Exhibit 1 - First Amendment — Alameda City Council, February 7, 2023

AMENDME

NT TO AGREEMENT
This
Amendment of the Agreement, entered into this _____ day of __________, 2023, by and between the CITY OF ALAMEDA, a municipal corporation (hereinafter " the City") and CHRIST EPISCOPAL CHURCH ALAMEDA, a California corporation, whose address is 1700 Santa Clara Avenue, Alameda, CA 94501, (hereinafter "Provider"), is made with reference to the following:

RECITA
LS:

A. On January 18 2023, an agreement was entered into by and between the City and Provider (hereinafter "Agreement") in an amount not to exceed $70,000, for Winter Warming Services.

B. Whereas, the City Council authorized the City Manager to execute this amendment on ___________________.

C. The City and Provider desire to modify the Agreement on the terms and conditions set forth herein.

NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows:

1. Para
graph 3, COMPENSATION TO PROVIDER, is modified to read as follows:
a. By the
7th day of each month, Provider shall submit to the City an invoice for the total amount of work done the previous month. Pricing and accounting of charges are to be according to the
fee schedule as set forth in Exhibit B- 1 and incorporated herein by this reference. Extra work mus
t be approved in writing by the City Manager or his/her designee prior to performance and shall be paid on a Time and Material basis as set forth in Ex hibit B-1. b. Provider shall be com pensated for the services performed in accordance w it h the original contract consistent w ith th e te rms of thos e ag reements . Additionally, Provider shall be compensated for the
1st Amendment, as set forth in Exhibit B-1 of the 1st Amendment.

Compensation for services
performed pursuant to the 1st Amendment shall not exceed $53,385. Total Compensation for this Agreement shall not exceed $12
3,385.

4. Except as expressly modified herein, all other te rms and covenants set forth in the Ag
reement shall rem ain t he same and shall be in full force and effect.

Signatures on following page
10/25/21
AMEND.AGR
DocuSign Envelope ID: A47E2A65-252E-4E74-BA69-91DB617902BA DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 2-7-2023
7-A Exhibit 1
10/25/21
AMEND.AGR
IN W
ITNESS WHEREOF, the parties have each caused this Agreement to be duly executed on its behalf as of the Effective Date.

CHRI

ST EPISCOPAL CHURCH ALAMEDA CITY OF ALAMEDA
a California corporation a municipal corporation
The Reverend Stephen McHale Jennifer Ott
Chief Executive Officer City Manager
REC

OMMENDED FOR APPROVAL
Nancy Salamy
Secretary
Lisa Maxwell
Community Development Department
APPR
OVED AS TO FORM:

City Attorney
Len A slanian
Assistant City Attorney
DocuSign Envelope ID: A47E2A65-252E-4E74-BA69-91DB617902BA DocuSign Envelope ID: D3038DA4-F589-41A6-A84E-A482A2B5C671 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10

1/23/23
AMEND.AGR
Exhibit B-1
Due to extreme inclement weather, and to better serve Alameda’s unhouse residents, the City of Alameda is increasing the number of days of service for the Christ Church Winter Warming Shelter, from 3 days per week (Monday, Wednesday, and Friday) to seven days per week (Monday – Sunday) beginning January 5, 2023 and ending April 30, 2023. The City of Alameda agrees to contribute up to $53,385 and Christ Episcopal Church agrees to contribute an additional $9,000 towards additional days of service. See additional dates and detail fee schedule below.

Detail Fee Schedule Per Day of Service
Payroll: 2 people for 16 hours $624
Laundry $100
Misc. – Other Expenses $100
Per day estimated $824
ICR 13% $107
Total $931
Additional Dates of Service for Christ Church Winter Warming Shelter Thursday, January 5, 2023 Tuesday, February 14, 2023 Sunday, March 26, 2023 Saturday, January 7, 2023 Thursday, February 16, 2023 Tuesday, March 28, 2023 Sunday, January 8, 2023 Saturday, February 18, 2023 Thursday, March 30, 2023 Tuesday, January 10, 2023 Sunday, February 19, 2023 Saturday, April 1, 2023 Thursday, January 12, 2023 Tuesday, February 21, 2023 Sunday, April 2, 2023 Saturday, January 14, 2023 Thursday, February 23, 2023 Tuesday, April 4, 2023 Sunday, January 15, 2023 Saturday, February 25, 2023 Thursday, April 6, 2023 Tuesday, January 17, 2023 Sunday, February 26, 2023 Saturday, April 8, 2023 Thursday, January 19, 2023 Tuesday, February 28, 2023 Sunday, April 9, 2023 Saturday, January 21, 2023 Thursday, March 2, 2023 Tuesday, April 11, 2023 Sunday, January 22, 2023 Saturday, March 4, 2023 Thursday, April 13, 2023 Tuesday, January 24, 2023 Sunday, March 5, 2023 Saturday, April 15, 2023 Thursday, January 26, 2023 Tuesday, March 7, 2023 Sunday, April 16, 2023 Saturday, January 28, 2023 Thursday, March 9, 2023 Tuesday, April 18, 2023 Sunday, January 29, 2023 Saturday, March 11, 2023 Thursday, April 20, 2023 Tuesday, January 31, 2023 Sunday, March 12, 2023 Saturday, April 22, 2023 Thursday, February 2, 2023 Tuesday, March 14, 2023 Sunday, April 23, 2023 Saturday, February 4, 2023 Thursday, March 16, 2023 Tuesday, April 25, 2023 Sunday, February 5, 2023 Saturday, March 18, 2023 Thursday, April 27, 2023 Tuesday, February 7, 2023 Sunday, March 19, 2023 Saturday, April 29, 2023 Thursday, February 9, 2023 Tuesday, March 21, 2023 Sunday, April 30, 2023 Saturday, February 11, 2023 Thursday, March 23, 2023
Sunday, February 12, 2023 Saturday, March 25, 2023
DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 1/18/2023
DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 1/24/2023
DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 Minis
try
F
ir
s
t
sm
C
ommer
cial Multi-P
eril
Insur
anc
e C
o
v
er
ag
e Summary
T
hese ar
e y
our policy’
s Declar
ations.

R
ene
w
al of 04M5A04
9 432
6 Chris
t Episc
opal Chur
ch in Alameda, Calif
ornia
17 00 Santa C
lar
a A
v
e
Alameda, C
A 9
450
1-
25 15
Br
otherhood Mutual Insur
anc
e C
ompan
y
www
.br
otherhoodmutual.
c
om
800
.
333.
3 735
6 400 Br
otherhood W
a
y
, P
.

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
1 of
15 P
olicy Number 04M5A04
9 432
6 Br
otherhood Mutual Insur
anc
e C
ompan
y
P
rint D
at
e: Oct
ober 21, 20
2 2
P
olicy P
eriod: 12/
0 1/
20 2
2 at 12:0
1 a.m. t
o
12/
0 1/
20 23 at 12:0
1 a.m.
909-30
7 -8500
Chur
ch
w
es
t Insur
anc
e Servic
es 400
2 -0
13 W
ww
.

Chur
ch
w
es
t.

C
om
20 1 Cajon Str
eet
R
edlands, C
A 9
23 73-46
45 C
ontact y
our ag
ent with y
our cust
omer
servic
e questions, including updating y
our
policy or r
epor
ting a claim.
***
.br
otherhoodmutual.
c
om/
pa
y
online
F
or y
our c
on
v
enienc
e, y
ou can mak
e
pr
emium pa
yments online.

NAMED INSURED
Christ Episc
opal Chur
ch in Alameda, Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at 12:0
1 a.m.

K
e
y F
acts About Y
our P
olicy
T
hese Declar
ations r
eplac
e y
our pr
e
vious ones. Y
our policy’
s Declar
ations c
ontain a summary of the c
o
v
er
ag
e c
ontained in the insur
anc
e policy
.

Y
our policy c
ontains a full e
xplanation of y
our c
o
v
er
ag
e.

GREEMENT
:

In r
eturn f
or the pa
yment of the pr
emium and subject t
o all the t
erms of the policy
, w
e agr
ee t
o pr
o
vide the insur
anc
e stat
ed in the policy
.

TYPE OF OR
GANIZA
TION:

Chur
ch Institution
F
ORM OF OR
GANIZA
TION:

C
orpor
ation
P
olicy Ov
ervie
w
C
O
VERA
GE DES

CRIPTION
DET
AILS
C
O
VERA
GE DES

CRIPTION
DET
AILS
P
r
oper
t
y C
o
v
er
ag
e
P
ag
e
2 -
6 T
err
orism P
r
emium
$383 (
See Notic
e F
orm BN-6-D
X 3.
0 f
or details
)
Liabilit
y C
o
v
er
ag
e
P
ag
e
7 -
14 Ex
c
es
s Liabilit
y C
o
v
er
ag
e
P
ag
e
15 -
15 P
olicy P
r
emium Ov
ervie
w
T
his pr
emium is subject t
o adjustment at each anniv
er
sary
. T
his pr
emium is subject t
o adjustment due t
o pr
emium audit pr
o
vision.

ANNU
AL PREMIUM:
$2
2,
730
.
00 P
A
Y
MENT S
CHEDULE:

See in
v
oic
e.

C
ommon P
olicy F
orms
F
ORM
F
ORM NAME
F
ORM
F
ORM NAME
BN2B 1.
1 Notic
e t
o our P
olicyholder
CL100 1.
0 C
ommon P
olicy C
onditions
CL300 1.
0 Amendat
ory Endor
sement
CP1 1.
0 T
able of C
ont
ents
BCP100 4.5
C
ommer
cial P
r
oper
t
y C
o
v
er
ag
e C
onditions
GL100 1.
0 C
ommer
cial Liabilit
y C
o
v
er
ag
e
BCL30
1 1.
0 F
orm Number R
ef
er
enc
e
BN11A 1.
2 C
ust
omer Notic
e: V
alue-
A
dded Benefits
BCL120 1.
0 Amendat
ory Endor
sement - As
signment
CL0
16 2 0
1 19
Amendat
ory Endor
sement Calif
ornia
BN1B 1.
0 Notic
e Of P
a
yment
-R
elat
ed Char
g
es
BCL100 1.
1 A
dditional P
olicy C
onditions
EX0606 1.
0 C
onditional T
err
orism Ex
clusion
BN6EX 4.
0 Notic
e-C
ond Ex
cl-
T
err
orism-R
elat
ed L
os
s
BN-6-D
X 3.
0 T
err
orism R
elat
ed L
os
s
DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 NAMED INSURED
Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at
12:0
1 a.m.

P
r
oper
t
y C
o
v
er
ag
e Summary
Ministry
F
ir
st
sm

c
ommer
cial multi-peril policy Declar
ations c
ontinued…
W
e pr
o
vide the C
ommer
cial P
r
oper
t
y c
o
v
er
ag
e at the declar
ed pr
emise(
s
) f
or the c
o
v
er
ag
e and limits indicat
ed. T
he C
o
v
er
ag
es list
ed her
e ar
e pr
o
vided ac
c
or
ding
t
o the t
erms of the designat
ed c
o
v
er
ag
e f
orm and an
y other applicable f
orms or endor
sements.

Br
otherhood Mutual Insur
anc
e C
ompan
y
www
.br
otherhoodmutual.
c
om
800
.
333.
3 735
6 400 Br
otherhood W
a
y
, P
.

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
2 of
15 P
r
oper
t
y C
o
v
er
ag
e Details
PR
OPER
TY DEDUC
TIBLE
GLAS
S DEDUC
TIBLE
$5,
000
$500
Schedule of L
ocations
L
OC
A
TION #
DES

CRIPTION
ADDRES
S
1/1
Multi-P
urpose
17 00 Santa C
lar
a A
v
e Alameda, C
A 9
450
1-
25 15
1/
2 Guild Hall/P
arish Hall
17 00 Santa C
lar
a A
v
e Alameda, C
A 9
450
1-
25 15
2/1
R
ental Dw
elling
17 14 Santa C
lar
a A
v
e Alameda, C
A 9
450
1-
25 15
Schedule of Buildings and P
er
sonal P
r
oper
t
y
MUL

TI-PURPO
SE
17 00 Santa C
lar
a A
v
e Alameda, C
A 9
450
1-
25 15
L
OC
A
TION 1/1
C
O
VERA
GE DES

CRIPTION
(INCL. TYPE OF PR
OPER
TY)
C
O
VERA
GE LIMIT
C

OINSURANCE
E
Q DED
V
AL
U
A
TION TYPE
A
UT
O INCR
PERIL TYPE
F
ORM
Building
See C
ombined
Schedule
P
er
sonal P
r
oper
t
y
See C
ombined
Schedule
Building Or
dinanc
e
& La
w C
ost of
C
onstruction
$1,
000
,
000
N/
A
N/
A
N/
A
N/
A
N/
A
BCP138 4.5
Building Or
dinanc
e &
La
w Incr
eased Building
L
os
s
$10
,
148,
000
N/
A
N/
A
N/
A
N/
A
N/
A
BCP138 4.5
Building Or
dinanc
e &
La
w Incr
eased Debris
R
emo
v
al
$1,
000
,
000
N/
A
N/
A
N/
A
N/
A
N/
A
BCP138 4.5
GUILD HALL/P
ARISH HALL
17 00 Santa C
lar
a A
v
e Alameda, C
A 9
450
1-
25 15
L
OC
A
TION 1/
2 C
O
VERA
GE DES

CRIPTION
(INCL. TYPE OF PR
OPER
TY)
C
O
VERA
GE LIMIT
C

OINSURANCE
E
Q DED
V
AL
U
A
TION TYPE
A
UT
O INCR
PERIL TYPE
F
ORM
Building
See C
ombined
Schedule
P
er
sonal P
r
oper
t
y
See C
ombined
Schedule
DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 NAMED INSURED
Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at
12:0
1 a.m.

P
r
oper
t
y C
o
v
er
ag
e Summary
Ministry
F
ir
st
sm

Br
otherhood Mutual Insur
anc
e C
ompan
y
www
.br
otherhoodmutual.
c
om
800
.
333.
3 735
6 400 Br
otherhood W
a
y
, P
.

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
3 of
15 RENT
AL D

WELLING
17 14 Santa C
lar
a A
v
e Alameda, C
A 9
450
1-
25 15
L
OC
A
TION 2/1
C
O
VERA
GE DES

CRIPTION
(INCL. TYPE OF PR
OPER
TY)
C
O
VERA
GE LIMIT
C

OINSURANCE
E
Q DED
V
AL
U
A
TION TYPE
A
UT
O INCR
PERIL TYPE
F
ORM
Building
See C
ombined
Schedule
P
er
sonal P
r
oper
t
y
See C
ombined
Schedule
C
ombined Schedule(
s
) of Buildings and P
er
sonal P
r
oper
t
y (Includes Stat
ement of V
alues
) - BCP
-
14 7
GR
OUP A
C
OMBINED LIMIT
: $14,
6 45,
000
C
OINSURANCE:

Agr
eed Amount
A
UT
OMA
TIC INCREASE:
0%
V
AL
U
A
TION TYPE:

R
eplac
ement C
ost
PERIL F
ORM:

BCP85 4.5
PERIL TYPE:

Special with T
hef
t
EAR
THQU
AKE DEDUC
TIBLE:

Ex
clude Ear
thquak
e
C
O
VERA
GE DES
CRIPTION (INCL. TYPE OF PR
OPER
TY)
R
OOF SETTLEMENT OPTION
V
AL
UE
L
ocation 1/1 (MultiP
urp
): 17
00 Santa C
lar
a A
v
e, Alameda, C
A, 9
450
1-
25 15
Building
R
eplac
ement C
ost
$10
,
148,
000
P
er
sonal P
r
oper
t
y
N/
A
$2,
0 30
,
000
L
ocation 1/
2 (
Guild Hall/P
arish Hall): 17
00 Santa C
lar
a A
v
e, Alameda, C
A,
9 450
1-
25 15
Building
R
eplac
ement C
ost
$1,
4 7
5,
000
P
er
sonal P
r
oper
t
y
N/
A
$296,
000
L
ocation 2/1 (R
ental): 17
14 Santa C
lar
a A
v
e, Alameda, C
A, 9
450
1-
25 15
Building
R
eplac
ement C
ost
$66
2,
000
P
er
sonal P
r
oper
t
y
N/
A
$34,
000
DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 NAMED INSURED
Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at
12:0
1 a.m.

P
r
oper
t
y C
o
v
er
ag
e Summary
Ministry
F
ir
st
sm

Br
otherhood Mutual Insur
anc
e C
ompan
y
www
.br
otherhoodmutual.
c
om
800
.
333.
3 735
6 400 Br
otherhood W
a
y
, P
.

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
4 of
15 Schedule of A
dditional C
o
v
er
ag
es: All L
ocations
T
he policy's pr
oper
t
y deductible applies t
o each of these c
o
v
er
ag
es. Details ar
e f
ound on the C
ommer
cial P
r
oper
t
y C
o
v
er
ag
es BCP12BC
A 4.5
f
orm.

C
O
VERA
GE DES

CRIPTION
C
O
VERA
GE LIMIT
DEDUC
TIBLE
F
ORM
P
r
oper
t
y Off P
r
emises
$50
,
000+
$5,
000
BCP12BC
A 4.5
Owned P
er
sonal P
r
oper
t
y
-P
ar
sonag
e
$10
,
000
$5,
000
BCP12BC
A 4.5
Building
/P
er
sonal P
r
oper
t
y - Ne
wly A
c
quir
ed/
C
onstruct
ed
$2,
000
,
000++
$5,
000
BCP12BC
A 4.5
Outside Objects and Structur
es
$20
,
000
/
cat
eg
ory
, $30
,
000 T
otal
$5,
000
BCP12BC
A 4.5
F
or an
y one landscaping it
em
$2,
000
$5,
000
BCP12BC
A 4.5
Each los
s caused b
y wind
$5,
000
$5,
000
BCP12BC
A 4.5
Other Structur
es
$15,
000
$5,
000
BCP12BC
A 4.5
Owned P
er
sonal P
r
oper
t
y - Dw
ellings
5% of dw
elling v
alue
$5,
000
BCP12BC
A 4.5
C
ont
ents - Buildings and Structur
es Described on the
Declar
ations
$15,
000+++
$5,
000
BCP12BC
A 4.5
T
r
ailer
s
$10
,
000
$5,
000
BCP12BC
A 4.5
V
ehicle E
quipment and A
c
c
es
sories
$25,
000
$5,
000
BCP12BC
A 4.5
Mone
y and Securities
$5,
000 (L
os
s fr
om specified perils only
. Doubled on specified
holida
y
s
)
$5,
000
BCP12BC
A 4.5
Spoilag
e
$10
,
000
$5,
000
BCP12BC
A 4.5
D
amag
e t
o Buildings and P
er
sonal P
r
oper
t
y fr
om Animals
$10
,
000 ($2,500 sublimit f
or los
s caused b
y animals list
ed in
policy f
orm)
$5,
000
BCP12BC
A 4.5
T
empor
ary Emer
g
ency C
oor
dination/Shelt
er Oper
ation C
lean-
Up
$50
,
000 f
or clean-up c
osts
$5,
000
BCP12BC
A 4.5
+ If the los
s r
esult
ed fr
om a c
o
v
er
ed peril and the pr
oper
t
y is off pr
emises f
or no longer than 180 da
y
s.
++ C
o
v
er
age applies f
or 180 da
y
s fr
om the time c
onstruction begins or the ne
w pr
oper
t
y is ac
quir
ed.
+++ Only applies if the limit of insur
anc
e sho
wn f
or the structur
e is no mor
e than $15,
000 and ther
e is no limit of Or
ganiz
ational P
er
sonal P
r
oper
t
y sho
wn on the declar
ations f
or the
structur
e.

T
he policy's pr
oper
t
y deductible does not apply t
o the f
ollo
wing c
o
v
er
ag
es. Details ar
e f
ound on the C
ommer
cial P
r
oper
t
y C
o
v
er
ag
es f
orm.

C
O
VERA
GE DES

CRIPTION
C
O
VERA
GE LIMIT
F
ORM
Debris R
emo
v
al Expense - P
ar
tial or T
otal L
os
s
P
ar
tial L
os
s: R
emaining Limit f
or C
o
v
er
ed P
r
oper
t
y - T
otal
L
os
s: $25,
000
BCP12BC
A 4.5
Emer
g
ency R
emo
v
al
C
o
v
er
ag
e applies up t
o 30 da
y
s af
t
er pr
oper
t
y is fir
st mo
v
ed
BCP12BC
A 4.5
F
ir
e Depar
tment Servic
e Char
g
es
$50
,
000
BCP12BC
A 4.5
F
ir
e Extinguisher R
echar
g
e
$50
,
000 if r
echar
g
ed within 30 da
y
s
BCP12BC
A 4.5
P
ollutant C
lean-Up and R
emo
v
al
$10
,
000 (annual aggr
eg
at
e)*
BCP12BC
A 4.5
Installed L
ock R
ecalibr
ation
$10
,
000 if r
ecalibr
at
ed within 10 da
y
s
BCP12BC
A 4.5
Ar
son R
e
w
ar
d
$20
,
000**
BCP12BC
A 4.5
P
aper
s and R
ec
or
ds (including electr
onic data)
$50
,
000
BCP12BC
A 4.5
P
er
sonal P
r
oper
t
y Owned b
y Other
s (non-cler
gy
)
$5,
000 per per
son/$25,
000 maximum (
e
x
c
es
s
)***
BCP12BC
A 4.5
P
er
sonal P
r
oper
t
y Owned b
y C
ler
gy
$30
,
000 (
e
x
c
es
s
)***
BCP12BC
A 4.5
T
hef
t or V
andalism R
e
w
ar
d
$5,
000**
BCP12BC
A 4.5
* If the los
s r
esult
ed fr
om a c
o
v
er
ed peril and w
as r
epor
t
ed within 180 da
y
s.
** Or the amount paid t
o the insur
ed as a r
esult of the dir
ect los
s, if les
s than the limit st
at
ed abo
v
e.
*** A
dditional limits ar
e a
v
ailable
DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 NAMED INSURED
Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at
12:0
1 a.m.

P
r
oper
t
y C
o
v
er
ag
e Summary
Ministry
F
ir
st
sm

Br
otherhood Mutual Insur
anc
e C
ompan
y
www
.br
otherhoodmutual.
c
om
800
.
333.
3 735
6 400 Br
otherhood W
a
y
, P
.

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
5 of
15 Optional C
o
v
er
ag
es: All L
ocations
C
ombined Or
dinanc
e or La
w Enf
or
c
ement C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTION
C
O
VERA
GE LIMIT
DEDUC
TIBLE
F
ORM
Or
dinanc
e or La
w A - Incr
eased Building L
os
s
$1,
000
,
000
$5,
000
BCP138B 4.5
Or
dinanc
e or La
w B - Incr
eased Debris R
emo
v
al
$500
,
000
$5,
000
BCP138B 4.5
Or
dinanc
e or La
w C - Incr
eased C
ost of C
onstruction
$500
,
000
$5,
000
BCP138B 4.5
Org
aniz
ational Optional T
hef
t C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTION
C
O
VERA
GE LIMIT
DEDUC
TIBLE
F
ORM
T
hef
t of Mone
y and Securities
$25,
000
$500
BCP36 4.5
T
hef
t b
y Electr
onic Means
$10
,
000
$500
BCP36 4.5
T
hef
t b
y C
oer
cion
$10
,
000 ($30
,
000Annual Aggr
eg
at
e Limit)
$500
BCP36 4.5
Minis
try P
er
sonnel Dishones
t
y C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTION
C
O
VERA
GE LIMIT
DEDUC
TIBLE
F
ORM
P
er
sonnel Dishonest
y C
o
v
er
ag
e
$100
,
000
N/
A
BCP3
7A 4.5
Earnings and Donations and Extr
a Expense C
o
v
er
ag
e P
ar
t
P
erils P
ar
t: See P
eril T
ype f
or the P
r
oper
t
y Described on the Schedule of Buildings and P
er
sonal P
r
oper
t
y T
hat Sustains a L
os
s
C
O
VERA
GE DES

CRIPTION
C
O
VERA
GE LIMIT
DEDUC
TIBLE
F
ORM
Earnings and Donations
$1,
000
,
000
N/
A
BCP7
1 4.
6 Extr
a Expense
$500
,
000
N/
A
BCP7
1 4.
6 W
at
er D
amag
e - F
lood, Back
up
, and Subsur
f
ac
e
C
O
VERA
GE DES

CRIPTION
C
O
VERA
GE LIMIT
DEDUC
TIBLE
F
ORM
W
at
er D
amag
e-F
lood, Back
-up
, and Subsurf
ac
e
$10
,
000
$5,
000
BCP2
7C
A 4.5
Se
w
er and Dr
ain Back
-up Ext
ension
C
O
VERA
GE DES

CRIPTION
C
O
VERA
GE LIMIT
DEDUC
TIBLE
F
ORM
Se
w
er
/Dr
ain Back
up Ext
ension
See Building
/P
er
sonal P
r
oper
t
y Limit
$5,
000
BCP135C
A 4.
1 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 NAMED INSURED
Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at
12:0
1 a.m.

P
r
oper
t
y C
o
v
er
ag
e Summary
Ministry
F
ir
st
sm

Br
otherhood Mutual Insur
anc
e C
ompan
y
www
.br
otherhoodmutual.
c
om
800
.
333.
3 735
6 400 Br
otherhood W
a
y
, P
.

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
6 of
15 S
y
s
t
ems / E
quipment Br
eak
do
wn C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTION
C
O
VERA
GE LIMIT
DEDUC
TIBLE
F
ORM
S
y
st
ems/E
quipment Br
eak
do
wn C
o
v
er
ag
e
Building
/P
er
sonal P
r
oper
t
y Limit
$5,
000
BSEB100 4.
1 R
ent
ed P
er
sonal P
r
oper
t
y of Other
s C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTION
C
O
VERA
GE LIMIT
DEDUC
TIBLE
F
ORM
R
ent
ed P
er
sonal P
r
oper
t
y of Other
s
$10
,
000
$1,
000
BCP12BC
A 4.5
Int
erior Building D
amag
e C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTION
C
O
VERA
GE LIMIT
DEDUC
TIBLE
F
ORM
Int
erior Building D
amag
e C
o
v
er
ag
e-Including Gutt
er
s/
Do
wnspouts C
o
v
er
ag
e
$14,
665,
000
$5,
000
BCP4
9 4.
0 T
err
orism L
os
s C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTION
C
O
VERA
GE LIMIT
DEDUC
TIBLE
F
ORM
Limit
ed T
err
orism
$14,
665,
000
$5,
000
EX06
21X 3.
0 A
dditional P
r
oper
t
y F
orms
F
ORM
F
ORM NAME
F
ORM
F
ORM NAME
BCP85 4.5
Special P
erils P
ar
t
BCP0631C
A 1.
0 Amendat
ory Endor
sement Calif
ornia
BCP0832C
A 1.
0 Amendat
ory Endor
sement
-Calif
ornia
BCP14
7 1.
0 Blank
et
/
C
ombined V
aluation F
orm
BCP188 4.5
Ear
th Mo
v
ement Ex
cl-F
ollo
wing Dmg. Ded.

BCP500 4.5
L
os
s F
r
ee Deductible R
eduction End
BCP7
0 1C
A 1.
0 Appr
aisal Endor
se P
r
o
vision Amend - C
A
BN12V 1.
0 Notic
e R
eg
ar
ding Building V
aluation
BN256
7 1.
0 Notic
e W
at
er D
amag
e/F
lood C
o
v
er
ag
e
CP0
17 1 10 08
Ex
clusion W
at
er D
amag
e
CP132 1.
0 L
os
s P
a
y
able Options
BCP12G 2.
2 Building Glas
s Deductible
EX065
1X 3.
0 NBC T
err
orism Ex
clusion
A
dditional Int
er
es
ts
NAME
TYPE
L
O
AN NUMBER

INTERES
T
ADDRES
S
KBA Docus
y
s, Inc. c/
o
Insur
anc
e C
ent
er
L
os
s P
a
y
ee
4 144
17 0
3-
1 Other: Canon IR
AD
V C55040
1 C
opier
PO Bo
x 3886 Belle
vue, W
A 98009 -3886
DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 NAMED INSURED
Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at
12:0
1 a.m.

Liabilit
y C
o
v
er
ag
e Summary
Ministry
F
ir
st
sm

c
ommer
cial multi-peril policy Declar
ations c
ontinued…
T
he C
o
v
er
ag
es list
ed within these declar
ations ar
e pr
o
vided ac
c
or
ding t
o the t
erms of the designat
ed c
o
v
er
ag
e f
orms and an
y other applicable f
orms or
endor
sements. Only one liabilit
y c
o
v
er
ag
e and one medical c
o
v
er
ag
e will apply t
o an oc
curr
enc
e and an
y r
elat
ed los
s. An
y limit which is specifically stat
ed within
a c
o
v
er
ag
e f
orm or endor
sement r
epr
esents the most w
e will pa
y f
or the c
o
v
er
ag
e t
o which such a limit applies. F
or application of limits, see Liabilit
y and Medical
C
o
v
er
ag
e f
orm (BGL11 4.5).
* Only a single limit applies t
o the los
s. All c
o
v
er
age limits ar
e subject t
o the gener
al oc
curr
enc
e limit and all aggr
egat
e limits ar
e subject t
o the gener
al aggr
egat
e limit.
+ per per
son limit
Br
otherhood Mutual Insur
anc
e C
ompan
y
www
.br
otherhoodmutual.
c
om
800
.
333.
3 735
6 400 Br
otherhood W
a
y
, P
.

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
7 of
15 K
e
y Liabilit
y C
o
v
er
ag
e F
acts: Schedule of Limits
GENERAL OC
CURRENCE LIMIT
GENERAL A
GGRE
GA
TE LIMIT
$1,
000
,
000
$10
,
000
,
000
P
rincipal Liabilit
y C
o
v
er
ag
es
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
Bodily Injury
/P
r
oper
t
y D
amag
e Liabilit
y (L
)
$1,
000
,
000*
$10
,
000
,
000*
GL100 1.
0 Medical P
a
yments (M)
$10
,
000*+
$10
,
000
,
000*
GL100 1.
0 P
r
oducts/
C
omplet
ed W
ork (N)
$1,
000
,
000*
$10
,
000
,
000*
GL100 1.
0 F
ir
e L
eg
al Liabilit
y (
O
)
$1,
000
,
000*
$10
,
000
,
000*
BGL9
5 1 4.5
Supplemental C
o
v
er
ag
es
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
Incidental C
ontr
actual Liabilit
y
$1,
000
,
000*
$10
,
000
,
000*
GL100 1.
0 Incidental Medical Malpr
actic
e
$1,
000
,
000*
$10
,
000
,
000*
GL100 1.
0 Mobile E
quipment
$1,
000
,
000*
$10
,
000
,
000*
GL100 1.
0 A
dditional C
o
v
er
ag
es
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
Member
ship Emotional Injury Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL5
1 4.5
Nur
sery
/
Child Car
e C
orpor
al P
unishment Liabilit
y
$1,
000
,
000*
$10
,
000
,
000*
BGL5
1 4.5
Supervision-R
elat
ed Emotional Injury Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL5
1 4.5
F
ood P
r
epar
ation Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL5
1 4.5
P
riv
acy V
iolation Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL5
1 4.5
D
amag
e T
o P
r
oper
t
y Of Other
s C
o
v
er
ag
e
BGL5
1 4.5
Not in Y
our C
ontr
ol
$1,
000*+
$10
,
000
,
000*
BGL5
1 4.5
In Y
our C
ontr
ol
$2,500*+
$10
,
000
,
000*
BGL5
1 4.5
P
r
osthetic De
vic
es
$500*+
$10
,
000
,
000*
BGL5
1 4.5
Incidental Camper Medical C
o
v
er
ag
e
$10
,
000*
$10
,
000
,
000*
BGL5
1 4.5
A
dditional Incidental C
ontr
actual Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL5
1 4.5
Def
ense C
o
v
er
ag
e
Applies in addition t
o the liabilit
y limit unles
s otherwise specifically stat
ed in an applicable c
o
v
er
ag
e f
orm.

DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 NAMED INSURED
Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at
12:0
1 a.m.

Liabilit
y C
o
v
er
ag
e Summary
Ministry
F
ir
st
sm

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
8 of
15 C
emet
ery Liabilit
y C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
Emotional Injury Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL113 4.
0 Emotional Injury
/Burial Discrimination Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL113 4.
0 F
inancial L
os
s t
o Other
s C
o
v
er
ag
e
$3,500+, $35,
000 per
oc
curr
enc
e
$10
,
000
,
000*
BGL113 4.
0 D
amag
e t
o P
r
oper
t
y of Other
s C
o
v
er
ag
e
$2,500+, $50
,
000 per
oc
curr
enc
e
$10
,
000
,
000*
BGL113 4.
0 Medical C
o
v
er
ag
e Ext
ension - C
lergy A
c
cidental Death
C
O
VERA
GE DES

CRIPTIONS
P
AS
T
ORS
C
O
VERA
GE LIMIT
PER A
C
CIDENT LIMIT
F
ORM
Br
oadened C
ler
gy A
c
cidental Death Benefit
3 $25,
000*+
$150
,
000*
BGL998B 1.
0 C
ounseling A
cts Liabilit
y C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
C
ounseling A
cts Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL63 4.
1 Outside C
ounseling R
eimbur
sement C
o
v
er
ag
e
$5,
000+
$10
,
000
,
000*
BGL63 4.
1 C
yber Liabilit
y C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
C
omput
er Use Liabilit
y C
o
v
er
ag
e
$200
,
000*
$2,
000
,
000*
BGL8
7C
A 4.5
Electr
onic C
ommer
c
e Liabilit
y C
o
v
er
ag
e
$200
,
000*
$2,
000
,
000*
BGL8
7C
A 4.5
D
ata Br
each Liabilit
y C
o
v
er
ag
e
$200
,
000*
$2,
000
,
000*
BGL8
7C
A 4.5
Outsour
c
ed IT Liabilit
y C
o
v
er
ag
e
$200
,
000*
$2,
000
,
000*
BGL8
7C
A 4.5
Special R
eimbur
sement C
o
v
er
ag
e (D
ata Br
each R
ectification
C
osts
)
$50
,
000
$50
,
000
BGL8
7C
A 4.5
Special R
eimbur
sement C
o
v
er
ag
e (Electr
onic Disc
o
v
ery C
osts
)
$20
,
000
$20
,
000
BGL8
7C
A 4.5
Special Def
ense C
o
v
er
ag
e (
Subpoenas, R
egulat
ory A
ctions and
Injunctiv
e)
$20
,
000
$20
,
000
BGL8
7C
A 4.5
Def
ense R
eimbur
sement C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
C
o
v
er
ed La
w
suit P
r
oc
eeding (P
r
oc
eeding Limit)
$50
,
000
$100
,
000
BGL8
9C
A 4.5
La
w Enf
or
c
ement Inquiry (Inquiry Limit)
$10
,
000
$30
,
000
BGL8
9C
A 4.5
DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 NAMED INSURED
Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at
12:0
1 a.m.

Liabilit
y C
o
v
er
ag
e Summary
Ministry
F
ir
st
sm

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
9 of
15 Dir
ect
or
s and Of
fic
er
s Liabilit
y C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
Dir
ect
or
s and Offic
er
s L
eader
ship Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL81BC
A 4.5
Benefits A
dminis
tr
ation Liabilit
y C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
Emplo
y
ee Benefit
/F
iduciary Liabilit
y C
o
v
er
ag
e
$1,
000
,
000
$10
,
000
,
000
BGL83B 4.
1 (Medical Expense Limit)
$500
,
000*
$1,
000
,
000*
BGL83B 4.
1 Limit
ed F
iduciary P
enalties C
o
v
er
ag
e
$250
,
000*
$500
,
000*
BGL83B 4.
1 Incidental In
v
estment C
ounseling C
o
v
er
ag
e
$500
,
000*
$500
,
000*
BGL83B 4.
1 Emplo
yment P
r
actic
es ("Emplo
yment P
r
act") Liabilit
y C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
Emplo
yment
-R
elat
ed Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL85 4.5
F
ir
e L
eg
al/Nono
wned P
r
oper
t
y D
amag
e Liabilit
y C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
Nono
wned P
r
oper
t
y D
amag
e Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL9
5 1 4.5
A
dditional Incidental C
ontr
actual Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL9
5 1 4.5
L
eg
al Aid C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
L
eg
al Aid Liabilit
y C
o
v
er
ag
e
$500
,
000*
$500
,
000*
BGL236 1.
0 Special Def
ense C
o
v
er
ag
e
$100
,
000*
$100
,
000*
BGL236 1.
0 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 NAMED INSURED
Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at
12:0
1 a.m.

Liabilit
y C
o
v
er
ag
e Summary
Ministry
F
ir
st
sm

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
10 of
15 Media Liabilit
y C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
P
er
sonal Injury Liabilit
y C
o
v
er
ag
e (Media/
C
ommunications
A
ctivit
y
)
$1,
000
,
000*
$10
,
000
,
000*
BGL4
1 1.
0 P
er
sonal Injury Liabilit
y C
o
v
er
ag
e (P
er
sonal V
iolations
)
$1,
000
,
000*
$10
,
000
,
000*
BGL4
1 1.
0 P
er
sonal Injury Liabilit
y C
o
v
er
ag
e (Unauthoriz
ed A
c
c
es
s/
P
osting
)
$1,
000
,
000*
$10
,
000
,
000*
BGL4
1 1.
0 Special Def
ense C
o
v
er
ag
e (
Alleg
ed Int
entional A
cts
)
$1,
000
,
000*
$10
,
000
,
000*
BGL4
1 1.
0 Medical C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
R
eligious A
thletic Medical C
o
v
er
ag
e
$10
,
000*+
$10
,
000
,
000*
BGL91 4.5
Nono
wned V
ehicle C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
Nono
wned V
ehicle Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL7
1B 4.
0 Def
ense C
o
v
er
ag
e: A
uthoriz
ed Oper
at
or
$1,
000
,
000*
$10
,
000
,
000*
BGL7
1B 4.
0 Nono
wned V
ehicle Medical P
a
yments Ext
ension
$10
,
000*+
$150
,
000*
BGL7
1B 4.
0 L
os
s of Use C
o
v
er
ag
e
$1,500 per v
ehicle
$3,
000*
BGL7
1B 4.
0 T
rip Oc
cupant C
o
v
er
ag
e
$1,
000*+
$10
,
000
,
000*
BGL7
1B 4.
0 D
amag
e t
o P
r
oper
t
y of Other
s
$1,
000*
$10
,
000
,
000*
BGL7
1B 4.
0 Nono
wned V
ehicle Deductible R
eimbur
sement C
o
v
er
ag
e
$1,
000*
$10
,
000
,
000*
BGL7
1B 4.
0 R
ental V
ehicle Ph
y
sical D
amag
e C
o
v
er
ag
e
$90
,
000 per v
ehicle, $250
deductible
$180
,
000*
BGL777 3.
0 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 NAMED INSURED
Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at
12:0
1 a.m.

Liabilit
y C
o
v
er
ag
e Summary
Ministry
F
ir
st
sm

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
11 of
15 R
elief A
ctivit
y A
dditional C
o
v
er
ag
es
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
Emotional Injury and F
inancial D
amag
e Liabilit
y
$1,
000
,
000*
$10
,
000
,
000*
BGL99
4 1.
0 A
dditional Medical Expense C
o
v
er
ag
e
$50
,
000+,$250
,
000 per
oc
currr
enc
e
$10
,
000
,
000
BGL99
4 1.
0 Br
oadened W
ag
e L
os
s R
eimbur
sement C
o
v
er
ag
e
$10
,
000+, $50
,
000 per
oc
curr
enc
e
$10
,
000
,
000
BGL99
4 1.
0 D
amag
e t
o R
elief W
ork
er's T
ools and E
quipment C
o
v
er
ag
e
$2,500+, $10
,
000 per
oc
curr
enc
e
$10
,
000
,
000
BGL99
4 1.
0 P
rimary Liabilit
y C
o
v
er
ag
e f
or R
elief W
ork
er
s
$1,
000
,
000*
$10
,
000
,
000*
BGL99
4 1.
0 R
eligious F
r
eedom P
r
ot
ection C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
R
eligious C
ommunication Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL66C
A 1.
2 R
eligious A
ctivit
y Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL66C
A 1.
2 Discriminat
ory A
cts Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$10
,
000
,
000*
BGL66C
A 1.
2 T
ax Ex
empt Challeng
e: Expense R
eimbur
sement C
o
v
er
ag
e
$25,
000*
$25,
000*
BGL66C
A 1.
2 Litig
ation A
ctivit
y: L
eg
al Def
ense R
eimbur
sement C
o
v
er
ag
e
See f
orm
See f
orm
BGL66C
A 1.
2 Litig
ation A
ctivit
y: Declar
at
ory A
ction R
eimbur
sement C
o
v
er
ag
e
See f
orm
See f
orm
BGL66C
A 1.
2 Securit
y Oper
ations C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
A
dditional Medical Expense C
o
v
er
ag
e
$50
,
000*+
$250
,
000*
BGL99
3 4.
0 Br
oadened W
ag
e L
os
s R
eimbur
sement C
o
v
er
ag
e (Emotional
Injury
)
$10
,
000*+
$50
,
000*
BGL99
3 4.
0 Individual C
ounseling C
o
v
er
ag
e
$10
,
000*+
$50
,
000*
BGL99
3 4.
0 D
amag
e t
o Securit
y
-R
elat
ed E
quipment
$2,500*+
$10
,
000*
BGL99
3 4.
0 P
rimary C
o
v
er
ag
e f
or Specified Individuals
See F
orm
See F
orm
BGL99
3 4.
0 Enf
or
c
ement of Securit
y P
olicy or W
eapons P
olicy
$1,
000
,
000*
$1,
000
,
000*
BGL99
3 4.
0 Neglig
ent Infliction of Emotional Distr
es
s Arising fr
om Securit
y
Oper
ations
$1,
000
,
000*
$1,
000
,
000*
BGL99
3 4.
0 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 NAMED INSURED
Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at
12:0
1 a.m.

Liabilit
y C
o
v
er
ag
e Summary
Ministry
F
ir
st
sm

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
12 of
15 T
r
aumatic Incident R
esponse C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
A
dditional Medical Expense C
o
v
er
ag
e
$50
,
000*+
$1,
000
,
000*
BGL991D 4.
1 Br
oadened W
ag
e L
os
s R
eimbur
sement C
o
v
er
ag
e (Including
Emotional Injury
)
See f
orm
$1,
000
,
000*
BGL991D 4.
1 Individual C
ounseling C
o
v
er
ag
e
$10
,
000*+
$1,
000
,
000*
BGL991D 4.
1 A
dditional Or
g
aniz
ational Expense
$500
,
000*
$1,
000
,
000*
BGL991D 4.
1 W
orldwide Liabilit
y Ext
ension C
o
v
er
ag
e
Ext
ended F
or
eign Minis
try Oper
ations- Ex
cluded
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
Shor
t
-
T
erm T
rip Limit
ed Kidnap and Ext
or
tion Expense
R
eimbur
sement C
o
v
er
ag
e
See F
orm
See F
orm
BGL112 1.
0 Shor
t
-
T
erm F
or
eign T
rip T
err
orism-R
elat
ed T
r
a
v
el Int
erruption
R
eimbur
sement
See F
orm
See F
orm
BGL112 1.
0 Shor
t
-
T
erm F
or
eign T
rip Death R
eimbur
sement C
o
v
er
ag
e F
or
Y
our L
eader
s
See F
orm
See F
orm
BGL112 1.
0 F
or
eign Oper
ations Imag
e R
est
or
ation Ext
ension
See F
orm
See F
orm
BGL112 1.
0 Expanded Medical C
o
v
er
ag
e F
or F
or
eign Ministry P
ar
ticipants
See F
orm
See F
orm
BGL112 1.
0 W
ag
e R
eimbur
sement C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
W
ag
e L
os
s R
eimbur
sement C
o
v
er
ag
e
$3,500+
$35,
000 per oc
curr
enc
e
BGL99 4.
0 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 NAMED INSURED
Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at
12:0
1 a.m.

Liabilit
y C
o
v
er
ag
e Summary
Ministry
F
ir
st
sm

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
13 of
15 Se
xual A
cts Liabilit
y C
o
v
er
ag
e
C
O
VERA
GE DES

CRIPTIONS
C
O
VERA
GE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
Se
xual A
cts Liabilit
y C
o
v
er
ag
e W
ith Scr
eening
$1,
000
,
000*
$2,
000
,
000*
BGL6
1 4.
7 Se
xual Har
as
sment Liabilit
y C
o
v
er
ag
e (
other than y
our
emplo
y
ees
)
$1,
000
,
000*
$2,
000
,
000*
BGL6
1 4.
7 Impr
oper R
epor
ting of Se
xual A
cts Liabilit
y C
o
v
er
ag
e
$1,
000
,
000*
$2,
000
,
000*
BGL6
1 4.
7 Impr
oper Supervision of C
on
vict
ed Se
xual Off
ender
s Liabilit
y
C
o
v
er
ag
e
$1,
000
,
000*
$2,
000
,
000*
BGL6
1 4.
7 Outside C
ounseling R
eimbur
sement C
o
v
er
ag
e
$5,
000*+
$100
,
000*
BGL6
1 4.
7 Se
xual A
cts Medical P
a
yment Ext
ension
$10
,
000*+
$100
,
000*
BGL6
1 4.
7 Imag
e R
est
or
ation Ext
ension
$10
,
000*
$2,
000
,
000*
BGL6
1 4.
7 R
edemptiv
e Emplo
yment
/
Appointment
$300
,
000*
$300
,
000*
BGL6
13 4.5
Schedule of Liabilit
y Exposur
es
In is
suing this policy
, w
e ha
v
e r
elied on mat
erial inf
ormation pr
o
vided t
o us b
y the Named Insur
ed. T
he f
ollo
wing schedule discloses all of the
insur
ed’
s insur
able e
xposur
es (as c
on
v
e
y
ed b
y the Named Insur
ed) kno
wn t
o e
xist at the policy inc
eption dat
e. Declar
ed pr
emises must be o
wned,
oc
cupied, or r
ent
ed b
y y
ou or y
our scheduled r
elat
ed or
g
aniz
ations.

EXPO
SURE DES

CRIPTIONS
ADDRES
S / BUILDING DES

CRIPTION
C
ODE
RA
TING B
ASIS
Dw
ellings - One-F
amily
L
ocation 2 Building 1 R
ental
0 100
1 1 Each
F
ood P
antry
L
ocation 1 Building 2 F
ello
w
ship
05813
500 Squar
e F
eet
Chur
ch
L
ocation 1 Building 1 MultiP
urp
0810
1 18,
050 Squar
e F
eet
L
ocation 1 Building 2 F
ello
w
ship
3,
6 25 Squar
e F
eet
F
amily Shelt
er
L
ocation 1 Building 2 F
ello
w
ship
1540
2 3,
6 25 Squar
e F
eet
Building or P
r
emises - L
es
sor's Risk - NOC
L
ocation 1 Building 1 MultiP
urp
177
0 3
1,500 Squar
e F
eet
Building or P
r
emises - L
es
sor's Risk - NOC
L
ocation 1 Building 2 F
ello
w
ship
177
0 3
4,
300 Squar
e F
eet
Outr
each Ministry
30 130
1 # it
ems/
activities
Outr
each Ministry
17 00 Santa C
lar
a A
v
e Alameda C
A 9
450
1-
25 15
30 130
1 # it
ems/
activities
Pla
y
gr
ounds
17 00 Santa C
lar
a A
v
e Alameda C
A 9
450
1-
25 15
30 320
1 Each
P
ast
or
al C
ounseling
3 P
ast
or(
s
)
Special E
v
ents
DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 NAMED INSURED
Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at
12:0
1 a.m.

Liabilit
y C
o
v
er
ag
e Summary
Ministry
F
ir
st
sm

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
14 of
15 High Haz
ar
d A
ctivities
F
or details r
eg
ar
ding ho
w these c
o
v
er
ag
e limits will apply
, see the
Ho
w Much W
e P
a
y
section of the High Haz
ar
d A
ctivities C
o
v
er
ag
e Limits F
orm (BGL
-
21).

A
C
TIVITY DES

CRIPTION
MEDIC
AL LIMIT
OC
CURRENCE LIMIT
C
O
VERA
GE A
GGRE
GA
TE LIMIT
F
ORM
Sk
at
e P
ark Oper
ations
$0 per per
son
$100
,
000
$1,
000
,
000
BGL21 4.
1 F
ir
e
w
ork
s Sales
$0 per per
son
$100
,
000
$1,
000
,
000
BGL21 4.
1 F
ir
e
w
ork
s Displa
y
$0 per per
son
$100
,
000
$1,
000
,
000
BGL21 4.
1 C
onstruction Ov
er
sight
$0 per per
son
$100
,
000
$1,
000
,
000
BGL21 4.
1 Other Liabilit
y and Medical F
orms
F
ORM
F
ORM NAME
F
ORM
F
ORM NAME
BGL100A1 2.
2 C
ommer
cial Liabilit
y Endor
sement
BGL11 4.5
Liabilit
y And Medical C
o
v
er
ag
e F
orm
BGL15
2 1.
0 A
dditional Insur
ed Endor
sement
EX909 1.
0 Asbest
os Exposur
e Ex
clusion
GL0
363 08 06
Amendat
ory Endor
sement Calif
ornia
GL09
50 12 99
Kno
wn Injury or D
amag
e Amendments
GL8
90 1.
0 L
ead Liabilit
y Ex
clusion
BGL9
39AISP 1.
0 P
r
o
vision Modification-Ex
c
es
s Liabilit
y
BGL9
7 8 4.
1 C
o
v
er
ag
e Ext
ension V
eh-r
ent
ed w
/
driv
er
BN998 1.
0 C
ler
gy A
c
cidental Death Medical Ext
EX0
2 6
1X 3.
0 T
err
orism Ex
clusion
EX0
281X 3.
1 NBC T
err
orism Ex
clusion
A
dditional Insur
eds
NAME
L
O
AN/REFERENCE NUMBER

INTERES
T
ADDRES
S
Alameda Emer
g
ency F
ood Bank,
A
dditional Insur
ed
Other: F
ood
Bank
1900 T
hau W
a
y Alameda, C
A 9
450
1 C
it
y of Alameda, A
dditional
Insur
ed
Other: F
amily
Shelt
er
P
r
ogr
am
2 2
63 Santa C
lar
a A
v
e Alameda, C
A 9
450
1 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 NAMED INSURED
Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NU
MBER
04M5A04
9 432
6 POLIC
Y PERIOD
12/
0 1/
20 2
2 at 12:0
1 a.m. t
o 12/
0 1/
20 23 at
12:0
1 a.m.

C
ommer
cial Ex
c
es
s Liabilit
y Supplemental C
o
v
er
ag
e Summary
Ministry
F
ir
st
sm

c
ommer
cial multi-peril policy Declar
ations c
ontinued…
In r
eturn f
or the pa
yment of the pr
emium, and subject t
o all the t
erms of the policy
, w
e agr
ee with y
ou t
o pr
o
vide the insur
anc
e as stat
ed in the Ex
c
es
s/Umbr
ella
Liabilit
y C
o
v
er
ag
e endor
sement BGL9
39 4.
7 .

Br
otherhood Mutual Insur
anc
e C
ompan
y
www
.br
otherhoodmutual.
c
om
800
.
333.
3 735
6 400 Br
otherhood W
a
y
, P
.

O
. Bo
x 2
2 2
7 , F
or
t W
a
yne, IN 4680
1-
2 2
2 7
M1 DE
C 12/
20 “Bear y
e one another’
s bur
dens and so fulfill the la
w of Christ.
” — Galatians 6:2
P
ag
e
15 of
15 K
e
y Ex
c
es
s Liabilit
y C
o
v
er
ag
e F
acts
NAME OF INSURED
ADDRES
S
EX
CES
S LIABILITY POLIC
Y PERIOD
EX
CES
S LIABILITY ANNU
AL PREMIUM
Christ Episc
opal Chur
ch in Alameda, Calif
ornia
17 00 Santa C
lar
a A
v
e, Alameda, C
A 9
450
1-
25 15
12/1/
20 2
2 t
o 12/1/
20 23 at 12:0
1 a.m. at the location list
ed abo
v
e
$3,
450
Ex
c
es
s Liabilit
y C
o
v
er
ag
e - Limit of Insur
anc
e
C
o
v
er
ag
e Limit (per Oc
curr
enc
e)
C
o
v
er
ag
e Aggr
eg
at
e Limit
Deductible/R
et
ention
$4,
000
,
000
$4,
000
,
000
N/
A
Optional Ex
c
es
s C
o
v
er
ag
e Inf
ormation
C
O
VERA
GE
S
T
A
TUS
LIMIT
Dir
ect
or
s and Offic
er
s Liabilit
y C
o
v
er
ag
e
Included
$4,
000
,
000
Se
xual A
cts Liabilit
y C
o
v
er
ag
e
Included
$1,
000
,
000
Emplo
yment P
r
actic
es Liabilit
y C
o
v
er
ag
e
Ex
cluded
N/
A
C
yber Liabilit
y C
o
v
er
ag
e
Ex
cluded
N/
A
Benefits A
dministr
ation Liabilit
y C
o
v
er
ag
e
Ex
cluded
N/
A
Optional C
o
v
er
age Limits ar
e the same as the Ex
c
es
s Liabilit
y “per Oc
curr
enc
e
” and A
ggr
egat
e limits sho
wn abo
v
e, unles
s otherwise specified.

Schedule of Underlying Insur
anc
e
TYPE

INSURER
POLIC
Y PERIOD
POLIC
Y NUMBER
LIMIT
S OF LIABILITY
Gener
al Liabilit
y
Br
otherhood Mutual Insur
anc
e C
ompan
y
12/
0 1/
20 2
2 - 12/
0 1/
20 23
04M5A04
9 432
6 $1,
000
,
000 Oc
c/$10
,
000
,
000 Agg
Emplo
y
er's Liabilit
y
Liber
t
y Mutual
See applicable declar
ations pag
e.
0000000
$1000000
/$1000000
/$1000000
DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 INSURED NAME:

Christ Episc
opal Chur
ch in Alameda,
Calif
ornia
POLIC
Y NUMBER:
04M5A04
9 432
6 A
GENC
Y NAME:

Chur
ch
w
est Insur
anc
e Servic
es
A
GENC
Y NUMBER:
400
2 -0
13 D
A
TE:
10 /
21/
20 2
2 A
dministr
ativ
e F
orm INCHG1, A
ugust 20
15 P
ag
e
1 of
1 Dear P
olicyholder:

T
he
purpose
of
this
lett
er
is
t
o
inf
orm
y
ou
that
one
or
mor
e
chang
es
will
tak
e
eff
ect
on
12/
0 1/
20 2
2,
the
r
ene
w
al
of
y
our
ministry policy
.

In
some
cases,
the
eff
ects
of
these
policy
chang
es
will
mean
enhanc
ed
c
o
v
er
ag
e,
while
in
other
cases,
limits,
c
onditions,
e
x
clusions,
and
limitations
ma
y
narr
o
w
the
sc
ope
of
c
er
tain
c
o
v
er
ag
es
when
c
ompar
ed
t
o
y
our
prior
policy
.

F
ollo
wing
ar
e
the
names
of
the
c
o
v
er
ag
e
f
orms
that
ha
v
e
either
been
added
or
r
emo
v
ed
fr
om
y
our
policy
.**
Please
r
e
vie
w
y
our
declar
ations
pag
e f
or chang
es in the policy v
alues, deductibles, and pr
emium.

NEW F
ORMS
BCP0631C
A 1.
0 Amendat
ory Endor
sement Calif
ornia
BCP7
0 1C
A 1.
0 Appr
aisal Endor
sement P
r
o
vision Amendment - C
A
DELETED F
ORMS
CP0631 0
1 12
Amendat
ory Endor
sement Calif
ornia
Please r
ead y
our policy car
efully
.

Y
our
Br
otherhood
Mutual
ag
ent
will
be
pleased
t
o
addr
es
s
an
y
questions
y
ou
ma
y
ha
v
e
c
onc
erning
y
our
policy
.

Y
ou
ma
y
c
ontact
y
our
ag
ent
at
909-30
7 -8500
.

If
y
ou
ha
v
e
an
y
questions,
y
ou
ma
y
c
ontact
our
cust
omer
servic
e
depar
tment
at
1-800-333-3
735. T
hank y
ou f
or trusting us with y
our ministry
.
**NO
TE:

No
c
o
v
er
age
of
an
y
kind
is
pr
o
vided
b
y
this
notic
e.

T
his
Summary
of
Impor
t
ant
Changes
does
not
in
an
y
w
a
y
r
eplac
e
an
y
pr
o
vision
of
y
our
policy
,
nor
is
e
v
ery
change
in
y
our
policy
list
ed
abo
v
e.

All
insur
anc
e
c
o
v
er
age
is
subject
t
o
c
onditions,
c
o
v
er
age
limits,
limit
ations,
and
e
x
clusions.

F
or
pr
ecise
det
ails
of
c
o
v
er
age,
please
r
ef
er
t
o
y
our
actual
policy
.

While
our
c
ompan
y's
goal
is
t
o
pr
o
vide
ongoing
insur
anc
e
pr
ot
ection
t
o
ministry
or
ganiz
ations,
changes
in
c
ompan
y
oper
ations,
the r
egulat
ory or insur
anc
e en
vir
onment, or signific
ant los
s e
xperienc
e c
an r
esult in policy r
e
vision or policy t
ermination.

DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 AAIS
CP132
Ed 1.0
CP132 Ed 1.0
Copyright MXMXCIV
, American Association of Insurance Services
Page
1 of
2 This endorsement changes the Commercial
Property Coverages provided by this policy
PLEASE READ IT CAREFULL
Y
LOSS P
A
Y
ABLE OPTIONS

SCHEDULE
(The information required below may be shown on a separate schedule or supplemental declarations
.)
Prem.

No.

Bldg.

No.

Description of Property
Name and Address
of Loss Payee
Canon IR ADV C550401 Copier
KBA Docusys, Inc. c/o Insurance Center
PO Box 3886
Bellevue, W
A 980093886
In addition to the policy
terms
which are contained in
other sections of the Commercial Property Coverage,
the following conditions apply to the property
described on the schedule and only when indicated
by an “X”:

X
LOSS P
A
Y
ABLE
Any
loss
shall
be
adjusted
with
you

and
shall
be
payable
to
you

and
the
loss
payee
shown
on
the
schedule as
your
and their interests appear
.

LENDER'S LOSS P
A
Y
ABLE
Any
loss
shall
be
payable
to
you

and
the
loss
payee
shown
on
the
schedule
as
interests
appear
.

If
more
than
one
loss
payee
is
named,
they
shall
be paid in order of precedence.

The
insurance
for
the
loss
payee
continues
in
ef
fect
even
when
your
insurance
may
be
void
because
of
your
acts,
neglect,
or
failure
to
comply
with
the
coverage
terms
.

The
insurance
for
the
loss
payee
does
not
continue
in
ef
fect
if
the
loss
payee
is
aware
of
changes
in
ownership
or
substantial
increase in risk and does not notify
us
.

If
we
cancel this policy
,
we
notify the loss payee at
least 10 days before the ef
fective date of cancellation
if
we
cancel for
your
nonpayment of premium, or 30
days before the ef
fective date of cancellation if
we
cancel for any other reason.

W
e
may
request
payment
of
the
premium
from
the
loss payee, if
you
fail to pay the premium.

If
we
pay
the
loss
payee
for
a
loss
where
your
insurance
may
be
void,
the
loss
payee’
s
right
to
collect
that
portion
of
the
debt
from
you

then
belongs
to
us.

This
does
not
af
fect
the
loss
payee’
s
right
to
collect
the
remainder
of
the
debt
from
you
.

As
an
alternative,
we
may
pay
the
loss
payee
the
remaining
principal
and
accrued
interest
in
return
for
a
full
assignment
of
the
loss
payee’
s
interest
and
any
instruments
given
as
security
for
the
debt.

If
we

choose
not
to
renew
this
policy
,
we
give
written
notice
to
the
loss
payee
at
least
10 days
before the expiration date of this policy
.

CONTRACT OF SALE
Any
loss
shall
be
adjusted
with
you
and
shall
be
payable
to
you

and
the
loss
payee
shown
on
the
schedule as
your
and their interests appear
.

The
loss
payee
shown
on
the
schedule
is
a
person
or
organization
you

have
entered
a
contract
with
for the sale of covered property
.

When
covered
property
is
the
subject
of
a
contract
of sale, the word
you
also means the loss payee.

DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 04M5A04
9 432
6 BG
L
-
77 7 (
3 .0)
C
o
py
r
i
gh
t,
2 0
07 B
r
ot
he
r
h
o
o
d M
u
t
u
a
l

In
su
r
a
n
c
e C
o
.

Pag
e
1 o
f
2 A
l
l
Ri
g
h
t
Re
se
r
v
e
d
P
R
O
V
I
S
ION M
O
DIFIC
A
T
I
ONS

PROVISION M
OD
IFI
C
A
TION -
RENT
A
L

VEHICLE PHYSIC
A
L D
A
M
A

GE COVER
A
G
E
-
M
ODIF
IED
L
I
M
I
T
OF

COV
E
R
A
GE -
We
pr
ov
i
de th
e Pr
o
v
is
i
on M
o
d
i
f
i
c
a
t
i
on des
c
r
ib
ed i
n

t
h
is

en
dor
s
em
ent
, b
ut
on
l
y
if
t
hi
s
f
or
m
(
B
G
L-
77 7)
a
nd
th
e

Non
o
wne
d

V
e
h
i
c
l
e
Co
ver
a
ge
F
o
r
m
(
B
G
L
-
71)
[or
t
h
e

B
r
oa
de
ne
d N
onow
ne
d
V
e
h
i
cl
e

C
o
ve
r
a
g
e
F
o
r
m
(
B
GL
-
71 B)
]
i
s
pr
op
er
l
y
d
es
i
gn
at
e
d in t
he
De
cl
ar
a
t
i
o
n
s
,
and

on
l
y
wit
h
r
es
p
ec
t to th
e

Re
nt
al
Ve
hic
l
e

P
h
y
s
ic
al

Dam
age A
d
d
i
t
i
o
n
a
l
Co
v
e
r
a
g
e
.

Eac
h of
the
w
or
ds
or
phr
as
es
def
in
ed
in t
he D
ef
i
n
i
t
i
o
n

s
ec
t
i
on
of
th
e Com
m
er
c
ial
Li
ab
i
l
i
t
y

Co
v
er
a
ge F
or
m

(
G
L-
10 0)
,
th
e
Li
ab
i
l
i
t
y

a
nd
Me
d
i
c
a
l C
o
ver
ag
e F
or
m

(
B
G
L
-
11)
a
nd th
e No
no
wn
ed V
e
h
i
c
l
e Co
v
e
r
a
ge F
o
r
m

(
B
G
L
-
71)
[or
th
e Br
o
a
d
e
n
ed No
no
wn
ed V
e
h
i
c
l
e

C
ov
e
r
a
ge
F
o
r
m
(
B
GL
-
7 1B
)
]

a
pply

to
thi
s

en
dor
s
em
ent
, un
l
es
s
ot
her
wis
e m
od
i
f
i
e
d her
e
i
n. T
he

fo
l
l
ow
i
ng
de
fi
ni
ti
on
s a
pply
o
n
l
y
to
t
he
P
r
ov
i
s
i
on
M
o
d
i
fi
c
a
ti
on
s
o
f thi
s
en
do
r
s
e
m
e
n
t
.

1. P
er
ve
h
i
cl
e
l
i
m
i
t
m
eans
on
l
y
t
he
am
ount
ent
er
e
d
ab
o
v
e as

t
h
e

P
E
R V
E
HI
CL
E LI
MIT
.

2. Pe
r po
lic
y p
e
r
i
od
limit
m
eans
o
nl
y

th
e
am
ount e
nter
ed a
bo
v
e as
the P
E
R
PO
L
I
C
Y
PE
R
I
O
D
LI
MI
T
.

1. M
odific
a
tion of
A
d
ditio
n
a
l
Cov
e
ra
ge
-
W
i
thin t
he
No
no
wn
ed
V
e
h
i
c
l
e
Co
ver
a
g
e
F
o
r
m
(
B
G
L
-
71)
or
,
a
l
t
er
n
at
i
v
e
l
y
,

t
he Br
o
ad
en
ed No
no
wne
d Ve
hic
l
e
Co
ver
ag
e F
or
m
(
B
G
L-
7 1
B
)
,
th
e f
ol
l
o
w
i
ng
pr
o
v
is
i
on
r
ep
l
ac
es
a
nd s
up
er
s
e
des
th
e gr
an
t of
c
o
v
er
a
ge
ent
it
l
e
d
Ve
hic
l
e R
e
n
t
a
l
V
e
h
i
c
l
e P
h
y
s
ic
a
l
D
a
m
a
ge

Co
v
e
r
a
g
e
:

R
E
N
T
A
L

VE
HI
C
L
E

PH
YSI
C
A
L

D
A
M
A
G
E

COV
E
R
A
G
E
-
We
w
i
l
l
p
a
y
f
or
p
h
y
s
ic
al
da
m
age to,
or
th
e t
ota
l
los
s
of
,

a
r
e
nte
d v
e
hi
c
l
e
re
g
a
rd
le
ss o
f

yo
u
r
li
ab
ili
t
y
,
b
u
t
o
n
l
y

if
:
a.
the
d
a
m
age t
o
,
or
t
o
t
al
l
o
s
s
of
, th
e
re
nted
ve
h
i
c
l
e
is
pr
op
er
l
y

d
oc
um
ente
d;
a
n
d
b.
the

d
am
age or
los
s
oc
c
ur
s

i
n th
e
ba
s
i
c
te
rr
ito
r
y
dur
i
ng th
e
pol
ic
y
pe
riod
.

T
h
is

P
h
y
s
ic
a
l
D
a
m
a
ge
C
o
ver
a
g
e
is

pr
im
ar
y

c
ov
er
a
ge,
s
ubj
ec
t t
o a
$2
5 0 d
ed
uc
t
i
b
le
.

We
w
i
ll pa
y
the
les
s
er
of
the
am
ount t
o r
ep
air

or
to r
ep
l
ac
e th
e

v
ehi
cle
.

We
w
i
ll
n
o
t
u
nde
r
any

c
i
rcu
m
st
a
n
ce
s p
a
y

m
or
e
than th
e
ac
t
u
al
c
as
h v
al
ue of

the v
eh
i
c
l
e, an
d wi
ll

pa
y
n
o
m
o
r
e th
an
th
e
pe
r v
e
hic
l
e
li
mit
tow
a
r
d
th
e
r
epa
ir
or
r
e
p
l
ac
em
ent of
an
y
o
ne
ve
h
i
c
l
e c
o
ver
e
d

her
e
i
n, s
u
bj
ec
t
to
th
e
pe
r
po
l
i
c
y
pe
r
i
o
d
l
i
m
i
t
s
t
at
ed i
n
the
H
o
w

Muc
h
W
e Pa
y
s
ec
t
i
on
of
th
is

en
dor
s
em
ent.

2. M
o
d
i
f
i
cat
io
n
o
f

Ho
w
M
u
ch
W
e
Pa
y
Se
ct
io
n
-
T
h
e f
o
ll
o
w
in
g pr
o
v
is
io
n r
e
p
l
ac
es
an
d s
u
per
s
e
des

th
e
Ph
y
s
ic
a
l
Dam
age
Lim
i
t pr
ov
is
io
n s
t
at
ed
in t
h
e H
o
w
Muc
h

W
e
Pa
y
s
e
c
t
io
n o
f
the Non
o
w
n
ed
Ve
hic
l
e
C
o
v
e
r
a
ge
F
o
r
m
(
B
GL
-71
)
o
r
,
al
t
e
r
n
at
ive
l
y
,

in
t
he
B
r
oa
de
ne
d N
onow
ne
d
V
e
h
i
cl
e

C
o
ve
r
a
g
e
F
o
r
m
(
B
GL
-
71 B)
:

Ph
ysi
ca
l
D
am
a
g
e L
i
m
i
t
W
e
w
i
ll

p
a
y

no
m
o
r
e
th
an

t
h
e
pe
r v
e
h
icl
e
lim
it
f
or

al
l dam
ag
e or
los
s

s
us
t
ai
ne
d b
y
a
n
y

c
o
v
er
e
d
ren
t
ed
v
eh
i
cl
e
t
o
w
h
i
c
h
t
h
e
R
e
n
t
al
Ve
hi
cle
Ph
y
s
ic
a
l
D
a
m
age C
o
ver
a
g
e
ap
pl
i
e
s
.

We
w
ill
pa
y

no
m
o
r
e
th
an
t
h
e

p
e
r p
o
li
c
y p
e
rio
d
li
m
i
t
un
der

T
his
Co
ver
ag
e E
nd
or
s
em
ent is
s
u
bj
ec
t t
o t
he
te
r
m
s
of
the C
o
m
m
er
c
i
al L
i
ab
il
it
y Co
ver
a
g
e
F
o
r
m
(
G
L-
100)
,
the

Li
ab
i
l
i
t
y
a
nd
Me
dic
al C
o
ve
r
age F
or
m
(
B
G
L-
11)
an
d t
he No
no
wn
ed
Ve
hic
l
e C
o
ver
ag
e F
or
m
(
B
G
L-
71)
[or
the
Br
o
ad
en
ed N
on
o
wne
d V
eh
i
c
l
e C
ov
er
a
ge F
or
m
(
B
G
L-
7 1B)
]
. O
n
l
y

on
e l
i
a
bi
l
it
y
c
o
v
er
ag
e (
P
r
i
nc
i
pa
l
,
Su
pp
lem
enta
l
,

o
r
Ad
di
ti
ona
l
)

w
i
ll
ap
pl
y
to
an

o
c
c
u
rr
en
ce
a
nd an
y

re
la
t
ed
lo
s
s
.

A
tt
ac
hm
ent of
this
endor
s
em
ent to the p
ol
i
c
y

wi
ll

not c
o
ver
t
t
he p
ol
i
c
y

int
o a
n
autom
obi
le p
ol
i
c
y
.
-
P
L
E
AS
E
R
E
AD
T
H
I
S
C
A
R
E
F
U
L
L
Y
-
A
G
R
E
EM
ENT
DEFI
NIT
I
ON
S
PER
VE

HICLE LIM
IT
:

PER POLICY
P
ERIOD

LIMIT
:

$180,000
$ 90,000
DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 04M5A04
9 432
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L
-
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3 .0)
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r
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u
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a
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In
su
r
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c
e C
o
.

Pag
e
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f
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i
g
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CONDIT
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OT

HER PRO
V
I
S
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EX
C
L
US
I
O
N
S
the
Re
nt
a
l

Ve
hic
l
e
P
h
y
s
ic
al
Dam
age
C
o
v
e
r
a
ge

f
o
r
al
l c
o
v
e
r
e
d R
e
n
t
a
l

Ve
hi
c
l
e
Ph
y
s
ic
a
l
D
a
m
age
los
s
e
s
oc
c
u
r
r
in
g
dur
in
g t
h
e

polic
y
p
e
riod.

Eac
h

t
he ex
c
l
us
i
o
ns

s
e
t
f
o
r
t
h in th
e Ex
c
l
us
i
ons

Sec
t
i
on
of
th
e G
L
-
1 0
0 ,
BG
L
-
11 an
d t
h
e
BG
L-
7 1
[
o
r
t
h
e

BG
L-
71 B]
wi
l
l
a
p
p
l
y
t
o
t
h
e
Pr
o
v
is
i
on
Mo
d
i
f
i
c
a
t
i
on
of

th
is
e
n
d
o
r
s
em
ent.

Eac
h

t
he Co
nd
it
i
ons

s
e
t
f
or
t
h
in th
e
C
o
n
d
i
t
i
ons

Sec
t
i
on
of
th
e G
L
-
1 0
0 ,
BG
L
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d t
h
e
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L-
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o
r
t
h
e
BG
L-
71 B]
wi
l
l
a
p
p
l
y
t
o
t
h
e
Pr
o
v
is
i
on
Mo
d
i
f
i
c
a
t
i
on
of

th
is
e
n
d
o
r
s
em
ent.

Not
h
i
ng in th
is

e
n
d
o
r
s
em
ent wil
l

ac
t
to inc
r
eas
e an
y
oth
e
r

li
m
i
t
s
of
c
o
ver
a
g
e
of
t
h
is

po
l
i
c
y
.

No
c
o
ver
a
g
e

pr
o
v
i
d
e
d

b
y
t
h
is
e
n
d
o
r
s
em
ent
u
n
l
e
s
s
t
h
e
N
o
n
o
w
n
ed

Ve
hic
l
e
Co
v
e
r
a
g
e
F
o
r
m
(
B
G
L
-
71)

or
th
e Br
oa
de
ne
d

N
o
now
n
ed

V
e
h
i
c
l
e C
o
ve
r
a
ge
F
o
r
m
(
B
GL
-
7 1B
)
i
s
i
n
c
l
ud
ed
a
s

pa
r
t
o
f

t
h
i
s
p
o
li
cy
.

Al
l
oth
e
r
pr
ov
is
io
ns
of
th
is
po
lic
y
r
e
m
a
i
n
u
n
c
h
a
n
g
e
d.

Not
h
i
n
g
i
n

th
is
e
n
dor
s
e
m
ent
wi
l
l
ac
t t
o
m
odif
y
a
n
y
te
r
m
s
of
the
po
l
i
c
y

oth
e
r
tha
n
th
e
te
rms
spe
c
i
f
ie
d
her
e
i
n.

DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10 ALAMECAL02 MORR
1/18/2023
The Church Insurance Agency Corp
210 South St, Ste 2
Bennington, VT 05201-2894
The First Liberty Ins Corp 33588
Christ Church
1700 Santa Clara Ave
Alameda, CA 94501-2515
XA
N WC6625900161013002 1/1/2023 1/1/2024 1,000,000
1,000,000
1,000,000
Proof of Insurance
Proof of Insurance
-

ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?

INSR ADDL SUBR

LTR 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 COMPENSATION

AND 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), AUTHORIZ ED 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 OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)
$
$
$
$
$
The ACORD name and logo are registered marks of ACORD
DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: A8A33904-A2AE-43FC-A3B3-6F12BF330E10

Alameda City CouncilFebruary 7, 2023

Alameda City Council
February 7, 2023