Exhibit 2 - Original Agreement — Alameda City Council, February 7, 2023

Christ Episcopal Church Alameda 1 Version 10-26-22

SERVICE PROVIDER AGREEMENT
This SERVICE PROVIDER AGREEMENT (“Agreement”) is entered into this ___ day of ________________, 2023 (“Effective Date”), by and between the CITY OF ALAMEDA, a munic
ipal corporation (“the City”), and CHRIST EPISCOPAL CHURCH A LAMEDA, a Ca
lifornia corporation, whose address is 1700 Santa Clara Avenue, Alameda, CA 94501 (“P
rovider”), in reference to the following facts and circumstances:

RECITALS
A. The C
ity is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to carry on its business as it is now being conducted under the statutes of the State of California and the Charter of the City.

B. The City is in need of the following services: Winter Warming Services. Provider was selected on a sole source basis because of their previous experience and skill in providing winter warming services to the unhoused.

C. Provider possesses the skill, experience, ability, background, certification and knowledge to provide the services described in this Agreement on the terms and conditions described herein.

D. The City and Provider desire to enter into an agreement for Winter Warming Services, upon the terms and conditions herein.

AGREEMENT
NOW, THEREFORE, in consideration of the forgoing, which are incorporated herein by reference, and for good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, the City and Provider agree as follows:

1. TERM:

The term of this Agreement shall retroactively commence on the 23 day of December 2022, and shall terminate on the 30 day of April, 2023, unless terminated earlier as set forth herein.

2. SERVICES TO BE PERFORMED:

Provider agrees to do all necessary work at its own cost and expense, to furnish all labor, tools, equipment, materials, except as otherwise specified, and to do all necessary work included in Exhibit A as requested.

Provider acknowledges that the work plan included in Exhibit A is tentative and does not commit the City to request Provider to perform all tasks included therein.

3. COMPENSATION TO PROVIDER:
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 and incorporated herein by this reference.

Use of contingency shall be for items of work outside the original scope and requires prior written authorization by the City.

4. TIME IS OF THE ESSENCE:

Provider and the City agree that time is of the essence regarding the performance of this Agreement.

5. STANDARD OF CARE:

Provider agrees to perform all services hereunder in a manner commensurate with the prevailing standards of like professionals or service providers, as applicable, in the San Francisco Bay Area and agrees that all services shall be performed by qualified and experienced personnel who are not employed by the City.

6. INDEPENDENT PARTIES:

Provider hereby declares that Provider is engaged as an independent business and Provider agrees to perform the services as an independent contractor. The manner and means of conducting the services and tasks are under the control of Provider except to the extent they are limited by statute, rule or regulation and the express terms of this Agreement. No civil service status or other right of employment will be acquired by virtue of Provider ’s services. None of the benefits provided by the City to its employees, including but not limited to unemployment insurance, workers’ compensation plans, vacation and sick leave, are available from the City to Provider, its employees or agents. Deductions shall not be made for any state or federal taxes, FICA payments, PERS payments, or other purposes normally associated with an employer-employee relationship from any compensation due to Provider. Payments of the above items, if required, are the responsibility of Provider.

7. IMMIGRATION REFORM AND CONTROL ACT (IRCA):

Provider assumes any and all responsibility for verifying the identity and employment authorization of all of its employees performing work hereunder, pursuant to all applicable IRCA or other federal, or state rules and regulations. Provider shall indemnify, defend, and hold the City
harmless from and against any loss, damage, liability, costs or expenses arising from any noncompliance of this provision by Provider.

8. NON-DISCRIMINATION:

Consistent with the City ’s policy and state and federal law that harassment and discrimination are unacceptable conduct, Provider and its employees, contractors, and agents shall not harass or discriminate against any job applicant, City employee, or any other person on the basis of any kind of any statutorily (federal, state or local) protected class, including but not limited to: race, religious creed, color, national origin, ancestry, disability (both mental and physical) including HIV and AIDS, medical condition (e.g.
cancer), genetic information, marital status, sex,
gender, gender identity, gender expression, age, sexual orientation, pregnancy, political affiliation, DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500

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military and veteran status or legitimate union activities. Provider agrees that any violation of this provision shall constitute a material breach of this Agreement.

9. HOLD HARMLESS:
a. To the fullest extent permitted by law, Provider shall indemnify, defend (with counsel acceptable to the City) and hold harmless the City, its City Council, boards, commissions, officials, employees, agents and volunteers (“Indemnitees”) from and against any and all loss, damages, liability, obligations, claims, suits, judgments, costs and expenses whatsoever, including reasonable attorney ’s fees and costs of litigation (“Claims”), arising from or in any manner connected to Provider’s performance of its obligations under this Agreement or out of the operations conducted by Provider even if the City is found to have been negligent . If the Claims filed against Indemnitees alleg e negligence, recklessness or willful misconduct on the part of Provider, Provider shall have no right of reimbursement against Ind emnitees for the costs of defense even if negligence, recklessness or willful misconduct is not found on the part of Provider.

Provider shall not have any obligations to indemnify Indemnitees if the loss or damage is found to have resulted solely from the negligence or the willful misconduct of the City. The defense and indemnification obligations of this Agreement are undertaken in addition to, and shall not in any way be limited by, the insurance obligations contained in this Agreement. b. As to Claims for professional liability only, Provider’s obligation to defend Indemnitees (as set forth above) is limited as provided in California Civil Code Section 2782.8. c. Provider’s obligation to indemnify, defend and hold harm less Indemnities shall expressly survive the expiration or early termination of this Agreement.

10. INSURANCE:
a. On or before the commencement of the terms of this Agreement, Provider shall furnish the City ’s Risk Manager with certificates showing the type, amount, class of operations covered, effective dates and dates of expiration of insurance coverage in compliance with Sections

10.b. (1) through (5) Such certificates, which do not limit Provider ’s indemnification, shall also contain substantially the following statement:
“Should any of the above insurance covered by this certificate be canceled or coverage reduced before the expiration date thereof, the insurer affording coverage shall provide thirty ( 30) days’ advance written notice to the City of Alameda.

Attention: Risk Manager.”
Provider shall maintain in force at all times during the performance of this Agreement all appropriate coverage of insurance required by this Agreement with an insurance company licensed to offer insurance business in the State of California with a current A.M. Best’s rating of no less than A:VII or Standard & Poor’s Rating (if rated) of at least BBB unless otherwise acceptable to the City. Provider shall deliver updated insurance ce
rtificates to the City at the address described
in Section 17.f. prior to the expiration of the existing insurance certificate for the duration of the term of Agreement. Endorsements naming the City, its City Council, boards, commissions, officials, employees, agents, and volunteers
as additional insured shall be submitted with the
insurance certificates.

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_____________
Provider Initials
b. COVERAGE REQUIREMENTS:

Provider shall maintain insurance coverage and limits at least as broad as:
(1) Workers ’ Compensation:

Statutory coverage as required by the State of California. (2) Liability:

Commercial general liability coverage in the following minimum limits:

Bodily Injury: $1,000,000 each occurrence
$2,000,000 aggregate - all other
Property Damage: $1,000,000 each occurrence
$2,000,000 aggregate
If submitted, combined single limit policy with per occurrence limits in the amounts of $2,000,000 and aggregate limits in the amounts of $4,000,000 will be considered equivalent to the required minimum limits shown above. Additional Insured Endorsement naming the City, its City Council, boards, commissions, officials, employees, agents, and volunteers is required. (3) Automotive:

Comprehensive automobile liability coverage (any auto) in the following minimum limits:

Bodily injury: $1,000,000 each occurrence
Property Damage: $1,000,000 each occurrence
or
Combined Single Limit: $
2,000,000 each occurrence
Additional Insured Endorsement naming the City, its City Council, boards, commissions, officials, employees, agents, and volunteers is required.

As to commercial general liability and automobile liability insurance, such insurance will provide that it constitutes primary insurance with respect to claims insured by such policy, and, except with respect to limits, that insurance applies separately to each insured against whom claim is made or suit is brought. Such insurance is not additional to or contributing with any other insurance carried by or
for the benefit of the City.
c. SUBROGATION WAIVER:

Provider hereby agrees to waive rights of subrogation that any insurer of Provider may acquire from Provider by virtue of the payment of any loss. Provider agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether the City has received a waiver of subrogation endorsement from the insurer. The Workers’ DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500

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Compensation policy shall be endorsed with a waiver of subrogation in favor of the City for all work performed by Provider, its employees, agents and subcontractors.

d. FAILURE TO SECURE:

If Provider at any time during the term hereof should fail to secure or maintain the foregoing insurance, the City shall be permitted to obtain such insurance in Provider’s name or as an agent of Provider and shall be compensated by Provider for the costs of the insurance premiums at the maximum rate permitted by law and computed from the date written notice is received that the premiums have not been paid.
e. ADDITIONAL INSUREDS:

The City, its City Council, boards, commissions, officials, employees, agents, and volunteers shall be named as additional insured(s) under all insurance coverages, except workers’ compensation and professional liability insurance. The naming of an additional insured shall not affect any recovery to which such additional insured would be entitled under this policy if not named as such additional insured. An additional insured named herein shall not be held liable for any premium, deductible portion of any loss, or expense of any nature on this policy or any extension thereof. Any other insurance held by an additional insured shall not be required to contribute anything toward any loss or expense covered by the insurance provided by this policy.

Additional Insured coverage under Provider’s policy shall be primary and non -contributory and will not seek contribution from the City’s insurance or self -insurance.

Any available insuranc e
proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits shall be available to the additional insured(s).

E. SUFFICIENCY OF INSURANCE:

The insurance limits required by the City are not represented as being sufficient to protect Provider. Provider is advised to consult Provider ’s insurance broker to determine adequate coverage for Provider. The coverage and limits shall be (1) the minimum coverage and limits specified in this Agreement; or (2) the broader coverage and maximum limits of the coverage carried by or available to Provider; whichever is greater.

11. CONFLICT OF INTEREST:

Provider warrants that it is not a conflict of interest for Provider to perform the services required by this Agreement. Provider may be required to fill out a conflict of interest form if the services provided under this Agreement require Provider to make certain governmental decisions or serve in a staff capacity as defined in Title 2, Division 6, Section 18700 of the California Code of Regulations.

12. PROHIBITION AGAINST TRANSFERS:
a. Provider shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest therein, directly or indirectly, by operation of law or otherwise, without prior written consent of the City Manager. Provider shall submit a written request for consent to transfer to the City Manager at least thirty (30) days in advance of the desired transfer. The City Manager or their designee may consent or reject such request in their sole and absolute discretion. Any attempt DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500

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to do so without said consent shall be null and void, and any assignee, sublessee, hypothecate or transferee shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. However, claims for money against the City under this Agreement may be assigned by Provider to a bank, trust company or other financial institution without prior written consent. b. The sale, assignment, transfer or other disposition of any of the issued and outstanding capital stock, membership interest, partnership interest, or the equivalent, which shall result in changing the control of Provider, shall be construed as an assignment of this Agreement.

Control means fifty percent or more of the voting power of Provider.

13. APPROVAL OF SUB-PROVIDERS:
a. Only those persons and/or businesses whose names and resumés are attached to this Agreement shall be used in the performance of this Agreement. However, if after the start of this Agreement, Provider wishes to use sub-providers, at no additional costs to the City, then Provider shall submit a written request for consent to add sub-providers including the names of the sub- providers and the reasons for the request to the City Manager at least five (5) days in advance. The City
Manager may consent or reject such requests in their sole and absolute discretion. b. Each sub-provider shall be required to furnish proof of workers ’ compensation insurance and shall also be required to carry general, automobile and professional liability insurance (as applicable) in reasonable conformity to the insurance carried by Provider. c. In addition, any tasks or services performed by sub-providers shall be subject to each provision of this Agreement.

Provider shall include the following language in their agreement with any sub-provider: “Sub-providers hired by Provider agree to be bound to Provider and the City in the same manner and to the same extent as Provider is bound to the City.” d. The requirements in this Section 13 shall not apply to persons who are merely providing materials, supplies, data or information that Provider then analyzes and incorporates into its work product.

14. PERMITS AND LICENSES:

Provider, at its sole expense, shall obtain and maintain during the term of this Agreement, all appropriate permits, certificates and licenses, including a City b usiness license that may be required in connection with the performance of the services and tasks hereunder.

15. REPORTS:
a. Each and every report, draft, work product, map, record and other document produced, prepared or caused to be prepared by Provider pursuant to or in connection with this Agreement shall be the exclusive property of the City.
b.

No report, information or other data given to or prepared or assembled by Provider pursuant to this Agreement shall be made available to any individual or organization by Provider without prior approval of the City
Manager or their designee.
c. Provider shall, at such time and in such form as City Manager or their designee may DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500

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require, furnish reports concerning the status of services and tasks required under this Agreement.

16. RECORDS:
a. Provider shall maintain complete and accurate records with respect to the services, tasks, work, documents and data in sufficient detail to permit an evaluation of Provider’s performance under the Agreement, as well as maintain books and records related to sales, costs, expenses, receipts and other such information required by the City that relate to the performance of the services and tasks under this Agreement
(collectively the “Records”).
b. All Records shall be maintained in accordance with generally accepted accounting principles and shall be clearly identified and readily accessible. Provider shall provide free access to the Records to the representatives of the City or its designees during regular business hours upon reasonable prior notice. The City has the right to examine and audit the Records, and to make copies or transcripts therefrom as necessary, and to allow inspection of all proceedings and activities related to this Agreement. Such Records, together with supporting documents, shall be kept separate from other documents and records and shall be maintained by Provider for a period of three (3) years after receipt of final payment.
c. If supplemental examination or audit of the Records is necessary due to concerns raised by the City ’s preliminary examination or audit of records, and the City ’s supplemental examination or audit of the records discloses a failure to adhere to appropriate internal financial controls, or other breach of this Agreement or failure to act in good faith, then Provider sha ll reimburse the City for all reasonable costs and expenses associated with the supplemental examination or audit.

17. NOTICES:
a. All notices shall be in writing and delivered: (i) by hand; or (ii) sent by registered, express, or certified mail, with return receipt requested or with delivery confirmation requested from the U.S. postal service; or (iii) sent by overnight or same day courier service at the party’s respective address listed in this Section.
b.

Each notice shall be deemed to have been received on the earlier to occur of: (x) actual delivery or the date on which delivery is refused; or (y) three (3) days after notice is deposited in the U.S. mail or with a courier service in the manner described above (Sundays and City holidays excepted).
c. Either
party may, at any time, change its notice address (other than to a post office box address) by giving the other party three (3) days prior written notice of the new address. d. All notices, demands, requests, or approvals from Provider to the City shall be addressed to the City at:

City ofAlameda
Community Development Department
950 West Mall Square Suite 205
Alameda, CA 94501
ATTENTION: Lois Butler
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Ph: (510)747-6894 / [email protected]
e. All notices, demands, requests, or approvals from the City to Provider shall be addressed to Provider at:

Christ Episcopal Church Alameda
1700 Santa Clara Avenue
Alameda, CA 94501
ATTENTION: The Rev. Stephen McHale
Ph: (510) 523-7200 / [email protected]

f. All updated insurance certificates from Provider to the City shall be addressed to the City at:

City ofAlameda
Community Development Department
950 West Mall Square Suite 205
Alameda, CA 94501
ATTENTION: Annie Cox
Ph: (510) 747-6893 / [email protected]

18. SAFETY:
a. Provider will be solely and completely responsible for conditions of all vehicles owned or operated by Provider, including the safety of all persons and property during performance of the services and tasks under this Agreement. This requirement will apply continuously and not be limited to normal working hours. In addition, Provider will comply with all safety provisions in conformance with U.S. Department of Labor Occupational Safety and Health Act, any equivalent state law, and all other applicable federal, state, county and local laws, ordinances, codes, and any regulations that may be detailed in other parts of the Agreement. Where any of these are in conflict, the more stringent requirements will be followed. Provider’s failure to thoroughly familiarize itself with the aforementioned safety provisions will not relieve it from compliance with the obligations and penalties set forth herein. b.

Provider will immediately notify the City within 24 hours of any incident of death, serious personal injury or substantial property damage that occurs in connection with the performance of this Agreement. Provider will promptly submit to the City a written report of all incidents that occur in connection with this Agreement. This report must include the following information: (i) name and address of injured or deceased person(s); (ii) name and address of Provider’s employee(s) involved in the incident; (iii) name and address of Provider’s liability insurance carrier; (iv) a detailed description of the incident; and (v) a p olice report.

19. TERMINATION:
a. In the event Provider fails or refuses to perform any of the provisions hereof at the time and in the manner required hereunder, Provider shall be deemed in default in the performance of this Agreement. If such default is not cured within two (2) business days after receipt by Provider from the City of written notice of default, specifying the nature of such default and the DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500

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steps necessary to cure such default, the City may thereafter immediately terminate the Agreement forthwith by giving to Provider written notice thereof. b. The foregoing notwithstanding, the City shall have the option, at its sole discretion and without cause, of terminating this Agreement by giving seven (7) days’ prior written notice to Provider as provided herein.
c. Upon termination of this Agreement either for cause or for convenience, each party shall pay to the other party that portion of compensation specified in this Agreement that is earned and unpaid prior to the effective date of termination. The obligation of the parties under this Section 19.c. shall survive the expiration or early termination of this Agreement.

20. ATTORNEYS’ FEES AND COSTS:

In the event of any litigation, including administrative proceedings, relating to this Agreement, including but not limited to any action or suit by any party, assignee or beneficiary against any other party, beneficiary or assignee, to enforce, interpret or seek relief from any provision or obligation arising out of this Agreement, the parties and litigants shall bear their own attorney’s fees and costs. No party or litigant shall be entitled to recover any attorneys’ fees or costs from any other party or litigant, regardless of which party or litigant might prevail.

21. HEALTH AND SAFETY REQUIREMENTS.

Provider acknowledges that the City shall have the right to impose, at the City’s sole discretion, requirements that it deems are necessary to protect the health and safety of the City employees, residents, and visitors. Provider agrees to comply with all such requirements, including, but not limited to, mandatory vaccinations, the use of personal protective equipment (e.g. masks), physical distancing, and health screenings. Provider also agrees to make available to the City, at the City’s request, records to demonstrate Provider’s compliance with this Section. [See Certification of Compliance attached.]

22. COMPLIANCE WITH ALL APPLICABLE LAWS:

During the term of this Agreement, Provider shall keep fully informed of all existing and future state and federal laws and all municipal ordinances and regulations of the City of Alameda which affect the manner in which the services or tasks are to be performed by Provider, as well as all such orders and decrees of bodies or tribunals having any jurisdiction or authority over the same.

Provider shall comply with all applicable laws, state and federal and all ordinances, rules and regulations enacted or issued by the City.

23. CONFLICT OF LAW:

This Agreement shall be interpreted under, and enforced by the laws of the State of California without regard to any choice of law rules which may direct the application of laws of another jurisdiction. The Agreement and obligations of the parties are subject to all valid laws, orders, rules, and regulations of the authorities having jurisdiction over this Agreement (or the successors of those authorities). Any suits brought pursuant to this Agreement shall be filed with the courts of the County of Alameda, State of California.

24. WAIVER:

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A waiver by the City of any breach of any term, covenant, or condition contained herein shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant, or condition contained herein, whether of the same or a different character.

25. INTEGRATED CONTRACT:

Subject to the language of Section 30 , the Recitals and exhibits are a material part of this Agreement and are expressly incorporated herein. This Agreement represents the full and complete understanding of every kind or nature whatsoever between the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or nature are merged herein. No verbal agreement or implied covenant shall be held to vary the provisions hereof. Any modification of this Agreement will be effective only by written execution signed by both the City and
Provider.

26. CAPTIONS:

The captions in this Agreement are for convenience only, are not a part of the Agreement and in no way affect, limit or amplify the terms or provisions of this Agreement.

27. COUNTERPARTS:

This Agreement may be executed in any number of counterparts (including by fax, PDF, DocuSign, or other electronic means), each of which shall be deemed an original, but all of which shall constitute one and the same instrument.

28. SIGNATORY :

By signing this Agreement, signatory warrants and represents that they executed this Agreement in their authorized capacity and that by their signature on this Agreement, they or the entity upon behalf of which
they acted, executed this Agreement.

29. CONTROLLING AGREEMENT:

In the event of a conflict between the terms and conditions of this Agreement (as amended, supplemented, restated or otherwise modified from time to time) and any other terms and conditions wherever contained, including, without limitation, terms and conditions included within exhibits, the terms and conditions of this Agreement shall control and be primary.

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IN WITNESS WHEREOF, the parties have each caused this Agreement to be duly executed on its behalf as of the Effective Date.

CITY OF ALAMEDA CHRIST EPISCOPAL CHURCH

ALAMEDA
a (California corporation
a municipal corporation
The Reverend Stephen McHale
Chief Executive Officer
Jennifer Ott
City Manager

RECOMMENDED FOR APPROVAL
Nancy Salamy
Secretary
Lisa Maxwell
Community Development Department
APPROVED AS TO FORM:

City Attorney
Len Aslanian
Assistant City Attorney
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Certification of Compliance
With the City of Alameda’s Vaccination Requirement

The City of Alameda (“City”) requires all individuals who perform work for the City to be fully vaccinated1 against COVID-19. All service providers and contractors for the City must sign the following statement certifying compliance with this requirement.

By signing below, I certify that all of our personnel who are performing work for the City are fully vaccinated against COVID-19. I also acknowledge that the City reserves the right to review any relevant records to demonstrate our compliance with this requirement.

I declare under penalty of perjury that the foregoing is true and correct.

Christ Episcopal Church Alameda Date:______________________

__________________________________
By: Stephen McHale
Its Chief Executive Officer

1 For the purposes of this Certification of Compliance, an individual is considered to be fully vaccinated if two weeks have passed since their second dose in a 2-dose series (such as the Pfizer or Moderna vaccines) or if two weeks have passed since receiving their single-dose vaccine (such as Johnson & Johnson’s Janssen vaccine).

DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 12/21/2022
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EXHIBIT A
City of Alameda
Community Development Department
Provider Scope of Work

PROVIDER: Christ Episcopal Church
SUBCONTRACTOR: Housing Consortium of the East Bay (HCEB) PROGRAMS: Winter Warming Services
CLIENTS TO BE SERVED: Up to 20 individuals per overnight service CONTRACT AMOUNT: $70,000
CONTRACT PERIOD: December 23, 2022 to April 30, 2023
SCOPE OF WORK:

I. Definitions
Winter Warming Services: provides individuals experiencing homelessness with indoor shelter on scheduled days during the months in which inclement weather is anticipated. In addition, scheduled days, Winter Warming Services provides two meals per day and access to support including referrals to resources.

Homeless Individuals: an individual with a primary nighttime residence that is a public or private place not designed for or ordinarily use as a regular sleeping accommodation for human beings, such as in a car, park, tent, or abandoned building, or on a bus or train.

II. S ervices to be Provided
PROVIDER with the support of SUBCONTRACTOR, shall implement the Winter Warming Center program serving homeless individuals. Under this Agreement, SUBCONTRATOR will provide direct services to clients, coordinate programs and activities, and operate the Winter Warming Center.

The shelter will operate from 5:00 PM to 7:00 AM every Monday, Wednesday, and every Friday for a total of three nights per week.

At the minimum PROVIDER will ensure that the following service components will be provided by the SUBCONTRACTOR:
a. Serve a minimum of 20 unduplicated homeless individuals per week. Warming Center capacity is 20 guests per night.
b. Adhere to the Core Principles (Attachment A) established for the program that prioritize a housing first model, harm reduction approach, trauma informed care, and cultural competency, racial equity, and inclusivity in all facets of governance, operation, management, and service provision.
c. Provide a welcoming, safe, sanitary, and inclusive environment for all participants and guests from all walks of life, regardless of race, creed, gender identity, color or religion. Any person in need: men, women, LGBTQ, is welcome to receive services without judgment. d. Develop a clearly defined staffing plan and reporting responsibilities to support planned activities and programs.

PROVIDER (Christ Episcopal Church)
From 5pm-8pm:

1. Dinner Preparation and Service Volunteers

2. Shower Service Volunteers
SUBCONTRACTOR (HCEB):

From 4pm-midnight:

1. Program Manager Service Coordinator x1

2. Shelter Staff x1
From Midnight – 8am:

1. Shelter Staff x2

g. On open nights and mornings, shelter operating hours will be 5:00 pm to 7:00 am. h. On open nights, from 4:00 pm to 5:00 pm conduct cleaning and sanitizing and set up sleeping arrangements prior to open hours.

1. Floor swept and mopped

2. Kitchen surfaces wiped down and sanitized daily at end of open hours.

3. Restrooms wiped down and sanitized daily at end of open hours. i. On open mornings, from 7:00 am to 8:00 am, take down bedding, clean and sanitize after open hours.

1. Walk the entire property at the end of shift and report any vandalism or debris to Church staff.
j. Serve two meals: dinner and breakfast and offer showers to guests.

1. Shower service and Dinner to be coordinated by PROVIDER volunteers.

2. Shower service is restricted to overnight guests.

3. Dinner service will follow COVID food handling protocol. k. Enroll walk-in participants onsite for immediate services. Accept referrals from Alameda Police Department, Village of Love, 211, and Coordinated Entry. l. Provide sleeping arrangements.
m. Connect with service providers and provide service referrals as needed. Outreach for services available at the Day Center for daytime shelter.
n. Enroll program in County HMIS and provide housing problem solving and coordinated entry system services for all guests.
o. Develop, coordinate, implement, oversee, and evaluate Winter Warming Center operations, programs, and services. Services many include, but are not limited to, the following: intake, meals, information and referral, case management, showers, access to computers, housing navigation, etc.
p. Ensure that the Winter Warming Center follows all Alameda County Department of Public Health COVID-19 health and safety protocols.

1. Current County guidelines require shelter settings to provide onsite isolation and quarantine.

2. SUBCONTRACTOR will establish isolation and quarantine arrangements as needed.

3. SUBCONTRACTOR shall test all guests weekly on Friday evenings, using a rapid antigen test. If a guest is not present on Friday, they will be tested on the following Monday evening. All positive test results will be reported to Alameda Public Health and appropriate isolation and quarantine protocols will be followed.

4. Kitchen surfaces wiped down and sanitized daily at end of open hours.

5. Restrooms wiped down and sanitized daily at end of open hours.

Rules: Below is a condensed sample list of rules that PROVIDER with the support of SUBCONTRACTOR will communicate to and enforces with guests:

To keep order in the Warming Shelter we ask that everyone respect one another and their space:

1. Food and Drink: Guests are not permitted to bring outside food or drink into the building. No exceptions.

2. All overnight guests will be expected to keep their area clean.

3. No weapons will be allowed in or on property.

4. No Alcohol or drugs are allowed in or around the building. No smoking in the building. The use of drugs or alcohol on the property will lead to immediate eviction from property.

5. No abuse of staff or other guests. Threatening or violent behavior towards anyone in the building will not be tolerated. Bullying of any type will not be tolerated. Noncompliance can lead to a suspension of services for up to 30 days.

6. No viewing of inappropriate images or movies allowed on the property.

7. Clothing must be worn while sleeping.

8. No disturbing the peace. Once checked in for services, guests are expected to stay in. If a guest chooses to leave, guests will not be allowed back in.

9. Derogatory comments regarding race, creed, color, ethnic background, religion, or sexuality will not be tolerated.

10. One bag per person will be allowed for storage. The Provider and Subcontractor are not responsible for lost or stolen property.

11. Carts can be stored overnight behind the fence at the rear of the parking lot. All shopping carts must be removed in the morning when the Warming Center closes. Any belongings remaining after 7 am will be disposed of.

12. One approved pet per guest is allowed. Guests are responsible for the behavior of their pet and the pet must be always under the control of the guest. Leashes are required. If a pet’s behavior disrupts Warming Center operations or harms another guest of staff member, the guest and their pet may be asked to vacate the premises. A pet’s behavior in violation of the program rules can lead to a suspension of services for up to 30 days.

13. No food or drink allowed in the sleeping area.

14. All guests will be expected to remain law abiding.

15. Lights out and quiet time at 11 PM.

16. Guests will complete brief program intake and HMIS intake forms and provide signature acknowledging they understand the rules.

17. If guests are not satisfied with any aspect of the program operations, they are encouraged to present their concerns to the HCEB Program Manager. The Program Manager will respond to all concerns in a timely basis. If the guest is not satisfied with the Program Manager response, they can submit a formal grievance to the HCEB Director of Programs for the Unhoused. The HCEB Grievance Form is attached as Attachment C and will be provided to all guests upon request.

III. Program Evaluation and Reporting Requirements

a. PROVIDER shall submit monthly reports no later than 10 days after the end of the month being reported. Monthly reports will include, at the minimum, the following data elements:
• Number of clients served
• Demographic information of clients
• Description of services and resources provided
• Other information that will help in the evaluation of the program • Copies of all Grievance forms.
b. PROVIDER shall participate in the evaluation of the program to help identify areas that will improve service delivery, program effectiveness, and client outcomes. PROVIDER will implement program improvement strategies identified in the evaluation. Evaluation criteria will include approaches identified by the PROVIDER in its response to the Request for Proposal issued by the CITY.
c. PROVIDER shall submit a final narrative report no later than 15 days after the completion of the contract. The report shall include a narrative accounting of the progress achieved toward the Scope of Work.
d. PROVIDER shall make good faith efforts to provide other information, as requested by the City, in a timely manner.

GRAND TOTAL
*$70,000 Permanent Local Housing Allocation (PLHA) Funds Community Activities
COVID-Related Expenses

SUBTOTAL

TOTAL DIRECT COSTS
Operations
Initial Technology
Isolation and Quarantine Supplies
Linens, etc.

Direct Client Expenses
Cleaning Supplies

PROFESSIONAL SERVICES BUDGET
Grantee Name: HCEB
Alameda Warming Center
I. DIRECT COSTS
A. PERSONNEL
Exhibit B
DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 Attachment A
Core Principles
Housing First
According
to the webinar Core Principles of Housi ng First and Rapid Re-Housing issued by HUD and the Unites States In teragency Council on Homelessness (USICH), the Housing First approach is based on the following principles:

1. Housing is safe and affordable;

2. All people can achieve housing stability in permanent housing; supports may look different;

3. Everyone is “housing ready”; and

4. Improved quality of life, health, mental health, and employm ent can be achieved through housing.

Harm Reduction
Harm reduction policies, procedur es, and practices aim to reduc e the negative consequences of behaviors that are detrimental to the participant’s health and well-being (i.e., abuse of drugs and/or alcohol, failure to be medicati on compliant, engaging in crimin al activity, prostitution, choosing to sleep outside, etc.). In housing settings, harm reduction is intended to prevent a participant’s loss of housing and/or termination from the program based solel y on his or her inability to stop engaging in harmful behaviors.

Programs incorporating a harm reduction model must utilize all interventions possible, short of termination from the program, to enable the participant to reduce or minimize their risky behaviors, while at the same time assisting them to move into and become s tabilized in permanent housing.

Harm reduction is not intended to prevent the termination of a participant whose actions or behavior constitute a threat to the safety of other participants and staff. Organizations must develop a set of policies and procedures to be implemented in the event of such behavior on the part of a participant.

Trauma-Informed Care
Trauma-informed care requires that every part of the program’s design and operation be approached with an understanding of trauma and the impact it ha s on those receiving services.

Traumatic experiences can impact how clients receive services p rovided and the environment in which those services are delivered.

Establishing a safe and supportive environment are principal aspects of trauma-informed care. To do so, a program must ensure th at all staff receive training on traumatic stress and its impact, as well as the relationship between trauma and mental health, subs tance use, and homelessness.

Training should detail how working with trauma survivors can impact staff, and how these issues can impact their work. Staff training in crisis management may include learning how to help clients identify triggers, express their feelings safely, use healthy c oping skills, in addition to helping clients develop safety and self-care plans prior to a crisis.

Cultural Competency, Racial Equity, and Inclusivity
This program must consider cultural and linguistic competency, racial equity, gender inclusivity, DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 and other intersecting factors in addressing the needs of popul ations to be served. Subpopulation identities may include, but are not limited to, race and ethnicity, gender and gender identity, sexual orientation, economic class, age, family status, language spoken and understood, physical and mental disabilities, living situation, etc. Proposers must demonstrate the capacity to accommodate special populations within the proposer’s general population (i.e., youth, LGBT, disabled clients, veterans, victims of domestic v iolence) throughout all levels o f the organization, from organizational vision and mission statement, to policy implemen tation, and to service delivery procedures and philosophies. The Safe Parking Program requires, at a minimum, effective communication, including, among other things, the provision of service and information in appropriate language, at appropria te educational and literacy levels, and in the context of the individual’s cultural identity.

Permanent Local Housing Allocation
Final Guidelines

Gavin Newsom, Governor
State of California

Alexis Podesta, Secretary
Business, Consumer Services and Housing Agency
Douglas R. McCauley, Acting Director
California Department of Housing and Community Development

2020 West El Camino Avenue, Suite 150
Sacramento, CA 95833
October 2019

Department of Housing and Community Development 2 2019 PLHA Final Guidelines

The matters set forth herein are regulatory mandates, and are adopted in accordance with the authorities set forth below:

Quasi-legislative regulations … have the dignity of statutes … [and]… delegation of legislative authority includes the power to elaborate the meaning of key statutory terms… Ramirez v. Yosemite Water Co., 20 Cal. 4th 785, 800 (1999)

In consultation with stakeholders, the California Department of Housing and Community Development (Department) may adopt Guidelines to implement this Section, including determining allocation methodologies. Any guideline, rule, policy, or standard of general application employed by the Department in implementing this chapter shall not be subject to the requirements of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Title 2 Government Code, Part 1 of Division 3).

NOTE: Authority Cited: Health and Safety Code Section 50470, subdivision (d).

The Department reserves the right, at its sole discretion, to suspend or amend the provisions of these Guidelines, including, but not limited to, grant award amounts.

Department of Housing and Community Development 3 2019 PLHA Final Guidelines

INTRODUCTION

Chapter 364, Statutes of 2017 (SB 2, Atkins) was part of a 15-bill housing package aimed at addressing the state’s housing shortage and high housing costs. Specifically, it establishes a permanent source of funding intended to increase the affordable housing stock in California. The revenue from SB 2 will vary from year to year, as revenue is dependent on real estate transactions with fluctuating activity. The legislation directs the California Department of Housing and Community Development (Department) to use 70 percent of the revenue collected, beginning in calendar year 2019, to provide financial assistance to local governments for eligible housing-related projects and programs to assist in addressing the unmet housing needs of their local communities. This program is hereafter referred to as the Permanent Local Housing Allocation (PLHA) program.

Guidelines for the PLHA program are organized into five Articles as follows:

Article I. General provisions: This article includes information on the purpose of the Guidelines, program objectives, and definitions used throughout the document.

Article II. Program funding: This article describes allocation formulas and methodologies, and award amounts.

Article III. Formula allocation component: This article describes the requirements for Applicants to apply for funds under the formula allocation of the PLHA program.

Article IV. Competitive allocation component: This article describes requirements and uses for PLHA competitive allocation funds.

Article V. Administration: This article describes administrative functions such as terms, non-performance remedies, and reporting and monitoring requirements.

DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 Department of Housing and Community Development 4 2019 PLHA Final Guidelines Permanent Local Housing Allocation (PLHA) Program:
2019 Guidelines
Table of Contents
ARTICLE I. GENERAL PROVISIONS 5
Section 100. Purpose and Scope 5
Section 101. Definitions 5
ARTICLE II. PROGRAM FUNDING 9
Section 200. Allocations 9
Section 201. Award Amounts 10
ARTICLE III. FORMULA ALLOCATION COMPONENT 11
Section 300. Eligible Applicants 11
Section 301. Eligible Activities 12
Section 302. Threshold Requirements 13
Section 303. Application Review 16
Section 304. Deadlines and Funding Requirements 17
ARTICLE IV. COMPETITIVE ALLOCATION COMPONENT 17
Section 400. Eligible Applicants 17
Section 401. Eligible Activities 18
Section 402. Threshold Requirements 18
Section 403. Selection Criteria 20
Section 404. Application Review 22
Section 405. Deadlines and Funding Requirements 23
ARTICLE V. ADMINISTRATION 23
Section 500. Accounting Records 23
Section 501. Audits/Monitoring of Project Files 24
Section 502. Cancellation and Termination 25
Section 503. Reporting 26
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Department of Housing and Community Development 5 2019 PLHA Final Guidelines

ARTICLE I. GENERAL PROVISIONS

Section 100. Purpose and Scope
(a) These Guidelines (hereinafter “Guidelines”) implement, interpret, and make specific Chapter 364, Statutes of 2017 (SB 2, Atkins - hereinafter “SB 2”) as authorized by Health and Safety Code (HSC) Section 50470, which created the Building Homes and Jobs Trust Fund and the PLHA program. The principal goal of this program is to make funding available to eligible local governments in California for housing-related projects and programs that assist in addressing the unmet housing needs of their local communities. Twenty percent of the funding in the Building Homes and Jobs Trust Fund is required to be expended for Affordable Owner-Occupied Workforce Housing, and the program prioritizes investments that increase the supply of housing to households that are at or below 60 percent of the Area Median Income (AMI), adjusted for household size.

(b) These Guidelines establish terms, conditions, and procedures for local governments to submit applications to the Department for funds from the PLHA program’s three components, as listed below:
(1) Entitlement formula component per HSC 50470(b)(2)(B)(i)(I)

(2) Non-entitlement formula component per HSC 50470(b)(2)(B)(i)(II) (3) Non-entitlement competitive grant program component per HSC 50470(b)(2)(B)(i)(I) (eligible Applicants are the same as for component 2 above)

(c) The non-entitlement competitive grant program component prioritizes assistance to persons experiencing or At risk of homelessness.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(A), subdivision (b)(2)(B)(i) and subdivision (b)(2)(B)(ii)(I-V).

Section 101. Definitions
All terms not defined below shall, unless their context suggests otherwise, be interpreted in accordance with the meanings of terms described in HSC Section 50470.

(a) “Accessory dwelling unit” (ADU) means a dwelling unit which is attached, detached or located within the living area of the existing dwelling or residential dwelling unit and which provides complete independent living facilities for one or more persons pursuant to Government Code (GC) Section 65852.2 and 65852.22. It shall include permanent provisions for living, sleeping, eating, cooking, and sanitation on the same parcel as the single-family dwelling. An Accessory dwelling unit also includes the following: an efficiency unit, as defined in Section 17958.1 of the HSC, or a manufactured home, as DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500

Department of Housing and Community Development 6 2019 PLHA Final Guidelines

defined in Section 18007 of the HSC.

(b) "Activity" means any single eligible undertaking carried out as part of an Applicant's allocation(s) under the Program.
(c) “Affordable” means a housing unit that satisfies at least one of the following criteria:

1. If the unit is being rented to low-income, Very low-income or Extremely low-income households, it complies with the Multifamily Housing Program guidelines Section 7312 and the Section 7301 definition of “Affordable Rent”; or

2. If the unit is being sold, it is offered at an “Affordable housing cost”, as published in the Fannie Mae Selling Guide, Part B, Debt to Income Ratios, as updated annually
(https://www.fanniemae.com/content/guide/selling/b3/6/02.html#DTI.20Rat ios), and it complies with the income limits stated in the definitions of Moderate-Income and Lower-Income in this section; or

3. If the unit is being rented to Moderate-Income households, it is available at a gross rent, including a utility allowance, that does not exceed 30 percent of the applicable income eligibility level, and complies with the definition of Moderate-Income in these guidelines
(d) "Affordable Owner-Occupied Workforce Housing" (AOWH) means owner-occupied housing per HSC Section 50092.1 that is affordable to persons and families of low or moderate income, as that term is defined in HSC Section 50093, except in High-cost areas where Moderate-income shall include households earning up to 150 percent of AMI.

(e) “Annual Progress Report” (APR) means the Housing Element APR required by GC Section 65400 on the prior year’s activities and due to the Department April 1 of each year.
(f) “Annual Report" means a form issued by the Department and completed by a Local government awarded PLHA funds on which the Local government documents the uses and expenditures of any allocated funds and outcomes achieved.

(g) "Applicant" means an eligible Local government applying for the program to administer one or more eligible activities. Applicant also means a Local or Regional Housing Trust Fund delegated by an eligible Local government to apply for the program and administer its allocation in accordance with all program rules.

Department of Housing and Community Development 7 2019 PLHA Final Guidelines

(h) “Area Median Income” or “AMI” means the most recent applicable county median family income published by the Department, available at the following link:
http://www.hcd.ca.gov/grants-funding/income-limits/state-and-federal-income- limits.shtml

(i) “At risk of homelessness” means the same as defined in Title 24 Section 578.3 of the Code of Federal Regulations and also includes any household receiving rental assistance funded by the California Emergency Solutions and Housing (CESH) program or the California Homeless Emergency Aid Program (HEAP). (j) “Capitalized Reserve for Services” means the reserve funded by the Local government pursuant to Section 301(a)(5) to address project supportive service budget deficits attributable to shortfalls in service funding sources.

(k) “Comprehensive Housing Affordability Strategy” or “CHAS” means annual data compiled by the United States Census Bureau for the U.S. Department of Housing and Urban Development (HUD) to document the extent of housing problems and housing needs, particularly for low-income households.

(l) "Community Development Block Grant" or "CDBG" means the program created pursuant to Title I of the Housing and Community Development Act of 1974, 42 U.S.C. 5301 et seq., as amended.
(m) “Department” means the California Department of Housing and Community Development.

(n) “Extremely Low Income” has the meaning set forth in HSC Section 50106, which is a maximum of 30 percent of AMI. Grantees shall utilize income limits issued by the Department at the following link:
http://www.hcd.ca.gov/grants-funding/income-limits/state-and-federal-income- limits.shtml.
(o) “Fund” means the Building Homes and Jobs Trust Fund pursuant to HSC Section 50470.

(p) “High-cost area” means those counties defined as high cost by the Federal Housing Finance Agency (at: https://www.fhfa.gov/DataTools/ and those counties for which HUD adjusted the Very low income and low-income rents due to high costs (at:
https://www.huduser.gov/portal/pdrdatas_landing.html), as published by the Department in the annual PLHA Notice of Funding Availability.
(q) “Local government” means any city, including a charter city, any county, including a charter county, or a city and county, including a charter city and county.

Department of Housing and Community Development 8 2019 PLHA Final Guidelines

(r) “Local Housing Trust Fund” or “Regional Housing Trust Fund” means a public, joint public and private fund or charitable nonprofit organization described in Section 501(c)(3) of the Internal Revenue Code, which was established by legislation, ordinance, resolution (including nonprofit articles of incorporation), or a public-private partnership organized to receive specific revenue to address local or regional housing needs.

(s) “Low or Lower Income” has the meaning set forth in HSC Section 50079.5, which is a maximum of 80 percent of AMI. Grantees shall utilize income limits issued by the Department at the following link:
http://www.hcd.ca.gov/grants-funding/income-limits/state-and-federal-income- limits.shtml.
(t) “Moderate-Income” has the meaning set forth in HSC Section 50093, which is a maximum of 120 percent AMI, or in High-cost areas, 150 percent of AMI. Grantees shall utilize income limits issued by the Department at the following link:
http://www.hcd.ca.gov/grants-funding/income-limits/state-and-federal-income- limits.shtml.
(u) “Non-entitlement local government” means a Local government in an area which is not a metropolitan city or part of an urban county, a Local government that, as of September 1, 2017, was an incorporated city with a population of less than 50,000 or a county with an unincorporated area population of less than 200,000 persons which had not entered into a three-year Urban County Cooperation Agreement, or a Local government that was not otherwise entitled to receive CDBG funds directly from HUD.

(v) “Operating subsidies” means payments to owners of affordable housing developments that make the housing more affordable by covering a portion of the ongoing costs of operating the development. Such payments would have the same effect as rental assistance.

(w) “Owner-occupied” means a dwelling which is occupied by the owner and includes a single family dwelling or a dwelling unit in a stock cooperative, as defined by Business and Professions Code (BPC), Section 11003.2, a community apartment project, as defined by BPC Section 11004, or a condominium project, as defined by subdivision (c) of BPC Section 11004. 5.
(x) "Plan" means the document submitted by the Applicant to the Department as part of a complete application in which the Applicant proposes to use allocated funds for at least one eligible Activity. The Plan shall have a term of five years. In succeeding years, the Local government is required to obtain the approval of the Department for any amendments made to the Plan, as set forth in Section 302(c)(5).

(y) “Permanent Local Housing Allocation Program", “Program”, or "PLHA" means the program developed to annually allocate 70 percent of the moneys deposited into the Fund pursuant to HSC Section 50470(b)(2)(B)(i).

Department of Housing and Community Development 9 2019 PLHA Final Guidelines

(z) “Permanent supportive housing” has the same meaning as in HSC Section 50675.14, that is, housing with no limit on the length of stay, that is occupied by the target population, and that is linked to onsite or offsite services that assist the supportive housing residents in retaining the housing, improving his or her health status, and maximizing his or her ability to live and, when possible, work in the community.

Permanent supportive housing may include associated facilities if used to provide services to housing residents. Permanent supportive housing does not include “health facility” as defined by HSC Section 1250 or any “alcoholism or drug abuse recovery or treatment facility” as defined by HSC Section 11834.02 or “Community care facility” as defined in HSC Section 1502, “Mental health rehabilitation centers” as defined in Section 5675 of the Welfare and Institutions Code (WIC), or other residential treatment programs.

(aa) “Regional Housing Needs Allocation" or "RHNA" means the share of the regional housing need represented by persons at all income levels within the area significantly affected by the general plan of the city or county allocated to an Applicant Local government pursuant to GC Section 65584(b).

(bb) “Sponsor” means the legal entity or combination of legal entities with continuing control of a Rental Housing Development. Where the borrowing entity is or will be organized as a limited partnership, Sponsor includes the general partner or general partners who have effective control over the operation of the partnership, or, if the general partner is controlled by another entity, the controlling entity. Sponsor does not include the seller of the property to be developed as the rental housing Project, unless the seller will retain control of the Project for the period necessary to ensure Project feasibility as determined by the Department.

(cc) “Very Low Income” has the meaning set forth in HSC Section 50105, which is a maximum of 50 percent of AMI. Grantees shall utilize income limits issued by the Department at the following link:
http://www.hcd.ca.gov/grants-funding/income-limits/state-and-federal-income- limits.shtml.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470.5 and 50470, subdivision (b)(2).

ARTICLE II. PROGRAM FUNDING
Section 200. Allocations

(a) SB 2 created a dedicated revenue source for affordable housing and directed the Department to make available 70 percent of the moneys in the Building Homes and Jobs Trust Fund, collected on and after January 1, 2019, to Local governments through the following allocations:

Department of Housing and Community Development 10 2019 PLHA Final Guidelines

(1) Ninety percent of the moneys available shall be allocated based on the formula used under Federal law to allocate CDBG funds within California. This is the formula specified in Title 42 United States Code (USC), Section 5306.

(A) The amount of funds awarded to each Local government eligible for the entitlement formula component shall be determined by the 90 percent of PLHA funds available pursuant to this paragraph (1) and the percentage of funds received by the entitlement Local government in the CDBG federal fiscal year 2017 allocation process performed by HUD.
(B) Through the formula specified in paragraph (1), the percentage of funds allocated to Non-entitlement local governments shall be distributed to Non-entitlement local governments through a competitive grant program.

(2) Ten percent of the moneys available shall be allocated equitably among Non-entitlement local governments. The equitable allocation awarded to each Local government eligible for the Non-entitlement formula component shall be based on the sum of: (1) 50 percent of the funding available for the Non-entitlement formula component divided by the number of local governments eligible for the Non-entitlement formula component and (2) 50 percent of the funding allocated in proportion to each Non-entitlement local government’s share of the total most severe housing need in California’s Non-entitlement local governments, based upon the most recent HUD Comprehensive Housing Affordability Strategy.
(b) After funds are appropriated by the Legislature as part of the budget act, the Department will issue one or more Notices of Funding Availability (NOFA). Local governments shall submit an application under the NOFA pertaining to the specific allocation for which the Local government is eligible.

(c) It is recommended that Local governments that were urban counties in accordance with the distribution of funds pursuant to the formula specified in 42 USC, Section 5306 for the federal fiscal year 2017 provide a proportional share of their allocations to Local governments within their county with which they had a three-year Urban County Cooperation Agreement as of September 1, 2017, provided that these Local governments meet the threshold requirements of the PLHA and expend sub-allocated funds for eligible activities within the deadlines of the Standard Agreement governing the sub-allocation.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B).

Section 201. Award Amounts
(a) The formula allocation amounts derived pursuant to the formulas in Section 200 will be announced in the NOFA.

Department of Housing and Community Development 11 2019 PLHA Final Guidelines

(b) The maximum application amount and the minimum application amount for the competitive allocation will be stated in the NOFA.

(c) An Applicant may apply for its formula allocation from the current and two prior NOFAs for which it did not receive an award, provided that the award meets the requirements of Section 304(a).

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B).

ARTICLE III. FORMULA ALLOCATION COMPONENT
Section 300. Eligible Applicants

(a) Eligible Applicants for the entitlement formula component described in Section 100(b)(1) are limited to the metropolitan cities and urban counties allocated a grant for the federal fiscal year 2017 pursuant to the federal CDBG formula specified in 42 USC, Section 5306.
(b) Eligible Applicants for the non-entitlement formula component described in Section 100(b)(2) and the competitive grant program component described in Section 100(b)(3) are limited to the Non-entitlement local governments.

(c) A Local government may delegate another Local government to submit an application and administer on its behalf its formula allocation of Program funds, provided that the Local governments enter into a legally binding agreement and the funds are expended for eligible Activities and consistent with Program requirements. The delegating Local government shall be identified in the application. The administering Local government shall be responsible for all Program requirements.
(d) A Local government may delegate a Local or Regional Housing Trust Fund to submit an application and administer on its behalf its formula allocation of Program funds, provided that the Local government enters into a legally binding agreement with the Local or Regional Housing Trust Fund and the funds are expended for eligible Activities and consistent with Program requirements. The delegating Local government shall be identified in the application. The Local or Regional Housing Trust Fund shall be responsible for all Program requirements.

(e) An Applicant shall not be eligible to receive a new allocation of PLHA funds if it has an uncommitted amount of formula PLHA funds greater than the following:
(1) Four times the pending annual allocation if the pending annual allocation is $125,000 or less;
(2) $500,000 if the pending annual allocation is greater than $125,000 and less than $500,000;
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(3) The amount of the pending annual allocation if the pending allocation is $500,000 or more.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B).

Section 301. Eligible Activities

(a) Eligible Activities are limited to one or more of the following:
(1) The predevelopment, development, acquisition, rehabilitation, and preservation of multifamily, residential live-work, rental housing that is Affordable to Extremely low-,Very low-, Low-, or Moderate-income households, including necessary Operating subsidies.

(2) The predevelopment, development, acquisition, rehabilitation, and preservation of Affordable rental and ownership housing, including Accessory dwelling units (ADUs), that meets the needs of a growing workforce earning up to 120 percent of AMI, or 150 percent of AMI in high-cost areas. ADUs shall be available for occupancy for a term of no less than 30 days.
(3) Matching portions of funds placed into Local or Regional Housing Trust Funds.

(4) Matching portions of funds available through the Low- and Moderate-Income Housing Asset Fund pursuant to subdivision (d) of HSC Section 34176.

(5) Capitalized Reserves for Services connected to the preservation and creation of new Permanent supportive housing.

(6) Assisting persons who are experiencing or At risk of homelessness, including, but not limited to, providing rapid rehousing, rental assistance, supportive/case management services that allow people to obtain and retain housing, operating and capital costs for navigation centers and emergency shelters, and the new construction, rehabilitation, and preservation of permanent and transitional housing.
(A) This Activity may include subawards to Administrative Entities as defined in HSC Section 50490(a)(1-3) that were awarded CESH program or HEAP funds for rental assistance to continue assistance to these households.

(B) Applicants must provide rapid rehousing, rental assistance, navigation centers, emergency shelter, and transitional housing activities in a manner consistent with the Housing First practices described in 25 CCR, Section 8409, subdivision (b)(1)-(6) and in compliance with WIC Section 8255(b)(8). An Applicant allocated funds for the new construction, rehabilitation, and preservation of Permanent supportive housing shall incorporate the core DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500

Department of Housing and Community Development 13 2019 PLHA Final Guidelines

components of Housing First, as provided in WIC Section 8255, subdivision (b).

(7) Accessibility modifications in Lower-income Owner-occupied housing.

(8) Efforts to acquire and rehabilitate foreclosed or vacant homes and apartments.

(9) Homeownership opportunities, including, but not limited to, down payment assistance.
(10) Fiscal incentives made by a county to a city within the county to incentivize approval of one or more Affordable housing Projects, or matching funds invested by a county in an Affordable housing development Project in a city within the county, provided that the city has made an equal or greater investment in the Project. The county fiscal incentives shall be in the form of a grant or low-interest loan to an Affordable housing Project. Matching funds investments by both the county and the city also shall be a grant or low-interest deferred loan to the Affordable housing Project.
(b) A Local government that receives an allocation shall use no more than 5 percent of the allocation for costs related to the administration of the Activity(ies) for which the allocation was made. Staff and overhead costs directly related to carrying out the eligible activities described in Section 301 are “activity costs” and not subject to the cap on “administrative costs.” A Local government may share any funds available for administrative costs with entities that are administering its allocation.

(c) Two or more Local governments that receive PLHA allocations may expend those moneys on an eligible jointly funded project as provided for in Section 50470 (b)(2)(B)(ii)(IV). An eligible jointly funded project must be an eligible Activity pursuant to Section 301(a) and be located within the boundaries of one of the Local governments.
(d) Entitlement Local governments may use the flow of PLHA funds to incentivize private lender loans and to guarantee payments for some or all public agency bond financings for activities consistent with the uses identified in Section 301 “Eligible Activities”. This loan guarantee Activity must be identified and fully explained in the Applicant’s “Plan”.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivisions (b)(2)(B)(ii)(IV), (b)(2)(D)(i-x), and (b)(3).

Section 302. Threshold Requirements
Applicants must meet all the following threshold requirements for participation in the formula allocation:
(a) Housing Element compliance: The Applicant and any delegating Local government, if applicable, must have a Housing Element that has been adopted by the Local DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500

Department of Housing and Community Development 14 2019 PLHA Final Guidelines

government’s governing body by the application deadline and subsequently determined to be in substantial compliance with state Housing Element Law pursuant to GC Section 65585. A Local government’s current Housing Element compliance status can be obtained by referencing the Department’s website at http://www.hcd.ca.gov/community-development/housing-element.

(b) APR on the Housing Element submitted to the Department: The Applicant and any delegating Local government, if applicable, must submit to the Department the APR required by GC Section 65400 for the current or prior year by the application deadline date.
(1) Please be advised that the Department will not accept other reports in lieu of the APR. Housing Authority Financial Reports, Redevelopment Reports, and other similar reports will not be accepted as meeting this requirement. If uncertain of the status of the report submittal for a Local government, please contact the Department for more information.
(c) Submit, by the deadline specified in the NOFA, on a form made available by the Department, a complete application which shall meet the following minimum requirements:

(1) Application requests an allocation pursuant to Section 200 in order to carry out one or more of the eligible activities described in Section 301. Except for a jointly funded project as described in Section 301(c), any activities must be carried out within the jurisdiction of the Applicant Local government.

(2) Submission of the application is authorized by the governing boards of the Applicant.
(3) Certification in the resolution that, if the Local government proposes allocation of funds for any Activity to another entity, the Local government’s selection process shall avoid conflicts of interest and shall be accessible to the public. For the purposes of this paragraph, “entity” means a housing developer or program operator; “entity” does not mean an administering Local government to whom a Local government delegates its PLHA formula allocation, pursuant to Section 300(d).

(4) A Plan detailing:
(A) The manner in which allocated funds will be used for eligible Activities. (B) A description of the way the Local government will prioritize investments that increase the supply of housing for households with incomes at or below 60 percent of AMI. Programs targeted at households at or below 60 percent of AMI will be deemed to meet this requirement.

Department of Housing and Community Development 15 2019 PLHA Final Guidelines

(D) Evidence that the Plan was authorized and adopted by resolution by the Local government and that the public had an adequate opportunity to review and comment on its content.
(E) The following for each proposed Activity:

(i) A description of each proposed Activity, pursuant to Section 301, and the percentage of funding allocated to it. The description shall specifically include the percentage of funds, if any, directed to AOWH. (ii) The projected number of households to be served at each income level and a comparison to the unmet share of the RHNA at each income level.

(iii) A description of major steps/actions and a proposed schedule required for the implementation and completion of the Activity.
(iv) The period of affordability and level of affordability for each Activity. Rental Projects are required to have affordability periods of at least 55 years.

(5) The Plan submitted in response to the NOFA shall be for a term of five years. Local governments shall obtain approval of the Department for amendments made to the Plan in each succeeding year of the term of the Plan. Reallocations of more than 10 percent of funds among Activities require amendment of the Plan, with approval granted by the governing body at a publicly noticed public meeting. (6) A certification that, if funds are used for the acquisition, construction, or rehabilitation of for-sale housing projects or units within for-sale housing projects, the grantee shall record a deed restriction against the property that will ensure compliance with one of the following requirements if the property is no longer the primary residence of the homeowner due to sale, transfer or lease, unless it is in conflict with the requirements of another public funding source or law:

(A) The PLHA loan and any interest thereon shall be repaid to the Local government’s PLHA account. The Local government shall reuse the repayments consistent with Section 301; or

(B) The initial owner and any subsequent owner shall sell the home at an Affordable housing cost to a qualified Lower-Income or Moderate-Income household; or

(C) The homeowner and the Local government shall share the equity in the unit pursuant to an equity-sharing agreement. The grantee shall reuse the proceeds DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500

Department of Housing and Community Development 16 2019 PLHA Final Guidelines

of the equity-sharing agreement consistent with this section.

(7) A certification that, if funds are used for the development of an Affordable Rental Housing Development, the Local government shall make the PLHA assistance in the form of a low-interest, deferred loan to the Sponsor of the Project. The loan shall be evidenced through a Promissory Note secured by a Deed of Trust, and a Regulatory Agreement shall restrict occupancy and rents in accordance with the Local government-approved underwriting of the Project for a term of at least 55 years.

(8) A Program income reuse plan describing how repaid loans will be reused for eligible activities specified in Section 301.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B)(ii).

Section 303. Application Review

(a) Applicants must submit a complete application by the deadline stated in the NOFA in order to be eligible for funding. Application forms provided by the Department will be available upon release of the NOFA and will require Applicants to submit the forms and other documents to demonstrate that the Local government has met threshold requirements.
(b) The Department may request additional information to complete its review. (c) Applications recommended for funding are subject to conditions specified by the Department. Applicants will receive an official letter of award after the Department approves funding recommendations.

(d) The Department may issue an Over-the-Counter formula allocation NOFA after completing the NOFA process so that Local governments who were not able to submit formula allocation applications by the application deadline will have another opportunity to do so.
(e) If funding proposed in Local government Plans for AOWH activities is lower than 20 percent of the moneys available in the Fund, the Department may require Local governments to use a specific percentage of their annual formula allocations in some future year for AOWH activities as part of the annual funding process.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(A).

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Section 304. Deadlines and Funding Requirements

(a) The initial PLHA application, including the Plan, must be submitted within 48 months of the budget appropriation (for example, the budget appropriation for 2019 is July 1, 2019, so the application deadline is June 30, 2023). (b) Funds allocated to Local governments that do not submit a complete application by the deadline stated in subsection (a) will revert to the Housing Rehabilitation Loan Fund for the Multifamily Housing Program or for Department-administered technical assistance to Local governments.
(c) A Local government may petition the Department to return any funds allocated to it to be used for the Multifamily Housing Program.

(d) Except for predevelopment expenses for construction projects funded by PLHA and costs to develop and prepare the Plan and the PLHA application, no costs incurred more than one year prior to commitment by the Local government may be paid from PLHA funds. Reimbursement of expenses to prepare the Plan and the PLHA application are subject to the cap on administrative fees. (e) After the Standard Agreement and attachments have been finalized, the Local government will follow provided instructions for signing all required documents. The Local government must submit all supporting materials and a signed Standard Agreement within the timeline provided in the instruction.

(f) After the Standard Agreement has been executed by the state, the Local government may submit a request for 100 percent of the funds allocated to be used for eligible expenditures for the Activity(ies) that received the award, and subject to the terms and conditions of the Standard Agreement.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B)(i) and subdivision (b)(2)(B)(ii)(VI).

ARTICLE IV. COMPETITIVE ALLOCATION COMPONENT
Section 400. Eligible Applicants

(a) Eligible Applicants for the non-entitlement competitive allocation described in Section 100(b)(3) are limited to Non-entitlement local governments. For development of Rental Housing Projects, the Sponsor must be a co-Applicant.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B)(i)(I).

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Section 401. Eligible Activities

(a) Eligible Activities are limited to the following and must take place within the jurisdiction of the Applicant Local government:
(1) Development of new multifamily rental housing that is Affordable to households at or below 60 percent of AMI or substantial rehabilitation of multifamily rental housing that will be Affordable to households at or below 60 percent of AMI, but which is not currently restricted as Affordable housing; or

(2) Assistance to persons who are experiencing or At risk of homelessness, including, but not limited to, through rapid rehousing, or rental assistance, supportive services and case management services that allow people to obtain and retain housing, operating and capital costs for navigation centers, or new construction, rehabilitation, or preservation of permanent or transitional rental housing.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B)(i)(I)(ia), (b)(2)(B)(i)(I)(ib) and subdivision (b)(2)(B)(ii)(V).

Section 402. Threshold Requirements
Applicants must meet all the following threshold requirements for participation in the competitive allocation:

(a) Housing Element compliance: The Applicant must have a Housing Element that has been adopted by the jurisdiction’s governing body by the application deadline date and subsequently determined to be in substantial compliance with state Housing Element Law pursuant to GC Section 65585. A Local government’s current Housing Element compliance status can be obtained by referencing the Department’s website at http://www.hcd.ca.gov/community-development/housing-element.

(b) APR on the Housing Element submitted to the Department: The Applicant must submit to the Department the APR required by GC Section 65400 for the current or prior year by the application deadline date.
(1) Please be advised that the Department will not accept other reports in lieu of the APR. Housing Authority Financial Reports, Redevelopment Reports, and other similar reports will not be accepted as meeting this requirement. If uncertain of the status of the report submittal for a Local government, please contact the Department for more information.

(c) Submit by the deadline specified in the NOFA, on a form made available by the Department, a complete application which shall meet the following minimum requirements:

(1) Application requests a grant pursuant to Section 100(b)(3) in order to carry out one DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500

Department of Housing and Community Development 19 2019 PLHA Final Guidelines

or both of the eligible Activities set forth in Section 401.

(2) Submission of the application is authorized by the governing board of the Applicant and by the developer co-applicant, if any.
(3) Certification in the resolution that, if the Local government proposes allocation of funds for any Activity to another entity, the selection process shall avoid conflicts of interest, and shall be accessible to the public.

(4) Demonstration of readiness, including site control for development Projects, land use entitlements, environmental review and commitments of other funding and resources required, as further set forth in the NOFA;
(5) Underwriting requirements:
(A) Uniform Multifamily Regulations Subchapter 19 of Title 25, Division 1, Chapter 7 (commencing with Section 8300), as amended from time to time, and the Multifamily Housing Program Guidelines (commencing with Section 7300), as amended from time to time, are hereby incorporated by reference into this subchapter and shall apply to Rental Housing Developments receiving assistance under the PLHA competitive allocation. In the event of a conflict between the provisions of Subchapter 19 and these Guidelines, the provisions of these Guidelines shall prevail.

(i) Section 8312(c) of the Uniform Multifamily Regulations is hereby amended to read:
(c) For Projects utilizing 4 percent tax credits, Developer Fee payments shall not exceed the amount that may be included in Project costs pursuant to 4 CCR, Section 10327. In addition, the Developer Fee paid from development funding sources shall not exceed the following:
(1) For acquisition and/or rehabilitation Projects, or adaptive reuse Projects, the lesser of the amount of Developer Fee in Project costs or $2,000,000. (2) For new construction Projects, the base limit shall be the lesser of the amount that may be included in Project costs or $2,200,000. To arrive at the final limit on Developer Fee paid from development funding sources, the base limit shall then be multiplied by a ratio that is the average of (i) the difference between 2 and the Project’s high-cost ratio, as calculated pursuant to 4 CCR, Section 10317(i)(6) or successor language and (ii) 100 percent.

(ii) Section 8312(d) of the Uniform Multifamily Regulations shall not apply. (iii) Section 8314(a)(1)(A) of the Uniform Multifamily Regulations is amended to read:
(A) Approved deferred Developer Fee, pursuant to Section 8312, provided that the aggregate of the Developer Fee paid from sources and paid as deferred shall not exceed $3,500,000.

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(B) Period of affordability: All assisted rental units shall be restricted for not less than 55 years.
(C) All development Projects shall demonstrate fiscal integrity.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B)(ii).

Section 403. Selection Criteria
(a) Applications submitted within a competitive funding round shall be evaluated using the following criteria. Total available points shall equal 100.

1. Priority Points – 25 points

A. Population - 5 points
(i) If the Applicant is a county that has a population of 200,000 or less within the unincorporated areas of the county, the Applicant shall receive all points.

B. Prior Award – 5 points
(i) If the Applicant did not receive an award based on the formula specified in 42 USC, Section 5306 in 2016, the Applicant shall receive all points.

And either C (i) or C (ii) or C (iii) below:

C. Activity
(i) Assistance for Homeless Persons through Program Activities – 15 points

(a) Applications to assist persons experiencing or At risk of homelessness, including, but not limited to, through programs providing rapid rehousing, or rental assistance, or operating assistance to navigation centers shall receive all points.

Or
(ii) Assistance to Homeless Persons through Development of Navigation Centers– 15 points
(a) Applications for construction of navigation centers shall receive all points.

Or
DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500

Department of Housing and Community Development 21 2019 PLHA Final Guidelines

(iii) Assistance for Homeless Persons through Rental Projects – 15 points

(a) Applications for the new construction, rehabilitation, or preservation of permanent or transitional rental housing in which all or at least 10 percent of the units are restricted to occupancy by tenants who are homeless or At risk of homelessness shall receive all points.

2. Evaluation Criteria – 75 points
Precise scoring for these factors will be set forth in the NOFA.

A. Community Need – 30 points
(i) Applicants will receive up to a maximum of 30 points based on the rate of households experiencing the most severe housing need according to the most recent HUD CHAS dataset in the Applicant Local government.

Applicants will receive points in proportion to this percentage.

B. Applicant Administrative Experience – 15 points
(i) Applicants with prior experience administering local, state or federal affordable housing or community development programs or who have entered into a contract with an entity with prior experience in the implementation of local, state or federal affordable housing or community development programs will receive up to 15 points.

C. Demonstrated Capacity – 30 points
(i) Capacity points will be based on:
(a) Sponsor experience in Affordable Rental Housing Development and ownership (Up to 30 points) or

(b) Navigation center development experience (for development of these facilities) (Up to 30 points) or
(c) Program Operator experience (for non-development Activities) (Up to 30 points)

(b) Where applications requesting funds for more than one eligible Activity pursuant to Section 401 are permitted by the NOFA, each Activity will receive a separate score for each rating factor, and have an individual Activity total. It is possible that one Activity may score highly enough to receive an award, and the other Activity does not.

(c) In the event of tied point scores and insufficient funding for both applications, the Department shall rank the tied applications as follows:
(1) If one of the tied applications is for an Affordable Rental Housing Development and the other is for a program Activity or development of a navigation center, the DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500

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Affordable Rental Housing Development application will be selected for funding; (2) If one of the tied applications is for a navigation center and the other is for a program Activity, the navigation center will be selected for funding; (3) If both of the tied applications are for Affordable Rental Housing Developments, the Project with the lowest weighted average affordability of Restricted Units will be selected;
(4) If both of the tied applications are for navigation centers, the facility that provides overnight shelter to the greatest number of people will be selected; (5) If both of the tied applications are for programs, the Local government with the highest rate of households experiencing the most severe housing need according to the most recent HUD CHAS dataset will be selected.

(d) In the event there are insufficient funds to fulfill the entire funding request for the next highest scored application (Application A), the Department will determine whether Application A is feasible without the full funding request. If Application A is not feasible without full funding, the Department may offer the remaining funds to the application whose score is immediately below Application A. If the remaining funds are insufficient to fulfill the funding request for that application (Application B), the Department will again determine whether this application is feasible without the full funding request. If Application B is not feasible without the full funding request, the Department will perform the same analysis for the application whose score is immediately below Application B.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B)(i)(I)(ia) and subdivision (b)(2)(B)(ii)(V).

Section 404. Application Review

(a) Applicants must submit a complete application by the deadline stated in the NOFA in order to be eligible for funding. Application forms provided by the Department will be available upon release of the NOFA and will require Applicants to submit the forms and other documents to demonstrate that the Local government has met threshold requirements. The application will require submission of documentation adequate to demonstrate that the application has earned the appropriate number of points. (b) The Department may request additional information to complete its review, provided that the new information would not affect scoring.

(c) Applications recommended for funding are subject to conditions specified by the Department. Applicants will receive an official letter of award after the Department approves funding recommendations.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B)(ii).

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Section 405. Deadlines and Funding Requirements

(a) Applicants will be required to enter into a state Standard Agreement (Standard Agreement) that will set forth conditions for funding and milestones that are required to be met.
(b) After the Standard Agreement and attachments have been finalized, the Local government will follow provided instructions for signing all required documents. The Local government must submit all supporting materials and a signed Standard Agreement within the timeline provided in the instructions or risk forfeiting the grant award.

(c) Except for predevelopment expenses for construction projects funded by PLHA and the costs to develop and prepare the PLHA application, no costs incurred more than one year prior to commitment by the Local government may be paid from PLHA funds.

Reimbursement of expenses to prepare the PLHA application is subject to the cap on administrative fees.
(d) Grant funds shall not be disbursed until:

(1) the Department authorizes loan closing, in the case of development projects; or (2) all general and special conditions have been complied with, in the case of other Activities.

(e) If funds are used for the development of an Affordable Rental Housing Development, the Local government shall make the PLHA assistance in the form of a low-interest, deferred loan to the Sponsor of the project. The loan shall be evidenced through a Promissory Note secured by a Deed of Trust, and a Regulatory Agreement shall restrict occupancy and rents in accordance with the Department-approved underwriting of the project for at least 55 years.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B)(ii)(VI).

ARTICLE V. ADMINISTRATION
Section 500. Accounting Records

(a) The grantee shall establish a separate ledger account for receipts and expenditures of grant funds and maintain expenditure details in accordance with the approved work plan, budget, and schedule. Separate bank accounts are not required. (b) The grantee shall maintain documentation of its financial records for expenditures incurred during the course of the PLHA Activity in accordance with generally accepted accounting principles. Such records shall be kept for at least five years after the close-out report is submitted to the Department.

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(c) The Department or its designated representative shall have the right to review and copy any records and supporting documentation pertaining to the PLHA grant.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B)(ii)(III) and subdivision (b)(2)(B)(IV) and subdivision (b)(3).

Section 501. Audits/Monitoring of Project Files
(a) Grantee shall maintain PLHA files which, at a minimum, should include the following information and reports:
1) Project/Activity description
2) Land/site Information
3) Planning & zoning history (as appropriate)
4) Records of public hearings and public comments
5) Relocation needs (as appropriate)
6) Contracts, loan and grant agreements, Standard Agreement 7) Environmental records & reports/findings (as appropriate) 8) Design/engineering reports & plans (as appropriate)
9) Description of targeted beneficiaries, services to be provided, household incomes, special needs
10) PLHA Activity costs, invoices, purchase orders, sources and uses of funds for PLHA Activities, terms & conditions of financings, draws and all supporting documentation, change orders (as appropriate)
11) Activity schedule and amendments
12) History of Plan amendments
13) Procurement policy used for PLHA Activity(ies)

(b) The grantee shall maintain such records for possible audit for a minimum of three years after the close-out report is submitted, unless a longer period of records retention is stipulated in the Standard Agreement.
(c) The grantee shall be responsible for monitoring Rental Housing Developments that received PLHA funds for the term of the loan, including, but not limited to, the Projects’ compliance with the occupancy and rent requirements set forth in the Regulatory Agreement, compliance with reserve requirements, and the compliance with habitability standards.

(d) The grantee shall be responsible for monitoring AOWH loans to assure that the homes remain Owner-occupied.
(e) If requested by the Department, the grantee shall obtain a report from a qualified, DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500

Department of Housing and Community Development 25 2019 PLHA Final Guidelines

licensed third party that certifies to the amounts of disbursement and identifies the specific Activities for which the disbursements were made. Such a report is permitted to be a component of the A-133 audit.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B)(ii)(IV) and subdivision (b)(3).

Section 502. Cancellation and Termination

(a) In the event that it is determined, at the sole discretion of the Department, that the grantee is not meeting the terms and conditions of the Standard Agreement, the Department shall issue a notice to stop work. Immediately upon receiving the written notice to stop work, the grantee shall cease all work under the Standard Agreement.

The Department has the sole discretion to determine the grantee’s compliance with the terms and conditions after issuance of a stop work order, and to deliver a written notice to the grantee to resume work under this Standard Agreement. (b) The Department shall terminate the Standard Agreement if the grantee is not in compliance with the Guidelines or the terms and conditions of the Standard Agreement. At least 30 days prior to the effective date of the termination of the Standard Agreement, the Department shall provide written notice to the grantee of its intent to cancel the funding allocation. The notice shall specify the reason for early termination and may permit the grantee or the Department to cure any deficiency(ies) prior to the early termination date. The grantee will submit requested documents to the Department within 30 days of the early termination notice.

(c) Failure to meet reporting requirements will result in notice to the grantee that it must satisfactorily cure any deficiencies within three months of the notice or it will forfeit the following year’s PLHA formula allocation and be ineligible for a competitive award. The Local government will forfeit subsequent PLHA formula allocations and be ineligible for a competitive award until the Department determines that the Local government has met reporting requirements.
(d) The Department may, as it deems appropriate or necessary, request the repayment of funds from a Local government or offset future years’ funds, or pursue any other remedies available to it by law for failure to comply with the Guidelines and/or the terms and conditions of the Standard Agreement.

(e) Co-Applicants may be adversely impacted by a notice to stop work and/or termination if one grantee is deemed by the Department to not meet the terms and conditions of the Standard Agreement, or fails to meet the reporting requirements outlined in Section 503.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B)(ii)(IV) and subdivision (b)(3).

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Section 503. Reporting

(a) The Department shall provide grantees with reporting formats and instructions. (b) Annual Reports are required from all grantees pursuant to HSC Section 50470(b)(2)(B)(ii)(III) each year by July 31 for the term of the Standard Agreement.

The Annual Report shall document the uses and expenditures of all awarded allocations and outcomes achieved. This report must be signed by both the Local government’s PLHA administrator and the Local government’s City Manager (or his/her designee), or Chief Executive Officer (or his/her designee) or Chief Financial Officer (or his/her designee). The Annual Report must describe any proposed amendment(s) to the approved Activity and schedule.

(c) Upon expenditure of all allocated funds and completion of the Activities funded by PLHA, the grantee shall submit a close-out report, which will be part of the Annual Report.
(d) The Department may request additional information as needed to meet other applicable reporting or audit requirements.

NOTE: Authority cited: HSC Section 50470, subdivision (d). Reference cited: HSC Section 50470, subdivision (b)(2)(B)(ii)(III) and subdivision (b)(2)(B)(ii)(IV).

ATTACHMENT C

HOUSING CONSORTIUM OF THE EAST BAY GRIEVANCE FORM

GUEST NAME: ___________________________ PHONE #: _______________________

PROGRAM NAME: Alameda Winter Warming Center

1. Please describe your grievance, including the dates and times of any incidents, and the name(s) of the HCEB staff member(s) involved:
____________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
________________________________________________________ ___________________________________________________
(Attach additional pages if necessary.)

2. Please describe the resolution you would like to see for this issue:
__________________________________________________
__________________________________________________
________________________________________________________ ________________________________________________________ ___________________________________________________ ____________________________________ ___________________________________

GUEST SIGNATURE DATE
_______________________________________________________________________ DATE RECEIVED:

RECEIVED BY:

RESPONSE DATE:

NOTES:
______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________ DocuSign Envelope ID: 32BA4A7D-A606-4AD7-AAD8-169DA3CA7879 DocuSign Envelope ID: 46159AE7-5F77-4632-B225-3D300B41CE58 DocuSign Envelope ID: 629FBC96-5164-426B-89BB-74EBF21F2313 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 1/18/2023
DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 AAIS
CP132
Ed 1.0
CP132 Ed 1.0
Copyright MXMXCIV
, American Association of Insurance Services
Page
2 of
2 DocuSign Envelope ID: ED6BC813-28A9-4D9F-A76E-05E46F9DE500 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 04M5A04
9 432
6 BG
L
-
77 7 (
3 .0)
C
o
py
r
i
gh
t,
2 0
0 7
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
2 o
f
2 All R
i
g
ht
R
e
ser
v
e
d
CONDIT
I
ON
S
LIM
I
T
A
T
I
ON
OT

HER PRO
V
I
S
IO
NS
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
-
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.

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 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

Alameda City CouncilFebruary 7, 2023

Alameda City Council
February 7, 2023