to
injury or damage wllh respect lo which an
insured under this insurance is also an
insured under another policy or would be
an insured under such policy but for Its
termination or upon the exhaustion of Its
limlls of Insurance.
3. Newly Acquired Or Formed Organization
Any organization you newly acquire or form,
other than a partnership, Joint venture or
limited liability company, and over which you
maintain financial interest of more than 50% of
lhe voting stock, will qualify as a Named
Insured if there is no other simllar insurance
available to that organization. However.
a. Coverage under this provision is afforded
only until the 1 BOth· day after yor.1 acquire
or form the organization or the end of the
policy period, whichever is earlier; and
Form SS 00 OB 04 05
BUSINESS LIABILITY COVERAGE FORM
b. Coverage under this provision does not
apply lo:
(1) "Bodily injury" or "property damage•
that occurred; or
(2) "Personal and advertising injury'
arising out of an offense committed
before you acquired or formed lhe
organization.
4. Operator Of Mobile Equipment
With-respect -lo !'mobile -equipment~-registered -in
your name under any molar veh lcle registration
law, any person is an Insured while drjving such
equipment along a public highway wilh your
permission. Any other person or organization
responsible for the conduct .of such person ls
also an Insured, but only wm, respect lo llablnty
arising out of the operation of \he equipment, and
only If no other Insurance of eny kind is available
to that person or organization for this liabinly.
However, no person ororganiz.aUon Is an Insured
with respect to:
a. "Bodily Injury" to a co -"employee' of the
person driving the equipment; or
b. "Properly damage" to properly owned by,
rented to, In the charge of or occupied by
you or Uie employer of any person who ls
an insured under this provision.
5. Operator of Nonowned Watercraft
With respect to watercraft you do not own that
Is less than 51 feet long and is not being used
to carry persons for a charge, any person Is an
insured while operating such watercraft wllh
your permission. Any other person or
organization responsible for the conduct of
such person Is also an insured, but only wilh
respect lo liability arising out of !he operation
of the watercraft, and only lf no other
insurance of any kind is available to that
person or organization for this llability.
However, no person or organization is an
insured with respect to:
a. "Bodily injury" to a co-"ernployee" of the
person operating the watercraft, or
b. "Property damage" to property awned by,
rented to, in the charge of or occupied by
you or the employer of any parson who is
an insured under this provision.
6. Additional Insureds When Required By
Written Contract, Written Agreement Dr
Permit
The person(s) or organization(s) identified in
Paragraphs-a'.-·Uirough·t." b'elow are addltional
insureds when you have agreed, In a written
Page 11 of 24
BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a
permil issued by a stale or polilical
subdivision, thal such person or organization
be added as an addltional insured on your
policy, provided the injury or damage occurs
subsequent to U,e execution of the contract or
agreement, or the issuance of the permit
A person or organization is an additional
insured under this provision only for that
period of time required by the contract,
agrn!;!mml or p.ern1it.
However, no such person or organization Is an
. addltlonal insured under this provision If such
person or organization is included as an
addltlonal insured by an .endorsement lssuad
by us and made a part of this Coverage Part,
includlng alt persons or organizations added
as additional insureds under the specific
additional Insured coverage grants In Section
F. -Optional Additional Insured Coverages.
a. Vendors
Any person(s) or organlzation(s) [referred lo
below as vendor), but only wllh respect lo
"bodny injury" or "property damage" arising
out of "your praducls" which are distributed
or sold in U,e regular course of the vendor's
business and only if this Coverage Part
provides coverage for "bodily injury" or
"property damage" Included within the
"products-completed operations hazard".
(1) The Insurance afforded to the vendor
Is subject to U,e following additional
exclusions:
Page 12 of24
Thls insurance does not apply ta:
(a) "Bodily injury" or "property
damagen for which the vendor Is
oblfgated to pay damages by
reason of the assumption of
liability In a contract or agreemenL
This exclusion does not apply ta
liability for damages that the
vendor would have in the absence
of the contract or agreement;
(b) Any express warranty
unauthorized by you;
(c} Any physical or chemlcal change
in the product made intentionally
by the vendor;
(d) Repackaging, except when
unpacked so lely for U,e · purpose of
inspection, demonstration, testing,
or the s.ubstilution of parts .. under ..
instructions fi:om .. the manufacturer .
and the;· repackag~d · 1n th~
original container;
(e) Any failure lo make such
Inspections, adjustments, tests or
servicing as U,e vendor has
agreed lo make or normally
undertakes lo make in the usual
course of business, in connection
with the distribution or sale or the
products;
{f) Demonstration, !nstallatlon,
servicing or repair operations ,
'?_><_CE!P.l ?uch gg!fill~0'1!:! P-g[f.Qrrn~c!
at !he vendor's premises in
connection wilh the sale of the
produc~
(g) _Pruducls which, aft~r distribution
or sale by you, have been labeled
or relabeled or used as a
container, part or Ingredient or any
oU,er U,ing or substance by or for
the vendor; or
(h) "Bodily Injury" or 1'property
damage" arising out of the sols
negligence of the vendor for· its
own acts or om issions or those of
its employees or anyone else
acting on its behalf. However, this
exclusion does not apply La:
(I) The exceptions contained in
Subparagraphs (d) or (f); or
(il) Such Inspections, adjustments,
Lests or servicing as U,e vendor
has agreed to make or normally
undertakes lo make In the usual
course of business, in
connection wllh the distribution
1..,"',r sale of the products.
{2) This Insurance does not apply lo any
insured person o.r or9anlzatian from
wham you have acquired sui::h products,
or any ingredlen~ part or conifilm~r:
entering into , accompanying or
canraining such products.
b. Lessors Of Equipment
(1) Any person or organ ization from
whom you lease equipment; but only
with respect to their liability for "bodily
Injury", "property damage" or
"personal and advertising injury"
caused, in whole or in part, by your
maintenance, operation or use of
equipment leased la you by such
person or organization .
Form SS 00 OB 04 05
(2} Wilh respect la the insurance afforded
to these additional insureds, U,is
insurance does nal apply to any
"occurrence" which takes place after
you cease to lease lhal equlprnenl
c. Lessors Of Land Or Premises
(1) Any person or organization fram
whom you lease land or premises, but
only with respect lo liability arising aut
of the ownership, maintenance or use
of J!:lJ!l. part of .the land . or premises
leased lo you.
(2) With respect to the insurance afforded
to these addiUonal -Insureds, this
Insurance does not apply to:
(a} Any "occurrence" which lakes
place after you cease lo lease that
land or be a tenant in that
premises; or
(b) Structural alterations, new
construction or demolition
operations performed by or on
behalf of such person or
organization.
d. Architects, Engineers Or Surveyors
(1) Any architect, engineer, or surveyor, but
only with respect to liablllty for "bodily
Injury", "properly damage" or "personal
and advertising injury" caused, In whole
or in part, by your acts or omissions or
the acts or omissions of those acting on
your behalf:
(a) In connection with your premises;
or
(b) In the performance of your
ongoing operations performed by
you or on your behalf.
(2) With respect to the Insurance afforded
to these additional insureds, the
following additional exclusion applies:
This insurance does not apply to
"bodily Injury", "property damage" or
"personal and advertising injury"
arising out of the rendering of or the
failure to render any professional
services by or far you, Includ ing:
(a) The . preparing, approving, or
failure to prepare or approve,
maps, shop drawings, opinions,
reports, surveys, field orders,
change orders, designs or
drawings and specificali~ns; or .
(b) Supervisory, lrisp.ection,
archltectural or engineering
activities .
Form SS 00 08 04 05
BUSINESS LIABILITY COVffiAGE FORM
e. Pennits Issued By State Or Political
Subdivisions
(1) Any stale or polilical stixllvision, but
only with respect to operations
performed by you or on ,our behalf for
which the stale or political subdivision
has issued a permil
(2) With respecl to the insurance afforded
ta these additional Insureds, this
Insurance does not apply Ill:
(a)· "soaily mJury", ·"property · daniagel
or "personal and advertis ing
injury" arising out of operations
performed for the slate or
municipality; or
(b) "Bodny lnjuf)I" or •property damage"
included within the "products-
cornpleled operations lmard'.
f. Any other Party
(1) Any other person or organization who
is not an insured under Paragraphs a.
through e. above, but only with
respect to llabllity for "bodily injury",
"property damage" or "personal and
advertising injury" caused, in whole or
In part, by your acts or omissions or
the acts or omissions of those acting
an your behalf:
(a) In the performance of your
ongoing operations;
(b) ln connection with your premises
owned by or rented lo you; or
(c) In connection with "your work" and
Included within the "products-
cornpleted operations hazard", but
only If
(i) The written contract or written
agreement requires you lo
provide such coverage lo
such additional Insured; and
(li) This Coverage Part provides
coverage for "bodily injury" or
"property damage" included
within the . "products-
completed operations hazard".
(2) With respect lo the insurance afforded
lo these additional insureds, this
Insurance does not apply lo:
"Bodily injury", "property damage" or
"personal and advertisfng injury "
arising out of the rendering of, or the
failure to render, any professional
architectural, engineering or surveying
services, including:
Page 13 of24
BUSINESS LIABILITY COVERAGE FORM
(a) The preparing, approving, or
failure la prepare or approve,
maps, shop drawings, opinions,
reports, surveys, field orders,
change orders, designs or
drawings and specifications; or
(b) Supervisory, inspection,
archileclural or engineering
activll!es.
The limits of insurance that apply ta additional
insureds are described In ·Section ·-0.:.... Limits
Of Insurance.
How this Insurance applies when other
insurance ls available to an additlanal Insured
ls described in the Other Insurance Condition
in Section E. -Uability And Medical Expenses
General CondlUons.
No person or organization Is an Insured with
respect lo the conduct of any current or past
partnership, joint venture or limited llabil!ty
company \hat is not shown as a Named Insured in
lhe Declarations.
D. LIABILITY AND MEDICAL EXPENSES
LIMITS OF INSURANCE
1. The Most We WIii Pay
The Limits of Insurance shown In the
Declarations and the rules below fix the most
we will pay regardless of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits".
2. Aggregate Limits
The most we will pay for:
a. Damages because of "bodily Injury" and
"property damage " included in the
"products-compleled operations hazard" ts
the Products-Completed Operations
Aggregate Limit shown in the
Declaratlons.
b. Damages because of all other "bodily
injury", "property damage" or "personal
and advertising injury", Including medical
expenses, ls the General Aggregate Limit
shown In the Declarations.
This General Aggregate Limit applies
separately to each of your "locations"
owned by or rented to you.
"Location" means premises involving the
same or connecting lols, or premises
whose connection is interrupted only by a
street, roadway or righl-of-way of a
rallroad .
Page 14 of 24
This General Aggregate lim!L does not
apply to "property damage" ta premises
while rented to you or temporarily
occupied by you with permission of the
owner, arlsing out of fire, lightning or
explosion.
3. Each Occurrence Limit
Subject to 2.a. or 2.b above, whichever
applies, U,e mast we will pay for the sum of all
damages because of all "bodily inju,y•,
"p'rdpertr claiiiage" . ana iii'eoical" expenses
arising out of any one "occurrence" Is the
Liability and Medical Expenses Llmit shown in
the Declarations.
The most we will pay for all medical expenses
because of "bodily Injury" sustained by any
one person is the Medical Expenses Limit
shown in the Declarations.
4. Personal And Advertising Injury Limit
Subject to 2.b. above, the most we wlll pay for
the sum of ail damages because of al\
"personal and advertising injury" sustained .by
any one person or organization is the Personal
and Advertising Injury Limit shown ln U,e
Declarations.
5. Damage To Premises Rented To You Limit
The Damage To Premises Rented To You
Umlt is the most we wlll pay under Business
Liability Coverage for damages because of
"property damage" to any one premises, while
rented to you, or In the case of damage by fire,
lightning or explos!on, while rented to you or
temporarlly occupied by you with pennlssion of
the owner.
In the case of damage by lire, lightning or
explosion, the Damage lo Premises Rented To
You Limit applies to al! damage proximately
caused by the same event, wheU,er such
damage results from lire, lightning or explosion
or any combination of these.
6. Haw Limits Apply To Additional Insureds
The most we wlll pay on behalf of a person or
organization who ls an additional insured
under this Coverage Part Is the lesser of:
a. The limits of insurance specified in a
written contract, written agreement or
permit issued by a state or polltical
subdivision; or
b. The Limits of Insurance shown in lhe
Declarations .
Such amount shall be a part of and not in
addition ._to the Limits :of Insurance sh.own in
the Declarations and described in this SecLion .
Form SS 00 08 04 05
lf more than one llmit of insurance under this
policy and any endorsements attached thereto
applies to any claim or "suit", the most we w.il! pay
under this policy and the endorsements 1s the
single highest limit of liability of all coverag~s
appficable to such claim or. "suit". However, this
paragraph does not apply lo the Medical Expenses
limit sel forth In Paragraph 3. above.
The Limits of Insurance of this Coverage Part. apply
separately to each consecutive annual period and_ to
any remaining per! od of le_s~ than 12_ manµ,~, s\artirm
willi ·1ne ·begiiiniiiif ci(t}ie policy period ~hown in the
Declarations, unless the policy period is exten_ded
after issuance for an addilional period of Jess than 12
months. In that case, the additional period will be
deemed part of the last preceding period for purposes
of determining the Limits of Insurance.
E. LIABILITY AND MEDICAL EXPENSES
GENERAL CONDITIONS
1. Bankruptcy
Bankruptcy or insolvency of the lnsured or of
the insured's estate wiJJ not r~lleve us of our
obllgaUons under this Coverage Part.
2. Duties In The Event Of Occurren~e.
Offense, Claim Or Suit
a. Notice Of Occurrence Or Offense
You or any additional insured must see to
it that we are notlfled as soon as
practicable of an "occurrence" or an
offense which may result In a claim. To
Iha extent possible, notice should include:
(1) How, when and where the "occurrence"
or offense took place;
{2) The names and addresses of any
injured persons and witnesses; and
(3) The nature and location of any injury
or damage arising out of the
"occurrence" or offense.
b. Notice Of Claim
if a claim is mads or ''suit" is brought
against any insured, you or any additlonai
insured must
(1) Immediately record the specifics oftha
claim or "suil" and lhe dale received;
and
(2) Notify us as soon as practicable.
You or any additional insured must see to
it that we receive a written notice of the
claim or "suit" as soon as practicable.
c. Assistance And Cooperation Of The
Insured
You and any other involved Insured must
Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(1) lmmedtate!y send us copies al any
demands, notices, summonses or
legal papers received in connection
with lhe claim or "suit";
(2) Authorize us to obtain records and
olher information;
(3) Cooperate with us In the investigation,
settlement of the claim or defense
against the "suit"; and
(4) Assist us, upon our reques~ in the
enftli'cement · of any · nghl against' iiriy
person or organization that may be
liable to the insured because of injury
or damage to which · this Insurance
. may also apply.
d. Obligations At The lnsured's Own Cost
No lnsurad wm, except al that insured 's own
cost, valuntanly make a payment, assume
any obligation, or incur any expense, olher
than forfirsta[d, wilhout our consenL
e. Additional lnsured's Other Insurance
lf we cover a claim or "sull" under this
Coverage Part that may aisa be covered
by other Insurance avaliable lo an
additional Insured, such addltianal insured
must submit such claim or •suit" to the
other Insurer for defense and indemnity,
However, !his provision does not apply lo
the extent that you have agreed In a
written contract, written agreement or
permit thai !his insurance is primary and
non-contributory· with the addltlonal
insured's own Insurance.
f. Knowledge Of An Occurrenc~! Offense,
Claim Or Suit
Paragraphs a. and b. apply to you or lo
any additional insured only when such
"occurrence", offense, c;laim or "sull" Is
known to:
(1) You or any additional insured that ls
an individual;
(2) Any partner, if you or an additional
insured is a partnership;
(3) Any manager, if you or an additional
insured is a limited llab!iily company;
(4) Any "executive officer" or Insurance
manager, if you or an additional
insured is a corporaUon;
(5) Any trustee, lf you or an additional
insured is a trust; or
(6} Any elected or..appoint~d offici_al, if_you
or'ti.n '·add!tfonal'insured is a polltical
subdivision or public enllty.
Page 15 of 24
BUSINESS L\ABlLITY COVERAGE FORM
This Paragraph f. applies separately to
you and any additional insured.
3. Financial Responsibility Laws
a. When this policy is certified as proof of
financial responsibil!Ly for U,e future under
the provisions of any motor vehicle
financial responsibility law, the insurance
provided by the po!lcy for "bodily injury"
liability and "property damage" liability w!II
comply with \he provisions of the law lo
the-extent of-the -coverage-and -limits or
insurance required by that law. .
b. With respect to "mobile-equipment" lo
which th!s insurance applies, we · will
provide any liability, uninsured motorists,
underlnsured .motorists, no-fault or oU,er
coverage required by any motor vehicle
law. We wlli provide the required limits for
those coverages.
4. Legal Action Against Us
Na person or organization has a right under
this Coverage Form:
a. To join us as a party or otherwise bring us
into a "suit" asking for damages from an
insured; or
b. Ta sue us on U,!s Coverage Form unless
all of Its terms have been fully complied
with.
A person or organization may sue us to recover
on an agreed settlement or on a final Judgment
against an Insured; but we will not be Hable for
damages that are. not payable under the terms of
this insurance or that are in excess of the
applicable limit of insurance. An agreed
settlement means a setUement and release of
liabllity signed by us, the insured and the
claimant or the clalmant's legal representative.
5. Separation Of Insureds
Except with respect to the Um its of Insurance,
and any rights or duties specincaliy assigned
in this policy to the first Named Insured, this
insurance applies:
a. As if each Named Insured were Lhe only
Named Insured; and
b. Separately to each insured against whom
a claim Is made or "suit" is broughl
6. Representations
a. When You Accept This Polley
By accepting lhis policy, you agree:
{1) The statements in the Declarations
are accurate and complete; :._,
(2) Those stats·me~ts are based upon
represent.aliens you made lo us ; and
Page 16 of24
(3) We have issued this polfcy in reliance
upon your representations .
b. Unintentional Failure To Dfsclose
Hazards
lf unintentionally you should fail to disclose
all hazards relating lo the conduct of your
business al lhe inception date of th is
Coverage Part, we shall nol deny any
coverage under this Coverage Part
because of such failure.
7. Other tn·surance
If other valid . and collecllble insurance is
available for a /ass we cover under this
Coverage Part, our obllgatlons are limited as
follows:
a. Primary Insurance
This insurance is primary except when b.
below applies. If other Insurance is also
primary, we wlll share wllh all that other
insurance by the meUiod described in c.
below .
b. Excess Insurance
This insurance is excess over any of the
oU,er insurance, whether primary, excess,
contingent or on any other basis:
(1) YourWork
That ls Are, Extended Coverage,
Builder's Risk, installation Risk or
similar coverage for "your work";
(2) Premises Rented To You
That is fire, !ighlnlng or explosion
insurance far premises rented to you
or temporarily occupied by you with
permission of \he owner.
{3} Tenant Liability
That is Insurance purchased by you to
cover your liabillty as a tenant for
"property damage" to premises rented
lo you or temporarily occupied by you
with permission of the owner,
(4} Aircraft, Auto Or Watercraft
If the lass arises out of the maintenance
or use of aircraft, "autos" or watercraft to
Lhe extent nol subject to Excluslon g. of
Section A. -Coverages.
(5) Property Damage To Borrowed
Equipment Or Use Of Elevators
If the loss arises out of "property
damage" to borrowed equipment or
the use or elevators to the extent not
subject to Exclusion ·k. of Section · A. -
Coverages.
Form SS 00 OB 04 05
Insured -State Or Political Subdivision -
Permits, but only wllh respect lo
operations performed by you or on your
behalf for which the slate or political
subdivision has issued a permit.
b. With respect to the insurance afforded lo
these additional insureds, lhe following
additional exclusions apply:
This insurance does not apply to:
(1) "Bodlly injury", "property damage" or
"personal and· .. advertislii'(j injury"
arising out of operations perfonned for
the stale or municfpallly; or
· (2) "Bodily Injury" or ''property damage"
included· in the "product-completed
operations " hazard.
7. Additional Insured -Vendors
a. WHO IS AN INSURED under Section C. is
amended to Include es an addll!onal
Insured the person(s) or organizal!on(s)
(referred to below as vendor) shown in the
Declarations as an Additional Insured -
Vendor, but only with rsspeot lo "bodily
injury" or "property damage" arising out of
"your products" which are distributed or
sold in the regular course of the vendor's
business and only If this Coverage Part
provides coverage for "bodily injury" or
"property damage" Included within the
"products-completed operations hazard".
b. The insurance afforded to the vendor is
subject lo the followlng additional excluslons:
(1) This insurance does not apply to:
(a) "Bodily Injury" or "property
damage" for which the vendor is
obligated to pay damages by
reason of the assumption of
llablllty in a contract or agreemenL
This exclusion does not apply lo
liability for damages !hat the
vendor would have fn the absence
of the contract or agreement;
(b) Any express warranty
unauthorized by you;
(c) Any physical or chemical change
in the product made intentionally
by the vendor;
(d) Repackaging, unless unpacked
solely fur the purpose of inspecUon,
demonstration, testing, or lhe
substitution of parts under
instructions from the manufacturer,
and · then repackaged in the original
container;
Form SS 00 OB 04 05
BUSINESS LIABILITY COVERAGE FORM
(e} My failure lo make such
inspeclions, adjustments, tests or
servicing as the vendor has agroed
lo make or normally undertakes to
make in U,e usual c(II.Jrse of
busfriess, in connection wilh lhe
distribution or sale of the products;
(f) Demonstration, fnstallatlon,
servicing or repair operations,
except such operations performed
at --the -vendor's .. premises in
connection with the sale of the
pcoduct;
{g) · Products which, after dlstribuUon
or sale by you, have been labeled
or relabeled or used as a
container, part or ingredient of any
other thing or substance by or for
the vendor; or
(h) "Bodily injury• or "property
damage" arising out of the sole
negligence of the vendor for Its
own acts or omissions or those of
Its employees or anyone else
acUng on its behalf. However, this
exclusion does not apply lo;
(i) The exceptions contained in
Subparagraphs (d) or (f); or
(ii) Such lnspecUans,
adJustments, tests or servicing
as the vendor has agreed to
make or normally undertakes
!o make In the usual course of
business, In connecUon with
the dfstriJJulion or sale of \he
products.
(2) This insurance does not apply to any
Insured person or organization from
whom you have acquired such
products, or any Ingredient. part or
container, entering inlo,
accompanying or containing such
products.
B. Additional Insured -Controlling Interest
WHO IS AN INSURED under SecUon C. is
amended to include as an additional insured
the person(s) or organization(s) shown in the
Declarations as an Additional Insured -
Controlling Interest, but only with respect to
their liablllty arising out of:
a. Their financial control of you; or
b. Premises they own, mein!aln or control
w~lle you lea.se o.roccup~"these premises .
Page 19 of24
BUSINESS LIABILITY COVERAGE FORM
This Insurance does not apply to structural
alterations, new construction and demolillon
operations performed by or for that person or
organization.
9. Additional Insured -Owners, Lessees Or
Contractors -Scheduled Person Or
Organization
a. WHO IS AN INSURED under Section C. is
amended lo include as an additional
Insured the person{s) or organizalion{s)
shown.In the DeclaraUc:ins-as-an -Additional
Insured -Owner, Lessees Or Contractors,
but only w!th respect to liabll!ty for "bodily
Injury", "property damage" or "personal
and advertising injury". caused, in whole or
ln part, by your acts or omissions or lhe
acts or omissions of those acting on your
behalf:
{1) In the performance of your ongoing
operations for the additional
lnsured(s); or
{2) In connection with "your work"
performed for thaf additional insured
and included within the "products-
comple!ed operations hazard", but
only if tills Coverage Pi:i'.rt provides
coverage for "bodlly inJu.ry" or
"property damage" included within the
"products-completed operation§
hazard".
b. With respect to the Insurance afforded to
these additional Insureds, this insurance
does not apply to "bodlly Injury", "property
damage" or "personal an advertising
Injury" arising out of the rendering of, or
the tanura to render, any professional
archllectural, engineering or surveying
services, Including:
(1) The preparing, approving, or failure to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders, designs or
drawings and specifications; or
(2) Supervisory, inspection, architectural
or engineering acUvities.
10 . Additional Insured -Co-Owner Of Insured
Premises
WHO IS AN INSURED under Section C. is
amended lo lriclude as an additional insured
the person(s) or Organization{s} shown in the
Declarations as an Additional Insured -Co-
Owner Of Insured Premises, but only with
respect to their liability as co-owner of the .
premises shown in .the"beclarations.
Page 20 of 24
The limits of insurance lhat apply lo additional
insureds are described in Section D. -Limits Of
Insurance.
How this Insurance applies when other insurance
is available to an additional Insured is described in
the Other Insurance Condition in Section E. -
Liabiltty And Medical Expenses General
Condllions.
G. LIABILITY AND MEDICAL EXPENSES
D~f!t-{ff!QN§ .
1. "Advertisement" means lhe widespread pub lic
. dissemination of information or Images that
has the purpose of inducing the sale of goods,
products or serviaes thrmmh:
a. (1) Radio;
(2) Television;
(3) Billboard;
(4) Magazine;
(5) Newspaper;
b. The internet, but only that part of a web
slte that is about goods, producls or
services for the purposes of inducing the
sale of goads, products or services; or
c, Any other publication that Is given
widespread public distribution.
However, "advertisement" does not include:
a. Toe design, printed material, information
or Images contained In, on or upon the
packaging or labeling of any goods or
products; or
b. An interactive conversation between or
among persons U,rough a computer network.
2. "Advertisii~.9 idea" means any idea for an
"advertiseme1-;>l".
3. "Asbestos hazard" means an exposure or
lhreat of exposure ta the actual or alleged
properties of asbestos arid includes lhe mere
presence of asbestos in any form.
4. "Auto" means a land motor vehicle, trailer or
sernl-lraller designed for travel on public
roads, including any attached machinery or
equiprnenl But "auto" does not include
"mobile equipment".
5. "Bodily injury" means physical:
a. Injury;
b. Sickness; or
c. Disease
sustained by a person and, if arising out of the
above. mental angt,J_ish o_r death at an_y.,tlme.
6. "Coverage territory" means:
Form SS DO OB 04 05
a. The United States of America {including its
territories and possessions), Puerto Rico
and Canada;
b. International waters or airspace, but only if
the injury or damage occurs in the course
of travel or lransportallon between any
places included in a. above;
c. All other parts of the world if the Injury or
damage arises out of:
(1) Goods or products made or sold by you
in ·the·tenitory describecfln· a. aodve;
(2} The activities of a person whose home
Is In the territory described in a. ·
above, but Is away for a short tlme on
your-business; or
(3) "Personal and advertising Injury"
offenses lhat take place through the
Internet or simTiar electronic means of
communlcatlon
provided the insured's responsibility to pay
damages Is determined In the United States of
America Oncluding its territories and
possessions), Puerto Rico or Canada, In a
"suit" on lhe merits according to the
substantive !aw In such territory, or in a
setilernent we agree to.
7. "Electronic data" means Information, facts or
programs:
a. Stored as or on;
b. Created or used on; or
c. Transmitted to or from
computer software, including systems and
appllcallons software, hard or nappy disks,
CD-ROMS, tapes, drives, cells, data
processing devices or any other media which
are used with electronically controlled
equipmenl
B. "Employee" Includes a "leased worker".
"Employee" does not include a "temporary
worker".
9. "Executive officer" means a person holding
any of the officer positions created by your
charter, consUtulion, by-laws or any other
similar governing documenl
10. "Hostlle fire" means one which becomes
uncontrollable or breaks out from where It was
intended to be.
11. "Impaired property" means tangible property,
al.her than "your producl'' or "your work", that
cannot be used or is less useful because:
a. It incorporates "your product" or '.'your work"
that ls known or thought to be defective,
deficien~ Inadequate or dangerous; or
Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
b. You have failed to fulfill the tenns of a
contract or agreement;
if such property can be restored lo use by:
a. The repair, replacement, adjustment or
removal of "your product" or "your work";
or
b. Your rutrnling the terms or the contract or
agreemenl
12. "Insured contract" means:
a. A--·contract·· for · ·a · lease of · premises_
However, that portion of the contract for a
lease of premises that Indemnifies any
person or organization for damage by fire,
lightning or explosion lo premises while
rented to you or temporarily occupied by
you with permission of \he owner fs
subject to the Damage To Premises
Rented To You limit described In Section
D. -Uability and Medical Expenses Limits
of Insurance.
b. A sidetrack agreement;
c. Any easement or Jfcense ag·reement,
includlng an easement or license
agreement in connection with construction
or demolition operations on or within 50
feet of a railroad;
d. Any oblfgatlon, es required by ordinance,
to indemnify a municipality, except in
connection with work for a munlclpality;
e. An elevator maintenance agreement; or
f. That part of any alher contract or
agreement pertaining to your business
{Including an indemn!ficatlon of a
municipality in connection with work
performed for a munlclpallty).under which
you assume the tort llablllty of another
party lo pay for "bodlly injury" or "property
damage" lo a third person or organization,
provided the "bodily Injury" or "property
damage" Is caused, In whole or In part, by
you or by those acting on your behalf.
Tort liabillty means a liability that would be
imposed by law in the absence of any
contract or agreemenL
Paragraph f. includes that part of any
contract or agreement that indemnifies a
railroad for "bodily injury• or "property
damage" arising out of construction or
demolition operations within 50 feet of any
railroad property and affecting any railroad
bridge or trestle, tracks, road-beds, tunnel,
underpass or crossing.
However, Paragraph f. does not include
that part of any conlract or agreement
Page 21 of 24
BUSINESS LIABILITY COVERAGE FORM
(1) Thal indemnifies an architect,
engineer or surveyor for injury or
damage arising oul of:
(a) Preparing, approving or failing to
prepare or approve maps, shop
drawings, opinions, reports,
surveys, field orders, change
orders, designs or drawings and
specifications; or
{b) Giving directions or instructions,
or-falling to give -them,-If that is the
primary cause of the injury or
damage; or
{2) Under which the insured, if an
architect, engineer or surveyor,
assumes liability for an Injury or
damage arising oul of the insured's
rendering or failure lo render
professional services, including those
i!sted In (1} above and supervisory,
lnspecUon, archltectural or
engineering activities.
13. "Leased worker" means a person leased to
you by a labor leasing firm under an
agreement between you and the labor leasing
firm, to perform duties related to the conduct of
your business. "Leased worker" does not
Include a "temporary worker".
14. "Loading or unloading" means the handling of
property:
a. After it is moved from the place where !t ls
accepted for movement Into or onto an
aircraft, watercraft or "auto";
b. While it rs in or on an aircraft, watsrcraft or
"auton; or
c. While lt is being moved from an aircraft,
watercraft or "auto" to the place where it ls
finally delivered;
but "loading or unloading" does not include U,e
movement of property by means of a mechanical
device, other lhan a hand truck, that Is not
attached to U,e aircraft, watercraft or "auto".
15. "Mobile equipment" means any of the following
types of land vehicles, including any attached
machinery or equipment
a. Bulldozers, farm machinery, forklifts and
other vehicles designed for use principally
off publfc roads;
b. Vehicles maintained for use solely on or
next to premises you own or rent;
c. Vehicles that travel on crawler treads;
d. Vehicles, whether self-propelled or not, on
which are permanently mounted:
Page 22 of 24
(1) Power cranes, shovels, loaders,
diggers or drills; or
(2) Road construction or resurfacing
equipment such as graders, scrapers
or rollers;
e. Vehicles not described in a., b., c., or d.
above lhat are not self-propelled and are
maintained primarily lo provide mobility to
permanently attached equipment of the
following types:
{1) Atr · compressors, pumps and
generators, · Including spraying,
welding, building cleaning,
geophysical exploration, fighting and
well servicing equipment; or
(2) Cherry pickers and slmllar devices
used to raise or lower workers;
f. Vehicles not described in a., b., c., or d.
above maintained primarily for purposes
other than the transportation of persons or
cargo.
However, self-propelled vehicles with the
following types of permanently attached
equipment are not "mobile equipment'' but
will be considered "autos":
(1) Equipment, of at least 1,000 pounds
gross vehicle weight, designed
primarily for.
(a) Snow removal;
(b) Road maintenance, but nol
construcllon or resurfacing; or
(c) Street cleaning;
{2} Cherry pickers and similar devices
mounted on automobile or . truck
chassis and used to raise or lower
wa.rkers; and
(3) Air co.mpressors, pumps and
generators, Including spraying,
welding, bu·/!dfng cleaning,
geophysical exploratior1, lighting and
well servicing equipmenl
16. "Occurrence" means an acctden~ Including
continuous or repeated exposure to substantially
lhe same general harmful conditions.
17. "Personal and advertising Injury" means injury,
including consequential "bodlly injury", arising
out of one or more of the following offenses:
a. False arrest, detention or imprisonment;
b. Mallclous prosecution;
Form SS OD OB 04 05
c. The wrongful eviction from, wrongful entry
into, or invasion of the right of private
occupancy or a room, dwelling or
premises that the person occupies,
committed by or on behalf of its owner,
landlord or lessor;
d. Oral, written or electronic publication of
material that slanders or libels a person or
organization or disparages a person's or
organization's goods, products or services;
e. Qral; written ·or-··electronlc--publicaUon · of
material \hat violates a person's right of
privacy;
f. Copying, ln your "advertisement", a
person's or organization's "advertising
idea" or style of ''advertisement";
g, Infringement of copyright , slogan, or title of
any Hterary or artistic work, in your
"advertisement"; or
h. Dlscrimlnattan or hurnlllation \hat results in
injury to the feeUngs or reputation of a
na\ural person.
18. "Pollutants " means any solid, liquid, gaseous or
thermal initanl or cont.amlnan~ inc/!lding smoke,
vapor, soot, fumes, acids, alkalis, chemicals and
waste . Waste Includes malerials lo be recy"(,.ied,
reconditioned or reclaimed.
19 . "Products-completed operations hazard";
a. Includes ail "bodily Injury" and "property
damage" occurring away from premises
you awn or rent and artslng out of "your
product'' or "your work" except:
(1) Products U,at are still in your physical
possession; or
(2) Work that has not yet been completed
or abandoned. However, "your work"
will be deemed to be completed at the
earliest of the following times:
(a) When all of the work called for in
your contract has been completed.
(b) When all of the work to be done at
the job site has been cornple\ed if
your contract calls for work at
more than one job site.
(c) When that part of the work done at
a Job site has been put lo its
intended use by any person or
oryanlzation other than another
contractor or subcon\ractor
working on the same projecl
Form SS 00 DB 04 05
BUSINESS LIABILITY COVERAGE FORM
Work that may need service, maintenance,
correction, repair or replacement, but
which is otherwise compie\e, will be
treated as completed .
The "bodily injury" or "property damage"
must occur away from premises you own
or rent, unless your business includes the
selling, handling or distribution of "your
product" for consumption on premises you
own or renL
b. Doss··· ··nat · Tncmae ·"ooalry irijury" or
"property· damage" arising out of:
(1) The transportation of property, unle?s
the injury or damage arises out of a
condition in or on a vehicle not ovmed
or operated by you, and that condition
was created by the "loading or
unloading" of that vehicle by any
Insured; or
(2} The existence of tools, unlnslalied
equipment or abandoned or unused
materials.
20. ''Property damage" means:
a. Physical injury to tangible property,
including all resulUng loss of use of that
property. All such loss of use shall be
deemed to occur at the time of the
physical Injury that caused It; or
b. Loss of use of tangible property that is not
physically Injured . All such loss of use
13hall be deemed lo occur at the time of
"ocDurrence" that caused lt.
As used in !hls definition, "electronic data" is
not tangible property.
21. "Su it" means a c{fll proceeding ln which
damages because of "ti[ldlly injury", "property
damage" or "personal ana' _advertising injury"
to which this insurance applfe§ J3re alleged.
"Suit" includes:
a. An arbitration proceeding in which such
damages are claimed and to which the
insured must submit or does submit with
our consent, or
b. Any other alternative dispute resolution
proceeding ln which such damages are
claimed and to which the insured submits
with our consent
22. "Temporary worker" means a person who is
furnished to you to substitute for a permanent
"employee" on leave or la meet seasonal or
short-term workload conditions.
23. "Volunteer worker" means a person who:
a. Is not your "employee";
Page 23 of24
BUSINESS LIABILITY COVERAGE FORM
b. Donates his or her work;
c. Acts at the direction of and within the
scope of duties determined by you; and
d. Is not paid a fee, salary or other
compensation by you or anyone else for
their work performed for you.
24. "Your product":
a. Means:
(1) Any goods or products, other than real
P!"OY-.~r!Y! ffi?!:'l_u~gt_l,Jf!)tj, .~C?Jc:J, h11rnc!led,
distributed or disposed of by:
(a) You;
(b} Others trading under your name;
or
(c) A person or organization whose
business or assets you have
acquired; and
(2) Containers (other than vehicles),
equipment
with such
materials, parts or
furnished In connection
goods or products.
b. Includes:
(1) Warranties or representations mads at
any time with respect to the fitness,
quality, durability, performance or use
of "your product"; end
Page 24 of 24
(2) The providing of or failure to provide
warnings or instructions.
c. Does not include vending machines or
other property rented to or lm;ated for the
use of others but not sold.
25. "Your worl<":
a. Means:
(1) Work or operations performed by you
or on your behalf; and
(2) · Materials, parts cir · equipment
furnished In connection with such work
or operations.
b. Includes:
(1) Warranties or representations made at
any time with respect to the fitness,
quallly, durability, performance or use
of "your work"; and
(2) The providing of or failure to provide
warnings or Instructions.
Form SS 00 08 04 05
Declaration of Sole Proprietorship
DECLARATION AND ADDENDUM TO ALL CONTRACTS ENTERED INTO OR BID
A WARDED TO: Col~ lv\. l..opt.:< , hereinafter "Organization"
For the purpose of inducing the City of Cupertino ("City") to enter into any contracts with
Organization, or to go forward with any contracts awarded to Organization, I declare as
follows:
I am the authorized representative of Organization, an independent contractor for the purposes
of workers' compensation and labor laws in the State of California. This Organization will hire
no employees for work required for any bid awarded or any contract entered into with the City.
All work required will be performed personally and solely by me.
If the Organization hires employees to perform this contract or any portion thereof, the
Organization shall obtain workers' compensation insurance and provide proof of such coverage
to the City.
If the Organization hires a subcontractor to perform this contract or any portion thereof, and the
subcontractor has employees, then the Organization shall require its subcontractor to obtain
workers' compensation insurance coverage . In the alternative, the Organization shall obtain
workers' compensation insurance coverage on behalf of the subcontractor's employees.
This document constitutes a declaration by the Organization against its financial interest,
relative to any claims that it may assert under the applicable workers' compensation and/or
labor laws against the City relating to any bid awarded or contract entered into with this
Organization. The Organization shall defend, indemnify and hold harmless the City from any
and all liability, claims, demands, causes of action, charges, damages, injuries, fees including
attorney fees, costs and expense that may be asserted or established by any person or entity in
the event the Organization hires an employee in violation of this addendum.
I agree that this declaration shall constitute an addendum to any bid awarded or any contract
entered into with this Organization. I declare under penalty of perjury under the laws of the
State of California that the foregoing is true and correct.
DATE
A~Z'?r;R·E~TATIVE
Revised, 01 .05 .18
ACORD® CERTIFICATE OF LIABILITY INSURANCE I
DA TE (MM/00/YYYY)
~ 01/25/2018
THIS CERTIFICATE IS ISSUED AS A MAITER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the
terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER RENEE HUBER LIC#OG86164 ~~~~~CT Renee Huber
~.9~sxtl· 925-484-2222 I FAX AGENT FOR STATE FARM INSURANCE {A/C Nol : 925-484-1716
312 A ST MARYS STREET ~to';l~ss : renee@reneehubeinsurance.com
~ PLEASANTON , CA 94566 PHONE 925-484-2222 INSURERISI AFFORDING COVERAGE NAIC#
INSURER A: State Farm Mutual Automobile In surance Comoanv 2517S
INSURED COLLEEN LOPEZ INSURER B :
INSURER C:
INSURER D :
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
TH IS IS TO CERTIFY THAT THE POLI CIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED . NOTWI THSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WI TH RE SPECT TO WHI CH THIS
CERTIFI CAT E MAY BE ISSUED OR MAY PERTAIN, THE INSURAN CE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS ,
EXC LUSIONS AN D CONDITIONS OF SUCH POLICIES . LIMITS SHOWN MAY HAVE BEEN REDUCED BY PA ID CLAIMS .
INSR ADDL SUB R POLICY EFF POLIC Y EXP LTR TYPE OF INSURANCE OhlCD '"',n POLICY NUMBER IMMIDD/YYYY l IMM /00/YYYYl LI MITS
GENERAL LIABILITY D D EACH OCCURRENCE $ -UAMA\ot I V KtN I c U COMMERCIAL GENER AL LI AB ILI TY PREMISES !Ea occurrencel $ -
>--::::J CLA IMS -M ADE D OCCUR MED EXP (Any one person ) $
PERSONA L & ADV INJURY >--$
GENERAL AGGREGATE $ -GEN'L AGGRE GATE LIMIT APP LIES PER : PRODUCTS · COM P/OP AGG $ rxi POLICY n ':'bw,= nLOC s
A AUTOMOBILE LIABILITY D D 01/02/2018 01/02/2019 COMBINED SINGLE LIMIT
>--!Ea accident\ s
ANY AUTO BODILY IN JURY (Per pers on) s 500 ,0 00 x -ALL OWNED X SCHEDUL ED BODILY INJ URY (Pe r accident) $ 500 ,0 00 AUTOS AUTOS -NON-0\IVNED PROPERTY DAMAG E -HIRED AUTOS -AUTOS IPer accide nt\ $ 100 ,0 00
$
UMBRELLA LIAB H OCCUR :D D EAC H OCCURRENC E $ -
EXCESS LIAB CLA IMS-MADE AG GREGATE $
OED I I RETENTION $ $
WORKERS COMPENSATION I WCSTATU-I jOTH -
AND EMPLOYERS ' LIABILITY TORY I IMI T<a ER
Y/N ANY PRO PRIETOR/PARTNER/EXECUTIVE D D E.L. EACH ACCIDENT $
OFFICE/MEMBER EXC LUDED? N/A
(Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $
If yes, describe under E.L. DISEASE -POLICY LIMIT s n~r,r-n,nYl ()I\I ru::: r..ni::nATor"\ .. ,,.. h.ctn.u,
ID
I
D
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHI CLES (Atta ch ACOR D 101, Additional Remar ks Schedule, if more spac e is required)
A DDITIONAL INSURED :
C ITY O F CU PERTINO, ITS CITY COUNC IL .OFF ICERS. O FFICIALS .EM PLOYEES, AGENTS, SERVANTS AND VO LUNTEERS ARE TO BE COVER ED AS
ADDITION A L INS URED W ITH RESPECT TO LI ABI LITY A R ISING O UT OF WORK OR O PERATIONS PERFORMED BY OR ON BEHALF O F CONTRACTOR
IN CLUDIN G MATERIALS, P A RTS OR EQUIPMENT FURNISHED IN CONNECTION WITH SUCH WORK OR OPERATIONS.
CERTIFICATE HOLDER
CITY OF CUPERTINO
10300 TORRE A VE
CUPERTINO, CA 95014
ACORD 25 (2010/05)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS .
© 1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD 100 1486 132849.6 11-15-2010
FIRST AMENDMENT TO AGREEMENT BETWEEN THE CITY OF
CUPERTINO AND COLLEEN LOPEZ FOR AFFORDABLE HOUSING CONSUL TING
SERVICES
This First Amendment to the Agreem ent between the City of Cupertino and Co lle en
Lopez , for reference dated December 14 , 2016 , is by and bet\veen the CTTY OF CUPERTINO, a
municipal co rporation (hereinafter "City") a nd Co ll een Lopez a Cal iforni a individual
("Consultant") whose address is , and is made with
reference to the following:
RECITALS:
A. On May 17 , 2016 , an agreement was entered into by and bet\veen City and
Consultant (hereinafter "Agreement") for affordable housing consu lting services.
B. City a nd Consu ltant desire to modify the Agreement on the te1111s and conditions
set forth herein.
NOW , THEREFORE, it is mutually agreed by and between and undersigned parties as
follows:
1. Paragraph 1 of the Agreemen t is modified to read as follows:
The te1111 of this agreement sha ll commence on May 17 , 2016 and shall terminate on
December 31 , 20 17, unless terminated earli er as set forth herein .
2. Paragraph 3 of the Agr eement is modified to read as follows:
3. Con su lt ant sha ll be compensated for services performed pursuant to this Agreement
in a total amount not to exceed SIXTY-NONE THOUSAND AND THREE
HUNDRED dollars ($69 ,300.00) based on the rates and terms set fort h in Exhibit "C "
2 . The following Ex hibits to the Agreement, are amended and replaced to read as s hown
in the attachments to this Amendment:
a. Exhibit "A,"-Scope of Services and Compensation
3. Except as express ly modified herein , a ll other te1111s and covenants set forth in the
Agreement shall remain the same a nd shal l be in full force and effect.
TN WITNESS WHEREOF, the parties hereto have caused this modification of
Agreement to be executed .
CONSULTANT CTTY OF CUPERTINO
A Municipal Corporation J
By:~£ ~tlff/'~
Titl ~&s'"T WY //,<lA/.l/~0,--
RECOMMENDED FOR APPROVAL:
By ~ ~ 0~'1..,/
Title ~~~ How~o
y~
APPROVED AS TO FORM:
,-; Cit/ Atto rn ey
A TTEST:
~c~P-
c ity Clerk 'L--2..-I 7
EXPENDITURE DISTRIBUTION
PO #2016 -555 Account: 265-72-711 700-702
Original Contract: $34,650.00
Amendment #1 A ddition: $34,650.00
Total: $69,300.00
Exhibit A
Scope of Services and Compensation
1 Scope of Services: Consullanl s h a ll provide ge n era l affordable h o u si n g
co n s ultin g services as req u es ted by the C ity of Cupertino .
II. Compensation:
City shall compensate Cons ultant for professional services in accordance with the terms
a nd conditions of this Agreeme nt based o n th e rates and compensation sch ed ule set
forth below. Co mpensatio n s h all be calc ul ated based on th e h o url y r ates set forth below
up to th e not to exceed budget amount set forth below .
The compensation to be paid to Consultant under this Agreement for all services
described under Section 1 of thi s Exhibit sha ll not exceed $69,300 .00 . Any work
performed or ex p enses incurred for which payment wou ld result in a total exceeding the
maximum amount of compen sation set forth herein s hall be at no cost to the City.
fil Rates:
Hourly: $105
IV. Invoices
In order t o request payment, Consultant sha ll submit monthly invoices to the CITY
describing the services performed and the applicable c harges (including a s ummary of
work performed during that quarter, personnel who performed the services, hours
worked , task(s) for w hich wo rk was performed).
V. Reimbursab le Expenses
Norma l proj ect related reimbursab le ex p e n ses such as printing, postage, d e livery
se rvi ce, lon g distance phone calls, facsimile transmissions, mil eage, a nd s p ec ial
project-re lated supp li es.
VI. Additional Services
Consultant s h all provide additional services o utside of th e services identified in Exhibit
A on ly by advance written a uthori za ti on from the City's Project Manager pri or to
commen ce m e nt of any additional services . Consultant shall submit, at th e Project
Manager's requ est, a detai le d written proposa l including a description of the scope of
add itional services, schedule, and proposed maximum compensation.
AGREEMENT BETWEEN THE CITY OF CUPERTINO AND COLLEEN
LOPEZ FOR GENERAL AFFORDABLE HOUSING CONSULTING SERVICES
THIS AGREEMENT, is entered into this 17th day of May, 2016 , by and between
the CITY OF CUPERTINO, a California municipal corporation ("City"), and Colleen
Lopez , whose address is (hereinafter
referred to as "Consultant") (collectively referred to as the "Parties").
RECITALS:
A. City is a municipal corporation duly organized and validly existing under
the laws of the State of California with the power to carry on its business as it is now
being conducted under the Constitution and the statutes of the State of California and the
Cupertino Municipal Code.
B. Consultant is specially trained , experienced and competent to perform the
special services which will be required by this Agreement.
C. Consultant possesses the skill , experience, ability, background ,
ce1iification and knowledge to provide the services described in this Agreement on the
terms and conditions described herein.
D. City and Consultant desire to enter into an agreement for general
affordable housing consulting services upon the terms and conditions herein.
NOW , THEREFORE, the Parties mutually agree as follows:
1, TERM
The term of this Agreement shall commence on May 17 , 2016, and shall
terminate on December 31 , 2016, unless terminated earlier as set forth herein.
2. SERVICES TO BE PERFORMED
Consultant shall perform each and every service set forth in Exhibit "A", attached
hereto and incorporated herein by this reference.
3. COMPENSATION TO CONSULTANT
Consultant shall be compensated for services performed pursuant to this
Agreement in a total amount not to exceed THIRTY FOUR THOUSAND, SIX
HUNDERED AND FIFY dollars ($34 ,650.00) based on the rates and terms set forth in
Exhibit "C," which is attached hereto and incorporated herein by this reference.
4. TIME IS OF THE ESSENCE
Consultant and City agree that time is of the essence regarding the performance of
this Agreement.
5. ST AND ARD OF CARE
Consultant agrees to perform all services required by this Agreement 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
Colleen Lopez , Planning Consultant
May 17 , 2016 -Decernber 31 -2016
Pa ge I of 10
City.
6. INDEPENDENT PARTIES
City and Consultant intend that the relationship between them created by this
Agreement is that of employer-independent contractor. The manner and means of
conducting the work are under the control of Consultant, except to the extent they are
limited by statute , rule or regulation and the express terms of this Agreement. No civil
service status or other right of employment will be acquired by virtue of Consultant's
services. None of the benefits provided by City to its employees, including but not
limited to , unemployment insurance , workers' compensation plans , vacation and sick
leave are available from City to Consultant, its employees or agents. Deductions shall not
be made for any state or federal taxes , FICA payments, PERS payments, or other
purposes normally associated with an employer-employee relationship from any fees due
Consultant. Payments of the above items, if required , are the responsibility of Consultant.
7. IMMIGRATION REFORM AND CONTROL ACT (IRCA)
Consultant assumes any and all responsibility for verifying the identity and
employment authorization of all of his/her employees performing work hereunder,
pursuant to all applicable IRCA or other federal , or state rules and regulations. Consultant
shall indemnify and hold City harmles s from and against any loss , damage, liability, costs
or expenses arising from any noncompliance of this provision by Consultant.
8. NON-DISCRIMINATION
Consistent with City's policy prohibiting harassment and discrimination ,
Consultant agrees that it shall not harass or discriminate against a job applicant, a City
employee, or a citizen by Consultant or Consultant's e mployee or subcontractor on the
basis of race, religious creed , color, national origin , ancestry, handicap , disability, marital
status , pregnancy, sex, age, sexual orientation , or any other protected class. Consultant
agrees that any and all violations of this provision shall constitute a material breach of
this Agreement.
9. HOLD HARMLESS
IZI Standard Indemnification:
Consultant shall , to the fullest extent allowed by law and without limitation of the
provisions of this Agreement related to insurance, with respect to all services performed
in connection with the Agreement, indemnify, defend , and hold hannless the City and its
officers, officials, agents , employees and volunteers from and against any and all liability,
claims , actions , causes of action or demands whatsoever against any of them , including
any injury to or death of any person or damage to prope11y or other liability of any nature,
whether physical , emotional , consequential or otherwise, arising out, pertaining to, or
related to the negligent performance of this Agreement by Consultant or Consultant 's
employees, officers, officials, agents or independent contractors. Such costs and expenses
shall include reasonable attorneys' fees of counsel of City's choice, expert fees and all
other costs and fees of litigation. The acceptance of the Services by City shall not operate
as a waiver of the right of indemnification . The provisions of this Section surv ive the
completion of the Services or termination of this Contract.
Colleen Lop ez , Planning Consultant
May 17 , 2016-December 31-2016
Page 2 of JO
I 0. INSURANCE:
A. General Requirements . On or before the commencement of the term of this
Agreement, Consultant shall furnish City with certificates showing the type, amount,
class of operations covered , effective dates and dates of expiration of insurance coverage
in compliance with the requirements listed in Exhibit "D ". Such certificates, which do not
limit Consultant'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." Consultant shall maintain in force at all times during the
performance of this Agreement all appropriate coverage of insurance required by this
Agreement with an insurance company that is acceptable to City and licensed to do
insurance business in the State of California. Endorsements naming the City as additional
insured shall be submitted with the insurance certificates.
B. Subrogation Waiver. Consultant agrees that in the event of loss due to any
of the perils for which he/she has agreed to provide comprehensive general and
automotive liability insurance, Consultant shall look solely to his/her insurance for
recovery. Consultant hereby grants to City, on behalf of any insurer providing
comprehensive general and automotive liability insurance to either Consultant or City
with respect to the services of Consultant herein , a waiver of any right to subrogation
which any such insurer of said Consultant may acquire against City b y virtue of the
payment of any loss under such insurance.
C . Failure to secure or maintain insurance. If Consultant at any time during
the term hereof should fail to secure or maintain the foregoing insurance, City shall be
permitted to obtain such insurance in the Consultant's name or as an agent of the
Consultant and shall be compensated by the Consultant for the costs of the insurance
premiums at the maximum rate permitted by law and computed from the date written
notice is received that the premiums have not been paid.
D . Additional Insured. City, its City Council, boards and commissions,
officers, employees and volunteers shall be named as an additional insured under all
insurance coverages, except any professional liability insurance, required by this
Agreement. The naming of an additional insured shall not affect any recovery to which
such additional insured would be entitled under this policy if not named as such
additional insured. An additional insured named herein shall not be held liable for any
premium , deductible portion of any loss, or expense of any nature on this policy or any
extension thereof. Any other insurance held by an additional insured shall not be required
to contribute anything toward any loss or expense covered by the insurance provided by
this policy .
E. Sufficiency of Insurance. The insurance limits required by City are not
represented as being sufficient to protect Consultant. Consultant is advised to confer with
Consultant's insurance broker to determine adequate coverage for Consultant.
F. Maximum Coverage and Limits. It shall be a requirement under this
Agreement that any available insurance proceeds broader than or in excess of the
specified minimum Insurance coverage requirements and /or limits shall be available to
the additional insured City. Furthermore, th e requirements for coverage and limits shall
be the minimum coverage and limits specified in this Agreement, or the broader coverage
and maximum limits of coverage of any insurance policy or proceeds available to the
Colleen Lo p ez , Pl a nning Consultant
May 17 , 2016-Dece mber 31 -2016
Page 3of10
named insured , whichever is greater.
11. CONFLICT OF INTEREST
Consultant warrants that it presently has no interest, and will not acquire any
interest, direct or indirect , financial or otherwise, that would conflict in any way with the
performance of this Agreement, and that it will not employ any person having such an
interest. Consultant agrees to advise City immediately if any conflict arises and
understands that it may be required to fill out a conflict of interest form if the services
provided under this Agreement require Consultant to make certain governmental
decisions or serve in a staff capacity as defined in Title 2, Division 6, Section 18700 of
the California Code of Regulations.
12. PROHIBITION AGAINST TRANSFERS
Consultant shall not assign , sublease, hypothecate, or transfer this Agreement, or
any interest therein , directly or indirectly, by operation of law or otherwise, without prior
written consent of City. Any attempt to do so without said consent shall be null and void ,
and any assignee, sublessee, hypothecate or transferee shall acquire no right or interest by
reason of such attempted assignment, hypothecation or transfer. However, claims for
money by Consultant from City under this Agreement may be assigned to a bank, trust
company or other financial institution without prior written consent. Written notice of
such assignment shall be promptly furnished to City by Consultant.
The sale, assignment, transfer or other disposition of any of the issued and
outstanding capital stock of Consultant, or of the interest of any general partner or joint
venturer or syndicate member or cotenant, if Consultant is a paitnership or joint venture
or syndicate or cotenancy, which shall result in changing the control of Consultant, shall
be construed as an assignment of this Agreement. Control means fifty percent (50%) or
more of the voting power of the corporation.
13. SUBCONTRACTOR APPROVAL
Unless prior written consent from City is obtained , only those people and
subcontractors whose names and resumes are attached to this Agreement shall be used in
the performance of this Agreement.
In the event that Consultant employs subcontractors, such subcontractors shall be
required to furnish proof of workers' compensation insurance and shall also be required to
carry general , automobile and professional liability insurance in reasonable conformity to
the insurance carried by Consultant. In addition , any work or services subcontracted
hereunder shall be subject to each provision of this Agreement.
Consultant agrees to include with all subcontractors in their subcontract the same
requirements and provisions of this Agreement including the indemnity and insurance
requirements to the extent they apply to the scope of the subcontractor 's work.
Subcontractors hired by Consultant agree to be bound to Consultant and City in the same
manner and to the same extent as Consultant is bound to City under this Agreement.
Subcontractor further agrees to include these same provisions with any sub-
subcontractor. A copy of the Owner Contract Document Indemnity and Insurance
provisions will be furnished to the subcontractor upon request. Consultant shall require
all subcontractors to provide a valid certificate of insurance and the required
endorsements included in the agreement prior to commencement of any work and will
Colleen Lopez , Planning Consultant
May 17 , 2016-December 31 -2016
Page 4 of 10
provide proof of compliance to City.
14. PERMITS AND LICENSES
Consultant, at his/her sole expense, shall obtain and maintain during the term of
this Agreement, all appropriate permits , certificates and licenses including, but not
limited to , a City Business License , that may be required in connection with the
performance of services hereunder.
15. REPORTS
A. Each and every report , draft, work product, map , record and other
document, hereinafter collectively referred to as "Report", reproduced , prepared or
caused to be prepared by Consultant pursuant to or in connection with this Agreement,
shall be the exclusive property of City. Consultant shall not copyright any Report
required by this Agreement and shall execute appropriate documents to assign to City the
copyright to Reports created pursuant to this Agreement. Any Report, information and
data acquired or required by this Agreement shall become the property of City, and all
publication rights are reserved to City. Consultant may retain a copy of any repo11
furnished to the City pursuant to this Agreement.
B . All Repo11s prepared by Consultant may be used by City in execution or
implementation of: (1) The original Project for which Consultant was hired ; (2)
Completion of the original Project by others; (3) Subsequent additions to the original
project ; and/or ( 4) Other City projects as City deems appropriate.
C. Consultant shall , at such time and in such form as City may require ,
furnish reports concerning the status of services required under this Agreement.
D. All Reports required to be provided by this Agreement shall be printed on
recycled paper. All Reports shall be copied on both sides of the paper except for one
original, which shall be single sided.
E. No Report, information or other data given to or prepared or assembled by
Consultant pursuant to this Agreement shall be made available to any individual or
organization by Consultant without prior approval by City.
16. RECORDS
Consultant shall maintain complete and accurate records with respect to sales,
costs , expenses, receipts and other such information required by City that relate to the
performance of services under this Agreement, 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 readil y accessible. Consultant
shall provide free access to such books and records to the representatives of City or its
designees at all proper times , and gives City the right to examine and audit same, and to
make transcripts therefrom as necessary, and to allow inspection of all work, data,
documents , proceedings and activities related to this Agreement. Such records , together
with supporting documents, shall be kept separate from other documents and records and
shall be maintained for a period of three (3) years after Consultant receives final payment
from City for all services required under thi s agreement.
If supplemental examination or audit of the records is necessary due to concerns
raised b y 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
Colleen Lo pez , Planning Consultant
May 17 , 2016-December 31-2016
Pa ge 5of10
financial controls, or other breach of contract or failure to act in good faith , then
Consultant shall reimburse City for all reasonable costs and expenses associated with the
supplemental examination or audit.
17 . NONAPPROPRIATION
This Agreement is subject to the fiscal provisions of the Cupertino Municipal
Code and Agreement will terminate without any penalty (a) at the end of any fiscal year
in the event that funds are not appropriated for the following fiscal year, or (b) at any
time within a fiscal year in the event that funds are only appropriated for a portion of the
fiscal year and funds for this Agreement are no longer available. This Section shall take
precedence in the event of a conflict with any other covenant, term , condition, or
provision of this Agreement.
18. ENVIRONMENTALLY PREFERABLE PURCHASING
Consultant shall comply with the City's Environmentally Preferable Procurement
Policy whenever practicable in completing any work under this agreement, including but
not limited to :
• Using paper products made with recycled content and
recycled/remanufactured toner and inkjet cartridges ;
• Printing with soy or low volatile organic compounds (VOC) inks ;
• Using energy-star compliant equipment;
• Using cleansers and working with janitorial contractors to meet Green Seal 's
Industrial and Institutional Cleaners Standard ; and
• Ordering supplies electronically and practicing other internal waste reduction
and reuse protocols.
19. 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 shall be addressed as follows:
TO CITY :
City of Cupe1iino
10300 Torre Ave.
Cupertino CA 95014
Attention: Aarti Shrivastava, Assistant City Manager
TO CONSULTANT:
Colleen Lopez
20. TERMINATION
ln the event Consultant fails or refuses to perform any of the provisions hereof at
the time and in the manner required hereunder, Consultant shall be deemed in default in
Colleen Lopez , Planning Consultant
May 17 , 2016 -Decernber 31 -2016
Page 6 of JO
the performance of this Agreement. If Consultant fails to cure the default within the time
specified and according to the requirements set forth in City 's written notice of default,
and in addition to any other remedy available to the City by law, the City Manager may
terminate the Agreement by giving Consultant written notice thereof, which shall be
effective immediately. The City Manager shall also have the option , at its sole discretion
and without cause, of terminating this Agreement by giving seven (7) calendar days' prior
written notice to Consultant as provided herein. Upon receipt of any notice of
termination , Consultant shall immediately discontinue performance.
City shall pay Consultant for services satisfactorily performed up to the effective
date of termination. If the termination if for cause, City may deduct from such payment
the amount of actual damage, if any, sustained by City due to Consultant 's failure to
perform its material obligations under this Agreement. Upon termination , Consultant
shall immediately deliver to the City any and all copies of studies, sketches, drawings ,
computations, and other material or products , whether or not completed , prepared by
Consultant or given to Consultant, in connection with this Agreement. Such materials
shall become the property of City.
21. COMPLIANCE
Consultant shall comply with all state or federal laws and all ordinances, rules ,
policies and regulations enacted or issued by City.
22. 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 Superior Court of the County of Santa Clara, State of
California.
23. ADVERTISEMENT
Consultant shall not post, exhibit, display or allow to be posted , exhibited ,
displayed any signs , advertising, show bills , lithographs , posters or cards of any kind
pertaining to the services perforn1ed under this Agreement unless prior written approval
has been secured from City to do otherwise.
24. 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.
25. INTEGRATED CONTRACT
This Agreement represents the full and complete understanding of every kind or
nature whatsoever between the Parties , and all preliminary negotiations and agreements
of whatsoever kind or nature are merged herein. No verbal agreement or implied
Colleen Lopez , Planning Consultant
May 17 , 2016-December 31-2016
Page 7 of10
covenant shall be held to vary the provisions hereof. An y modification of this Agreement
will be effective only by written execution signed by both City and Consultant.
26. AUTHORITY
The individual(s) executing this Agreement represent and warrant that they have
the legal capacity and authority to do so on behalf of their respective legal entities .
27. 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 .
28. CAPTIONS AND TERMS
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. All unchecked boxes do not apply to this Agreement.
JN WITNESS WHEREOF, the parties have caused the Agreement to be executed.
CONSULTANT
Colleen Lopez
~;,le ~~
Date M c.i 2_o 1 2 0 I V
~ORM
~ uy AttOrneY
v '\ ATTEST:
~it
City Clerk {g ,...-6-f'Cf
Colleen Lopez , Planning Consultant
May 17 , 2016 -December 31 -2016
Page 8 of 10
CITY OF CUPERTINO
A Municipal Corporation
By k &ufllla;.
Ti ~~~h'AW~ Date ~!__2{__
D O ver $175,000-Council Approva l Required
D Over $45 ,000 -De partm ent Head Approva l Required
~ Up to $45,000-Des ignated Superv isor Approva l Required
RECOMMENDED FOR APPROVAL
Exhibits: (Check bo x for exhibits that app ly to thi s co ntra ct and attach)
~Exhib it "A "-Scope of Services
D Exhibit "B "-Schedule of Performance
D Exhibit "C "-Compensation
~ Exhibit "D "-Insurance Requirements and Proof of Insurance
D Exhibit "E"-Mandated Reporting Acknowledgement
D Exhibit "F"-Background/Fingerprint/TB Declaration
D Exhibit "G"-Nondiscrimination-Stat.e/Federal/HUD funded project
D Ex hibit "H" -Request for City Manager to Waive Informal Bidding Requirements
EXPENDITURE DISTRIBUTION
ACCO UNT NUMBER
PO #2016-555
265-72-711 700-702
Total:
Colleen Lopez , Planning Consultant
May 17 , 2016-December 31 -2016
AMOUNT
$34,650.00
$34,650.00
Page 9of10
Exhibit A
Scope of Services and Compensation
1 Scope of Services: Consultant shall provide general affordable housing
consulting services as requested by the City of Cupertino.
IL Compensation:
City shall compensate Consultant for professional services in accordance with the terms
and conditions of this Agreement based on the rates and compensation schedule set
forth below. Compensation shall be calculated based on the hourly rates set forth below
up to the not to exceed budget amount set forth below.
The compensation to be paid to Consultant under this Agreement for all services
described under Section 1 of this Exhibit shall not exceed $34,650.00. Any work
performed or expenses incurred for which payment would result in a total exceeding the
maximum amount of compensation set forth herein shall be at no cost to the City .
III. Rates :
Hourly: $105
IV. Invoices
In order to request payment, Consultant shall submit monthly invoices to the CITY
describing the services performed and the applicable charges (including a summary of
work performed during that quarter, personnel who performed the services, hours
worked, task(s) for which work was performed).
V. Reimbursable Expenses
Normal project related reimbursable expenses such as printing, postage, delivery
service, long distance phone calls, facsimile transmissions, mileage, and special
project-related supplies.
VI. Additional Services
Consultant shall provide additional services outside of the services identified in Exhibit
A only by advance written authorization from the City's Project Manager prior to
commencement of any additional services. Consultant shall submit, at the Project
Manager's request, a detailed written proposal including a description of the scope of
additional services, schedule, and proposed maximum compensation.
Exhibit D
Insurance Requirements and Proof of Insurance
Proof of insurance coverage described below is attached to this Exhibit, with City named
as additional insured.
Consultant shall maintain the following minimum insurance coverage:
A. COVERAGE:
(1) Workers' Compensation:
Statutory coverage as required by the State of California.
(2) Liability:
Commercial general liability coverage in the following minimum limits:
Bodily Injury: $500,000 each occurrence
$1 ,000 ,000 aggregate -all other
Property Damage : $100 ,000 each occurrence
$250 ,000 aggregate
If submitted, combined single limit policy with aggregate limits in the
amounts of $1 ,000,000 will be considered equivalent to the required
minimum limits shown above.
(3) Automotive:
Comprehensive automotive liability coverage in the following minimum limits :
Bodily Injury: $500 ,000 each occurrence
Property Damage: $100,000 each occurrence
or
Combined Single Limit: $500,000 each occurrence
(4) Professional Liability
Professional liability insurance which includes coverage for the professional acts ,
errors and omissions of Consultant in the amount of at least $1 ,000,000 .
10