Loading...
HomeMy WebLinkAboutSCC RoV - Vote Center Facility Use Agreement - 2020 Primary and General Elections (2019)V�e,4 log County of Santa Clara �,�r Registrar of Voters; 1555 Berger Driva Bldg. 2 Mi r Sail Josses CA 95112 Mailing Address PO Box 61136t). San Jose. CA 95161-1360 VOTER'S CHOICE (408) 299-VOTE (8683) (866) 430-VOTE (8683) PAX: (408) 998-7314 /Santa Registrar of Voters www.Sr..Cvotc,org Clara County :Election Name FaciliXy Name facility Owner.Name Building/Room_Reserved Physical, Address , `Mailing -Address :Primary Contact Name all Address :Secondary Contact Name _Etmaii, Address Ater'Hou�s Emergency Contact `Email Address. Vote Center Facility Use Agreement March 3, 2020 Presidential Primary November 3, 2020 Presidential General Gilroy Police Department Gilroy Police Department Community Room 7301 Hanna Street City/UP 7301 Hanna Street -Clay/Zip Tammy Puthoff .Phone # tammy.puthoff@cityofgilroy.org .Fax # Phone. # Fax # Phone # Alienate Phone # Gilroy/95020 Gilroy/95020 (408) 846-0309 (408) 846-0387 This agreement allows The County of Santa Clara, through its Registrar of Voters ("Registrar of Voters"), to access and use of the above named Facility subject to the following terms and conditions: 1. Facility Use and Hours. Facility Owner agrees that the Registrar of Voters shall be allowed to use the Facility and the Facility will be open to voters for the days before and including Election Day asset forth on Addendum A. Facility Owner acknowledges and agrees that the dates and times on Addendum A will be printed in publications by the Santa Clara County Registrar of Voters. Facility Owner agrees that there shall be no cancellations or room changes outside of an event of a natural disaster or unforeseen structural damage to the Facility, The Registrar of Voters shall be responsible for staffing all vote -related activities and is responsible for the security of the ballots and vote -casting activities. 2. Facility Requirements. Facility Owner agrees to the specifications regarding the Facility use set forth on Addendum B. Board of Supervisors: Mike wa.&serinan, Cindy Cl tavez, Dave Cortese, Susan Ellenberg. S. Joseph Simitian County Executive:.ieffre.y v. Smith Page 1 of 7 3. Facility Use Payment, The Registrar of Voters shall pay Facility Owner for use of the Facility In accordance with the below: Q Facility agrees to waive the pay ent. Facility Owner initial here $ NIA for the use of the Facility as set fo rth in this agreement, $ NIA any additional amounts for Facility Owner's standard fees or deposits. List amounts and reason for additional amotjttts: NiA 4. Registrar of Voters Insurance and Indemnity. The County of Santa Clara ("County") shall Indemnify, defend, and hold harmless the Facility Owner, Its officers, agents, and employees (collectively "owner") from and against any judgment, loss, damage, liability, cost, charge, or expense (including reasonable attorney's fees) arising out of the designation and utilization of the Facility as a polling place or election site, except to the extent such claims arlse through the negligent act(s) or omisslon(s) or willful misconduct of the owner. The foregoing indemnity obligation shall not be limited by the types and amounts of Insurance or self -Insurance maintained by County or owner. Please see Addendum C for the Santa Clara County certificate of Self-insurance. 5. General Conditions: No alteration or variation of the terms of this agreement shall be valid unless made In writing and signed by the parties; no oral understanding or agreement not Incorporated herein shall be binding on either of the parties; and no exceptions, alternatives, substitutes or revisions are valid or binding on the County unless authorized by the County in writing. Nothing in this agreement shall be construed to create any duty to, any standard of care with reference to, or any liability or obligation, contractual or otherwise, to any third party. At anytime and without reason, The Santa Clara County Registrar of Voters' may revoke this agreement and not use the above named facility, The undersigned have executed this agreement as of the dates set forth below, FACILITY OWNER,SIGNATURE: PRINTED NAME AND TITLE SIGNATURE OF AUTIiORIZeD AG DATE OF AUTHORIZED AGENT OF FACILITY OWNER REGISTRAR OF VOTERS SIGNATURE. COUNTY OF SANTA CLARA, a political subdivision of the State of California APPROVED AS TO FORM AND LEGALITY: By: //01 �.W Name: s��mv Name: Title: A Title: Deputy County Counsel Date: r., vvaterenterrantact Edward S. Morillo cu��tin�rm�a". (408) 282-3074 Page 2 of 7 3. Facility Use Payment, The Registrar of Voters shall pay Facility Owner for use of the Facility In accordance with the below: Facility agrees to waive the payment. Facility Owner Initial here 6 ❑ $ WA for the use of the Facility as set forth in this agreement, ❑ $ WA any additional amounts for Facility Owner's standard fees or deposits, list amounts and reason for additional amounts: NIA 4. Registrar of Voters insurance and Indemnity. The County of Santa Clara ("County") shall Indemnify, defend, and hold harmless the Facility Owner, its officers, agents, and employees (collectively "owner") from and against any judgment, loss, damage, liability, cost, charge, or expense (Including reasonable attorney's fees) arising out of the designation and utilization of the Facility as a polling place or election site, except to the extent such claims arise through the negligent act(s) or omission(s) or willful misconduct of the owner. The foregoing indemnity obligation shall not be limited by the types and amounts of insurance or self -Insurance maintained by County or owner. Please see Addendum C for the Santa Clara County certificate of Self -Insurance. S. General Conditions: No alteration or variation of the terms of this agreement shall be valid unless made In writing and signed by the parties; no oral understanding or agreement not incorporated herein shall be binding on either of the parties; and no exceptions, alternatives, substitutes or revisions are valid or binding on the County unless authorized by the County in writing. Nothing in this agreement shall be construed to create any duty to, any standard of care with reference to, or any liability or obligation, contractual or otherwise, to any third party. At anytime and without reason, The Sarita Clara County Registrar of Voters' may revoke this agreement and not use the above named facility. The undersigned have executed this agreement as of the dates set forth below. EACILiTY.OWNER SIGNATURE: PRINTED NAME AND TITLE SIGNATURE OF AUTHOR D A DATE OF AUTHORIZED AGENT OF FACILITY OWNER RPGI5TRAR OF VOTERS SIGNATURE. COUNTY OF SANTA CLARA, a political subdivision of the State of California By: Name: Title: Date: ForR@YUsat Ravv,at&Ce,csrohnrKt Edward S. Morillo APPROVED AS TO FORM AND LEGALITY: By: Name: Title: Deputy County Counsel ,contaciric"Mew: (408) 282-3074 Page 2 of 7 Approved as to Form: Gilroy City ttorney's Ofte By, City Attorney Addendum A Vote Center Facility Use Agreement Vote Center Hours The tables below Indicate what hours the Facility will be open to the public as a Vote Center as well as hours for which the Facility is reserved for Vote Center staff to have access. California Election code requires Vote Centers to be open a minimum of 8 hours per day for three (3) or ten (10) consecutive days prior to Election Day and on Election Day from 7a.m. to 8p.m., inclusive. Vote Center staff need access a minimum of an hour before and after voting hours, and on Election Day will need access for a minimum of two hours after voting concludes. Important: Please ensure the accuracy of the information as these dates and hours will be published and made public by the Santa Clara County Registrar of Voters'. Building/Room Reserved Community Room Physical Address 7301 Hanna Street, Gilroy 95020 Friday Saturday Sunday Monday (Tuesday Wednesday Thursday Friday Saturday Sunday Monday Tuesday Wednesday 2/21/20 2/22/20 2/23/20 2/24/20 2/25/20 2/26/20 2/27/20 2/28/20 2/29/20 3/1/20 3/2/20 3/3/20 3/4/20 N/A N/A N/A N/A N/A N/A N/A N/A N/A 9:00 a.m. - 5:00 p.m. 9:00 a.m. - 5:00 p.m. 9:00 a.m. - 5:00 p.m. 7:00 a.m. —8:00 p.m. W 0000'I7-00 N/A N/A N/A N/A N/A N/A N/A N/A Equipment Delivery/Set-up 8:00 a.m. - 6:00 p.m. 8:00 a.m. - 6:00 p.m. 8:00 a.m. - 6:00 p.m. 6:00 a.m. —10:00 p.m. Equipment Pull-out Page 3 of 7 NOVEM©ER 3, 2020 PRESIDENTIAL GENER"L ELCCTION SCHEDULE ay, _ Data Vote EntLi er Hours ' .� Reserved iiburs . Thursday 10/22/20 N/A N/A Friday 10/23/20 N/A N/A Saturday 10/24/20 N/A N/A Sunday 10/25/20 N/A N/A 1� Monday 10/26/20 N/A N/A 1 Tuesday 10/27/20 N/A N/A Wednesday 10/28/20 N/A N/A Thursday 10/29/20 N/A N/A Friday 10/30/20 N/A Equipment Delivery/Set-up Saturday 10/31/20 9:00 a.m. - 5:00 p.m. 8:00 a.m. - 6:00 p.m. Sunday 11/1/20 9:00 a.m. - 5:00 p.m. 8:00 a.m. - 6:00 p.m. Monday 11/2/20 9:00 a.m. - 5:00 p.m. 8:00 a.m. - 6:00 p.m. Tuesday 11/3/20 7:00 a.m. —8:00 p.m. 6:00 a.m.-10:00 P.M. Wednesday 11/4/20 NIA 7%ciooc4t- Iv:oli. Equipment Pull-out Page 4 of 7 Addendum B Vote Center Facility Use Agreement Checklist of Needs and Equipment Facility Requirements. Please check each box acknowledging you are able to allow or provide: 0 Facility access for Vote Center Staff one hour before and one hour after voting hours. On Election Day, Vote Center Staff will have access for one hour before voting hours and two hours after voting concludes. ❑� Accessibility survey conducted by Santa Clara County Election Officials; additional visits to facility may be required to test equipment or obtain additional information for vote center layout. ❑� Acceptance and secured storage of voting equipment delivered up to 1 day(s) prior to the opening of the Vote Center, for duration that the Vote Center is open, and up to 1 day(s) following Election Day. ❑ Reserved room for Vote Center will be cleared of any unused tables, chairs, and equipment prior to Vote Center equipment delivery. ❑ Functioning grounded electrical outlets in designated voting area. Designated Building/Room for voting is free of any activities during the 6 days. ❑ Restroom access for Vote Center Staff. ❑ Gender -neutral restroom available? ❑ Disability accessible restroom available? ❑ Sufficient inside/outside lighting. ❑ Air Conditioning/Heating available each day in the voting area. ❑ Free parking for voters and Vote Center Staff. ❑ No plans to remodel facility or changes to path of travel or parking area. Optional items you can. provide. Check any of the following: ❑ (4) 8 ft. tables or ❑ (6) 6 ft. tables ❑ 15 Chairs ❑ *Key access for Vote Center Staff ❑ *Badge access for Vote Center Staff ❑ *Alarm code access for Vote Center Staff ❑ *Parking passes for free Vote Center Staff Parking *The assigned Vote Center Lead will contact the facility up to 2 weeks prior to the opening of the Vote Center and arrange a time to pick up these items. Page 5 of 7 Schedule for Equipment Delivery and Pick -Up A deployment schedule for Vote Center equipment delivery and pick-up will be created based on the information you provide below. You will receive an email 2-3 weeks before the Vote Center opens to [ insert email address for receipt of Deployment Schedule] confirming the details of equipment coming to your facility. Please provide the name, phone number, and email information for the person, if different than the Primary Contact on page 1, who will be accepting delivery of the Vote Center equipment. Name: Phone: Email: If you would like others in your organization copied with the Vote Center Equipment Confirmation email, please list their email addresses here: Delivery of Equipment: Equipment delivery and setup of Vote Center will be scheduled on February 28, 2019 and October3 o, 2019 between 2:15 p.m. and 5:00 p.m. Other Arrangements: ® Equipment can be set up at this time. There are no other events occurring in this room. Pick-up of Equipment: Equipment pick-up at the Vote Center will be scheduled on March 4, 2020 and November 4, 2020 between 00 an? and ��? •011 191 Other Arrangements: ® Equipment can remain set up In the room on Election Day until pick-up occurs. ❑ Equipment cannot be left out on Election Night. All equipment must be packed up and stored until Election Staff arrive to remove it. The equipment will be securely stored in this location (name of room/building) until Vote Center staff arrive to pick it up: Page 6 of 7 Addendum C Vote Center Facility Use Agreement Certificate of Insurance Coverage County of Santa Clara Office of the County Executive Office of Risk Management L iabiltly/Propt`.rty Insurance DiASlon 2310 Norlh Flrst Street. Suite 203 San Jose. C:atifontin 95131 T01. NO. (408) 441.4.340 FaX (4W) 441-4341 Ins. Cart. No. FY20-082 CERTIFICATE OF COVERAGE ISSUED BY COUNTY OF SANTA CLARA This is to Certify to: All Vote Centers, Training Sites, Outreach and Presentation Sites and Election Related Activity Sites in County of Santa Clara Registrar of Voters County of Santa Clara That the following described coverages are in force on this date as set forth below: Assured: Countv of Santa Clara 70 W. Heddina Street San Jose. CA 95110 Insurer Exairation 1. Self -Funded Retention Continuous 2. Self -Funded Retention Continuous 3. Self -Funded Retention Continuous Tvne of Coverage Limits 1. Comprehensive General & Automobile Liability $2,000,000 Per Occurrence 2. Workers' Compensation $4,000,000 Per Occurrence 3. Physical Damage $ 50,000 This certificate of coverage is provided by the County of Santa Clara to the above named certificate holder. The coverage specified herein will not be cancelled or reduced without thirty (30) days written notice from County of Santa Clara to the certificate holder. This certificate pertains to the County of Santa Clara, Registrar of Voters for 2019 and 2020 elections, Election Officer Training, delivery, set-up and retrieval of equipment from July 1, 2019 to r e 30, 2020. du Hank Ford Insurance Technical Manager July 26, 2019 HFId FY20462ARPoffktg_Elecdon2D19.20_ROV soard of Supervisors: Mike Wasserman. Cindy Chavez. Dave Conese, Susan SiienbM. S. Jascph Simitian Fa County executive. Jaffrey V. Smith 040 Page 7 of 7 County of Santa Clara Registrar of Voters 1555 13ergcr Drive, Bldg. 2 San Jose, CA 95112 Mailing Address: PO Box 611360. San .lose, CA 95161-1360 (408) 299-VOTE (8683) (866) 430-VOTE (8683) FAX: (408) 998-7314 W W W.Sccvole.oi;g Vote Center Facility Use Agreement OO L!y,� *y�r l N>:1 GVP` VOTER'S CHOICE Registrar of Voters Santa Clara County Election Name March 3, 2020 Presidential Primary November 3, 2020 Presidential General Facility Name Gilroy Police Department Facility Owner Name Gilroy Police Department Building/Room Reserved Community Room Physical Address 7301 Hanna Street city/Zip Gilroy/95020 Mailing Address 7301 Hanna Street city/Zip Gilroy/95020 Primary Contact Name Tammy Puthoff Phone # (408) 846-0309 Email Address tammy.puthoff@cityofgilroy.org Fax # (408) 846-0387 Secondary Contact Name Phone # Email Address Fax # After Hours Emergency Contact Phone # Name Email Address Alternate Phone # This agreement allows The County of Santa Clara, through its Registrar of Voters ("Registrar of Voters"), to access and use of the above named Facility subject to the following terms and conditions: 1. Facility Use and Hours. Facility Owner agrees that the Registrar of Voters shall be allowed to use the Facility and the Facility will be open to voters for the days before and including Election Day as set forth on Addendum A. Facility Owner acknowledges and agrees that the dates and times on Addendum A will be printed in publications by the Santa Clara County Registrar of Voters. Facility Owner agrees that there shall be no cancellations or room changes outside of an event of a natural disaster or unforeseen structural damage to the Facility. The Registrar of Voters shall be responsible for staffing all vote -related activities and is responsible for the security of the ballots and vote -casting activities. 2. Facility Requirements. Facility Owner agrees to the specifications regarding the Facility use set forth on Addendum B. Board of Supervisors: Mike- Wasserman, Cindy Chavez, Dave Cortese, Susan Ellenberg, S. Josehl1 Sin'litian County Executive: Jcffrey V. Smilh Page 1 of 7 3. Facility Use Payment. The Registrar of Voters shall pay Facility Owner for use of the Facility in accordance with the below: 7 Facility agrees to waive the payment. Facility Owner initial here $ N/A for the use of the Facility as set forth in this agreement. $ N/A any additional amounts for Facility Owner's standard fees or deposits. List amounts and reason for additional amounts: N/A 4. Registrar of Voters Insurance and Indemnity. The County of Santa Clara ("County') shall indemnify, defend, and hold harmless the Facility Owner, its officers, agents, and employees (collectively "owner") from and against any judgment, loss, damage, liability, cost, charge, or expense (including reasonable attorney's fees) arising out of the designation and utilization of the Facility as a polling place or election site, except to the extent such claims arise through the negligent act(s) or omission(s) or willful misconduct of the owner. The foregoing indemnity obligation shall not be limited by the types and amounts of insurance or self-insurance maintained by County or owner. Please see Addendum C for the Santa Clara County certificate of Self -Insurance. S. General Conditions: No alteration or variation of the terms of this agreement shall be valid unless made in writing and signed by the parties; no oral understanding or agreement not incorporated herein shall be binding on either of the parties; and no exceptions, alternatives, substitutes or revisions are valid or binding on the County unless authorized by the County in writing. Nothing in this agreement shall be construed to create any duty to, any standard of care with reference to, or any liability or obligation, contractual or otherwise, to any third party. At any time and without reason, The Santa Clara County Registrar of Voters' may revoke this agreement and not use the above named facility. The undersigned have executed this agreement as of the dates set forth below. FACILITY OWNER SIGNATURE: ($AAA — PRINTED NAME AND TITLET— SIGNATURE OF AUTHORIZED AGn DATE OF AUTHORIZED AGENT OF FACILITY OWNER REGISTRAR OF VOTERS SIGNATURE: COUNTY OF SANTA CLARA, a political subdivision of the State of California By: Name: Title: Date: For ROV Use; Edward S. Morillo ROVVote Center Contact APPROVED AS TO FORM AND LEGALITY: By: Name: Title: Deputy County Counsel (408) 282-3074 Contatt Inf��rmati�on: Page 2 of 7 Approved as to Form: ATTEST: Gilroy City ttorney's Office City Clerk City Attorney Approved as to Form: Gilroy City Pttorney`s O ift By: City Attorney Addendum A Vote Center Facility Use Agreement Vote Center Hours The tables below indicate what hours the Facility will be open to the public as a Vote Center as well as hours for which the Facility is reserved for Vote Center staff to have access. California Election code requires Vote Centers to be open a minimum of 8 hours per day for three (3) or ten (10) consecutive days prior to Election Day and on Election Day from 7a.m. to 8p.m., inclusive. Vote Center staff need access a minimum of an hour before and after voting hours, and on Election Day will need access for a minimum of two hours after voting concludes. Important: Please ensure the accuracy of the information as these dates and hours will be published and made public by the Santa Clara County Registrar of Voters'. Facility Information Facility Name Gilroy Police Department Building/Room Reserved Community Room Physical Address 7301 Hanna Street, Gilroy 95020 MARCH 3, 2020 PRESIDENTIAL PRIMARY ELECTION SCHEDULE Day Thursday Friday Saturday Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sunday Monday Tuesday Wednesday Date 2/20/20 2/21/20 2/22/20 2/23/20 2/24/20 2/25/20 2/26/20 2/27/20 2/28/20 2/29/20 3/1/20 3/2/20 3/3/20 3/4/20 Vote Center Hours N/A N/A N/A N/A N/A N/A N/A N/A N/A 9:00 a.m. - 5:00 p.m. 9:00 a.m. - 5:00 p.m. 9:00 a.m. - 5:00 p.m. 7:00 a.m. — 8:00 p.m. ,NW W 00 - I z0 0 Reserved Hours N/A N/A N/A N/A N/A N/A N/A N/A Equipment Delivery/Set-up 8:00 a.m. - 6:00 p.m. 8:00 a.m. - 6:00 p.m. 8:00 a.m. - 6:00 p.m. 6:00 a.m. —10:00 p.m. Equipment Pull-out Page 3 of 7 NOVEMBER 3, 2020 PRESIDENTIAL GENERAL ELECTION SCHEDULE Day Date I Vote Center Hours Reserved Hours Thursday 10/22/20 N/A N/A Friday 10/23/20 N/A N/A Saturday 10/24/20 N/A N/A Sunday 10/25/20 N/A N/A Monday 10/26/20 N/A N/A Tuesday 10/27/20 N/A N/A Wednesday 10/28/20 N/A N/A Thursday 10/29/20 N/A N/A Friday 10/30/20 N/A Equipment Delivery/Set-up Saturday 10/31/20 9:00 a.m. - 5:00 p.m. 8:00 a.m. - 6:00 p.m. Sunday 11/1/20 9:00 a.m. - 5:00 p.m. 8:00 a.m. - 6:00 p.m. Monday 11/2/20 9:00 a.m. - 5:00 p.m. 8:00 a.m. - 6:00 p.m. Tuesday 11/3/20 7:00 a.m. — 8:00 p.m. 6:00 a.m. — 10:00 p.m. Wednesday 11/4/20 N/A "',-cioaw- woo�j,, Equipment Pull-out Page 4 of 7 Addendum B Vote Center Facility Use Agreement Checklist of Needs and Equipment Facility Requirements. Please check each box acknowledging you are able to allow or provide: ❑■ Facility access for Vote Center Staff one hour before and one hour after voting hours. On Election Day, Vote Center Staff will have access for one hour before voting hours and two hours after voting concludes. F Accessibility survey conducted by Santa Clara County Election Officials; additional visits to facility may be required to test equipment or obtain additional information for vote center layout. ❑■ Acceptance and secured storage of voting equipment delivered up to 2 day(s) prior to the opening of the Vote Center, for duration that the Vote Center is open, and up to 1 day(s) following Election Day. ❑ Reserved room for Vote Center will be cleared of any unused tables, chairs, and equipment prior to Vote Center equipment delivery. ❑ Functioning grounded electrical outlets in designated voting area. ❑ Designated Building/Room for voting is free of any activities during the _ days. ❑ Restroom access for Vote Center Staff. ❑ Gender -neutral restroom available? ❑ Disability accessible restroom available? ❑ Sufficient inside/outside lighting. ❑ Air Conditioning/Heating available each day in the voting area. ❑ Free parking for voters and Vote Center Staff. ❑ No plans to remodel facility or changes to path of travel or parking area. Optional items you can provide. Check any of the following: ❑ (4) 8 ft. tables or ❑ (6) 6 ft. tables ❑ 15 Chairs ❑ *Key access for Vote Center Staff ❑ *Badge access for Vote Center Staff ❑ *Alarm code access for Vote Center Staff ❑ *Parking passes for free Vote Center Staff Parking *The assigned Vote Center Lead will contact the facility up to 2 weeks prior to the opening of the Vote Center and arrange a time to pick up these items. Page 5 of 7 Schedule for Equipment Delivery and Pick -Up A deployment schedule for Vote Center equipment delivery and pick-up will be created based on the information you provide below. You will receive an email 2-3 weeks before the Vote Center opens to [ insert email address for receipt of Deployment Schedule] confirming the details of equipment coming to your facility. Please provide the name, phone number, and email information for the person, if different than the Primary Contact on page 1, who will be accepting delivery of the Vote Center equipment. Name: Phone: Email: If you would like others in your organization copied with the Vote Center Equipment Confirmation email, please list their email addresses here: Delivery of Equipment: Equipment delivery and setup of Vote Center will be scheduled on February 28, 2019 October 29, 2019 between 2:15 p.m. and 5:00 p.m. Other Arrangements: ❑ Equipment can be set up at this time. There are no other events occurring in this room. Pick-up of Equipment: Equipment pick-up at the Vote Center will be scheduled on March 4, 2020 November 4, 2020 Other Arrangements: between 00 91'n and IP • 0111019I ❑ Equipment can remain set up in the room on Election Day until pick-up occurs. and and ❑ Equipment cannot be left out on Election Night. All equipment must be packed up and stored until Election Staff arrive to remove it. The equipment will be securely stored in this location (name of room/building) until Vote Center staff arrive to pick it up: Page 6 of 7 Addendum C Vote Center Facility Use Agreement Certificate of Insurance Coverage County of Santa Clara Office of the County Executive Office of Risk Management Liability/Proncrty Insurance Division 2310 North First Street, Suite 203 San lose, California 95131 Tcl. No. (408) 441-4340 fax (408) 441-4341 CERTIFICATE OF COVERAGE ISSUED BY COUNTY OF SANTA CLARA -OutV�, Ins. Cert. No. FY20-082 This is to Certify to: All Vote Centers, Training Sites, Outreach and Presentation Sites and Election Related Activity Sites in County of Santa Clara Registrar of Voters County of Santa Clara That the following described coverages are in force on this date as set forth below: Assured: Countv of Santa Clara 70 W. Heddino Street San Jose. CA 95110 Insurer 1. Self -Funded Retention 2. Self -Funded Retention 3. Self -Funded Retention TVDe of Coveraae 1. Comprehensive General & Automobile Liability 2. Workers' Compensation 3. Physical Damage Expiration Continuous Continuous Continuous Limits $2,000,000 Per Occurrence $4,000,000 Per Occurrence $ 50,000 This certificate of coverage is provided by the County of Santa Clara to the above named certificate holder. The coverage specified herein will not be cancelled or reduced without thirty (30) days written notice from County of Santa Clara to the certificate holder. This certificate pertains to the County of Santa Clara, Registrar of Voters for 2019 and 2020 elections, Election Officer Training, delivery, set-up and retrieval of equipment from July //1, 2019 to J e 30, 2020. Hank Ford Insurance Technical Manager July 26, 2019 HF:td FY20-082AIIPolling Election2019.20_ROV Board of Supervisors: Mike Wasserman, Cindy Chavez, Dave Cortese, Susan Ellenberg, S. Joscph Simitian County Executive: Jeffrey V. Smith „5 Page 7 of 7