The URL can be used to link to this page

21-243 NGF, Blackberry Farm Golf Course Minimal Repair Scope EstimateBlackberry Farm Golf Course Minimal Repair Scope Estimate Page 1 of 9 Professional/Consulting Contracts /Version: October 2021 PROFESSIONAL/CONSULTING SERVICES AGREEMENT 1. PARTIES This Agreement is made by and between the City of Cupertino, a municipal corporation (“City”), and NGF Consulting, Inc (“Contractor”), a Corporation for Blackberry Farm Golf Course Minimal Repair Scope Estimate, and is effective on the last date signed below (“Effective Date”). 2. SERVICES Contractor agrees to provide the services and perform the tasks (“Services”) set forth in detail in Scope of Services, attached here and incorporated 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 3.1 This Agreement begins on the Effective Date and ends on June 30, 2022 (“Contract Time”), unless terminated earlier as provided herein. Contractor’s Services shall begin on the effective date and shall be completed by June 30, 2022. The City’s appropriate department head or the City Manager may extend the Contract Time through a written amendment to this Agreement, provided such extension does not include additional contract funds. Extensions requiring additional contract funds are subject to the City’s purchasing policy. 3.2 Schedule of Performance. Contractor must deliver the Services in accordance with the Schedule of Performance, attached and incorporated here Exhibit B. 3.3 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. 4. COMPENSATION 4.1 Maximum Compensation. City will pay Contractor for satisfactory performance of the Services an amount that will based on actual costs but that will be capped so as not to exceed $20,000.00 (“Contract Price”), based upon the scope of services in Exhibit A and the budget and rates included in Exhibit C, Compensation attached and incorporated here. The maximum compensation includes all expenses and reimbursements and will remain in place even if Contractor’s actual costs exceed the capped amount. No extra work or payment is permitted without prior written approval of City. 4.2 Invoices and Payments. Monthly invoices must state a description of the deliverable completed and the amount due for the preceding month. Within thirty (30) days of completion of Blackberry Farm Golf Course Minimal Repair Scope Estimate Page 2 of 9 Professional/Consulting Contracts /Version: October 2021 Services, Contractor must submit a requisition for final and complete payment of costs and pending claims for City approval. Failure to timely submit a complete and accurate payment requisition relieves City of any further payment or other obligations under the Agreement. 5. INDEPENDENT CONTRACTOR 5.1 Status. 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, worker’s compensation, or other benefits from the City. 5.2 Contractor’s Qualifications. Contractor warrants on behalf of itself and its subcontractors that they have the qualifications and skills to perform the Services 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 Services as required by law and have procured a City Business License, if required by the Cupertino Municipal Code. 5.4 Subcontractors. Only Contractor’s employees are authorized to work under this Agreement. Prior written approval from City is required for any subcontractor, and the terms and conditions of this Agreement will apply to any approved subcontractor. 5.5 Tools, Materials, and Equipment. Contractor will supply all tools, materials and equipment required to perform the Services under this Agreement. 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 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. PROPRIETARY/CONFIDENTIAL INFORMATION In performing this Agreement, Contractor may have access to private or confidential information owned or controlled by the City, which may contain proprietary or confidential details the disclosure of which to third parties may be damaging to City. Contractor shall hold in confidence Blackberry Farm Golf Course Minimal Repair Scope Estimate Page 3 of 9 Professional/Consulting Contracts /Version: October 2021 all City information provided by City to Contractor and use it only to perform this Agreement. Contractor shall exercise the same standard of care to protect City information as a reasonably prudent contractor would use to protect its own proprietary data. 7. OWNERSHIP OF MATERIALS 7.1 Property Rights. Any interest (including copyright interests) of Contractor in any product, memoranda, study, report, map, plan, drawing, specification, data, record, document, or other information or work, in any medium (collectively, “Work Product”), prepared by Contractor in connection with this Agreement will be the exclusive property of the City upon completion of the work to be performed hereunder or upon termination of this Agreement, to the extent requested by City. In any case, no Work Product shall be shown to any third-party without prior written approval of City. 7.2 Copyright. To the extent permitted by Title 17 of the U.S. Code, all Work Product arising out of this Agreement is considered “works for hire” and all copyrights to the Work Product will be the property of City. Alternatively, Contractor assigns to City all Work Product copyrights. Contractor may use copies of the Work Product for promotion only with City’s written approval. 7.3 Patents and Licenses. Contractor must pay royalties or license fees required for authorized use of any third party intellectual property, including but not limited to patented, trademarked, or copyrighted intellectual property if incorporated into the Services or Work Product of this Agreement. 7.4 Re-Use of Work Product. Unless prohibited by law and without waiving any rights, City may use or modify the Work Product of Contractor or its sub-contractors prepared or created under this Agreement, to execute or implement any of the following: (a) The original Services for which Contractor was hired; (b) Completion of the original Services by others; (c) Subsequent additions to the original Services; and/or (d) Other City projects. 7.5 Deliverables and Format. Contractor must provide electronic and hard copies of the Work Product, on recycled paper and copied on both sides, except for one single-sided original. 8. RECORDS Contractor must maintain complete and accurate accounting records relating to its performance in accordance with generally accepted accounting principles. The records must include detailed information of Contractor’s performance, benchmarks and deliverables, which must be available to City for review and audit. The records and supporting documents must be kept separa te from other records and must be maintained for four (4) years from the date of City’s final payment. Contractor acknowledges that certain documents generated or received by Contractor in connection with the performance of this Agreement, including but not limited to correspondence between Contractor and any third party, are public records under the California Public Records Act, California Government Code section 6250 et seq. Contractor shall comply with all laws Blackberry Farm Golf Course Minimal Repair Scope Estimate Page 4 of 9 Professional/Consulting Contracts /Version: October 2021 regarding the retention of public records and shall make such records available to the City upon request by the City, or in such manner as the City reasonably directs that such records be provided. 9. ASSIGNMENT Contractor shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest therein, directly or indirectly, by operation of law or otherwise, without prior written consent of City. Any attempt to do so 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 Agreement 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. 10. PUBLICITY / SIGNS Any publicity generated by Contractor for the project under this Agreement, during the term of this Agreement and for one year thereafter, will reference the City’s contributions in making the project possible. The words “City of Cupertino” will be displayed in all pieces of publicity, including flyers, press releases, posters, brochures, public service announcements, interviews and newspaper articles. No signs may be posted, exhibited or displayed on or about City property, except signage required by law or this Contract, without prior written approval from the City. 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, actions, causes of act ion, 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, property damage, or economic loss resulting from the work or performance of Contractor or its subcontractors or sub-subcontractors; (d) Unauthorized use or disclosure of City’s confidential and proprietary Information; (e) Claim of infringement or violation of a U.S. patent or copyright, trade secret, trademark, or service mark or other proprietary or intellectual property rights of any third party. 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. At City’s request, Contractor will assist City in the defense of a claim, dispute, or lawsuit arising out of this Agreement. 11.3 Contractor’s duties under this section are not limited to the Contract Price, workers’ compensation payments, or the insurance or bond amounts required in the Agreement. Nothing in Blackberry Farm Golf Course Minimal Repair Scope Estimate Page 5 of 9 Professional/Consulting Contracts /Version: October 2021 the Agreement shall be construed to give rise to an implied right of indemnity in favor of Contractor against City or any 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 Agreement, a purchase order, or other transaction. 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 Agreement. 12. INSURANCE Contractor shall comply with the Insurance Requirements, attached and incorporated here as Exhibit D, 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. 13. COMPLIANCE WITH LAWS 13.1 General Laws. Contractor shall comply with all local, state, and federal laws and regulations applicable to this Agreement. 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 authorization of employees performing the Services, as required by the Immigration Reform and Control Act. 13.2 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. 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. 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 its 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. Blackberry Farm Golf Course Minimal Repair Scope Estimate Page 6 of 9 Professional/Consulting Contracts /Version: October 2021 13.4 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 Title 2 of the California Code of Regulations. Contractor agrees to abide by the City’s 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 reimbursements or terminating this Agreement. City reserves all other rights and remedies available under the law and this Agreement, including the right to seek indemnification under Section 11 of this Agreement. 14. PROJECT COORDINATION City Project Manager. The City assigns Lisa Cameli as the City’s representative for all purposes under this Agreement, with authority to oversee the progress and performance of the Scope of Services. City reserves the right to substitute another Project manager at any time, and without prior notice to Contractor. Contractor Project Manager. Subject to City approval, Contractor assigns Ed Getherall as its single Representative for all purposes under this Agreement, with authority to oversee the progress and performance of the Scope of Services. Contractor’s Project manager is responsible for coordinating and scheduling the Services in accordance with the Scope of Services and the Schedule of Performance. Contractor must regularly update the City’s Project Manager about the progress with the work or any delays, as required under the Scope of Services. City written approval is required prior to substituting a new Representative. 15. ABANDONMENT OF PROJECT City may abandon or postpone the Project or parts therefor at any time. Contractor will be compensated for satisfactory Services performed through the date of abandonment, and will be given reasonable time to assemble the work and close out the Services. With City’s pre-approval in writing, the time spent in closing out the Services will be compensated up to a maximum of ten percent (10%) of the total time expended to date in the performance of the Services. 16. TERMINATION City may terminate this Agreement for cause or without cause at any time. Contractor will be paid for satisfactory Services rendered through the date of termination, but final payment will not be made until Contractor closes out the Services and delivers the Work Product. 17. GOVERNING LAW, VENUE, AND DISPUTE RESOLUTION 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 Blackberry Farm Golf Course Minimal Repair Scope Estimate Page 7 of 9 Professional/Consulting Contracts /Version: October 2021 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. 18. 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 Agreement, the prevailing party will be entitled to reasonable attorney fees and costs. 19. THIRD PARTY BENEFICIARIES There are no intended third party beneficiaries of this Agreement. 20. WAIVER Neither acceptance of the Services nor payment thereof shall constitute a waiver of any contract provision. City’s waiver of a breach shall not constitute waiver of another provision or breach. 21. ENTIRE AGREEMENT This Agreement represents the full and complete understanding of every kind or nature between the Parties, and supersedes any other agreement(s) and understanding(s), either oral or written, between the Parties. Any modification of 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 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. 22. INSERTED PROVISIONS Each provision and clause required by law for this Agreement is deemed to be included and will be inferred herein. Either party may request an amendment to cure mistaken insertions or omissions of required provisions. The Parties will collaborate to implement this Section, as appropriate. 23. HEADINGS The headings in this Agreement are for convenience only, are not a part of the Agreement and in no way affect, limit, or amplify the terms or provisions of this Agreement. 24. SEVERABILITY/PARTIAL INVALIDITY If any term or provision of this Agreement, or their application to a particular situation, is found by the court to be void, invalid, illegal, or unenforceable, such term or provision shall remain in force and effect to the extent allowed by such ruling. All other terms and provisions of this Blackberry Farm Golf Course Minimal Repair Scope Estimate Page 8 of 9 Professional/Consulting Contracts /Version: October 2021 Agreement or their application to specific situations shall remain in full force and effect. The Parties agree to work in good faith to amend this Agreement to carry out its intent. 25. SURVIVAL All provisions which by their nature must continue after the Agreement expires or is terminated, including the Indemnification, Ownership of Materials/Work Product, Records, Governing Law, and Attorney Fees, shall survive the Agreement and remain in full force and effect. 26. NOTICES All notices, requests and approvals must be sent in writing to the persons below, which will be considered effective on the date of personal delivery or the date confirmed by a reputable overnight delivery service, on the fifth 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 Attention: Lisa Cameli Email: LisaC@cupertino.org To Contractor: NGF Consulting, Inc 501 N. Highway A1A Jupiter FL 33477 Attention: Ed Getherall Email: egetherall@ngf.org 27. EXECUTION The person executing this Agreement on behalf of Contractor represents and warrants that Contractor has full right, power, and authority to enter into and carry out all actions contemplated by this Agreement and that he or she is authorized to execute this Agreement, which constitutes a legally binding obligation of 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. IN WITNESS WHEREOF, the parties have caused the Agreement to be executed. CITY OF CUPERTINO CONTRACTOR A Municipal Corporation By By Name Name Title Title Date Date Edward Getherall Director of Consulting Nov 2, 2021 Edward Getherall Susan Michael Nov 2, 2021 Capital Improvements Program Manager Susan Michael Blackberry Farm Golf Course Minimal Repair Scope Estimate Page 9 of 9 Professional/Consulting Contracts /Version: October 2021 APPROVED AS TO FORM: CHRISTOPHER D. JENSEN Cupertino City Attorney ATTEST: KIRSTEN SQUARCIA City Clerk Date Christopher D. Jensen Nov 2, 2021 NATIONAL GOLF FOUNDATION CONSULTING, INC. A Subsidiary of the National Golf Foundation 1150 SOUTH U.S. HIGHWAY ONE, SUITE 401, JUPITER, FL 33477 • (561) 744-6006 • FAX: (561) 744-9085 • www.ngf.org (408)777-1380 lisac@cupertino.org October 18, 2021 Lisa Cameli Project Manager, Public Works City of Cupertino 10300 Torre Avenue Cupertino, CA 95014 NGF Consulting Proposal #221025c Re: Blackberry Farm Golf Course Update – Minimal Repair Scope Dear Lisa: Our team enjoyed speaking with you earlier this week, and we’re excited to once again be working for the City. We’re pleased to submit this proposal for updated consulting due diligence related to the City’s Blackberry Farm Golf Course, which the NGF team did significant consulting on in the mid-2010s. This letter summarizes consulting services to be provided by the NGF team, with golf course architect Richardson-Danner, ASGCA, and Russell D. Mitchell, irrigation consultant, acting as subcontractors to NGF. The proposed engagement will commence with a meeting with appropriate City staff to review the scope of work and obtain relevant updated information on the golf facility, and will comprise the scope of services summarized below. UPDATED COST ESTIMATES The NGF team will formulate new probable cost estimates for the “minimal repairs” (i.e., “infrastructure only”) improvement scenario for Blackberry Farm GC. Key areas of focus for the study will include, but not be limited to: (1) Playability; (2) Safety; (3) Water Source; and, (4) Trail Protection. Updated cost estimation will apply to the following elements: •Replacing the irrigation system. The two scenarios of Potable vs Well Water will need to be addressed here, requiring a discussion of the logistics of re-activating the well (connection to potable water should be made regardless, as a back-up). •Replacing the empty ponds with lowland native areas. •Replacing tees and greens as needed (e.g., #3 tee - removing mat & replacing w/grass). Tees and greens are replaced approximately every 6 years as needed. NGF will opine on replacing the greens that need it if the course is going to be torn up for irrigation replacement. •Installing netting to protect the #6 tee box from errant shots on the Hole #4. Exhibit A & C National Golf Foundation Consulting, Inc. – Proposal #221025c – Blackberry Farm GC Update – 2 • Shortening the 9th hole to eliminate the number of errant shots to the parking lot, trail, and Hole #1. Flipping the driving net, and making it longer and with additional bays. Adding a short game practice area (chipping/sand bunker), with protective netting. • Identifying locations where installation of steps or terracing would be beneficial. ANALYSIS OF WELL REACTIVATION AND ESTIMATED COSTS The NGF team will undertake an evaluation and analysis of the logistics and cost feasibility of reactivating the on-site well. This analysis will include: • Physical evaluation of well to determine what is needed (e.g., new motor, new pump, new meter, etc.) to restore and revitalize existing well for irrigation. This will include a preliminary cost estimate. • Assessment of need from both administrative (e.g., permit requirements) and technical requirement standpoints. • Examination of annual cost of use of Potable water vs Well water for irrigation source at Blackberry Farm GC. PROJECT DELIVERABLES NGF Consulting anticipates frequent communication with City staff during the course of this engagement. At the conclusion of the study process, NGF will develop a concise written report that will contain all updated costs, financial models, and support documentation. Also, the implications of the direction the City decides to go in with respect to Blackberry Farm will involve sub-decisions; such as water source, potential turf area reductions, ADA issues, etc. As such, NGF will present these various scenarios in a matrix format, supported by explanatory narrative. A draft version of the document will be delivered to the City for review and comments. Once the report is finalized, relevant members of the NGF project team will be available to make a formal presentation of findings to the City Council in early 2022. Consultants will also be available to answer any questions related to the findings that will further assist in decision making. STUDY COST SUMMARY The total professional fee for this engagement will be $20,000. This total fee, as broken down in the summary table below, includes direct project expenses associated with the field research in Cupertino by NGF team members, as well as attendance at the referenced City Council meeting in early 2022. (Participation in other meetings may involve additional travel expenses and/or professional fees). Project Task Professional Fee Updated Cost Estimates $10,500 Analysis of Well Reactivation & Estimated Costs $4,500 Project Deliverables (including site visits) $5,000 Project Expenses (Two Trips) Included TOTAL $20,000 National Golf Foundation Consulting, Inc. – Proposal #221025c – Blackberry Farm GC Update – 3 ACCEPTANCE Acceptance of this proposal may be indicated by providing NGF Consulting with a signed copy of this proposal (incorporated in a City of Cupertino purchase order / contract as appropriate). Lisa, if you need any additional information, or would like to discuss any of the specifics of this proposal, please call me at (561) 354-1650. Sincerely, Ed Getherall Director of Consulting (561) 354-1650 egetherall@ngf.org Acceptance: Date: Exh. D-Insurance Requirements for Design Professionals & Consultant Contracts 1 Form Updated Sept. 2019 Consultant shall procure prior to commencement of Services and maintain for the duration of the contract, at its own cost and expense, the following insurance policies and coverage with companies doing business in California and acceptable to City. INSURANCE POLICIES AND MINIMUMS REQUIRED 1. Commercial General Liability (CGL) for bodily injury, property damage, personal injury liability for premises operations, products and completed operations, contractual liability, and personal and advertising injury with limits no less than $2,000,000 per occurrence (ISO Form CG 00 01). If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO Form CG 25 03 or 25 04) or it shall be twice the required occurrence limit. a. It shall be a requirement 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 (i) the minimum coverage/limits specified in this agreement; or (ii) the broader coverage and maximum limits of coverage of any insurance policy, whichever is greater. b. Additional Insured coverage under Consultant'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 Form 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 CA 00 01 covering any auto (including owned, hired, and non-owned autos) 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. Consultant has provided written verification of no employees. 4. Professional Liability for professional acts, errors and omissions, as appropriate to Consultant’s profession, with limits no less than $2,000,000 per occurrence or $2,000,000 aggregate. If written on a claims made form: a. The Retroactive Date must be shown and must be before the Effective Date of the Contract. b. Insurance must be maintained for at least five (5) years after completion of the Services. c. 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 Consultant must purchase “extended reporting” coverage for a minimum of five (5) years after completion of the Services. EXHIBIT D Insurance Requirements Design Professionals & Consultants Contracts Exh. D-Insurance Requirements for Design Professionals & Consultant Contracts 2 Form Updated Sept. 2019 OTHER INSURANCE PROVISIONS The aforementioned insurance shall be endorsed and have all the following conditions and provisions: Additional Insured Status The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers (“Additional Insureds”) are to be covered as additional insureds on Consultant’s CGL and automobile liability policies. General Liability coverage can be provided in the form of an endorsement to Consultant’s insurance (at least as broad as ISO Form CG 20 10 (11/ 85) or both CG 20 10 and CG 20 37 forms, if later editions are used). Primary Coverage Coverage afforded to City/Additional Insureds shall be primary insurance. Any insurance or self-insurance maintained by City, its officers, officials, employees, or volunteers shall be excess of Consultant’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 Consultant waives any right to subrogation against City/Additional Insureds for recovery of damages to the extent said losses are covered by the insurance policies required herein. Specifically, the Workers’ Compensation policy shall be endorsed with a waiver of subrogation in favor of City for all work performed by Consultant, its employees, agents and subconsultants. This provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer. Deductibles and Self-Insured Retentions Any deductible or self-insured retention must be declared to and approved by the City. At City’s option, either: the insurer must reduce or eliminate the deductible or self-insured retentions as respects the City/Additional Insureds; or Consultant must show proof of ability to pay losses and costs related investigations, claim administration and defense expenses. The policy shall provide, or be endorsed to provide, that the self-insured retention may be satisfied by either the insured or the City. Acceptability of Insurers Insurers must be licensed to do business in California with an A.M. Best Rating of A-VII, or better. Verification of Coverage Consultant must furnish acceptable insurance 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 prior to commencement of the Contract. City retains the right to demand verification of compliance at any time during the Contract term. Subconsultants Consultant shall require and verify that all subconsultants maintain insurance that meet the requirements of this Contract, including naming the City as an additional insured on subconsultant’s insurance policies. Higher Insurance Limits If Consultant maintains broader coverage and/or higher limits than the minimums shown above, City shall be entitled to coverage for the higher insurance limits maintained by Consultant. Adequacy of Coverage City reserves the right to modify these insurance requirements/coverage based on the nature of the risk, prior experience, insurer or other special circumstances, with not less than ninety (90) days prior written notice. ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTR INSD WVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 10/28/2021 (800) 243-6899 (407) 788-7933 24082 National Golf Foundation, Inc; National Golf Foundation (I), Inc.; National Golf Foundation Cons 501 N A1A Jupiter, FL 33477-4577 24074 25666 42374 A 1,000,000 BKS55924422 11/1/2021 11/1/2022 500,000 15,000 2,000,000 2,000,000 1,000,000A BAS55924422 11/1/2021 11/1/2022 4,000,000B USO55924422 11/1/2021 11/1/2022 4,000,000 10,000 C UB6J488844 11/1/2021 11/1/2022 1,000,000Y1,000,000 1,000,000 D Professional Liab H721-118510 11/9/2021 Per Claim 1,000,000 City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers are included as additional insured's with respect to General Liability as required per written contract or agreement. General Liability is primary and non-contributory. Waiver of subrogation is in favor of the additional insured's with respect to Work Comp as required per written contract or agreement. NOC: 30/10 days for non-payment of premium in accordance with policy provisions. City of Cupertino 10185 N. Stelling Rd. Cupertino, CA 95014-5732 NATIGOL-01 PETERSONM Insurance Office of America, Inc.1855 West State Road 434Longwood, FL 32750 Ohio Security Insurance Company Ohio Casualty Insurance Company Travelers Indemnity Company of America Houston Casualty Company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¶V SROLF\ KDV DQ 2WKHU ,QVXUDQFH SURYLVLRQ PDNLQJ LWV SROLF\ H[FHVV DQG \RX KDYH DJUHHG LQ D ZULWWHQ FRQWUDFW RU ZULWWHQ DJUHHPHQW WR SURYLGH WKH DGGLWLRQDO LQVXUHG FRYHUDJH RQ D SULPDU\ DQG QRQFRQWULEXWRU\ EDVLV WKLV SROLF\ VKDOO EH SULPDU\ DQG ZH ZLOO QRW VHHN FRQWULEXWLRQ IURP WKH DGGLWLRQDO LQVXUHG¶V SROLF\ IRU GDPDJHV ZH FRYHU E7KH IROORZLQJ LV DGGHG WR 3DUDJUDSK E ([FHVV ,QVXUDQFH :KHQ D ZULWWHQ FRQWUDFW RU ZULWWHQ DJUHHPHQW RWKHU WKDQ D SUHPLVHV OHDVHIDFLOLWLHV UHQWDO FRQWUDFW RU DJUHHPHQW DQ HTXLSPHQW UHQWDO RU OHDVH FRQWUDFW RU DJUHHPHQW RU SHUPLW LVVXHG E\ D VWDWH RU SROLWLFDO VXEGLYLVLRQ EHWZHHQ \RX DQG DQ DGGLWLRQDO LQVXUHG GRHV QRW UHTXLUH WKLV LQVXUDQFH WR EH SULPDU\ RU SULPDU\ DQG QRQFRQWULEXWRU\ WKLV LQVXUDQFH LV H[FHVV RYHU DQ\ RWKHU LQVXUDQFH IRU ZKLFK WKH DGGLWLRQDO LQVXUHG LV GHVLJQDWHG DV D 1DPHG ,QVXUHG 5HJDUGOHVV RI WKH ZULWWHQ DJUHHPHQW EHWZHHQ \RX DQG DQ DGGLWLRQDO LQVXUHG WKLV LQVXU DQFH LV H[FHVV RYHU DQ\ RWKHU LQVXUDQFH ZKHWKHU SULPDU\ H[FHVV FRQWLQJHQW RU RQ DQ\ RWKHU EDVLV IRU ZKLFK WKH DGGLWLRQDO LQVXUHG KDV EHHQ DGGHG DV DQ DGGLWLRQDO LQVXUHG RQ RWKHU SROLFLHV #BKS55924422 DATE OF ISSUE:CHANGE NO:PAGE POL. EXP. DATE:POL. EFF. DATE: OFFICE: PRODUCER: OF COUNTERSIGNED AGENT 10-21-21 MB 3 1 2 11-01-21 11-01-22 TAMPA FL 247 IOA - LONGWOOD VJ001 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE DOCUMENT WC 99 99 98 ( A) POLICY NUMBER: ONE TOWER SQUAREHARTFORD CT 06183 UB-6J488844-21-42-V CHANGE EFFECTIVE DATE:NCCI CO CODE: INSURER: INSURED'S NAME: ADDITIONAL PREMIUM RETURN PREMIUM$$ ADDITIONAL NON-PREMIUM RETURN NON-PREMIUM$$ This change is issued by the Company or Companies that issued the policy and forms a part of the policy. It is agreed that the policy is amended as follows: An absence of an entry in the premium spaces below means that the premium adjustment, if any, will be made at time of audit. 11-01-21 13439 THE TRAVELERS INDEMNITY COMPANY OF AMERICA NATIONAL GOLF FOUNDATION, INC. NIL NIL NIL NIL The following endorsement charge is added to the schedule: STATE OF FL LOCATION 001 WAIVER OF SUBROGATION SEE ATTACHED ENDORSEMENT ESTIMATED PREM. ANNUAL CLASSIFICATION CODE BASIS RATE PREMIUM SPECIFIC WAIVER WAIVER CALCULATION IS BASED ON CLASS CODE (S) PREMIUM X RATE 0930 2 .03 0 The following endorsement charge is added on the schedule: STATE OF FL LOCATION 001 TERRITORY WAIVER OF SUBROGATION SEE ATTACHED ENDORSEMENT ESTIMATED WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE DOCUMENT WC 99 99 98 ( A) POLICY NUMBER: ONE TOWER SQUAREHARTFORD CT 06183 UB-6J488844-21-42-V PREM. ANNUAL CLASSIFICATION CODE BASIS RATE PREMIUM SPECIFIC WAIVER 0930 2 .03 0 Specific Waiver Minimum Premium is added as follows: STATE MINIMUM PREMIUM FL 0 Item 3.D Form Number is added: WC 00 03 13 00 - 008 WAIVER OF OUR RIGHT TO RECOVER CHANGE NO:PAGE OF32 2 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 89 06 14 (00)– POLICY NUMBER: POLICY INFORMATION PAGE ENDORSEMENT Item 3.D. Endorsement numbers is changed to read: ONE TOWER SQUAREHARTFORD CT 06183 UB-6J488844-21-42-V WC 00 03 13 00 ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. DATE OF ISSUE:ST ASSIGN:10-21-21 ENDORSEMENT WC 00 03 13 (00) - POLICY NUMBER: EMPLOYERS LIABILITY POLICY AND WORKERS COMPENSATION WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 008 ONE TOWER SQUAREHARTFORD CT 06183 UB-6J488844-21-42-V We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED ORGANIZATION: DESIGNATED PERSON: CITY OF CUPERTINO 10185 N. STELLING RD CUPERTINO, CA 95014-5732 DATE OF ISSUE:PAGEST ASSIGN:OF10-21-21 1 1 NGF for Blackberry Farm Golf Course Minimal Repair Scope Estimate Final Audit Report 2021-11-02 Created:2021-11-01 By:City of Cupertino (webmaster@cupertino.org) Status:Signed Transaction ID:CBJCHBCAABAAYHWhF4MgnKIkVJnkqHBFhcr14uJMP5NQ "NGF for Blackberry Farm Golf Course Minimal Repair Scope Es timate" History Document created by City of Cupertino (webmaster@cupertino.org) 2021-11-01 - 11:32:34 PM GMT- IP address: 35.229.54.2 Document emailed to Julia Kinst (juliak@cupertino.org) for approval 2021-11-01 - 11:34:48 PM GMT Document approved by Julia Kinst (juliak@cupertino.org) Approval Date: 2021-11-01 - 11:35:15 PM GMT - Time Source: server- IP address: 216.198.111.214 Document emailed to Araceli Alejandre (aracelia@cupertino.org) for approval 2021-11-01 - 11:35:17 PM GMT Document approved by Araceli Alejandre (aracelia@cupertino.org) Approval Date: 2021-11-01 - 11:48:03 PM GMT - Time Source: server- IP address: 73.170.27.253 Document emailed to Edward Getherall (egetherall@ngf.org) for signature 2021-11-01 - 11:48:06 PM GMT Email viewed by Edward Getherall (egetherall@ngf.org) 2021-11-01 - 11:51:20 PM GMT- IP address: 172.58.128.85 Document e-signed by Edward Getherall (egetherall@ngf.org) Signature Date: 2021-11-02 - 5:17:24 PM GMT - Time Source: server- IP address: 96.80.64.177 Document emailed to Christopher D. Jensen (christopherj@cupertino.org) for signature 2021-11-02 - 5:17:26 PM GMT Email viewed by Christopher D. Jensen (christopherj@cupertino.org) 2021-11-02 - 5:20:58 PM GMT- IP address: 104.47.73.254 Document e-signed by Christopher D. Jensen (christopherj@cupertino.org) Signature Date: 2021-11-02 - 5:21:30 PM GMT - Time Source: server- IP address: 136.24.42.212 Document emailed to Susan Michael (susanm@cupertino.org) for signature 2021-11-02 - 5:21:32 PM GMT Email viewed by Susan Michael (susanm@cupertino.org) 2021-11-02 - 9:40:58 PM GMT- IP address: 104.47.73.254 Document e-signed by Susan Michael (susanm@cupertino.org) Signature Date: 2021-11-02 - 9:44:36 PM GMT - Time Source: server- IP address: 64.165.34.3 Document emailed to Kirsten Squarcia (kirstens@cupertino.org) for signature 2021-11-02 - 9:44:39 PM GMT Email viewed by Kirsten Squarcia (kirstens@cupertino.org) 2021-11-02 - 9:54:25 PM GMT- IP address: 104.47.73.126 Document e-signed by Kirsten Squarcia (kirstens@cupertino.org) Signature Date: 2021-11-02 - 9:54:36 PM GMT - Time Source: server- IP address: 162.245.20.145 Agreement completed. 2021-11-02 - 9:54:36 PM GMT