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21-190 Keish Environmental, Services AgreementMunicipal Regional Permit Inspection and Training 1 of 5 Services Agreement ($5,000) / August 2021 SERVICES AGREEMENT ($5,000 OR LESS) 1. Parties. This Agreement (“Agreement”) is made by and between the City of Cupertino, a municipal corporation (“City”) and Keish Environmental (“Contractor”), a Corporation, and is effective on the last date signed below (“Effective Date”). 2. Services. Contractor agrees to provide the programs, classes or activities (“Services”) set forth in detail in the Scope of Services, attached and incorporated here as Exhibit A. Contractor further agrees to carry out its work in compliance with any applicable local, State, or Federal order regarding COVID-19. 3. Time of Performance. This Agreement begins on the Effective Date and ends on December 31, 2021 (“Contract Time”), unless terminated earlier as provided herein. Contractor must deliver the Services in accordance with the Schedule of Performance included or attached to Exhibit A. Time is of the essence for the performance of all the Services. Contractor must have sufficient time, resources, and qualified staff to deliver the Services on time. The City’s designated supervisor for this Agreement may extend the Contract Time by up to six (6) months through a written amendment to this Agreement, provided such extension does not include additional contract funds. 4. Compensation. City will pay Contractor for satisfactory performance of the Services an amount that will based upon actual costs but that will be capped so as not to exceed $4,800.00 (“Contract Price”), based upon the Scope of Services and the budget and rates included in Exhibit A. The maximum compensation includes all expenses and reimbursements and will remain in place even if Contractor’s actual costs exceed the capped amount. Upon City approval of written invoices, Contractor will be paid as follows: (check one; cross out others): ☐ A lump sum amount of $________which shall not exceed the Contract Price. ☐ At the rate of $______per hour for a total not to exceed the Contract Price. ☒ Based on the payment schedule included or attached to Exhibit A which shall not exceed the Contract Price. 5. Independent Contractor. Contractor is an independent contractor and not an employee, partner, or joint venture of City. Contractor is solely responsible for the means and methods of performing the Services and for the persons hired to work under this Agreement. Contractor is not entitled to health benefits, workers compensation or other benefits from the City. Contractor must have the skills and qualifications to perform the Services in a competent and professional manner, and must be licensed, registered, and/or certified and have a City Business License. Contractor will supply all tools, materials and equipment required to perform the Services under this Agreement. 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 Municipal Regional Permit Inspection and Training 2 of 5 Services Agreement ($5,000) / August 2021 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 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. 7. Assignment. This Agreement is not assignable. Contractor may not substitute another or transfer any rights or obligations under this Agreement without prior written approval of City. Only those persons whose names are included in Exhibit A may perform the Services. 8. Indemnification. 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, actions, causes of action, demands, charges, losses, costs 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 Agreement or in any manner relating to any of the following: (a) Breach of contract, obligations, representations or warranties; (b) Negligent or willful acts or omissions committed during performance of the Services; (c) Personal injury, propert y damage, or economic loss resulting from the work or performance of Contractor or its subcontractors or sub-subcontractors; Contractor must pay any costs City may incur in enforcing this provision and must accept a tender of defense upon receiving notice from City. 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 Agreement. 9. Insurance. Contractor shall comply with the Insurance Requirements, attached and incorporated here as Exhibit B, and must maintain the insurance for the duration of the Agreement, or longer as required by City. City will not execute the Agreement until City approves 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 for Contractor and deducting the costs from Contractor’s compensation or terminating the Agreement. 10. Compliance with Laws. Contractor shall comply with all laws and regulations applicable to this Agreement, included without limitation the following laws: Municipal Regional Permit Inspection and Training 3 of 5 Services Agreement ($5,000) / August 2021 Labor Laws. Contractor shall comply with all labor laws applicable to this Agreement. If the Scope of Services includes a “public works” component, Contractor is required to comply with prevailing wage laws under Labor Code Section 1720 and other labor laws. ☐ Sole Proprietor. If Contractor is a sole proprietorship/individual, it must sign the Affidavit of No Employees included in this Agreement. 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. Consistent with City policy, 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. Conflicts of Interest. Contractor shall comply with all conflict of interest laws applicable to this Agreement and must avoid any conflict of interest. Contractor warrants that no public official, employee, or member of a City board or commission who might have been involved in the making of this Agreement, has or will receive a direct or indirect financial interest in this Agreement, in violation of California Government Code Section 1090 et seq. Contractor may be required to file a conflict of interest form if Contractor makes certain governmental decisions or serves in a staff capacity, as defined in Section 18700 of the California Code of Regulations. Contractor agrees to abide by the City’s rules governing gifts to public officials and employees. 11. Abandonment. City may abandon or postpone the Project at any time. Contractor will be compensated for satisfactory Services performed through the date of abandonment. 12. Termination. City may terminate this Agreement for cause or without cause at any time. City reserves the right to terminate the Agreement and the remainder of the Services offered by Consultant without notice based upon Contractor’s cancellation of a Service (i.e., program, class or activity) without giving advance notice or obtaining written approval from City. 13. Governing Law. This Agreement is governed by the laws of the State of California. Any lawsuits filed related to this Agreement must be filed with the Superior Court for the County of Santa Clara, State of California. Contractor must comply with the claims filing requirements under the Government Code prior to filing a civil action in court. If a dispute arises, Contractor must continue to provide the Services pending resolution of the dispute. 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. 14. Entire Agreement. This Agreement represents the full and complete understanding of every kind or nature between the Parties, and supersedes any other agreement or understanding, either oral or written, between the Parties. Any changes to this Agreement will be effective only if in writing and signed by each Party’s authorized representative. No verbal agreement or implied covenant will be Municipal Regional Permit Inspection and Training 4 of 5 Services Agreement ($5,000) / August 2021 valid to amend or abridge this Agreement. If there is any inconsistency between any term, clause, or provision of the main Agreement and any term, clause, or provision of the attachments or exhibits thereto, the terms of the main Agreement shall prevail and be controlling. Each provision and clause required by law for this Agreement is deemed to be inserted and will be inferred herein. 15. Services Coordinator. The Parties designate the following persons as Services Coordinators for this Agreement. Contractor’s designation and any substitution are subject to City approval. For City: For Contractor: Alex Wykoff Rachael Keish Environmental Programs Specialist CEO alexw@cupertino.org rachael@keishenv.com 16. Contract Interpretation. There are no intended third party beneficiaries of this Agreement. Neither acceptance of the Services nor payment therefor shall constitute a waiver of any contract provision. City’s waiver of a breach shall not constitute waiver of another provision or breach. The headings in this Agreement are for convenience only. The Indemnification and Governing Law sections expressly survive this Agreement. 17. Severability. If a term or provision of the Agreement or its application to a particular situation is found by the court to be void, invalid, illegal, or unenforceable, such term or provision shall remain in effect to the extent allowed by such ruling. All other terms and provisions of this Agreement or their application to specific situations shall remain in full force and effect. 18. Notices. All notices, demands, requests, and approvals must be sent to the persons below in writing, and will be considered effective on the date of personal delivery, upon confirmation of delivery by a reputable overnight delivery service, on the fifth calendar day after deposit thereof 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 Attention: Alex Wykoff Email: alexw@cupertino.org To Contractor: Keish Environmental 6768 Crosby Ct, San Jose, CA 95129 Attention: Rachael Keish Email: rachael@keishenv.com 19. Execution. Contractor’s signatory warrants that he or she is authorized to execute the Agreement and to legally bind Contractor. This Agreement may be executed in counterparts, each one of which is deemed an original and all of which, taken together, constitute a single binding instrument. Municipal Regional Permit Inspection and Training 5 of 5 Services Agreement ($5,000) / August 2021 IN WITNESS WHEREOF, the Parties have caused the Agreement to be executed as of the Effective Date written above. CITY OF CUPERTINO A Municipal Corporation Keish Environmental By: By: Name: Name: Title: Date: Title: Date: APPROVED AS TO FORM: By: CHRISTOPHER D. JENSEN City Attorney ATTEST: By: KIRSTEN SQUARCIA City Clerk Date: Chief Executive Officer Aug 4, 2021 Rachael Keish Christopher D. Jensen Aug 5, 2021 Environmental Programs Manager Ursula Syrova (she/her) Aug 5, 2021 CITY OF CUPERTINO MAINTENANCE SERVICE CENTER MRP Inspection & Training Proposal June 10, 2021 The scope of this proposal is for Keish Environmental, PC (Consultant) to provide the following Municipal Regional Permit (MRP) Support services to at the City’s maintenance facility. Consultant will review the existing Storm Water Pollution Prevention Plan (SWPPP), provide inspection and training Services for the above-referenced location in accordance with the terms and conditions of an Agreement to be executed by both parties if your Company is a successful bidder on the project. References Municipal Regional Permit (MRP) No. CAS612008 for Municipal Separate Storm Water Discharges Associated with jurisdictions and entities permitted under the San Francisco Bay Municipal Regional Stormwater Permit adopted by the State Water Resources Control Board on November 19, 2015 as Order No. R2-2015-0049 and all amendments: https://www.waterboards.ca.gov/sanfranciscobay/water_issues/programs/stormwater/Municipal/ California Stormwater Quality Association’s (CASQA’s) Handbook for Municipal Operations and the Caltrans Storm Water Quality Handbook Maintenance Staff Guide, May 2003, and its addenda, as appropriate. Work Scope Detail In summer 2021, Provide the following: Task 1: Corporation Yard SWPPP Review Task 2: C.2.f. Corporation Yard Inspection Task 3: Site-specific BMP Implementation Training Task 1: Corporation Yard SWPPP Review 1.1 Review of SWPPP: Consultant Qualified SWPPP Developer or Practitioner(QSD or QSP) will review the existing SWPPP to confirm that it incorporates all applicable BMPs as described in the CASQA Municipal BMP Manual. 1.2 Exclusions: This task includes only review of the document. Any modifications or re-writes would require a change order. Task 2: C.2.f. Corporation Yard Inspection 2.1 All MRP-required site inspections will be performed in accordance with Municipal Regional Permit (MRP) requirements by a Consultant QSP (or QSP-in-training, under supervision of the QSP). These site inspections include inspection of the corporation yard including vehicle maintenance, heavy equipment, maintenance vehicle parking areas and material storage facilities to ensure compliance with water quality standards. An initial inspection is designed to identify deficiencies and areas of concern. This will be followed by repeat inspection within 10 days. Scope includes EXHIBIT A- Scope of Services one (1) initial inspection and up to two (2) follow-up inspections. Any additional inspections would require a change order. Consultant will prepare a report using the SWPPP-preferred format which summarizes effective and ineffective BMP’s observed, and any deficiencies. Documentation reports of the inspections will be prepared using an MRP-compliant inspection checklist included in the SWPPP. This report will be the basis for focusing the training which is the scope of Task 3 – SWPPP Training Task 3: SWPPP Training 1.1 Consultant will conduct an in-person site specific training. Training will cover the successful and less successful aspects of the site BMPs, and inform the site staff what is necessary to bring the site into full compliance with the MRP 1.2 This scope assumes a training room with PowerPoint and projection capabilities will be available on-site. 1.3 An option for on-site field training for up to one shift of Parks Maintenance employees is included. Out-of-Scope Items – Not included in Estimate • Modifications to SWPPP • Unanticipated Inspections Deliverables In conjunction with the performance of the foregoing Services, Consultant shall provide the following submittals/deliverables (Documents) to Company: Task 1: Corporation Yard SWPPP Review Notes Task 2: C.2.f. Corporation Yard Inspection • Up to three (3) Inspection Reports Task 3: SWPP Training • PowerPoint training slides • Option: Tri-fold (in lieu of PowerPoint for field staff training) Schedule Consultant’s period of service is effective on the date of an executed Agreement and extends through mutually agreed completion of the Scope of Services. All work will be completed in a timely manner in accordance with the MRP requirements and project milestones. Consultant shall perform the Services and deliver the related Deliverables according to the following schedule: - All work as directed between June 14, 2021 to December 31, 2021. City’s Responsibilities City shall perform and/or provide the following in a timely manner so as not to delay the Services of Consultant. Unless otherwise provided in a separate Agreement, City shall bear all costs incident to compliance with the following: • Place at Consultant’s disposal all available information in its possession pertinent to the Agreement, including previous SWPPP, reports, drawings, specifications or any other data as may be reasonably required by Consultant to perform its Services. • Non-stormwater sampling and analysis (if required) and contracting with an ELAP certified analytical laboratory is City’s responsibility. • Give prompt written notice to Consultant whenever Company becomes aware of any development that affects the scope or timing of Keish Environmental, PC's Services. CITY OF CUPERTINO MAINTENANCE CENTER SERVICES SWPPP Inpection & Training Last updated: 6/10/2021 TASK Line Items UNIT UNIT UNIT COST TOTAL COST Task 1 (SWPPP Review)Perform SWPPP Review EA 1 300$ 300$ Initial Inspection EA 1 500$ 500$ Report Preparation EA 3 300$ 900$ Follow-up Inspections EA 2 300$ 600$ Prepare and Conduct PowerPoint Training EA 1 1,500$ 1,500$ Optional Field Training w/ Tri-fold EA 1 1,000$ 1,000$ TOTAL:4,800$ Task 2 (C.2.f. Corporation Yard Inspections) Task 3 (Training) PRICE PROPOSAL FORM 2021-06-10 Cupertino SWPPP Quote.xlsxCost Proposal 6/11/2021 Insurance Requirements for Services Agreement ($5,000 or less) 1 Version: Sept. 2019 Contractor shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance and results of the Services hereunder by the Contractor, his 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, including products and completed operations, contractual liability, property damage, bodily injury, and personal and advertising injury with limits no less than $2,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this Project (ISO CG 25 03 or 25 04) or it 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 Number 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 limits 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 occurrence for bodily injury or disease. (Not required if Contractor provides written verification it has no employees). 4.Professional Liability. Insurance which includes coverage for professional acts, errors and omissions, with limits no less than $2,000,000 per occurrence or claim, $2,000,000 aggregate (if applicable).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 higher insurance limits maintained by Contractor. 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 EXHIBIT B Insurance Requirements Services Agreement ($5,000 or less) Insurance Requirements for Services Agreement ($5,000 or less) 2 Version: Sept. 2019 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 Contract, the Contractor’s insurance coverage shall be primary coverage at least as broad as ISO CG 20 01 04 13 as respects the City, its officers, officials, employees and volunteers. Any insurance or self-insurance maintained by the City, its officers, officials, employees, or volunteers shall be excess of Contractor’s insurance and shall not contribute to it. Notice of Cancellation Each insurance policy shall state that coverage shall not be canceled or allowed to expire, except with written notice to City 30 days in advance or 10 days in advance if due to non-payment of premiums. Waiver of Subrogation Contractor grants to City a waiver of any right to subrogation which any insurer of said Contractor may acquire against City by virtue of the payment of any loss under such insurance. Contractor agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer. Self-Insured Retentions City may approve self-insured retentions and require proof of Contractor’s ability to pay losses and related investigations, claim administration and defense expenses within the retention. The policy shall provide, or be endorsed to provide, that the self-insured retention may be satisfied by either the named insured or City. Acceptability of Insurers Insurers must be acceptable to City and licensed to do business in 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. Claims Made Policies (applicable only to professional liability) If any of the required policies provide coverage on a claims-made basis: 1. The Retroactive Date must be shown and must be before the Effective Date of the Contract. 2. Insurance must be maintained for at least five (5) years after completion of the Services. 3. If coverage is canceled or non-renewed, and not replaced with another claims-made policy form with a Retroactive Date prior to the Contract Effective Date, the Contractor must purchase “extended reporting” coverage for a minimum of five (5) years after completion of the Services. Verification of Coverage Contractor shall furnish the City with acceptable original certificates and mandatory endorsements (or copies of the policies effecting the coverage required by this Contract), and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City prior to commencing the Services. City retains the right to demand verification of compliance at any time during the Contract. 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. Insurance coverage shall not limit Contractor’s duties to indemnify, defend and hold City harmless. City reserves the right to modify these requirements based on the nature of the risk, prior experience, insurer, coverage or other special circumstances. CERTIFICATE HOLDER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under SPECIAL PROVISIONS below © 1988- 2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECT PRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTION DEDUCTIBLE CLAIMS-MADE OCCUR $ $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY)LIMITS WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS $ COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident)$ $ $ $ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL WVD SUBR N / A $ $ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). The ACORD name and logo are registered marks of ACORD COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE (A/C, No, Ext): PRODUCER PRODUCER CUSTOMER ID #: ADDRESS: E-MAIL FAX (A/C, No): CONTACT NAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 07/01/2021 793-00-78-52-0003 04/07/2021 04/07/2022 04/07/2021 04/07/2022 793-00-78-53-0003 04/07/2021 04/07/2022 03/25/2021 03/25/2022 793-00-78-52-0003 04/07/2021 04/07/2022 The City of Cupertino, it's City Council, officers, officials, employees, agents, servants and volunteers are named as additional insured in respects to General and Automobile liability as per the attached endosement package. Policies are primary and noncontributory and subrogration has been waived. Project: Municipal Regional Permit Support- Service Center Annual C.2 Inspection and Training Clear All City of Cupertino 10300 Torre Ave., Cupertino, CA 95014 Policy Number: 793-0 0-7 8-52-0 0 03 Policy Number: 7 93-00-7 8-52-0003 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement only modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization that the "Named Insured" agreed to waive its rights of recovery against in a written contract or written agreement that was fully executed by the "Named Insured" prior to the performance of the "Named Insured's" work that is the subject of such written contract or written agreement. Such waiver will not be broader than the scope of the waiver agreed to by the "Named Insured" in such written contract or written agreement. SECTION IV -CONDITIONS, 13. Transfer of Rights of Recovery Against Others To Us is deleted and replaced with the following: 13.Transfer of Rights of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this policy, those rights are transferred to us. The insured must do nothing to impair them. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. Any recovery will be paid first to us until all amounts we have spent on a claim or suit have been reimbursed. The insured expressly waives the right to be made whole by any such recovery. We waive any right of recovery we may have against the person or organization shown in the SCHEDULE above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products-completed operations hazard. This waiver applies only to the person or organization shown in the SCHEDULE above. All other terms and conditions remain the same. OBENV GE 320 (04 11) Includes copyrighted material of Insurance Services Office, Inc. 1 of 1 Copyright 2011, OneBeacon Insurance Group LLC E-INSURED Policy Number: 7 93-0 0-7 8-52-0 0 03 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION -FORM Ill This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Any person or organization that the Any location, and completed operations Named Insured agreed to add as an at such location, where required by the additional insured in a written contract written contract or written agreement in or written agreement that was fully which the Named Insured agreed to add executed by the Named Insured prior to the person or organization qualifying as the performance of the Named Insured's an additional insured under this work that is the subject of such written endorsement. contract or written agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A.SECTION II -WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for bodily injury, property damage, environmental damage or personal and advertising injury caused, in whole or in part, by: 1.Your acts or omissions; or 2.The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to bodily injury, property damage or environmental damage occurring after: 1.All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or OBENV GE 346 (01 19) Contains copyrighted material of Insurance Services Office, Inc. with its permission. Copyright 2019, OneBeacon Insurance Group LLC E-INSURED Page 1 of2 03/25/2021 03/25/21 03/25/2022 Policy Number: 57WECAD0C11 Keish Environmental for Municipal Regional Permit Inspection and Training Final Audit Report 2021-08-05 Created:2021-08-04 By:City of Cupertino (webmaster@cupertino.org) Status:Signed Transaction ID:CBJCHBCAABAAt_JZxli_NcJ7RM1vs8t-Z6Ct3KZmYXUJ "Keish Environmental for Municipal Regional Permit Inspection a nd Training" History Document created by City of Cupertino (webmaster@cupertino.org) 2021-08-04 - 10:02:35 PM GMT- IP address: 35.229.54.2 Document emailed to Julia Kinst (juliak@cupertino.org) for approval 2021-08-04 - 10:06:53 PM GMT Document approved by Julia Kinst (juliak@cupertino.org) Approval Date: 2021-08-04 - 10:09:08 PM GMT - Time Source: server- IP address: 216.198.111.214 Document emailed to Araceli Alejandre (aracelia@cupertino.org) for approval 2021-08-04 - 10:09:10 PM GMT Document shared with nicolel@cupertino.org 2021-08-04 - 10:11:37 PM GMT- IP address: 216.198.111.214 Document approved by Araceli Alejandre (aracelia@cupertino.org) Approval Date: 2021-08-04 - 11:41:15 PM GMT - Time Source: server- IP address: 73.170.27.253 Document emailed to Rachael Keish (rachael@keishenv.com) for signature 2021-08-04 - 11:41:18 PM GMT Email viewed by Rachael Keish (rachael@keishenv.com) 2021-08-05 - 1:02:52 AM GMT- IP address: 24.6.168.79 Document e-signed by Rachael Keish (rachael@keishenv.com) Signature Date: 2021-08-05 - 3:27:42 AM GMT - Time Source: server- IP address: 24.6.168.79 Document emailed to Christopher D. Jensen (christopherj@cupertino.org) for signature 2021-08-05 - 3:27:45 AM GMT Email viewed by Christopher D. Jensen (christopherj@cupertino.org) 2021-08-05 - 4:14:22 AM GMT- IP address: 174.194.128.97 Document e-signed by Christopher D. Jensen (christopherj@cupertino.org) Signature Date: 2021-08-05 - 6:19:27 AM GMT - Time Source: server- IP address: 136.24.42.212 Document emailed to Ursula Syrova (she/her) (ursulas@cupertino.org) for signature 2021-08-05 - 6:19:29 AM GMT Email viewed by Ursula Syrova (she/her) (ursulas@cupertino.org) 2021-08-05 - 2:35:22 PM GMT- IP address: 104.47.73.254 Document e-signed by Ursula Syrova (she/her) (ursulas@cupertino.org) Signature Date: 2021-08-05 - 2:36:33 PM GMT - Time Source: server- IP address: 98.45.180.112 Document emailed to Kirsten Squarcia (kirstens@cupertino.org) for signature 2021-08-05 - 2:36:36 PM GMT Email viewed by Kirsten Squarcia (kirstens@cupertino.org) 2021-08-05 - 4:10:33 PM GMT- IP address: 69.110.137.176 Document e-signed by Kirsten Squarcia (kirstens@cupertino.org) Signature Date: 2021-08-05 - 6:40:27 PM GMT - Time Source: server- IP address: 69.110.137.176 Agreement completed. 2021-08-05 - 6:40:27 PM GMT