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21-065 Craig A. Jelich, McClellan Ranch Preserve MowingPublic Works Project: McClellan Ranch Preserve Mowing
Public Works Contract $60,000 / June 2021
Page 1 of 12
PUBLIC WORKS CONTRACT
$60,000 OR LESS
1. PARTIES
This public works contract (“Contract”) is made by and between the City of Cupertino (“City”), and
Craig A. Jelich, a Sole Proprietor (“Contractor”) for McClellan Ranch Preserve Mowing, and is
effective on the last date signed below (“Effective Date”).
2. SCOPE OF WORK
Contractor will perform and provide all labor, materials, equipment, supplies, transportation and any
other items or work necessary to perform and complete the work required for the Project (“Work”),
as required in the Scope of Work, attached here and incorporated as Exhibit A, and in accordance
with the terms and conditions of this Contract. Contractor further agrees to carry out its work in
compliance with the City’s Shelter In Place and Social Distancing Requirements, attached here and
incorporated as Exhibit A-A.
3. TIME FOR COMPLETION
3.1 Term. This Contract begins on the Effective Date and ends on June 30, 2022 (“Contract
Time”) unless terminated earlier as provided herein. Contractor’s Work shall begin on the date
shown on a written Notice to Proceed (“NTP”) and must be fully completed within the Contract
Time or on the date specifically provided in the Notice to Proceed. The City Engineer will not issue
a NTP until the Contract is fully executed by both parties and City has received satisfactory proof of
insurance and any performance and payment bonds that may be required. The Director of Public
Works may authorize the extension of the Contract Time by up to sixty (60) calendar days through a
written amendment to this Agreement, provided such extension does not include additional contract
funds.
3.2 Time is of the essence for Contractor’s performance and completion of the Work.
Contractor must have sufficient time, resources, and qualified staff to deliver the work on time.
3.3 Liquidated damages of $200.00 will be charged for each day of unexcused delay, or City may
deduct the amount from Contractor’s payments. Liquidated damages are based on reasonably
foreseeable consequences of delay and may include intangible losses which the Parties agree may be
difficult to ascertain, such as loss of public confidence in City and its contractors, interference or loss
of use of public facilities, and extended disruption to the public.
4. COMPENSATION
4.1 Maximum Compensation. City will pay Contractor for satisfactory performance of the
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Public Works Contract $60,000 / June 2021
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Work an amount that will based on actual costs but that will be capped so as not to exceed
$12,000.00 (“Contract Price”), for all of Contractor’s direct and indirect costs, including all labor,
materials, supplies, equipment, taxes, insurance, bonds, and all overhead costs.
4.2 Invoices and Payments. Contractor must submit an invoice on the first day of each month,
describing the Work performed during the preceding month, itemizing labor, materials, equipment
and any incidental costs incurred. Contractor will be paid ninety-five percent (95%) of the undisputed
amounts billed within thirty (30) days after City receives a properly submitted invoice. Any retained
amounts will be included with Contractor’s final payment within sixty (60) days of City’s acceptance
of the Work as complete.
5. INDEPENDENT CONTRACTOR
5.1 Status. Contractor is an independent contractor and not an employee of City. Contractor is
solely responsible for the means and methods of performing the Work and for the persons under
this employment. Contractor is not entitled to worker’s compensation or any other City benefits.
5.2 Contractor’s Qualifications. Contractor warrants on behalf of itself and its subcontractors that
they have the qualifications and skills to perform the Work in a competent and professional manner and
according to the highest standards and best practices in the industry.
5.3 Permits and Licenses. Contractor warrants on behalf of itself and its subcontractors that they
are properly licensed, registered, and/or certified to perform the Work as required by law, and have
procured a City Business License, if required by the Cupertino Municipal Code. Contractor shall
possess a California Contractor’s License in good standing for the following classification(s): n/a,
which must remain valid for the entire Contract Time.
5.4 Subcontractors. Only Contractor’s employees are authorized to work under this Contract.
Prior written approval from City is required for any subcontractor, and the terms and conditions of
this Contract will apply to any approved subcontractor.
5.5 Tools, Materials, and Equipment. Contractor will supply all tools, materials and
equipment required to perform the Work under this Contract.
5.6 Payment of Benefits and Taxes. Contractor is solely responsible for the payment of
employment taxes incurred under this Agreement and any similar federal or state taxes. Contractor
and any of its employees, agents, and subcontractors shall not have any claim under this Agreement
or otherwise against City for seniority, vacation time, vacation pay, sick leave, personal time off,
overtime, health insurance, medical care, hospital care, insurance benefits, social security, disability,
unemployment, workers compensation or employee benefits of any kind. Contractor shall be solely
liable for and obligated to pay directly all applicable taxes, fees, contributions, or charges applicable
to Contractor’s business including, but not limited to, federal and state income taxes. City shall
have no obligation whatsoever to pay or withhold any taxes or benefits on behalf of Contractor.
Should any court, arbitrator, or administrative authority, including but not limited to the California
Public Employees Retirement System (PERS), the Internal Revenue Service or the State
Employment Development Division, determine that Contractor, or any of its employees, agents, or
subcontractors, is an employee for any purpose, then Contractor agrees to a reduction in amounts
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Public Works Contract $60,000 / June 2021
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payable under this Agreement, or to promptly remint to City any payments due by the City as a
result of such determination, so that the City’s total expenses under this Agreement are not greater
than they would have been had the determination not been made.
6. CHANGE ORDERS
Amendments and change orders must be in writing and signed by City and Contractor. Contractor’s
request for a change order must specify the proposed changes in the Work, Contract Price, and
Contract Time. Each request must include all the supporting documentation, including but not
limited to plans/drawings, detailed cost estimates, and impacts on schedule and completion date.
7. ASSIGNMENTS; SUCCESSORS
Contractor shall not assign, hypothecate, or transfer this Contract or any interest therein, directly or
indirectly, by operation of law or otherwise, without prior written consent of City. Any attempt to do
so will be null and void. Any changes related to the financial control or business nature of Contractor
as a legal entity is considered an assignment of the Contract and subject to City approval, which
shall not be unreasonably withheld. Control means fifty percent (50%) or more of the voting power
of the business entity. This Contract is binding on Contractor, its heirs, successors, and permitted
assigns.
8. PUBLICITY / SIGNS
Any publicity generated by Contractor for the Project during the Contract Time, and for one (1) year
thereafter must credit City contributions to the Project. The words “City of Cupertino” must be
displayed in all pieces of publicity, flyers, press releases, posters, brochures, interviews, public service
announcements, and newspaper articles. No signs may be posted or displayed on or about Cit y
property, except signage required by law or this Contract, without prior written approval from the City.
9. SUBCONTRACTORS
9.1 Contractor must perform all the Work with its own forces, except that Contractor may hire
qualified subcontractors to perform up to 0% of the Work, provided that each subcontractor is
required by contract to be bound by the provisions of this Contract. Contractor must provide City
with written proof of compliance with this provision upon request.
9.2 City may reject any subcontractor of any tier and bar a subcontractor from performing Work on
the Project, if City in its sole discretion determines that subcontractor’s Work falls short of the
requirements of this Contract or constitutes grounds for rejection under the Public Contract Code. If
City rejects a subcontractor, Contractor at its own expense must perform the subcontractor’s Work or
hire a new subcontractor that is acceptable to City. A Notice of Completion must be recorded within
fifteen (15) days after City accepts the Work if the Contract involves work by subcontractors.
10. RECORDS AND DAILY REPORTS
10.1 Contractor must maintain daily reports of the Work and submit them to City upon request and
at completion of Project. The reports must describe the Work and specific tasks performed, the number
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of workers, the hours, the equipment, the weather conditions, and any circumstances affecting
performance. City will have ownership of the reports, but Contractor will be permitted to retain copies.
10.2 If applicable, Contractor must keep a separate set of as-built drawings showing changes and
updates to the Scope of Work or the original drawings as changes occur. Actual locations to scale must
be identified for all major components of the Work, including mechanical, electrical and plumbing
work; HVAC systems; utilities and utility connections; and any other components City determines
should be included in the final drawings of the Project. Deviations from the original drawings must be
shown in detail, and the location of all main runs, piping, conduit, ductwork, and drain lines must be
shown by dimension and elevation.
10.3 Contractor must maintain complete and accurate accounting records of its Work, in accordance
with generally accepted accounting principles, which must be available for City review and a udit, kept
separate from other records, and maintained for four (4) years from the date of City’s final payment.
11. INDEMNIFICATION
11.1 To the fullest extent allowed by law, and except for losses caused by the sole and active
negligence or willful misconduct of City personnel, Contractor shall indemnify, defend, and hold
harmless City, its City Council, boards and commissions, officers, officials, employees, agents,
servants, volunteers and consultants (“Indemnitees”), through legal counsel acceptable to City, from
and against any and all liability, damages, claims, stop notices, actions, causes of action, demands,
charges, losses and expenses (including attorney fees, legal costs, and expenses related to litigation
and dispute resolution proceedings), of every nature arising directly or indirectly from this Contract or
in any manner relating to any of the following:
(a) Breach of contract, obligations, representations or warranties;
(b) Performance or nonperformance of the Work or of any obligations under the Contract
by Contractor, its employees, agents, servants, subcontractors or subcontractors;
(c) Payment or nonpayment by Contractor or its subcontractors or sub-subcontractors for
Work performed on or off the Project Site; and
(d) Personal injury, property damage, or economic loss resulting from the work or performance
of Contractor or its subcontractors or sub-subcontractors.
11.2 Contractor must pay the costs City incurs in enforcing this provision. Contractor must accept a
tender of defense upon receiving notice from City of a third-party claim, in accordance with
California Public Contract Code Section 9201. At City’s request, Contractor will assist City in the
defense of a claim, dispute, or lawsuit arising out of this Contract.
11.3 Contractor’s duties under this entire Section 11 are not limited to Contract Price, Workers’
Compensation, or other employee benefits, or the insurance and bond coverage required in this
Contract. Nothing in the Contract shall be construed to give rise to any implied right of indemnity
in favor of Contractor against City or any other Indemnitee.
11.4 Contractor’s payments may be deducted or offset to cover any money the City lost due to
a claim or counterclaim arising out of this Contract, a purchase order or other transaction.
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11.5 Contractor agrees to obtain executed indemnity agreements with provisions identical to
those set forth here in this Section 11 from each and every subcontractor, or any other person or
entity involved by, for, with, or on behalf of Contractor in the performance of this Agreement.
Failure of City to monitor compliance with these requirements imposes no additional obligations
on City and will in no way act as a waiver of any rights hereunder.
11.6 This Section 11 shall survive termination of the Contract.
12. INSURANCE
Contractor shall comply with the Insurance Requirements, attached and incorporated here as Exhibit
B. Contractor must provide satisfactory proof of insurance and maintain it for the Contract Time or
longer as required by City. City will not execute the Contract until City has approved receipt of
satisfactory certificates of insurance and endorsements evidencing the type, amount, class of
operations covered, and the effective and expiration dates of coverage. Failure to comply with this
provision may result in City, at its sole discretion and without notice, purchasing insurance at
Contractor’s expense, deducting the costs from Contractor’s compensation, or terminating the
Contract.
13. COMPLIANCE WITH LAWS
13.1 General Laws. Contractor shall comply with all laws and regulations applicable to this
Contract. Contractor will promptly notify City of changes in the law or other conditions that may
affect the Project or Contractor’s ability to perform. Contractor is responsible for verifying the
employment status of employees performing the Work, as required by the Immigration Reform and
Control Act
13.2 Labor Laws.
(a) The following provisions apply to contracts of $1,000 or more:
(i) In General. For purposes of California labor law, this is a public works
contract subject to the provisions of Part 7 of Division 2 of the California Labor
Code (Sections 1720 et seq.). In accordance with Labor Code Section 1771,
Contractor and all subcontractors shall pay not less than current prevailing
wage rates as determined by the California Department of Industrial Relations
(“DIR”) to all workers employed on this project. In accordance with Labor
Code Section 1815, Contractor and all subcontractors shall pay all workers
employed on this project 1 ½ the basic rate of pay for work performed in excess
specified hour limitations. The work performed pursuant to this Contract is
subject to compliance monitoring and enforcement by the Department of
Industrial Relations.
(ii) Registration. Contractor and all subcontractors shall not engage in the
performance of any work under this Contract unless currently registered and
qualified to perform public work pursuant to section 1725.5 of the California
Labor Code. Contractor represents and warrants that it is registered and
qualified to perform public work pursuant to section 1725.5 of the Labor Code
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and will provide its DIR registration number, along with the registration
numbers of any subcontractors as required, to the City.
(iii) Posting. Contractor shall post at the job site the determination of the DIR
director of the prevailing rate of per diem wages together with all job notices
that are required by regulations of the DIR.
(iv) Reporting. Contractor and any subcontractors shall keep accurate payroll
records in accordance with Section 1776 of the Labor Code and shall furnish
the payroll records directly to the Labor Commissioner in accordance with the
law.
(v) Report on Prevailing Rate of Wages. The City has obtained the general
prevailing rate of per diem wages in the vicinity of the project for each type of
worker needed, a copy of which is on file at the City of Cupertino City Hall,
and shall be made available to any interested party upon request.
(vi) Employment of Apprentices. Contractor’s attention is directed to the
provisions in Sections 1777.5 and 1777.6 of the Labor Code concerning the
employment of apprentices by the Contractor or any subcontractor. It shall be
the responsibility of the Contractor to effectuate compliance on the part of itself
and any subcontractors with the requirements of said sections in the
employment of apprentices. Information relative to apprenticeship standards,
wage schedules, and other requirements may be obtained from the Director of
Industrial Relations, ex-officio the Administrator of Apprenticeship, San
Francisco, California, or from the Division of Apprenticeship Standards and its
branch offices.
(vii) Penalties. Contractor’s attention is directed to provisions in Labor Code
Sections 1775 and 1813. In accordance with Labor Code Section 1775,
Contractor and subcontractors may be subject to penalties for Contractor’s
and subcontractors’ failure to pay prevailing wage rates. In accordance with
Labor Code Section 1813, Contractor or subcontractors may be subject to
penalties for Contractor’s or subcontractors’ failure to pay overtime pay rates
for hours worked by workers employed on this project in excess specified
hour limitations.
(b) Contractor must compensate workers who are paid less than prevailing wages or required to
work more than a legal day’s work. Contractor will also be required to pay City a penalty of
$200.00 per worker for each day of violation.
(c) As required by Labor Code Section 1861, by signing this Contract Contractor certifies as
follows: “I am aware of the provisions of Section 3700 of the Labor Code which require every
employer to be insured against liability for workers’ compensation or to undertake self-
insurance in accordance with the provisions of that code, and I will comply with such
provisions before commencing the work of this contract.”
13.3 Discrimination Laws. Contractor shall not discriminate on the basis of race, religious creed,
color, ancestry, national origin, ethnicity, handicap, disability, marital status, pregnancy, age, sex,
gender, sexual orientation, gender identity, Acquired-Immune Deficiency Syndrome (AIDS), or any
other protected classification. Contractor shall comply with all anti-discrimination laws, including
Government Code Sections 12900 and 11135, and Labor Code Sections 1735, 1777, and 3077.5.
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Consistent with City policy prohibiting harassment and discrimination, Contractor understands that
harassment and discrimination directed toward a job applicant, an employee, a City employee, or
any other person, by Contractor or Contractor's employees or sub-contractors will not be tolerated.
Contractor agrees to provide records and documentation to the City on request necessary to monitor
compliance with this provision.
13.4 Conflicts of Interest. Contractor, its employees, subcontractors, servants and agents, may not
have, maintain or acquire a conflict of interest in relation to this Contract in violation of law,
including Government Code section 1090 and Government Code section 81000 and their
accompanying regulations. No officer, official, employee, consultant, or other agent of the City (“City
Representative”) may have, maintain, or acquire a “financial interest” in the Contract, as that term is
defined by state law, or in violation of a City ordinance or policy while serving as a City
Representative or for one year thereafter. Contractor, its emplo yees, subcontractors, servants, and
agents warrant they are not employees of City nor do they have any relationship with City officials,
officers, or employees that creates a conflict of interest. Contractor may be required to file a conflict
of interest form if it makes certain governmental decisions or serves in a staff capacity, as defined in
Section 18700 of Title 2 of the California Code of Regulations. Contractor agrees to abide by City
rules governing gifts to public officials and employees.
13.5 Remedies. Any violation of Section 13 constitutes a material breach and may result in City
suspending payments, requiring reimbursement, or terminating the Contract. City reserves all
rights and remedies under the law and this Contract, including seeking indemnification.
14. BONDS
For contracts of $25,000 or more, Contractor must obtain a payment bond and a performance bond,
each in the penal sum of 100% of the Contract Price, using the Bond Forms attached and incorporated
here as Exhibit C. Each bond must be issued by a surety admitted in California, with a financial rating
from A.M. Best Company of Class A- or higher, or as otherwise acceptable to City. If an issuing surety
cancels a bond or becomes insolvent, Contractor must provide a substitute bond from a surety
acceptable to City within seven (7) calendar days after written notice from City. If Contractor fails to
do so, City may in its sole discretion and without prior notice, purchase bonds at Contractor’s expense,
deduct the cost from payments due Contractor, or terminate the Contract. City will not execute the
Contract nor issue the NTP until the required bonds are submitted.
15. UTILITIES, TRENCHING, AND EXCAVATION
15.1 Contractor must call the Underground Service Alert (“USA”) 811 hotline and request marking
of utility locations before digging or commencing Work. For underground service alerts for street
lighting and traffic signal conduits, City’s Service Center must be called at (408) 777-3269.
Government Code Section 4215 requires Contractor to notify City and Utility in writing if it
discovers utilities or utility facilities not identified in the Contract.
15.2 Pursuant to Government Code Section 7104, Contractor must stop work, notify City in
writing, and wait for instructions if one of the conditions below is found at the worksite. City will
work with Contractor to amend the Contract or issue a change order if the discovered conditions
materially change the Work/Performance, Contract Time or Contract Price.
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(a) Material believed to be hazardous waste under Health and Safety Code Section 25117, and
which requires removal to a Class I, Class II, or Class III disposal site pursuant to law;
(b) Subsurface or latent physical conditions at the Project worksite differing from those
indicated by information about the worksite made available to Contractor; and
(c) Unknown physical conditions at the Project worksite of any unusual nature, materially
different from those ordinarily encountered and from those generally recognized as
inherent in the character of the Work.
15.3 For contracts $25,000 or higher that require excavation or involve trenches five feet or more in
depth, Contractor must submit a detailed plan for City approval, per Labor Code Section 6705, prior
to commencing work. The plan must show the design of shoring, bracing, sloping, and other
provisions for worker protection from caving ground and other hazards. The protective system must
comply with all Construction Safety Orders. If the plan varies from shoring system standards, it must
be prepared by a registered civil or structural engineer.
16. URBAN RUNOFF MANAGEMENT
16.1 All Work must fully comply with federal, state, and local laws and regulations concerning
storm water management. Contractor must avoid creating excess dust when breaking asphalt or
concrete and during excavation and grading. If water is used for dust control, Contractor will use only
the amount of water necessary to dampen the dust. Contractor will take all steps necessary to keep
wash water out of the streets, gutters, and storm drains. Prior to the start of the Work, Contractor will
implement erosion and sediment controls to prevent pollution of storm drains, and must upgrade and
maintain these controls based on weather conditions or as otherwise required by City. These controls
must be in place during the entire Contract Time and must be removed at the end of construction and
completion of the Work. Such controls must include, but will not be limited to, the following
requirements:
(a) Install storm drain inlet protection devices such as sand bag barriers, filter fabric fences, and
block and gravel filters at all drain inlets impacted by construction. During the annual rainy
season, October 15 through June 15, storm drain inlets impacted by construction work must be
filter-protected from onsite de-watering activities and saw-cutting activities. Shovel or
vacuum saw-cut slurry and remove from the Work site;
(b) Cover exposed piles of soil or construction material with plastic sheeting. Store all
construction materials in containers;
(c) Sweep and remove all materials from paved surfaces that drain to streets, gutters and storm
drains prior to rain and at the end of each work day. When the Work is completed, wash the
streets, collect and dispose of the wash water offsite in lawful manner;
(d) After breaking old pavement, remove debris to avoid contact with rainfall/runoff;
(e) Maintain a clean work area by removing trash, litter, and debris at the end of each work
day and when Work is completed. Clean up any leaks, drips, and other spills as they occur.
16.2 These requirements must be used in conjunction with the California Stormwater Quality
Association and California Best Management Practices Municipal and Construction Handbooks,
local program guidance materials from municipalities, and any other applicable documents on
stormwater quality controls for construction. Contractor’s failure to comply with this Section will
result in the issuance of noncompliance notices, citations, Work stop orders and regulatory fines.
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17. PROJECT COORDINATION
City Project Manager. City assigns Brian Gathers as the City representative for all purposes under
this Contract, with authority to require compliance with the Scope of Work. City may substitute
Project Managers at any time and without prior notice to Contractor.
Contractor Project Manager. Subject to City approval, Contractor assigns Craig Jelich as its single
representative for all purposes under this Contract, with the responsibility to ensure progress with the
Work. Contractor’s Project Manager is responsible for coordinating and scheduling the Work and must
regularly update the City Project Manager about the status and any delays with the Work, consistent
with the Scope of Work. Any substitutions must be approved in writing by City.
18. ABANDONMENT AND TERMINATION
18.1 City may abandon or postpone the Project or parts therefor at any time. Contractor will be
compensated for satisfactory Work performed through the date of abandonment and will be given
reasonable time to close out the Work. With City’s pre-approval in writing, the time spent in closing
out the Work will be compensated up to ten percent (10%) of the total time expended in performing
the Work.
18.2 City may terminate the Contract for cause or without cause at any time. Contractor will be paid
for satisfactory Work rendered through the termination date and will be given reasonable time to close
out the Work.
18.3 Final payment will not be made until Contractor delivers the Work and provides records
documenting the Work, products and deliverables completed. Nothing in the Section below is intended
to delay, abridge or bar City’s right under this Section.
19. GOVERNING LAW, VENUE AND DISPUTE RESOLUTION
This Contract is governed by the laws of State of California. Venue for any legal action shall be the
Superior Court of the County of Santa Clara, California. The dispute resolution procedures of Public
Contract Code Section 20104, et seq., incorporated here by reference, apply to this Contract and
Contractor is required to continue the Work pending resolution of any dispute. Prior to filing a lawsuit,
Contractor must comply with the claim filing requirements of the California Government Code. If the
Parties elect arbitration, the arbitrator’s award must be supported by law and substantial evidence and
include detailed written findings of law and fact.
20. ATTORNEY FEES
If City initiates legal action, files a complaint or cross-complaint, or pursues arbitration, appeal, or
other proceedings to enforce its rights or a judgment in connection with this Contract, the prevailing
party will be entitled to reasonable attorney fees and costs.
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21. SIGNS/ADVERTISEMENT
No signs may be displayed on or about City’s property, except signage which is required by law or by
the Contract, without City’s prior written approval as to size, design and location.
22. THIRD PARTY BENEFICIARIES
There are no intended third party beneficiaries of this Contract.
23. WAIVER
Neither acceptance of the Work nor payment thereof shall constitute a waiver of any contract
provision. City waiver of any breach shall not constitute waiver of another provision or breach.
24. WARRANTY
Contractor warrants that materials and equipment used will be new, of good quality, and free from
defective workmanship and materials, and that the Work will be free from material defects not
intrinsic in the design or materials. All Work, materials and equipment should pass to City free of
claims, liens or encumbrances. Contractor warrants the Work and materials for one year from the date
of City’s acceptance of the Work as complete (“Warranty Period”), except when a longer guarantee is
provided by a supplier, manufacturer or is required by this Contract. During the Warranty Period,
Contractor will repair or replace any Work defects or materials, including damage that arises from
Contractor’s Warranty Work, except any wear and tear or damage resulting from improper use or
maintenance.
25. ENTIRE CONTRACT
This Contract and the attachments, documents, and statutes attached, referenced, or expressly
incorporated herein, including authorized amendments or change orders constitute the final and
complete contract between City and Contractor with respect to the Work and the Project. No oral
contract or implied covenant will be enforceable against City. If there is any inconsistency between
any term, clause, or provision of the main Contract and any term, clause, or provision of the
attachments or exhibits thereto, the terms of the main Contract shall prevail and be controlling.
26. SEVERABILITY/PARTIAL INVALIDITY
If a court finds any term or provision of this Contract to be illegal, invalid, or unenforceable, the
legal portion of said provision and all other contract provisions will remain in full force and effect.
27. SURVIVAL
The contract provisions which by their nature should survive the Contract or Completion of Project,
including without limitation all provisions regarding warranties, indemnities, payment obligations,
insurance, and bonds, shall remain in full force and effect after the Work is completed or Contract
ends.
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28. INSERTED PROVISIONS
Each provision and clause required by law to be inserted in this Contract will be deemed to be
included and will be inferred herein. Either party may request an amendment to cure mistaken
insertions or omissions of required provisions.
29. CAPTIONS
The captions, titles, and headings in this Contract are for convenience only and may not be used in
the construction or interpretation of the Contract or for any other purpose.
30. COUNTERPARTS
This Contract may be executed in counterparts, each of which is an original and all of which
taken together shall form one single document.
31. NOTICES
All notices, requests, and approvals must be sent in writing to the persons below and will be
considered effective on the date of personal delivery, the date confirmed by a reputable
overnight delivery service, on the fifth (5th) calendar day after deposit in the United States
Mail, postage prepaid, registered or certified, or the next business day following electronic
submission:
To City of Cupertino:
Office of the City Manager
10300 Torre Ave.
Cupertino CA 95014
cc: Representative/Coordinator:
Brian Gathers
Email: briang@cupertino.org
To Contractor:
Craig A Jelich
3525 Victor St.
Santa Clara, CA 95054
cc: Representative/Coordinator:
Craig Jelich
Email: craigj4welding@sbcglobal.net
32. EXECUTION
The persons signing below warrant they have the authority to enter into this Contract and to
legally bind their respective Parties. If Contractor is a corporation, signatures from two officers
of the corporation are required pursuant to California Corporations Code Section 313.
SIGNATURES CONTINUE ON THE FOLLOWING PAGE
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IN WITNESS WHEREOF, the parties have caused this Contract to be executed as of the Execution
Date first above written.
CITY OF CUPERTINO,
a Municipal Corporation
By: __________________________________
Title: ________________________________
Signature Date: _________________________
Craig A Jelich
By: __________________________________
Title: ________________________________
Signature Date: _________________________
APPROVED AS TO FORM:
By:
HEATHER M. MINNER
Cupertino City Attorney
ATTEST:
By:
KIRSTEN SQUARCIA
City Clerk
Date:
Sole proprietor
Jun 15, 2021
Heather M. Minner
Jun 15, 2021
Public Works Supervisor
Jun 15, 2021
Revised, 01.01.19
Declaration of Sole Proprietorship
DECLARATION AND ADDENDUM TO ALL CONTRACTS ENTERED INTO OR BID
AWARDED TO: ______________________________, 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
______________________________
AUTHORIZED RESPRESENTATIVE
Jun 15, 2021
Sole proprietor
Craig Jelich
3525 Victor Street
Santa Clara CA 95054
Phone (408)982-9695
Fax (408)982-9691
4/19/2021
TO: City of Cupertino
Quote: Mowing - McLellan Ranch Preserve,
2221 McClellan Road, Cupertino,CA. 95014
Mow all areas of the property identified by the City .Mowing will be done twice
a year with the first mowing in April and the second mowing in July. These are
approximate times that will be based on density and height of weeds. The
mowing will be done by Craig Jelich owner and operator of Valley Welding.
The cost will be $4,000 per mowing.
Exhibit A
Revised: July 13, 2020 – Public Works Contracts
1
Exhibit A-A – SHELTER IN PLACE AND SOCIAL DISTANCING REQUIREMENTS
A. Health Laws Acknowledged. It is acknowledged that Consultant’s/Contractor’s
(“Contractor”) duty to comply with Laws, as defined in Section 13 of the Contract/Agreement
(“Contract”), includes immediate compliance by Contractor and its subcontractors with the
restrictions on travel and the Social Distancing Requirements set forth in the most recent health
order issued by the County of Santa Clara Health Department in response to the COVID-19
pandemic, and any subsequent amendments or superseding orders thereto (the “Health
Order”), and any other local, state, or federal laws that have been or may be enacted in
response to the COVID-19 pandemic (collectively, “Health Laws”).
B. Health Order Compliance. Contractor shall comply with any restrictions on travel and social
distancing requirements in the Health Order when preforming work under this Contract. If a
scope of work item, notice to proceed, or work order under this Contract specifies work that
cannot be performed in compliance with the Health Order or other Health Laws, Contractor
shall refrain from conducting the work and immediately inform the City.
C. Individuals at High Risk of Severe Illness. Nothing in this Contract shall be interpreted to
require any person at high risk of severe illness from COVID-19 to leave their residence to
perform work under the Contract. Contractor will inform the City if other arrangements for the
work must be made, and City will do so, with no penalty to Contractor, although Contractor will
not be compensated for work performed by the City or third parties. Information from the
Center for Disease Control ("CDC") on "high risk" categories is available at the CDC's website at:
https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/people-at-higher-risk.html.
D. Health Order Requirements and Best Practices. Contractor will immediately undertake all
appropriate measures to ensure compliance with the Social Distancing Requirements in the
Health Order by all individuals on any project site or work area performing work under this
Contract, including Contractor's or any subcontractor's workers, employees, representatives,
vendors, or suppliers (collectively, "workers"), and shall maintain these measures for as long as
required by the Health Order or other Health Laws. In particular, Contractor must comply with
the provisions of the County’s Mandatory Directive for Construction Projects (attached hereto),
as applicable.
Further, as long as required by the operative Health Order or Mandatory Directive for
Construction Projects, or other Health Laws, these measures shall include, but are not limited
to, the following best practices:
1. Information. Inform all workers of the Social Distancing Requirements and these best
practices, including any updates or modifications, and require compliance as a condition
to being present on the project site or work area.
Revised: July 13, 2020 – Public Works Contracts
2
2. Social Distancing Protocol. Fill out and submit the newest version of the Social
Distancing Protocol to the County, using the County’s online form available at
https://www.sccgov.org/sites/covid19/Pages/social-distancing-protocol.aspx.
3. Sick Workers. Prohibit any individuals who have been tentatively or conclusively
diagnosed with COVID-19 or who have any symptoms of illness, including the following,
from entering or remaining on the project site or work area: fever, cough, shortness of
breath, sore throat, body aches, chills, sudden loss of smell or taste or other flu-like
symptoms. Encourage sick workers to get immediate medical attention.
4. Signage/Posters. As required, post or distribute (1) the most updated version of the
COVID-19 PREPARED Sign, and (2) a Social Distancing Protocol Visitor Information Sheet.
5. Face Coverings. Everyone at a job site must wear a face covering at all time, except
children under the age of 2, people who are medically prevented from wearing a face
covering, and for communication by or with people who are hearing impaired.
6. Sanitary Facilities. Ensure adequate handwashing and/or hand-sanitizing facilities are
available at all times and encourage frequent handwashing and/or hand-sanitizing
throughout the day as specified below. Portable sanitary facilities must be serviced and
cleaned on a daily basis. Provide hand sanitizer in or around all toilet facilities and
common areas, including project trailers.
a. Handwashing. Wash hands using soap and water for at least 20 seconds.
b. Hand-sanitizer. Use a hand sanitizer that contains at least 60-95% alcohol
when handwashing is not immediately available.
c. Paper Products. Ensure that toilet paper, tissues, and paper towels are
available as appropriate, with designated receptacles for disposal.
7. Distancing. Prohibit workers from being less than six feet apart, unless and only to
the extent that would compromise worker safety or violate safety Laws for specific
operations. Prohibit handshaking or any physical contact among workers, with the sole
and limited exception of any physical contact required for worker safety or to comply
with safety Laws. Avoid sharing tools to the extent possible. Require workers to provide
their own transportation where possible and to avoid having more than two workers in
a vehicle.
8. Groups/Meetings/Site Access. Avoid any group gatherings of 10 or more people. Use
electronic alternatives to in person meetings, e.g., conference calls, video-conferencing,
etc., to the greatest extent possible. Limit access to the project site or any work area to
workers who are necessary to perform the work at that time. Allow non-essential
Revised: July 13, 2020 – Public Works Contracts
3
personnel to work from home to the extent possible. Avoid all non-essential travel. Do
not stack trades if possible.
9. Frequent Cleaning. Provide for regular and appropriate cleaning of all high touch
surfaces at a project site or work area, including, but not limited to, shared tools or
equipment, doorknobs and handles, toolboxes, sanitary facilities, common break areas,
keypads, touch screens, project trailer surfaces and equipment, light or power switches,
workstations, countertops, break areas, and the like. Clean and/or disinfect any reusable
items or equipment. Clean surfaces of shared vehicles, including steering wheels, gear
shifts, handles, instrument panels, etc. Ensure that cleaning products are used correctly
and safely, and avoid cleaning techniques, such as use of pressurized air or water sprays,
that may generate bioaerosols.
10. Personal Protective Equipment. When workers cannot avoid close proximity or
physical contact, e.g., based on applicable safety laws, or are otherwise at risk for
exposure to COVID-19, ensure that the affected workers are provided with appropriate
personal protective equipment ("PPE"), which may include disposable gloves and/or
other PPE. Instruct workers to wash or sanitize hands after removing gloves or other
PPE. Ensure that all personal protective equipment is disposed of properly.
11. Water and Food. Prohibit shared or communal food or common water coolers.
Provide individual water bottles for workers or instruct workers to bring their own.
12. Enforcement. Immediately eject any worker who fails or refuses to comply with the
Health Laws, Social Distancing Requirements, or these best practices from the project
site until or unless the Project Manager issues a written authorization for the worker to
return, subject to full compliance.
F. Proof of Compliance. If Contractor is subject to the Mandatory Directive for Construction
Projects, Contractor must provide to the City the name and contact information for its
designated site-specific COVID-19 supervisor(s).
E. Oversight. In other to ensure that all workers comply with the Social Distancing
Requirements to the extent possible, Contractor shall designate a named individual to have
primary responsibility for implementation and enforcement of the Social Distancing
Requirements and these best practices, and to serve as the primary point of contact with the
City in this regard. Contractor shall promptly inform the City of the name of this individual.
F. Changed Requirements. It is understood and acknowledged that circumstances pertaining to
the COVID-19 pandemic are evolving rapidly and that new local, state, or federal requirements
may modify the requirements under this Exhibit. Contractor agrees to work cooperatively with
the City to implement new or changed requirements as quickly as possible.
Revised: July 13, 2020 – Public Works Contracts
4
G. Subcontracts. Contractor shall include the terms of this Exhibit in all subcontracts and
require any agents, subcontractors, or subconsultants to comply with its provisions.
Attachments to Exhibit A-A
Santa Clara County Mandatory Directive for Construction Projects
1228578.5
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Mandator y Directive for Construction
Projects
Mandatory Directive for Construction Projects
– PDF:
English | Spanish | Vietnamese | Chinese | Tagalog |
*Please confirm that your facility and/or construction
project jobsite may open under the State Order. Where
there is a dierence between the local County Order
and the State Order, the more restrictive order must be
followed. The State also has specific guidance for
certain facilities that must be followed in addition to
this mandatory directive.*
Information on the State’s Order and State guidance is
available at covid19.ca.gov.
Issued: July 7, 2020
Revised: October 13, 2020
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On August 28, 2020, the State released its Blueprint
for a Safer Economy (“Blueprint”), a statewide
system of COVID-19 restrictions. Santa Clara County
is currently in Tier Three (Orange) of the Blueprint.
Under the Blueprint, construction ser vices may
operate in Tier Three counties, including Santa Clara
County. See the Statewide Public Health Oicer
Order here and the State’s Blueprint here . These
businesses must follow the mandatory
requirements in this Directive, the State and County
Health Oicer Orders, and the State’s COVID-19
Industr y Guidance documents, including the State’s
COVID-19 Industry Guidance for Construction
available here.
While the construction industr y is critical to ensuring a
safe and suicient supply of residential and
commercial space, construction work can also pose
significant risks to public health due to the COVID-19
pandemic. Because construction projects typically
involve many workers actively working on a jobsite at
the same time, oen in close proximity to one another
or sharing equipment, businesses and individuals
performing and overseeing construction projects must
take extra precautions to reduce the risk of COVID-19
transmission for workers, visitors, and others. This
Directive applies to all construction projects, but the
restrictions vary by the size of the project, as specified
below.
“Construction project” means any work (including a
public works project) carried out in connection with the
construction, alteration, conversion, fitting-out,
remodel, renovation, refurbishment, demolition,
decommissioning, or dismantling of a building or other
structure; the preparation of a physical site for any such
activity; and education or training at which any such
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activity is taught through onsite practice or experience.
“Construction project” does not include architectural,
design, financial, or administrative work related to a
construction project, unless that work occurs at the
construction jobsite. “Construction project” also does
not include basic repair or maintenance work, which
means a repair or maintenance job that requires no
more than 2 workers and no more than 2 days, and that
is not architecturally, financially, or administratively
associated with an active construction project.
This Directive explains how construction projects may
operate. This Directive is mandatory, and failure to
follow it is a violation of the Health Oicer’s Order
issued on October 5, 2020 (“Order”). Construction
projects must comply with the Order and all
requirements of this Directive.
The Order Issued October 5
The Order imposes several restrictions on all
businesses and activities to ensure that the County
stays as safe as possible, including but not limited to
the following:
The Social Distancing Protocol: All businesses and
governmental entities must fill out and submit a
Revised Social Distancing Protocol within 14 days
of the Order’s eective date. The Revised Social
Distancing Protocol must be filled out using an
updated template, which will be available here .
The Protocol is submitted under penalty of
perjur y, meaning that everything written on the
form must be truthful and accurate to the best of
the signer’s knowledge, and submitting false
information is a crime. The Protocol must be
distributed to all workers, and it must be
accessible to all oicials who are enforcing the
Order. For any business that only performs
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services for dispersed facilities or worksites that
the business does not own or operate, the
business must complete a Social Distancing
Protocol for its operation as a whole. For any
business that has a facility, but also provides
services at dispersed facilities or worksites that
the business does not own or operate, the
business must complete a Social Distancing
Protocol for its own facility and provide that
Protocol to the owners or operators of any facility
where it operates.
Example: A construction company ser ves as
a subcontractor on various jobsites
throughout the County and also operates a
base facility within the County, where it
maintains its vehicles and equipment. The
subcontractor must complete a Social
Distancing Protocol for its base facility. It
must also distribute the Protocol to the
owners or operators of the jobsites to which
it sends its workers. The subcontractor’s
workers must be given a copy of, be trained
on, and comply with the measures in both
the subcontractor’s Social Distancing
Protocol and the Social Distancing Protocol
for any jobsite at which they are performing
work.
Signage: All businesses and government entities
must print (1) an updated COVID-19 PREPARED
Sign and (2) a Social Distancing Protocol Visitor
Information Sheet, and both must be posted
prominently at all facility entrances. These are
available for printing aer online submission of
the Revised Social Distancing Protocol. The
Revised Social Distancing Protocol specifies
additional signage requirements.
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Businesses do not need to post these
documents if they do not have their own
facility or worksite and only perform
services for dispersed facilities or worksites
that the business does not own or operate.
Face Coverings: Everyone must wear face
coverings at all times specified in the California
Department of Public Health’s mandatory
Guidance for the Use of Face Coverings (“Face
Covering Guidance”) and in any specific directives
issued by the County Health Oicer. Further, even
where not required under State or local guidance
and orders, face coverings should be worn to the
maximum extent possible (1) when indoors and
not in one’s own residence and (2) whenever
outdoors and within six feet of anyone outside
one’s own household. Face coverings must be
worn even while working at a construction
project unless if it would create a risk to the
person related to their work, in accordance with
local, state, or federal workplace safety
guidelines.
Capacity Limitation: All businesses must limit the
number of people inside a facility at the same
time ensure that everyone is able to maintain at
least 6 feet of social distance from everyone
outside their household at all times. This
Directive describes a limited exception to the
density limitation applicable only to construction
project jobsites.
See the Order and the FAQ page for more details.
In addition to these general requirements applicable to
all businesses under the Order, construction projects
must comply with the following directives.
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Construction Projects on Own Residence Exempted
This Directive does not apply to construction projects
where a person is performing construction on their
current residence alone or solely with members of their
own household.
Rules for Single-Worker Construction Projects
This section lists the requirements for construction
projects performed by only 1 worker, such as someone
who is working alone on a kitchen remodel project.
This section for single-worker projects does not apply
to construction projects that involve multiple workers,
even if only 1 worker is at the jobsite at any time; those
projects must follow the Rules For All Construction
Projects, which are listed in the next section.
a. If the worker is working for a business, the worker
must comply with the Social Distancing Protocol
of that business.
b. The worker must maintain 6 feet of social
distance from all other people at all times,
including when entering and leaving the work
area or building.
c. The worker must use and properly wear face
coverings. In addition, the worker must wear
other personal protective equipment (PPE)
appropriate for use in construction, including
gloves, goggles, and/or face shields.
d. To the extent possible, the worker must seal o
the work area so that there is a barrier between
the worker and any other people in the building.
For example, a worker performing construction in
the hallway of a residence must install a barrier
(such as plastic sheeting) between the area where
the worker is working and the rest of the hallway.
e. The worker must frequently wash hands with
soap and water for at least 20 seconds or use
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hand sanitizer with at least 60% alcohol.
f. The worker must not work or come to the jobsite
if the worker has a fever, cough, or any other
COVID-19 symptoms.
g. The worker must maintain records of the dates
and times the worker was at the jobsite and must
make those records immediately available upon
request to any County oicial.
h. If the worker tests positive for COVID-19, the
worker must notify the County Public Health
Department within 4 hours of learning of the
positive result by following the instructions at
www.sccsafeworkplace.org .
Rules for All Construction Projects (Except Single-
Worker Construction Projects)
This section lists requirements for all construction
projects (other than single-worker construction
projects).
*Note: Large Construction Projects must also follow
additional requirements, which are described
beginning on page 10.*
1. Responsibilities of the General Contractor and
Subcontractors
a. The business with the responsibility to
oversee a construction project, described in
this Directive as the “General Contractor,”
must complete and submit a Revised Social
Distancing Protocol specific to the
construction project jobsite. (The General
Contractor may also need to submit social
distancing protocols for its base facility or
for other jobsites subject to this Directive.)
b. The General Contractor is responsible for
ensuring that all work and operations at the
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construction jobsite is performed in
compliance with the Order, this Directive,
and the jobsite-specific Revised Social
Distancing Protocol.
c. The General Contractor must train its
workers to comply with the Order, this
Directive, and the jobsite-specific Revised
Social Distancing Protocol.
d. Subcontractors do not need to submit their
own jobsite-specific Revised Social
Distancing Protocols for the same site, but
the General Contractor must not allow any
subcontractor onto the jobsite unless that
subcontractor has given the General
Contractor a signed certification that:
i. the subcontractor has reviewed the
Order and this Directive and will
comply with them;
ii. the subcontractor has reviewed the
General Contractor’s jobsite-specific
Revised Social Distancing Protocol
and trained its workers on that
Protocol; and
iii. the subcontractor has completed and
submitted its own Revised Social
Distancing Protocol covering its
operations, and has provided a copy
of that Protocol to the General
Contractor.
2. General Contractors and Subcontractors Must
Report COVID-19 Positive Cases
a. Whenever the General Contractor learns
that a person who has tested positive for
COVID-19 was at the jobsite within 48 hours
of the date they were tested or within 48
hours of becoming symptomatic, the
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General Contractor must immediately
implement the jobsite-specific Revised
Social Distancing Protocol’s procedures for
when a person tests positive for COVID-19.
All positive cases must be reported by
following the instructions at
www.sccsafeworkplace.org .
b. All subcontractors must immediately
(within 1 hour, regardless of the time of day)
alert the General Contractor as soon as they
learn that an employee has tested positive
who is currently at the jobsite, or who was
at the jobsite within 48 hours of the date
they were tested or within 48 hours of
becoming symptomatic. This reporting
requirement is in addition to the
subcontractor’s own reporting
requirements under the Order and the
procedures in the subcontractor’s Revised
Social Distancing Protocol.
3. Cleaning Aer Positive Case Identified
Upon learning of a confirmed positive case at the
jobsite within the last 48 hours, any location
where the infected worker was known to have
been present must be immediately closed and
sanitized. Work in these locations must cease
until sanitization is complete.
4. General Contractor is Responsible for Ensuring
the Jobsite is Operated Safely Following All Legal
Requirements
a. The General Contractor must ensure that
everyone at the jobsite—including its own
workers, the subcontractors’ workers, and
visitors—complies with the Order, this
Directive, the jobsite-specific Revised Social
Distancing Protocol, and any other laws and
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regulations that apply to the work (for
example, OSHA and Cal-OSHA
requirements). If there is a conflict in what
dierent laws require, the strictest standard
applies.
b. The General Contractor’s responsibility for
ensuring jobsite compliance under this
paragraph 4 does not, however, relieve any
subcontractors of their own responsibilities
under the Order, their Revised Social
Distancing Protocol, this Directive, and all
other applicable laws and regulations.
c. Any worker, or any subcontractor, may file a
complaint that the General Contractor has
not complied with the Order, this Directive,
or the jobsite-specific Revised Social
Distancing Protocol, or that the General
Contractor has failed to require others to
comply. Complaints may be filed at
www.sccCOVIDconcerns.org or by calling
the County Oice of Labor Standards
Enforcement Advice Line at 866-870-7725.
5. Designated COVID-19 Supervisor(s)
a. The General Contractor must designate a
site-specific COVID-19 Super visor or
Supervisors to enforce the jobsite-specific
Revised Social Distancing Protocol and this
Directive. The designated COVID-19
Supervisor(s) must be present at the jobsite
at all times during construction activities.
The COVID-19 Supervisor may be an on-site
worker who is designated to ser ve in this
role. The General Contractor must
prominently post a sign at all entrances to
the jobsite clearly identifying the COVID-19
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Supervisor(s) by name and providing their
phone number and email address.
b. The designated COVID-19 Supervisor(s)
must review this Directive and the jobsite-
specific Revised Social Distancing Protocol
with all workers and other persons at the
jobsite. The General Contractor is
responsible for making sure this occurs.
c. The COVID-19 Supervisor must monitor and
ensure implementation at the jobsite of all
requirements in this Directive, the jobsite-
specific Revised Social Distancing Protocol,
and the Order.
6. Seal O Area of Construction Project from Other
Parts of Occupied Sites
Where construction work occurs within an
occupied residential or commercial building, all
of the following rules apply:
a. Work areas must, to the extent feasible, be
sealed o from the remainder of the
building (and from the remainder of the
unit, if work is performed within a
residential unit) with physical barriers such
as plastic sheeting or closed doors sealed
with tape.
b. If possible, workers must access the work
area from entry/exit door(s) dierent from
the entr y/exit door(s) used by residents or
occupants accessing the remainder of the
building that is not under construction.
c. Available windows and/or doors must be
used to ventilate the work area during the
workday and any other times work is
performed.
d. If residents or occupants have access to the
work area between workdays, the work area
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must be cleaned and sanitized at the
beginning and at the end of workdays.
e. Ever y eort must be taken to minimize
contact between workers and residents or
occupants, including maintaining a
minimum of at least 6 feet of social distance
at all times.
7. Personal Protective Equipment (PPE)
The General Contractor must obtain, provide at
no cost to workers, and require that all workers
use personal protective equipment (PPE)
appropriate for use in construction, including
gloves, goggles, face shields, and face coverings
as appropriate for the activity being performed.
Face coverings must be worn in compliance with
the State’s Face Covering Guidance for the Use of
Face Coverings and any additional directives
issued by the County Health Oicer. At no time
may medical-grade PPE be used at a construction
site unless it is required due to the medical nature
of the jobsite or local, state, or federal workplace
safety requirements.
8. Social Distancing and other Measures
a. The General Contractor must:
Ensure that workers are able to maintain at
least 6 feet social distance at all times,
except as strictly and temporarily necessary
to safely carry out a specific job function.
i. This may require staggering shis,
breaks, and trade-specific work as
necessar y to reduce density and allow
for easy maintenance of at least 6 feet
of social distancing. Staggered shis
and breaks must comply with
applicable wage and hour laws.
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ii. Eliminate or resolve “choke points”
and “high-risk areas” where workers
are unable to maintain at least 6 feat
of social distance. The General
Contractor must prohibit or limit use
of these areas to ensure that 6 feet of
social distance can easily be
maintained between individuals.
iii. If possible, ensure workers eat their
meals and take their breaks outdoors,
and maintain social distancing during
meals and breaks.
iv. Prohibit gatherings of any size on the
jobsite (except for meetings required
by this Directive), including gatherings
for breaks or eating. Sharing of any
food or beverage is strictly prohibited.
v. Cal-OSHA requires employers to
provide water. Water must be
provided in single-ser ve containers.
vi. Prohibit use of microwaves, water
coolers, and other similar shared
equipment.
b. Workers must:
i. Unless strictly necessary to carry out a
job function, maintain at all times at
least 6 feet of social distance at all
times from fellow workers and all site
visitors, including delivery workers,
design professionals and other project
consultants, government agency
representatives (including building
and fire inspectors), and residents at
residential construction sites.
ii. Not carpool to and from the jobsite
except with others living within the
same household, or if necessary
3/8/2021 Mandatory Directive for Construction Projects - Novel Coronavirus (COVID-19) - County of Santa Clara
https://www.sccgov.org/sites/covid19/Pages/Archive/mandatory-directives-construction.aspx 14/20
because they have no alternative
means of transportation. If workers
from dierent households must
carpool, they must wear face
coverings while riding together in the
same vehicle, sit at the greatest
distance possible, and maintain
ventilation by keeping windows open
as feasible.
9. Notice for Workers and Visitors of Required
Practices
The General Contractor must prominently post a
notice at all entrances to the jobsite visible to all
workers and visitors instructing workers and
visitors to do the following:
a. Do not touch your face with unwashed
hands or with gloves.
b. If equipment is shared, it must be fully
sanitized before and aer each use.
c. Wash your hands oen with soap and water
for at least 20 seconds each time, or use
hand sanitizer with at least 60% alcohol.
d. Clean and disinfect objects and surfaces you
touch oen, such as work stations,
keyboards, telephones, handrails,
machines, shared tools, elevator control
buttons, and doorknobs.
e. Cover your mouth and nose with a tissue or
cloth when you cough or sneeze, or cough
or sneeze into your elbow/sleeve – never
into your hands.
f. Do not enter the jobsite if you have a fever,
cough, or other COVID-19 symptoms. If you
feel sick, or have been exposed to anyone
who is sick, stay at home.
3/8/2021 Mandatory Directive for Construction Projects - Novel Coronavirus (COVID-19) - County of Santa Clara
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g. Constantly make sure you are staying at
least 6 feet away from co-workers at all
times, unless it is absolutely necessar y to
get closer to safely complete a task for the
construction project.
h. Do not carpool to and from the jobsite with
anyone except members of your own
household, or if necessary because you
have no alternative means of
transportation. If you carpool with people
from another household, you must wear a
face covering while riding together in the
same vehicle.
i. Do not share phones or PPE.
Posters conforming to this requirement are
available for download at
https://www.sccgov.org /sites/covid19/Pages/l
earn-what-to-do-flyers.aspx .
10. Cooperate with County’s Case Investigation and
Contact Tracing Eorts
The General Contractor must maintain a daily
attendance log of all workers and visitors at the
jobsite that includes contact information
(including name, phone number, address, and
email) and the date, time, and duration of each
person’s presence at the jobsite. If someone on
the jobsite tests positive for COVID-19, the
General Contractor is legally required to assist the
County Public Health Department in any case
investigation and contact tracing eorts.
11. Monitor and Inform Supervisors and
Subcontractors of Revised Requirements
The General Contractor must regularly check for
revisions to the Order, this Directive, relevant
3/8/2021 Mandatory Directive for Construction Projects - Novel Coronavirus (COVID-19) - County of Santa Clara
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industry-specific guidance published by the
California Department of Public Health, and other
relevant rules or guidance. The General
Contractor must inform all jobsite supervisors
(including the designated COVID-19 Supervisor(s),
all field supervisors, forepersons, and safety
directors) and all subcontractors of any revisions
or additions to the requirements for construction
projects.
Additional Rules for Large Construction Projects
This section describes additional requirements that
apply only to Large Construction Projects.
12. What is a Large Construction Project?
A “Large Construction Project” is a construction
project that meets any of the following
specifications:
a. For residential projects, any single-family,
multi-family, senior, student, or other
residential construction project consisting
of 10 or more units;
b. For commercial projects, any construction
project consisting of 20,000 or more square
feet of floor area;
c. For mixed-use construction projects, any
construction project that meets either of
the specifications above in Subparagraphs
(a) and (b); or
d. Any infrastructure project that requires 20
or more workers at the jobsite at any one
time.
13. COVID-19 Supervisor’s Additional Compliance,
Monitoring, and Remediation Responsibilities
a. The designated COVID-19 Supervisor must:
3/8/2021 Mandatory Directive for Construction Projects - Novel Coronavirus (COVID-19) - County of Santa Clara
https://www.sccgov.org/sites/covid19/Pages/Archive/mandatory-directives-construction.aspx 17/20
i. Conduct daily briefings in person
(with proper social distancing) or by
teleconference that must cover the
following topics:
A. New jobsite rules and pre-
jobsite travel restrictions for the
prevention of COVID-19
community spread.
B. Review of sanitizing and hygiene
procedures.
C. Worker feedback on improving
safety and sanitizing.
D. Coordination of construction
site daily cleaning /sanitization
requirements.
E. Any newly available information
regarding COVID-19.
F. Emergency protocols in the
event of an exposure or
suspected exposure to COVID-
19.
ii. Each day, verify and record
verification that each jobsite is
compliant with this Directive. The
General Contractor must collect each
written verification, store them for at
least 1 year, and make them
immediately available upon request
to any County oicial.
iii. Conduct the following activities to
make sure that the jobsite is ready to
fix any violations of this Directive:
G. Develop a remediation plan;
H. If any non-compliance is
identified, ensure that the
remediation plan is
implemented, and post the
3/8/2021 Mandatory Directive for Construction Projects - Novel Coronavirus (COVID-19) - County of Santa Clara
https://www.sccgov.org/sites/covid19/Pages/Archive/mandatory-directives-construction.aspx 18/20
remediation plan at all
entrances to the jobsite during
the remediation period;
I. Stop any construction activity
until the jobsite is back in
compliance; and
J. Report repeated non-
compliance with this Directive to
the appropriate jobsite
supervisors and the permitting
agency for the local government
where the project is located.
b. The General Contractor is responsible for
making sure the designated COVID-19
Supervisor takes all of these steps.
14. Jobsite Safety Accountability Supervisor (JSAS)
The General Contractor must assign a COVID-19
Third-Party Jobsite Safety Accountability
Supervisor (JSAS) for the jobsite. The JSAS may
not be an employee of the General Contractor.
The JSAS must at a minimum hold an OSHA-30
certificate and first-aid training, or equivalent
credentials, from within the past 2 years. The
JSAS must be trained in the requirements in this
Directive and the jobsite-specific Social
Distancing Protocol and must verify compliance
with those requirements, including by visual
inspection and random interviews with workers.
The JSAS must inspect the jobsite as oen as
needed to ensure consistent compliance, but not
less than once per week. The JSAS must inspect
the jobsite during normal construction hours.
a. The General Contractor must prominently
post a sign at all entrances to the jobsite
visible to all workers and visitors that
clearly identifies the JSAS for the jobsite by
3/8/2021 Mandatory Directive for Construction Projects - Novel Coronavirus (COVID-19) - County of Santa Clara
https://www.sccgov.org/sites/covid19/Pages/Archive/mandatory-directives-construction.aspx 19/20
name and providing their phone number
and email address.
b. Within 7 calendar days of each jobsite visit,
the JSAS must complete a written
assessment identifying any failure to
comply with this Directive. The written
assessment must be copied, stored, and,
produced upon request to the County or
local permitting agency.
c. If the JSAS discovers that a jobsite is not in
compliance with this Directive and the
jobsite-specific Revised Social Distancing
Protocol, the JSAS must work with the
designated COVID-19 Super visor to develop
and implement a remediation plan.
d. The JSAS must coordinate with the
designated COVID-19 Super visor to prohibit
continuation of any work activity not in
compliance with this Directive or the
jobsite-specific Revised Social Distancing
Protocol. The JSAS must make sure that the
work activity does not resume until the
noncompliance is fixed and the continuing
work is compliant with this Directive.
e. The remediation plan must be sent to the
local permitting agency and a designated
County oicial within 5 calendar days of the
JSAS’s discovery of the failure to comply.
15. Translation for Non-English-Speaking Workers
The General Contractor must translate (and,
where otherwise required, post) all of the
following documents as necessary to ensure that
all non-English-speaking workers are able to
understand the documents:
a. The Notice for Workers and Visitors of
Required Practices described in Paragraph 9
3/8/2021 Mandatory Directive for Construction Projects - Novel Coronavirus (COVID-19) - County of Santa Clara
https://www.sccgov.org/sites/covid19/Pages/Archive/mandatory-directives-construction.aspx 20/20
(on page 8).
b. The remediation plan described in
Paragraph 13.a.iii.1 (on page 11).
Stay Informed
For answers to frequently asked questions about this
industry and other topics, please see the FAQ page.
Please note that this Directive may be updated. For
up-to-date information on the Health Oicer Order,
visit the County Public Health Department’s website at
www.sccgov.org /coronavirus .
Last updated: 12/1/2020 11:23 AM
Report a problem with this page
All Content Copyright © 2021 , County of Santa Clara, CA
Insurance Requirements for Construction Contracts - $60,000 Version: Sept. 2019
1
Contractor shall procure and maintain for the duration of the contract, and for five years following the completion of
the Project, insurance against claims for injuries to persons or damages to property which may arise from or in
connection with the performance of the work hereunder by Contractor, its agents, representatives, employees or
subcontractors.
MINIMUM SCOPE AND LIMIT OF INSURANCE
Coverage shall be at least as broad as:
1.Commercial General Liability (“CGL”): Insurance Services Office (ISO) Form CG 00 01 covering CGL on an
“occurrence” basis, written on a comprehensive general liability form, and must include coverage for liability
arising from Contractor’s or Subcontractor’s acts or omissions, including Contractor’s protected coverage,
blanket contractual, products and completed operations, vehicle coverage and employer’s non-ownership liability
coverage, with limits of at least $2,000,000 per occurrence. The CGL policy must protect against any and all
liability for personal injury, death, property damage or destruction, and personal and advertising injury. If a general
aggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO CG
25 03 or 25 04) or the general aggregate limit shall be twice the required occurrence limit.
a.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 made available to the
Additional Insured and shall be (1) the minimum coverage/limits specified in this agreement; or (2) the broader
coverage and maximum limits of coverage of any insurance policy, whichever is greater.
b.Additional Insured coverage under Contractor's policy shall be "primary and non-contributory," will not seek
contribution from City’s insurance/self-insurance, and shall be at least as broad as ISO CG 20 10 04 13
c.The limits of insurance required may be satisfied by a combination of primary and umbrella or excess
insurance, provided each policy complies with the requirements set forth in this Contract. Any umbrella or
excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a
primary basis for the benefit of City before the City’s own insurance or self-insurance shall be called upon to
protect City as a named insured.
2.Automobile Liability: ISO Form CA 00 01 covering any auto (Code 1), or if Contractor has no owned autos, then
hired autos (Code 8) and non-owned autos (Code 9), with limit no less than $1,000,000 per accident for bodily
injury and property damage.
3.Workers’ Compensation: As required by the State of California, with Statutory Limits, and Employer’s
Liability Insurance of no less than $1,000,000 per accident for bodily injury or disease, or as otherwise required by
statute. If Contractor is self-insured, Contractor must provide a Certificate of Permission to Self-Insure, duly
authorized by the DIR.
N/A if box checked (Contractor provides written verification it has no employees).
4.Professional Liability with limits no less than $1,000,000 per occurrence or claim, and $2,000,000 aggregate.
N/A if box checked (Contract is not design/build).
5.Builder’s Risk. Course of Construction insurance utilizing an “All Risk” (Special Perils) coverage form, with
limits equal to the completed value of the project and no coinsurance penalty provisions.
N/A if box checked (Project does not involve construction or improvements/installations to property).
PUBLIC WORKS CONSTRUCTION CONTRACTS
Small Projects - $60,000
Insurance Requirements: Exhibit B
Insurance Requirements for Construction Contracts - $60,000 Version: Sept. 2019
2
6. Contractors’ Pollution Legal Liability and/or Asbestos Legal Liability and/or Errors and Omissions with limits
no less than $1,000,000 per occurrence or claim, and $2,000,000 policy aggregate.
N/A if box checked (Project does not involve environmental hazards).
If Contractor maintains broader coverage and/or higher limits than the minimums shown above, City requires and
shall be entitled to the broader coverage and/or higher limits maintained by the contractor. Any available insurance
proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City.
Self-Insured Retentions. Self-insured retentions must be declared to and approved by City. At City’s option, either:
(1) Contractor shall cause the insurer to reduce or eliminate self-insured retentions as respects City, its officers,
officials, employees, and volunteers; or (2) Contractor shall provide a financial guarantee satisfactory to City
guaranteeing payment of losses and related investigations, claim administration, and defense expenses. The policy
language shall provide, or be endorsed to provide, that the self-insured retention may be satisfied by either the named
insured or the City.
OTHER INSURANCE PROVISIONS
The insurance policies are to contain, or be endorsed to contain, the following provisions:
Additional Insured Status
The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers are to be covered
as additional insureds on the CGL and automobile liability policies with respect to liability arising out of the Services
performed by or on behalf of Contractor including materials, parts, or equipment furnished. Endorsement of CGL
coverage shall be at least as broad as ISO Form CG 20 10 11 85 or if not available, through the addition of both CG
20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 20 37 if a later edition is used.
Primary Coverage
For any claims related to this Project, Contractor’s insurance coverage shall be “primary and non-contributory” and
at least as broad as ISO CG 20 01 04 13 with respect to City, its officers, officials, employees and volunteers, and shall
not seek contribution from City’s insurance. If the limits of insurance are satisfied in part by Umbrella/Excess
Insurance, the Umbrella/Excess Insurance shall contain or be endorsed to contain a provision that such coverage shall
also apply on a “primary and non-contributory” basis for the benefit of City.
Notice of Cancellation
Each insurance policy required shall provide that coverage shall not be canceled, except with notice to the City. Each
certificate of insurance must state that the coverage afforded by the policy is in force and will not be reduced, cancelled
or allowed to expire without at least 30 days advance written notice to City, unless due to non-payment of premiums,
in which case ten days advance written notice must be provided to City. Such notice must be sent to City via certified
mail and addressed to the attention of the City Manager.
Builder’s Risk
Contractor may submit Builder’s Risk insurance in the form of Course of Construction coverage, which shall name
the City as a loss payee, as its interest may appear. The Builder’s Risk policy must be issued on an occurrence basis,
for all-risk coverage on a 100% completed value basis on the insurable portion of the Project, with no coinsurance
penalties, and for the benefit of City. If the Project does not involve new or major reconstruction, City may elect, acting
in its sole discretion, to accept an Installation Floater policy instead of Builder’s Risk. For such projects, the Property
Installation Floater shall include improvement, remodel, modification, alteration, conversion or adjustment to existing
buildings, structures, processes, machinery and equipment, and shall provide property damage coverage for any
building, structure, machinery or equipment damaged, impaired, broken, or destroyed during the performance of the
Work, including during transit, installation, and testing at the City’s site.
X
Insurance Requirements for Construction Contracts - $60,000 Version: Sept. 2019
3
Waiver of Subrogation
Each required policy must include an endorsement providing that the carrier agrees to waive any right of subrogation
it may have against City. Contractor agrees to waive rights of subrogation which any insurer of Contractor may acquire
from Contractor by virtue of the payment of any loss. Contractor agrees to obtain any endorsement that may be
necessary to affect this waiver of subrogation. The Workers’ Compensation policy shall be endorsed with a waiver of
subrogation in favor of the City for all work performed by the Contractor, its employees, agents and subcontractors.
Acceptability of Insurers
Insurance must be issued by insurers acceptable to City and licensed to do business in the State of California, and each
insurer must have an A.M. Best’s financial strength rating of “A” or better and a financial size rating of “VII” or better.
Verification of Coverage
Contractor shall furnish the City with original certificates and amendatory endorsements, or copies of the applicable
insurance language, effecting coverage required by this contract. All certificates and endorsements are to be received
and approved by the City before work commences. The City reserves the right to require complete, certified copies of
all required insurance policies, including endorsements, required by these specifications, at any time.
Subcontractors
Contractor shall require and verify that all subcontractors maintain insurance meeting all the requirements stated
herein, and Contractor shall ensure that City is an additional insured on insurance required from subcontractors. For
CGL coverage subcontractors shall provide coverage with a form at least as broad as CG 20 38 04 13.
Surety Bonds
As required by Contract and described in the Contract Documents. The Payment and Performance Bonds shall be in a
sum equal to the Contract Price. If the Performance Bond provides for a one-year warranty a separate Maintenance
Bond is not necessary. If the warranty period specified in the Contract is for longer than one year a Maintenance Bond
equal to 10% of the Contract Price is required. Bonds shall be duly executed by a responsible corporate surety,
authorized to issue such bonds in the State of California and secured through an authorized agent with an office in
California.
Special Risks or Circumstances
City reserves the right to modify these requirements, based on the nature of the risk, prior experience, insurer, coverage,
or other circumstances.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:CONTACT
(A/C, No):FAX
E-MAILADDRESS:
PRODUCER
(A/C, No, Ext):PHONE
INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
$
$
$
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)
COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOSAUTOS ONLY NON-OWNED
SCHEDULEDOWNED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?(Mandatory in NH)
DESCRIPTION OF OPERATIONS belowIf yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
EROTH-STATUTEPER
LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR
CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED $PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-JECT LOC
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIREDAUTOS ONLY
04/14/2021
insureCAL Insurance Agency
1065 Colorado Ave., Ste 5
Turlock CA 95380
Colbie McRae
(209) 250-0269 (209) 633-5799
info@insurecal.com
Craig Jelich
1537 Meadow Lane
Mountain View CA 94040
HISCOX INS CO INC 10200
ACE PROPERTY AND CASUALTY INSURANCE COMPANY20699
A Y Y UDC-4449150-CGL-21 04/19/2021 04/19/2022
2,000,000
100,000
5,000
1,000,000
2,000,000
2,000,000
B UMBCAF161537831 04/19/2021 04/19/2022
2,000,000
2,000,000
PR/COMP OPS AGG 2,000,000
The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers are to be covered as additional insureds and waiver of
subrogation on the CGL with respect to liability arising out of the Services performed by or on behalf of Contractor including materials, parts, or equipment
furnished per attached endorsement. Excess Liability Policy is follow form.
City of Cupertino
22221 McClellan Road
Cupertino CA 95014
Hiscox Insurance Company Inc.
Policy Number:
Named Insured:
Endorsement Number:
Endorsement Effective:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CGL E5402 CW (03/10)
Page 1 of 1
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
MODIFIED WAIVER OF TRANSFER OF RIGHTS OF
RECOVERY AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV – Conditions:
You may waive your rights against another party so
long as you do so in writing prior to: (i) an offense
arising out of your business that caused a “personal
and advertising injury”; or (ii) an “occurrence” that
caused “bodily injury” or “property damage”.
UDC-4449150-CGL-21
Craig Jelich
2
April 19, 2021
Hiscox Insurance Company Inc.
Policy Number:
Named Insured:
Endorsement Number:
Endorsement Effective:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CGL E5421 CW (02/14) Includes copyrighted material of Insurance Services Office, Inc., with its
permission.
Page 1 of 1
ADDITIONAL INSURED – AUTOMATIC STATUS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II – Who Is An Insured is amended
to include as an additional insured any per-
son(s) or organization(s) for whom you are
performing operations or leasing a premises
when you and such person(s) or organiza-
tion(s) have agreed in writing in a contract or
agreement that such person(s) or organiza-
tion(s) be added as an additional insured on
your policy. Such person or organization is
an additional insured only with respect to lia-
bility for "bodily injury", "property damage" or
"personal and advertising injury" caused, in
whole or in part, by your acts or omissions or
the acts or omissions of those acting on your
behalf:
1.In the performance of your ongoing opera-
tions; or
2.In connection with your premises owned by or
rented to you.
A person's or organization's status as an addi-
tional insured under this endorsement ends
when your operations or lease agreement for
that additional insured are completed.
UDC-4449150-CGL-21
Craig Jelich
8
April 19, 2021
Hiscox Insurance Company Inc.
Policy Number:
Named Insured:
Endorsement Number:
Endorsement Effective:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CGL E5581 CW (03/16) Includes copyrighted material of
Insurance Services Office, Inc., with its permission
Page 1 of 1
PRIMARY AND NONCONTRIBUTORY – OTHER
INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. The following is added to the Other Insurance
Condition and supersedes any provision to the
contrary:
Primary And Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other insurance available
to an additional insured under your policy, pro-
vided:
1.you have agreed in a written contract or
agreement to add such additional insured to
a policy providing the type of coverage af-
forded by this policy; and
2.you have agreed in a written contract or
agreement with such additional insured that
this insurance would be primary and would
not seek contribution from any other insur-
ance available to the additional insured.
UDC-4449150-CGL-21
Craig Jelich
22
May 21, 2021
1001486 132849.13 04-22-2020
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:
CONTACT
(A/C, No):
FAX
E-MAIL
ADDRESS:
PRODUCER
(A/C, No, Ext):
PHONE
INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
$
$
$
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)
COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOSAUTOS ONLY
NON-OWNED
SCHEDULEDOWNED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-
STATUTE
PER
LIMITS(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR
CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED
$PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOC
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
Annette Parker, Agent
4546 El Camino Real Suite B-4
Los Altos, Ca 94022
Annette Parker
650 941-5000 650 917-2105
Craig Jelich
1537 Meadow Lane
Mountain View, CA 94040
25178
Y C33 3987-C16-05D 04/26/2021 09/16/2021
1,000,000
1,000,000
1,000,000
2020 Dodge Ram 3500 Pickup-
McClellan Ranch Preserves/City of Cupertino
2221 McClellan Road
Cupertino, CA 95014
State Farm Mutual Automobile Insurance Company
© 1988-2015 ACORD CORPORATI©
Craig Jelich for McClellan Ranch Preserve
Mowing
Final Audit Report 2021-06-15
Created:2021-06-10
By:City of Cupertino (webmaster@cupertino.org)
Status:Signed
Transaction ID:CBJCHBCAABAAb-YYmZu1UW2XUJyk-jCOEoVbm7izLv9A
"Craig Jelich for McClellan Ranch Preserve Mowing" History
Document created by City of Cupertino (webmaster@cupertino.org)
2021-06-10 - 5:32:26 PM GMT- IP address: 35.229.54.2
Document emailed to Julia Kinst (juliak@cupertino.org) for approval
2021-06-10 - 5:35:35 PM GMT
Document approved by Julia Kinst (juliak@cupertino.org)
Approval Date: 2021-06-10 - 5:36:06 PM GMT - Time Source: server- IP address: 64.178.242.15
Document emailed to Araceli Alejandre (aracelia@cupertino.org) for approval
2021-06-10 - 5:36:09 PM GMT
Document approved by Araceli Alejandre (aracelia@cupertino.org)
Approval Date: 2021-06-10 - 5:48:44 PM GMT - Time Source: server- IP address: 73.170.27.253
Document emailed to craigj4welding@sbcglobal.net for signature
2021-06-10 - 5:48:46 PM GMT
Email sent to craigj4welding@sbcglobal.net bounced and could not be delivered
2021-06-10 - 5:48:49 PM GMT
Email sent to craigj4welding@sbcglobal.net bounced and could not be delivered
2021-06-10 - 9:29:49 PM GMT
Email sent to craigj4welding@sbcglobal.net bounced and could not be delivered
2021-06-12 - 3:26:54 PM GMT
City of Cupertino (webmaster@cupertino.org) replaced signer craigj4welding@sbcglobal.net with Craig Jelich
(craigj4vwelding@sbcglobal.net)
2021-06-15 - 2:44:20 PM GMT- IP address: 64.178.242.15
Document emailed to Craig Jelich (craigj4vwelding@sbcglobal.net) for signature
2021-06-15 - 2:44:20 PM GMT
Email sent to craigj4welding@sbcglobal.net bounced and could not be delivered
2021-06-15 - 2:44:24 PM GMT
Email viewed by Craig Jelich (craigj4vwelding@sbcglobal.net)
2021-06-15 - 3:34:37 PM GMT- IP address: 166.216.158.77
Document e-signed by Craig Jelich (craigj4vwelding@sbcglobal.net)
Signature Date: 2021-06-15 - 3:40:40 PM GMT - Time Source: server- IP address: 166.216.158.77
Document emailed to Heather M. Minner (minner@smwlaw.com) for signature
2021-06-15 - 3:40:42 PM GMT
Email sent to Craig Jelich (craigj4vwelding@sbcglobal.net) bounced and could not be delivered
2021-06-15 - 3:40:49 PM GMT
Email viewed by Heather M. Minner (minner@smwlaw.com)
2021-06-15 - 6:34:43 PM GMT- IP address: 45.41.142.83
Document e-signed by Heather M. Minner (minner@smwlaw.com)
Signature Date: 2021-06-15 - 6:35:10 PM GMT - Time Source: server- IP address: 52.39.49.65
Document emailed to Brian Gathers (briang@cupertino.org) for signature
2021-06-15 - 6:35:13 PM GMT
Email viewed by Brian Gathers (briang@cupertino.org)
2021-06-15 - 9:40:38 PM GMT- IP address: 104.47.45.254
Document e-signed by Brian Gathers (briang@cupertino.org)
Signature Date: 2021-06-15 - 9:47:24 PM GMT - Time Source: server- IP address: 64.165.34.3
Document emailed to Kirsten Squarcia (kirstens@cupertino.org) for signature
2021-06-15 - 9:47:27 PM GMT
Email viewed by Kirsten Squarcia (kirstens@cupertino.org)
2021-06-15 - 10:46:04 PM GMT- IP address: 104.47.45.254
Document e-signed by Kirsten Squarcia (kirstens@cupertino.org)
Signature Date: 2021-06-15 - 10:46:15 PM GMT - Time Source: server- IP address: 162.245.22.179
Agreement completed.
2021-06-15 - 10:46:15 PM GMT
