HomeMy WebLinkAboutCounty of Santa Clara ROV (3)County of Santa Clara
Registrar of Voters
1555 Berger Drive, Bldg. 2
San Jose, CA 95112
Mailing Address: PO Box 611360, San Jose, CA 95161-1360
(408) 299 -VOTE (8683) (866) 430 -VOTE (8683) FAX: (408) 998-7314
www.sccvote.org Nl�
Supplemental Vote Center Facility Use Agreement
VOTER'S CHOICE
Registrar of Voters
Santa Clara County
Election Name
November 2, 2021— Special Election
FacihtydName d*
Town of Los Altos Hills
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FacilrtyC�wnerName ry
Town Of Los Altos Hills
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Building/RoomzReserved� `
Council Chambers
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Physical Address'
26379 Fremont Rd. Cy/Zips �, Los Altos Hills, CA 94022
Mallmg Address kr
26379 Fremont Rd.54
city/zip r
Los Altos Hills, CA 94022
Primary Contact Name
Deborah Padovan -City Clerk
Phone # `
650-947-2513 707-479-4040 (cell)
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Email Address t
dpadovan@losaltoshills.ca.gov
650-941-3160
Secondary Contact Na :
Keren Brunner
Phone # v
650-941-7222
Email Address
kbrunner losaltoshills.ca. ov
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Fax #
650-941-3160
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After Hour`s Emergency Contact :
H'
ector HuertaPlione#
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650-504-4496
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Etnailgddress
hilUerta@IOSaItoSi111ls.Ca.goV
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This agreement supplements the Facility Owner's form of agreement ("Facility Owner's Form") which allows The
County of Santa Clara, through its Registrar of Voters ("Registrar of Voters"), to access and use of the above named
Facility. The Facility Owner and the Registrar of Voters agrees that this Supplemental Vote Center Facility Use
Agreement shall be a part of and shall be deemed incorporated into the Facility Owner's Form.
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.
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 payment.
Facility Owner initial here
❑ $ for the use of the Facility as set forth in this agreement.
❑ $ any additional amounts for Facility Owner's standard fees or deposits. List amounts and
reason for additional amounts:
November 2, 2021 Special Election 10 to 16 days
Board of Supervisors: Mike Wasserman, Cindy Chavez, Susan Ellenberg, S. Joseph Simitian, Otto Lee
County Executive: Jeffrey V. Smith 19)
Page 6
4. 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. At any time and without reason, The Santa Clara County Registrar of Voters' may revoke this
request and not use the above-named facility.
this agreement as of the dates set forth below.
FACILITY OWNER SIGNATURE:
Carl Cahill, City Manager
PRINTED NAME AND TITLE
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:
z Z02--)
SIGNATURE OF AUTHORIZED AGENT DATE
APPROVED AS TO FORM AND LEGALITY:
By:
Name:
Title: Deputy County Counsel
For ROV Use: p n _
ROV Vote Center Contact: Smita Shah Contact Information: 408-282-3199
Board of Supervisors: Mike Wasserman, Cindy Chavez, Susan Ellenberg S. Joseph Simitian, Otto Lee
County Executive: Jeffrey V. Smith Page 2®f 6
Addendum A
Supplemental 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 Name Town of Los Altos Hills
Building/Room Reserved I Council Chambers
Physical Address 26379 Fremont Rd Los Altos Hills, CA 94022
• '
r.
r.
MEr
•. ,
Thursday
10/21/21
Equipment Delivery
8:00 a.m. - 5:00 p.m.
Friday
10/22/21
Equipment Delivery/Vote Center Set Up
8:00 a.m. - 5:00 p.m.
Saturday
10/23/21
9:00 a.m. - 5:00 p.m.
8:00 a.m. - 6:00 p.m.
Sunday
10/24/21
9:00 a.m. - 5:00 p.m.
8:00 a.m. - 6:00 p.m.
Monday
10/25/21
9:00 a.m. - 5:00 p.m.
8:00 a.m. - 6:00 p.m.
Tuesday
10/26/21
9:00 a.m. - 5:00 p.m.
8:00 a.m. - 6:00 p.m.
Wednesday
10/27/21
9:00 a.m. - 5:00 p.m.
8:00 a.m. - 6:00 p.m.
Thursday
10./28/21
9:00 a.m. - 5:00 p.m.
8:00 a.m. - 6:00 p.m.
Friday
10/29/21
9:00 a.m. - 5:00 p.m.
8:00 a.m. - 6:00 p.m.
Saturday
10/30/21
9:00 a.m. - 5:00 p.m.
8:00 a.m. - 6:00 p.m.
Sunday
10/31/21
9:00 a.m. - 5:00 p.m.
8:00 a.m. - 6:00 p.m.
Monday
11/1/21
9:00 a.m. - 5:00 p.m.
8:00 a.m. - 6:00 p.m.
Tuesday
11/2/21
7:00 a.m. — 8:00 p.m.
6:00 a.m. —10:00 p.m.
Wednesday
11/3/21
Equipment Pick Up
8:00 a.m. - 5:00 p.m.
Thursday
11/4/21
Equipment Pick Up
8:00 a.m. - 5:00 p.m.
Friday
11/5/21
Equipment Pick Up
8:00 a.m. - 5:00 p.m.
Board of Supervlsors: Mike Wasserman, Cindy Chavez, Susan Eltenberg, S. Joseph Simitian, Otto Lee
County Executive: Jeffrey V. Smith
Page 3 of 6
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.
0 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.
0 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 3 day(s) following Election Day.
❑Q Reserved room for Vote Center will be cleared of any unused tables, chairs, and equipment prior to Vote Center
equipment delivery.
0 Functioning grounded electrical outlets in designated voting area.
0 Designated Building/Room for voting is free of any activities during the 10 to 16 days.
0 Restroom access for Vote Center Staff.
❑ Gender -neutral restroom available? ❑ Disability accessible restroom available?
0 Sufficient inside/outside lighting.
0 Air Conditioning/Heating available each day in the voting area.
0 Free parking for voters and Vote Center Staff.
0 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 0 (6) 6 ft. tables
F0 15 Chairs
0 *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.
Board of Supervisors: Mike Wasserman, Cindy Chavez, Susan Ellenberg, S. Joseph Simitian, Otto Lee
County Executive: Jeffrey V. Smith
Page 4 of 6
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 dpadovan@iosaltoshiiis.ca.gov [insert
email address for receipt of Deployment Schedule] confirming the details of equipment coming to you rfacility.
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 Thursday, Oct. 21 2021 To Thursday, Oct. 22 2021and
Thursday, Oct. 22 2021
Other Arrangements:
between 8:00 a.m. and 5:00 p.m.
❑ 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 Wednesday, Nov. 3, 2021 To Thursday, Nov. 5, 2021and
between 8:00 a.m. and 5:00 p.m.
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:
Board of Supervisors: Mike Wasserman, Cindy Chavez, Susan Ellenberg, S. Joseph Simitian, Otto Lee
County Executive: Jeffrey V. Smith
Page FU6
Addendum C
Vote Center Facility Use Agreement
Certificate of Insurance Coverage
County of Santa Clara
Office of the County Executive
Department of Risk Management
Liability/Property Insurance Division
2310 North First Street, Suite 203
San Jose, California 95131
Tel. No. (408) 441.4340 FAX (408) 441-4341
CERTIFICATE OF COVERAGE
ISSUED BY
COUNTY OF SANTA CLARA
GnUN�}
Ins. Cert. No. FY21-090
This is to Certify to: All Vote Centers, Training Sites, Outreach and Presentation Sites
And Election Related Activity Sites in County of Santa Clara
County of Santa Clara Registrar Voters
That the following described coverages are in force on this date as set forth below:
Assured: County of Santa Clara
70 W. Hedding Street
San Jose, CA 95110
Insurer
1. Self -Funded Retention
2. Self -Funded Retention
3. Self -Funded Retention
Type of Coverage
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 November 2020 Election, Election Officer Training, delivery, set-up and retrieval
equipment. This certificate expires June 30, 2021.
na.uBig. d-dy� j
Han�i��oerc�°�"B
Insurance Contracts & Claims Manager
July 29, 2020
HF:td
FY21-090 Novemb er2020 Election ROV
Board of Supervisors: rvIllee Wasserman, Cindy Chavez, Dave Cortese, Susan Ellenberg, S. Joseph Sindtian
County Executive: Jeffrey V. Smith
Board of Supervisors: Mike Wasserman, Cindy Chavez, Susan Ellenberg, S. Joseph Simitian, Otto Lee
County Executive: Jeffrey V. Smith Page Sof 6