Vallejo City Council
July 22, 2025

City of Vallejo Prop 47 Grant Agreement – DOVE

6. City will not pay for Project costs with any other grants.

7. Regardless of any other provisions herein, City shall not provide payment to DOVE in excess of DOVE’s actual Prop 47 Program expenses. Furthermore, the City shall not reimburse DOVE for expenses that exceed the amount allocated to DOVE.

8. DOVE is liable for repayment of disallowed costs. Disallowed costs may be identified through audits, monitoring, or other means. DOVE shall be afforded the opportunity to respond to any adverse findings which may lead to disallowed costs.

E. Payment Process and Documentation

1. All Requests for Payments must be submitted using a completed Request for Payment Form attached as Exhibit B which is incorporated herein by this reference. This form must be accompanied by 1) an itemized list of all expenditures according to Project Budget Categories, and 2) supporting documentation that clearly identifies the expenditure(s) in relation to the Project Budget Categories set forth in Exhibit A. Payment requests may not be submitted more often than quarterly.

2. If the Request for Payment Form is incomplete, inadequate or inaccurate, the City may withhold all or a portion of the payment request until all required information is received or corrected. Any penalties whatsoever imposed on DOVE by a government agency or a contractor for any reason whatsoever are the responsibility of DOVE and are not reimbursable under this Agreement.

F. Project Review and Documentation.

DOVE shall submit progress reports as described in Exhibit C which is incorporated herein by this reference.

G. Subrecipient Monitoring
DOVE shall perform all monitoring and reporting requirements of subrecipients, if any, in accordance with 2.CFR.200. Details regarding the subrecipient monitoring plan are set forth in Exhibit E which is incorporated herein by this reference.

H. Project Termination

1. Prior to the completion of the Project, either Party may terminate this Agreement by providing the other Party with thirty (30) days’ written notice.

2. If the City terminates this Agreement prior to the project completion date stated in Section B, DOVE shall take all reasonable measures to prevent further costs to the City hereunder. The City shall be responsible for any reasonable and non-cancelable obligations incurred by DOVE under this Agreement prior to the date of the notice to terminate, but only up to the undisbursed balance of funding authorized in this Agreement and only for authorized expenses.

I. Financial Records

1. DOVE shall establish an official file for the Project. The file shall contain adequate DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

City of Vallejo Prop 47 Grant Agreement – DOVE

documentation of all actions that are taken with respect to the Project.

2. DOVE shall keep separate and complete accounting records for receipt, deposit, and payment of all Project funds, including interest.

3. DOVE agrees that adequate supporting documentation shall be maintained in sufficient detail to provide an audit trail which will permit tracing transactions from support documentation to the accounting records to the financial reports and billings.

4. DOVE shall maintain books, records, documents, and other evidence sufficient to reflect properly the amount, receipt, and disposition of all Project funds, including non-City funds, interest earned, and any matching funds by DOVE and the total cost of the Project. Time and effort reports shall also be required for consultants and contractors. Adequate supporting documentation shall be maintained by consultants and contractors in sufficient detail to provide an audit trail which will permit tracing transactions from the invoices to the financial statement, to the accounting records, and to the supporting documentation.

5. DOVE shall use applicable Generally Accepted Accounting Principles, unless otherwise agreed to by the City.

J. Audit Requirements
The City reserves the right to call for a program audit or a financial audit at any time during the term of this Agreement and for two years following termination of this Agreement. Within ten (10) working days of a request by the City, DOVE shall furnish, at its own expense, legible copies of all materials deemed pertinent to the request. At any time, the City may disallow all or part of the cost of any activity or action which it determines to be out of compliance with the terms and conditions of this Agreement.

K. Assignment
Except as expressly provided by written agreement between the Parties, this Agreement is not assignable by DOVE either in whole or in part.

L. No Agency Agreement
In carrying out this Agreement, DOVE and its agents and employees shall be deemed to be acting in an independent capacity with respect to the City, and not as the officers, employees, or agents of the City or the State.

M. Liability and Insurance

1. DOVE shall defend, indemnify, and save harmless the City (including its inspectors, project managers, trustees, officers, elected officials, appointed officials, agents, members, employees, affiliates, consultants, subconsultants, volunteers and representatives), and each of them, of and from any and all claims, demands, suits, causes of action, damages, costs, expenses, attorneys' fees, losses, or liability, in law or in equity, of every kind and nature whatsoever arising out of, or in connection with, DOVE’s operations to be performed under this Agreement, including, but not limited to:

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

City of Vallejo Prop 47 Grant Agreement – DOVE

A. Personal injury (including, but not limited to, bodily injury, emotional injury or distress, sickness, or disease) or death to persons, including, but not limited to, any employees or agents of DOVE, the City, or any subcontractor, or damage to property of anyone including the work itself (including loss of use thereof), caused or alleged to be caused in whole or in part by any negligent act or omission of DOVE, the City, or anyone directly or indirectly employed by them, or anyone for whose acts they may be liable;
B. Penalties threatened, sought, or imposed on account of the violation of any law, order, citation, rule, regulation, standard, ordinance, or statute, caused by the action or inaction of DOVE;
C. Alleged infringement of any patent rights which may be brought arising out of DOVE’s work;
D. Claims and liens for labor performed or materials used or furnished to be used on the job, including all incidental or consequential damages from such claims or liens; E. DOVE’s failure to fulfill any of the covenants set forth in this Agreement; F. Failure of DOVE to comply with the provisions of this Agreement relating to insurance; and,
G. Any violation or infraction by DOVE of any law, order, citation, rule, regulation, standard, ordinance, or statute in any way relating to the occupational, health, or safety of employees.

The indemnities set forth in this section shall not be limited by the insurance requirements set forth in this Agreement.

DOVE's indemnification of the City will not include indemnification for claims which arise as the result of the active negligence of the City, or the sole negligence or willful misconduct of the City, its agents, servants or independent contractors who are directly responsible to the City, or for defects in design furnished by such persons.

The indemnification provisions set forth above shall survive the termination of this Agreement.

2. Insurance shall conform to the following requirements: DOVE shall procure and maintain for the duration of this Agreement, insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder by DOVE, its agents, representatives, employees, volunteers or subcontractors. Such insurance shall not be construed to relieve DOVE of any liability in excess of such coverage.

A. Minimum Scope of Insurance Coverage shall be at least as broad as:

1. Insurance Services Office form number GL 0002 (Ed. 1/73) covering Comprehensive General Liability and Insurance Services Office from number GL 0404 covering Broad Form Comprehensive General Liability; or Insurance Services Office Commercial General Liability coverage ("occurrence" form CG 0001).

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

City of Vallejo Prop 47 Grant Agreement – DOVE

2. Insurance Services Office form number CA 0001 (Ed. 1/78) covering Automobile Liability, code 1 "any auto" and endorsement CA 0025.

3. Workers' Compensation insurance as required by the Labor Code of the State of California and Employers Liability insurance.

B. Minimum Limits of Insurance
DOVE shall maintain limits no less than:

1. General Liability: $2,000,000 combined single limit per occurrence for bodily injury, personal injury and property damage. If Commercial General Liability Insurance or other form with a general aggregate limit is used, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit.

2. Automobile Liability: $1,000,000 combined single limit per accident for bodily injury and property damage.

3. Workers' Compensation and Employers Liability: Workers' compensation limits as required by the Labor Code of the State of California and Employers Liability limits of $1,000,000 per accident.

C. Deductibles and Self Insured Retention
Any deductibles or self-insured retention must be declared to and accepted by the City. At the option of the City, either the insurer shall reduce or eliminate such deductibles or self-insured retention as respects the City, its officers, officials, elected officials, appointed officials, employees and volunteers; or DOVE shall procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses.

D. Other Insurance Provisions
The policies are to contain, or be endorsed to contain the following provisions:

1. General Liability and Automobile Liability Coverage
i. The City, its officers, officials, elected officials, appointed officials, employees and volunteers are to be covered as insured as respects: liability arising out of activities performed by or on behalf of DOVE, including the insured's general supervision of DOVE; products and completed operations of DOVE, premises owned, occupied or used by DOVE. The coverage shall contain no special limitations on the scope of protection afforded to the City, its officers, officials, elected officials, appointed officials, employees or volunteers. ii. DOVE's insurance coverage shall be primary insurance as respects the City, its officers, officials, elected officials, appointed officials, employees, and volunteers. Any insurance or self- insurance maintained by the City, its officers, officials, elected officials, appointed officials, employees or volunteers shall be excess of DOVE's insurance and shall not contribute with it.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

City of Vallejo Prop 47 Grant Agreement – DOVE

iii. Any failure to comply with reporting provisions of the policies shall not affect coverage provided to the City, its officers, officials, elected officials, appointed officials, employees or volunteers.
iv. DOVE's coverage applies separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability.

2. Workers' Compensation and Employers Liability Coverage The insurer shall agree to waive all rights of subrogation against the City, its officers, officials, elected officials, appointed officials, employees and volunteers for losses arising from work performed by DOVE for the City.

3. All Coverage
Each insurance policy required by this clause shall be endorsed to state that coverage shall not be suspended, voided, canceled by either party, reduced in coverage or in limits except after thirty (30) days' prior written notice has been given to the City.

E. Acceptability of Insurers
Insurance is to be placed with insurers with a Best's rating of no less than A:VII.

F. Verification of Coverage
Agency shall furnish the City with certificates of insurance and with original endorsements effecting coverage required by this section. The certificates and endorsements for each insurance policy are to be signed by a person authorized by that insurer to bind coverage on its behalf. All certificates and endorsements are to be received and accepted by the City before work commences. The City reserves the right to require complete, certified copies of all required insurance policies, at any time.

G. Subcontractors
DOVE shall include all subcontractors as insured under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverage for subcontractors shall be subject to all of the requirements stated herein.

DOVE shall ensure that all subcontractors include the City as additional insured.

N. Nondiscrimination
DOVE shall not discriminate against any person on the basis of sex, race, color, ancestry, religious creed, national origin, physical disability, mental disability, medical condition, age, marital status, military status, sexual orientation or gender selection in the performance of the services set forth in this Agreement.

O. Severability
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

City of Vallejo Prop 47 Grant Agreement – DOVE

If any provision of this Agreement or the application thereof is held invalid, that invalidity shall not affect other provisions or applications of this Agreement which can be given effect without the invalid provision or application, and to this end the provisions of this Agreement are severable.

P. Waiver
No term or provision hereof will be considered waived by either Party, and no breach is excused or consented to by either Party, unless such waiver or consent is in writing and signed on behalf of the Party against whom the waiver is asserted. No express or implied consent by either Party to, waiver of, or failure of a Party to enforce its rights with respect to a breach by the other Party shall constitute consent to or, waiver of any subsequent or other breach by the other Party.

Q. Time of the Essence
Time is of the essence with respect to the Completion Date as set forth in Section B of this Agreement. With respect to all other dates set forth herein, DOVE shall use its best efforts to accomplish the tasks by the specified dates.

R. Amendment
This Agreement may be amended by mutual agreement in writing between the Parties. Any request by DOVE for amendments must be in writing stating the amendment request and reason for the request. DOVE shall make requests in a timely manner and in no event less than thirty (30) days before the effective date of the proposed amendment.

S. Notices
All notices or instruments required to be given or delivered by law or this Agreement shall be in writing and shall be effective upon receipt thereof and shall be by personal service or delivered by depositing the same in any United States Post Office, registered or certified mail, postage prepaid, addressed to:

City: Project HOME Project Director
Vallejo Police Department
111 Amador Street
Vallejo, CA 94590
(707) 648-5565
Agency: Cameron Clark
Executive Director
2635 Napa Street, Box# 1174
Vallejo, CA 94590
[email protected]

T. List of Exhibits
Exhibit A – Scope of Services
Exhibit B – Request for Payment Form
Exhibit C – Progress Report Form
Exhibit D – Determination of suitability required, in advance, for certain individuals who may interact with participating minors
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

City of Vallejo Prop 47 Grant Agreement – DOVE

Exhibit E - Subrecipient Monitoring Plan
U. Entire Agreement
This Agreement, and the attached exhibits, constitute the entire Agreement between the parties hereto relating to the Project and may not be modified except by an instrument in writing signed by the parties hereto.
(signatures on next page)
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

City of Vallejo Prop 47 Grant Agreement – DOVE

IN WITNESS WHEREOF, the parties have entered into this Agreement on the day and year first hereinabove appearing.

DOVE
a California non-profit corporation CITY OF VALLEJO
By:_______________________

CAMERON CLARK
Executive Director
DATE: ____________________
_______________________
Vallejo Business License #
(City Seal)
By: ___________________

MICHAEL MALONE
City Manager
DATE: _________________
ATTEST:
_______________________________
DAWN G. ABRAHAMSON
City Clerk
APPROVED AS TO CONTENT:
________________________________

JASON TA
Chief of Police
________________________________
APPROVED AS TO FORM:

VERONICA A. F. NEBB
City Attorney
APPROVED AS TO INSURANCE:
________________________________

ARMOND SARKIS
Risk Manager
05/15/2023
11718454
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57 7/10/2023

City of Vallejo Prop 47 Grant Agreement – DOVE

EXHIBIT A
DOVE

SCOPE OF SERVICES
A. Program Description:

DOVE and partners’ will provide prevention and intervention programs for individuals impacted by the criminal justice system through implementing innovative program services using lived experiences to identify barriers to sustainability to assist at-risk and in-risk individuals transitioning from the criminal justice system back into their communities successfully.

Specifically, DOVE will use their Vallejo Community Ambassador Program (VCAP) to provide on-site support to the Vallejo Police Department (VPD) in addressing justice-involved TAY youth in the community. The key responsibilities of VCAP are centered on building trust and engaging in trauma-informed community-based crisis response that promotes safety, helps to resolve conflict, alternative to prison, on-site support, resources, and reliable referrals for peer support and a host of critical needs and services..

KEY PROGRAM OBJECTIVES

1. Provide safety net for justice-involved transitional aged youth (TAY) through case management,
service connection, emergency access through hotel vouchers and advocacy.

2. Host free quarterly training sessions for community leaders, service providers and other key stakeholders on the justice-involved TAY including lived experiences, available resources and distinguishing criminality from culture.

3. Provide transportation to necessary appointments including case management services, job interviews and court appearances.

4. Provide wraparound holistic services and programming to justice-involved TAY youth through comprehensive case management, warm hand off referrals and voluntary service connection to navigate systems.

5. Provide key alternative programming to prevent incarceration, such as prevention curriculum to address criminal and addictive thinking, gang addiction prevention and drug/alcohol treatment.

Program Budget:

DOVE program elements will cost $200,000 over the course of the grant.

Costs include salaries for VCAP - 1 Service Coordinator, 1 Project Coordinator (Director of Programs & Services) and Executive Director. The Service Connector will provide direct service to eligible participants and be the primary point of contact for eligible participants. The Director of Programs & Services will provide project oversight and supervision to Service Connector.

Project oversight will include monthly invoice and data input. The Executive Director will provide overall oversight of program compliance and primary contact for organization. The program office will be located at the D.O.V.E administration office.

Breakdown of budget costs - to be amended as necessary throughout the grant period, and MOU will be updated and executed accordingly.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

City of Vallejo Prop 47 Grant Agreement – DOVE

Activity Year 1 Year 2 Year 3
Staff/Salaries
● Executive Director
● Director of Programs and Services
● Service Connector
$5,000
$7,000
$24,600
$5,000
$7,000
$24,600
$5,000
$7,000
$24,600
Operational Cost(s)
● Website Maintenance
● Telecommunications
● Technology & Software
● Utilities
● Repairs & Maintenance
$8,000 $8,000 $8,000
Overhead Cost(s)
● Building Rent
● Insurance & Taxes
$6,000
$3,400
$6,000
$3,400
$6,000
$3,400
Office Supplies
● Printer Paper
● Pens/Pencils
● Printer Ink
● Stapler(s)
● Staples
● Hanging Files
● File Folders
● Envelope(s)
● Wireless keyboard*
● New file cabinet with key*
● Paper clips
● White board*
● Hanging Information Board*
$1,400 $1,400 $1,400
Travel
● Gas Mileage Reimbursement
● Purchase of used passenger van**
$1,500
$3,500
$1,500 $1,500
● Emergency Hotel Vouchers
● Program Cost
○ Food for participants and
activities
$1,700
$500
$1,700
$500
$1,700
$500
10% VPD Indirect Costs $6,700 $6,700 $6,600
TOTAL: $200,000
*one time cost
** if van is not eligible purchase we will reallocate to program costs DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

City of Vallejo Prop 47 Grant Agreement – DOVE

EXHIBIT B

REQUEST FOR PAYMENT
“Quarterly Financial Status Reports” will be due quarterly and act as a request for payment. The City will email DOVE an excel file for this mandatory reporting along with the schedule of due dates for each reporting period. Information regarding financial reports and reimbursements should be emailed to [email protected].

Sample Report Format:

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

City of Vallejo Prop 47 Grant Agreement – DOVE

EXHIBIT C

PROGRESS REPORT
Progress reports are due quarterly and will be developed and discussed as a part of the City and DOVE’s participation in the Prop 47 Local Advisory Committee.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

City of Vallejo Prop 47 Grant Agreement – DOVE

EXHIBIT D
Determination of suitability required, in advance, for certain individuals who may interact with participating minors

1. Advance determination regarding suitability. The recipient (and any subrecipient at any tier) may not permit any covered individual to interact with any participating minor in the course of activities under the award, unless the recipient or subrecipient first has made a written determination of the suitability of that individual to interact with participating minors, based on current and appropriate information as described in paragraph 3.E., and taking into account the factors and considerations described in paragraph 4.

2. Updates and reexaminations
A. The recipient (or subrecipient) must, at least every five years, update the searches described in paragraph 3.E.1. and 2., reexamine the covered individual's suitability determination in light of those search results, and, if appropriate, modify or withdraw that determination.

B. The recipient also must reexamine a covered individual's suitability determination upon learning of information that reasonably may suggest unsuitability and, if appropriate, modify or withdraw that determination.

3. Definitions
A. "Covered individual" means any individual (other than a participating minor, as defined in this condition, or a client of the recipient (or subrecipient)) who is expected, or reasonably likely, to interact with any participating minor (other than the individual's own minor children). A covered individual need not have any particular employment status or legal relationship with the recipient (or subrecipient). Such an individual might be an employee of a recipient (or subrecipient), but also might be (for example) a consultant, contractor, employee of a contractor, trainee, volunteer, or teacher.

B. "Participating minor." All individuals under 18 years of age within the set of individuals described in the scope section of this condition as it appears on the award document are participating minors.

C. "Interaction" includes physical contact, oral and written communication, and the transmission of images and sound and may be in person or by electronic (or similar) means. But "interaction” does not include--
(1) brief contact that is both unexpected by the recipient (or subrecipient) and unintentional on the part of the covered individual -- such as might occur when a postal carrier delivers mail to an administrative office.
(2) personally-accompanied contact -- that is, infrequent or occasional contact (for example, by someone who comes to make a presentation) in the presence of an accompanying adult, pursuant to written policies and procedures of the recipient (or subrecipient) that are designed to ensure that -- throughout the contact -- an appropriate adult who has been determined to be suitable pursuant to this condition will closely and personally accompany, and remain continuously within view and earshot of, the covered individual.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

City of Vallejo Prop 47 Grant Agreement – DOVE

D. "Activities under the award." Whether paid for with federal funds from the award, "matching” funds included in the OJP-approved budget for the award, or "program income" for the award as defined by the (DOJ) Part 200 Uniform Requirements), activities under the award include both-- (1) activities carried out under the award by the recipient (or subrecipient); and (2) actions taken by an entity or individual pursuant to a procurement contract under the award or to a procurement contract under a subaward at any tier.

E. "Current and appropriate information"
In addition to information resulting from checks or screening required by applicable federal, state, tribal, or local law, and/or by the recipient's (or subrecipient's) written policies and procedures, current and appropriate information includes the results of all required searches listed below, each of which must be completed no earlier than six months before the determination regarding suitability.
(1) Public sex offender and child abuse websites/registries A search (by current name, and, if applicable, by previous name(s) or aliases), of the pertinent and reasonably- accessible federal, state, and (if applicable) local and tribal sex offender and child abuse websites/public registries, including--
(a) the Dru Sjodin National Sex Offender Public Website (www.nsopw.gov); (b) the website/public registry for each state (and/or tribe, if applicable) in which the individual lives, works, or goes to school, or has lived, worked, or gone to school at any time during the past five years; and
(c) the website/public registry for each state (and/or tribe, if applicable) in which the individual is expected to, or reasonably likely to, interact with a participating minor in the course of activities under the award.
(2) Criminal history registries and similar repositories of criminal history records For each individual at least 18 years of age who is a covered individual under this FY 2019 award, a fingerprint search (or, if the recipient or subrecipient documents that a fingerprint search is not legally available, a name-based search, using current and, if applicable, previous names and aliases) -- encompassing at least the time period beginning five calendar years preceding the date of the search request -- of pertinent state (and, if applicable, local and tribal) criminal history registries or similar repositories, including-- (a) the criminal history registry for each state in which the individual lives, works, or goes to school, or has lived, worked, or gone to school at any time during the past five years; and (b) the criminal history registry for each state in which he or she is expected to, or reasonably likely to, interact with a participating minor in the course of activities under the award.

4. Factors and considerations in determinations regarding suitability In addition to the factors and considerations that must or may be considered under applicable federal, state, tribal, or local law, and under the recipient's (or subrecipient's) written policies and procedures, in making a determination regarding suitability, the recipient (or subrecipient) must DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

City of Vallejo Prop 47 Grant Agreement – DOVE

consider the current and appropriate information described in paragraph 3.E.

In particular (unless applicable law precludes it), with respect to either an initial determination of suitability or a subsequent reexamination, the recipient (or subrecipient) may not determine that a covered individual is suitable to interact with participating minors in the course of activities under the award if the covered individual--
A. Withholds consent to a criminal history search required by this condition.

B. Knowingly makes (or made) a false statement that affects, or is intended to affect, any search required by this condition.

C. Is listed as a registered sex offender on the Dru Sjodin National Sex Offender Public Website;
D. To the knowledge of the recipient (or subrecipient), has been convicted -- whether as a felony or misdemeanor -- under federal, state, tribal, or local law of any of the following crimes (or any substantially equivalent criminal offense, regardless of the specific words by which it may be identified in law):
(1) sexual or physical abuse, neglect, or endangerment of an individual under the age of 18 at the time of the offense;
(2) rape/sexual assault, including conspiracy to commit rape/sexual assault; (3) sexual exploitation, such as through child pornography or sex trafficking; (4) kidnapping;
(5) voyeurism; or
E. Is determined by a federal, state, tribal, or local government agency not to be suitable.

5. Administration; rule of construction
A. The requirements of this condition are among those that must be included in any subaward (at any tier), and must be monitored. They apply as of the date of acceptance of this award, and throughout the remainder of the period of performance.

B. The recipient is to contact the DOJ awarding agency with any questions regarding the requirements of this condition and must not allow a covered individual to interact with a participating minor until such questions are answered.

C. Award funds may be obligated for the reasonable, necessary, and allocable costs (if any) of actions designed to ensure compliance with this condition, provided that such funds would not supplant non-federal funds that would otherwise be available for such costs.

D. Nothing in this condition shall be understood to authorize or require any recipient, any subrecipient at any tier, or any person or other entity, to violate any federal, state, tribal, or local law, including any applicable civil rights or nondiscrimination law.

More information found at: https://www.ojp.gov/funding/explore/interact-minors DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

City of Vallejo Prop 47 Grant Agreement – DOVE

EXHIBIT E
Subrecipient Monitoring Plan
The City of Vallejo will be responsible for collecting, aggregating, and submitting all required reports and performing necessary subrecipient monitoring activities to ensure Project H OME is compliant with all relevant federal guidelines, including Prop 47 program guidance and BSCC requirements.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

INSTRUCTIONS TO PRINTERS
FORM W-9, PAGE 1 of 4
MARGINS: TOP 13mm (1⁄2"), CENTER SIDES. PRINTS: HEAD to HEAD PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216mm (81⁄2") 3 279mm (11")
PERFORATE: (NONE)

Give form to the
requester. Do not
send to the IRS.

Form W-9 Request for Taxpayer
Identification Number and Certification

(Rev. October 2007)
Department of the Treasury
Internal Revenue Service
Name (as shown on your income tax return)

List account number(s) here (optional)
Address (number, street, and apt. or suite no.)
City, state, and ZIP code
Print or type
See Specific Instructions on page 2.

Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.

Social security number
or
Requester’s name and address (optional)
Employer identification number Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter.

Certification

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and

2. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.

For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. See the instructions on page 4.

Sign
Here

Signature of
U.S. person©

Date©
General Instructions

FormW-9(Rev. 10-2007)
Part I

Part II

Business name, if different from above

Cat. No. 10231X

Check appropriate box:

Under penalties of perjury, I certify that:

13 I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT TLS, have you
transmitted all R
text files for this
cycle update?

Date

Action

Revised proofs
requested

Date

Signature

O.K. to print

Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to:

1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued),

2. Certify that you are not subject to backup withholding, or

3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners’ share of effectively connected income.

3. I am a U.S. citizen or other U.S. person (defined below).

A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA.

Individual/Sole proprietor

Corporation

Partnership

Other (see instructions)©

Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9.

cAn individual who is a U.S. citizen or U.S. resident alien, cA partnership, corporation, company, or association created or organized in the United States or under the laws of the United States,
cAn estate (other than a foreign estate), or

Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are:

Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners’ share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax.

Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income.

The person who gives Form W-9 to the partnership for
purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases:
cThe U.S. owner of a disregarded entity and not the entity,

Section references are to the Internal Revenue Code unless otherwise noted.

cA domestic trust (as defined in Regulations section
301.7701-7).

Limited liability company. Enter the tax classification (D=disregarded entity, C=corporation, P=partnership)©

Exempt
payee

Purpose of Form

07/30/2022
Developing Organizing Visions for Everyone, Inc. (D.O.V.E.) ✔
2635 Napa Street, Box 1174
Vallejo, CA 94590
82 4418652
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

INSTRUCTIONS TO PRINTERS
FORM W-9, PAGE 2 of 4
MARGINS: TOP 13 mm (1⁄2"), CENTER SIDES. PRINTS: HEAD to HEAD PAPER: WHITEWRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216 mm (81⁄2") 3 279 mm (11")
PERFORATE: (NONE)

Form W-9 (Rev. 10-2007) Page2
Sole proprietor. Enter your individual name as shown on your income tax return on the “Name” line. You may enter your business, trade, or “doing business as (DBA)” name on the “Business name” line.

13 I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT Other entities. Enter your business name as shown on required federal tax documents on the “Name” line. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on the “Business name” line.

If the account is in joint names, list first, and then circle, the name of the person or entity whose number you entered in Part I of the form.

Specific Instructions
Name

Exempt Payee

5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only).

Certain payees and payments are exempt from backup
withholding. See the instructions below and the separate Instructions for the Requester of Form W-9.

Civil penalty for false information with respect to
withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty.

Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment.

Penalties
Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect.

Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties.

If you are an individual, you must generally enter the name shown on your income tax return. However, if you have changed your last name, for instance, due to marriage without informing the Social Security Administration of the name change, enter your first name, the last name shown on your social security card, and your new last name.

If you are exempt from backup withholding, enter your name as described above and check the appropriate box for your status, then check the “Exempt payee” box in the line following the business name, sign and date the form.

4. The IRS tells you that you are subject to backup
withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or

3. The IRS tells the requester that you furnished an incorrect TIN,

2. You do not certify your TIN when required (see the Part II instructions on page 3 for details),

You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return.

1. You do not furnish your TIN to the requester,

What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 28% of such payments. This is called “backup withholding.” Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding.

Payments you receive will be subject to backup
withholding if:

If you are a nonresident alien or a foreign entity not subject to backup withholding, give the requester the appropriate
completed Form W-8.

Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption.

Note. You are requested to check the appropriate box for your status (individual/sole proprietor, corporation, etc.).

4. The type and amount of income that qualifies for the exemption from tax.

5. Sufficient facts to justify the exemption from tax under the terms of the treaty article.

Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income.

However, most tax treaties contain a provision known as a “saving clause.” Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes.

If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items:

1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien.

2. The treaty article addressing the income.

3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions.

Also see Special rules for partnerships on page 1.

Foreign person. If you are a foreign person, do not use Form W-9. Instead, use the appropriate Form W-8 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities).

cThe U.S. grantor or other owner of a grantor trust and not the trust, and
cThe U.S. trust (other than a grantor trust) and not the beneficiaries of the trust.

Limited liability company (LLC). Check the “Limited liability company” box only and enter the appropriate code for the tax classification (“D” for disregarded entity, “C” for corporation, “P” for partnership) in the space provided.

For a single-member LLC (including a foreign LLC with a domestic owner) that is disregarded as an entity separate from its owner under Regulations section 301.7701-3, enter the owner’s name on the “Name” line. Enter the LLC’s name on the “Business name” line.

For an LLC classified as a partnership or a corporation, enter the LLC’s name on the “Name” line and any business, trade, or DBA name on the “Business name” line.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

INSTRUCTIONS TO PRINTERS
FORM W-9, PAGE 3 of 4
MARGINS: TOP 13 mm (1⁄2"), CENTER SIDES. PRINTS: HEAD to HEAD PAPER: WHITEWRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216 mm (81⁄2") 3 279 mm (11")
PERFORATE: (NONE)

I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT Form W-9 (Rev. 10-2007) Page3
13 Part I. Taxpayer Identification
Number (TIN)
Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below.

How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local Social Security Administration office or get this form online at www.ssa.gov. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/businesses and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W-7 and SS-4 from the IRS by visiting www.irs.gov or by calling 1-800-TAX-FORM (1-800-829-3676).

If you are asked to complete Form W-9 but do not have a TIN, write “Applied For” in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup
withholding on all such payments until you provide your TIN to the requester.

If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. However, the IRS prefers that you use your SSN.

If you are a single-member LLC that is disregarded as an entity separate from its owner (see Limited liability company (LLC) on page 2), enter the owner’s SSN (or EIN, if the owner has one). Do not enter the disregarded entity’s EIN. If the LLC is classified as a corporation or partnership, enter the entity’s EIN.

Note. See the chart on page 4 for further clarification of name and TIN combinations.

Note. Entering “Applied For” means that you have already applied for a TIN or that you intend to apply for one soon.

Caution: A disregarded domestic entity that has a foreign owner must use the appropriate Form W-8.

9. A futures commission merchant registered with the
Commodity Futures Trading Commission,

10. A real estate investment trust,

11. An entity registered at all times during the tax year under the Investment Company Act of 1940,

12. A common trust fund operated by a bank under section 584(a),

13. A financial institution,

14. A middleman known in the investment community as a
nominee or custodian, or

15. A trust exempt from tax under section 664 or described in section 4947.

THEN the payment is exempt
for . . .

IF the payment is for . . .

All exempt payees except
for 9

Interest and dividend payments

Exempt payees 1 through 13.

Also, a person registered under
the Investment Advisers Act of
1940 who regularly acts as a
broker

Broker transactions

Exempt payees 1 through 5

Barter exchange transactions
and patronage dividends
Generally, exempt payees
1 through 7

Payments over $600 required
to be reported and direct
sales over $5,000

See Form 1099-MISC, Miscellaneous Income, and its instructions.

However, the following payments made to a corporation (including gross proceeds paid to an attorney under section 6045(f), even if the attorney is a corporation) and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys’ fees, and payments for services paid by a federal executive agency.

The chart below shows types of payments that may be
exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 15.

1 2

7. A foreign central bank of issue,

8. A dealer in securities or commodities required to register in the United States, the District of Columbia, or a possession of the United States,

2 The following payees are exempt from backup withholding:

1. An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2),

2. The United States or any of its agencies or
instrumentalities,

3. A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or instrumentalities,

4. A foreign government or any of its political subdivisions, agencies, or instrumentalities, or

5. An international organization or any of its agencies or instrumentalities.

Other payees that may be exempt from backup withholding include:

6. A corporation,

Generally, individuals (including sole proprietors) are not exempt from backup withholding. Corporations are exempt from backup withholding for certain payments, such as interest and dividends.

Note. If you are exempt from backup withholding, you should still complete this form to avoid possible erroneous backup withholding.

1 1. Interest, dividend, and barter exchange accounts
opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification.

2. Interest, dividend, broker, and barter exchange
accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form.

Part II. Certification

For a joint account, only the person whose TIN is shown in Part I should sign (when required). Exempt payees, see Exempt Payee on page 2.

To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if items 1, 4, and 5 below indicate otherwise.

Signature requirements. Complete the certification as indicated in 1 through 5 below.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

INSTRUCTIONS TO PRINTERS
FORM W-9, PAGE 4 of 4
MARGINS: TOP 13 mm (1⁄2"), CENTER SIDES. PRINTS: HEAD to HEAD PAPER: WHITEWRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216 mm (81⁄2") 3 279 mm (11")
PERFORATE: (NONE)

Form W-9 (Rev. 10-2007) Page4
I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Give name and EIN of:

For this type of account:

3. Real estate transactions. You must sign the certification.

You may cross out item 2 of the certification.

A valid trust, estate, or pension trust

6. Legal entity 4

4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. “Other payments” include payments made in the course of the
requester’s trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a
nonemployee for services, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations).

The corporation

Corporate or LLC electing
corporate status on Form 8832

7. The organization

Association, club, religious,
charitable, educational, or other
tax-exempt organization

8. 5. Mortgage interest paid by you, acquisition or
abandonment of secured property, cancellation of debt,
qualified tuition program payments (under section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or
distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification.

The partnership

Partnership or multi-member LLC

9. The broker or nominee

A broker or registered nominee

10. The public entity

Account with the Department of
Agriculture in the name of a public
entity (such as a state or local
government, school district, or
prison) that receives agricultural
program payments

11. Privacy Act Notice

List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person’s number must be furnished.

Circle the minor’s name and furnish the minor’s SSN.

You must show your individual name and you may also enter your business or “DBA” name on the second name line. You may use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN.

List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.) Also see Special rules for partnerships on page 1.

Note. If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed.

Disregarded entity not owned by an
individual

The owner

12. 13
You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold 28% of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to a payer. Certain penalties may also apply.

Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons who must file information returns with the IRS to report interest, dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA, or Archer MSA or HSA. The IRS uses the numbers for identification purposes and to help verify the accuracy of your tax return.

The IRS may also provide this information to the Department of Justice for civil and criminal litigation, and to cities, states, the District of Columbia, and U.S. possessions to carry out their tax laws. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism.

1 2

3 4

Secure Your Tax Records from Identity Theft
Identity theft occurs when someone uses your personal
information such as your name, social security number (SSN), or other identifying information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund.

What Name and Number To Give the Requester
Give name and SSN of:

For this type of account:

The individual

1. Individual
The actual owner of the account or,
if combined funds, the first
individual on the account

2. Two or more individuals (joint
account)

The minor 2

3. Custodian account of a minor
(Uniform Gift to Minors Act)
The grantor-trustee 1

4. a.The usual revocable savings
trust (grantor is also trustee)
The actual owner 1

b.So-called trust account that is
not a legal or valid trust under
state law
The owner 3

5. Sole proprietorship or disregarded
entity owned by an individual

Call the IRS at 1-800-829-1040 if you think your identity has been used inappropriately for tax purposes.

1 To reduce your risk:
cProtect your SSN,
cEnsure your employer is protecting your SSN, and
cBe careful when choosing a tax preparer.

Victims of identity theft who are experiencing economic harm or a system problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance.

You can reach TAS by calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD 1-800-829-4059.

Protect yourself from suspicious emails or phishing
schemes. Phishing is the creation and use of email and
websites designed to mimic legitimate business emails and websites. The most common act is sending an email to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft.

The IRS does not initiate contacts with taxpayers via emails.

Also, the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords, or similar secret access information for their credit card, bank, or other financial accounts.

If you receive an unsolicited email claiming to be from the IRS, forward this message to [email protected]. You may also report misuse of the IRS name, logo, or other IRS personal property to the Treasury Inspector General for Tax Administration at 1-800-366-4484. You can forward suspicious emails to the Federal Trade Commission at: [email protected] or contact them at www.consumer.gov/idtheft or 1-877-IDTHEFT(438-4338).

Visit the IRS website at www.irs.gov to learn more about identity theft and how to reduce your risk.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

11/28/2022
Anixter & Oser, Inc.

License 0E28888
205 San Marin Drive
Novato CA 94945-1227
Kimberly D White
(415) 898-1600 (415) 898-3922
[email protected]
Developing Organizing Visions for Everyone, DBA: D.O.V.E. Bay Area PO Box 1174
Vallejo CA 94590
Nonprofits Insurance Alliance 813319
State Compensation Ins. Fund 35076
CL22112829935
A Improper Sexual Conduct Y 2022-76673 11/24/2022 11/24/2023 1,000,000
500,000
20,000
1,000,000
2,000,000
2,000,000
A Y 2022-76673 11/24/2022 11/24/2023
1,000,000
B Y 9328515-2022 11/29/2022 11/29/2023
1,000,000
1,000,000
1,000,000
The City of Vallejo, City, its officers, officials, employees, agents and volunteers are named as additional insured per form attached City of Vallejo Attn: Risk Manager
555 Santa Clara St
Vallejo CA 94590

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE
INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #
NAME:

CONTACT
(A/C, No):

FAX
E-MAIL
ADDRESS:

PRODUCER
(A/C, No, Ext):

PHONE

INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
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).

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD

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. $
$
$
$PROPERTY DAMAGE

BODILY INJURY
(Per accident)
BODILY INJURY (Per person)

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY
Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-

STATUTE
PER

LIMITS(MM/DD/YYYY)

POLICY EXP
(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR

CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE

DAMAGE TO RENTED
$PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY PRO-

JECT LOC

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED

AUTOS ONLY
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

2022-76673 COMMERCIAL GENERAL LIABLITY
CG 20 26 04 13

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED--DESIGNATED

PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Name of Additional Insured Person(s) Or Organization(s) Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy.

The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization.

City of Vallejo, its officers, officials, employees, agents and volunteers

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf:

1. In the performance of your ongoing operations; or

2. In connection with your premises owned by or rented to you.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

B. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.

This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

IMPORTANT POLICY INFORMATION

ENCLOSED
Broker Anixter & Oser, Inc.
205 San Marin Drive
Novato, CA 94945-1227
November 28, 2022
:

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

Dear NIA Member,

Your insurance broker has put your policy on our Direct Bill Program. We have developed this more flexible billing system in response to feedback from our members.

Each month you will receive a statement documenting recent activity on your account. Similar to a credit card statement, you will have the choice to pay off the entire balance or make the minimum payment. Your first statement will require a minimum payment of 20% of the total annual premiums. The second through ninth statements will require a minimum payment of approximately 10% of the total annual premiums, plus any unpaid portion of the previous minimum payment. In addition, the minimum payment will reflect adjustments for changes in coverage.

We hope this more flexible payment method meets the needs of your organization. If you have any questions or comments, feel free to call our finance department at 800-359-6422, ext. 1737.

Sincerely,

NIA Finance Department

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

Including ALLIANCE OF NONPROFITS FOR INSURANCE (ANI) &

NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC)
www.insurancefornonprofits.org
Claims Reporting Procedure
REPORT CLAIMS IMMEDIATELY!
There is no negative impact on your policy for reporting an incident.

When in doubt – report it!
If you have any questions concerning whether to report an incident or claim, call your broker.

HOW DO YOU KNOW WHEN AN INCIDENT REQUIRES A CLAIM TO BE REPORTED?

1. There’s been an accident

2. Someone has been hurt

3. Property has been damaged

4. You think someone ought to know “just in case”
IF YOU NEED TO REPORT A CLAIM:

1. Complete the appropriate reporting form:
• Driver Accident Report Form – motor vehicle accident
• Incident Report Form – all other accidents
An original of these forms follows this page of your policy. Additional forms are available at our secure website: www.insurancefornonprofits.org.

NOTE: Claims for Swiss Re Corporate Solutions Elite Insurance Corp. or NIAC Property Insurance do not require a separate form. Your insurance broker will send us an ACORD claim form.

2. Tell your insurance broker to report the claim to our Claims Department by email at: [email protected]

EMERGENCY SITUATIONS
If you need to report a claim during non-business hours and cannot reach your broker, call 1-866-718-1947. This number should only be used for true claims emergencies.

Rev. 07/2016

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

Including ALLIANCE OF NONPROFITS FOR INSURANCE (ANI) &

NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC)
www.insurancefornonprofits.org

Rev. 10/2014 Page 1 of 3

Incident Report Form

CLAIMS REPORTING PROCEDURE
If you have a question concerning whether to report an incident or claim, call your broker.

NONPROFIT / INSURED --- Complete all items to the best of your ability, sign and date page 2, and immediately give it to your supervisor.

Supervisor -- - Fax this Incident Report Form to your insurance broker immediately.

Important: Retain any equipment or furniture which caused or contributed to an injury until it can be inspected by an insurance representative.

BROKER --- Refer to our website for instructions on claim reporting.

If a claim needs to be reported after business hours or on the weekend, call (866) 718-1947.

This number is reserved for true claims emergencies after business hours and weekends.

General Information
Name of Nonprofit Organization ANI/NIAC Policy Number
Name of Contact Title
Nonprofit Address --- Street City State Zip
Business Phone # Ext.
( )
Business Fax #
( )
E-mail Address
Incident Information
Date of Incident

Day of Week (circle one)
Mon Tue Wed Thurs Fri Sat Sun
Time of Incident

AM / PM
Did the incident occur on organization’s premises?
Yes No
Location of Incident (if possible, take pictures of the area with a digital or disposable camera) Description of Incident (A brief factual account of the incident; include who was involved, how the incident occurred and what action is being taken in response
to the incident. Use the back of t he sheet if more space is needed.)

Witness Information
Name and Address Daytime Phone Email Address DOB

1. 2.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

Rev. 10/2014 Page 2 of 3

Claimant Information

1. Name of Injured Party

DOB Employee Client Volunteer Visitor
Other ---
Address --- Street City State Zip

Home Phone # Business Phone # Email Address
( ) ( )
Description of Injury (nature and extent of; please be specific):

Transported by Ambulance
Yes No
Name and Phone # of Hospital or Doctor, if applicable
Observations of Nonprofit
Claimant’s Attire/Description of Clothing (i.e., shorts, t-shirt)

Type of Shoes Was Claimant carrying anything? (if yes, what) No Yes ---
Describe claimant’s demeanor when making the report (i.e., agitated, in obvious or no obvious pain, able to move around while describing what happened, etc.)

(use the back of the form or attach an additional sheet of paper if needed) Claimant Information

2. Name of Injured Party

DOB Employee Client Volunteer Visitor
Other ---
Address --- Street City State Zip
Home Phone # Business Phone # Email Address
( ) ( )
Description of Injury (nature and extent of; please be specific):

Transported by Ambulance
Yes No
Name and Phone # of Hospital or Doctor, if applicable
Observations of Nonprofit
Claimant’s Attire/Description of Clothing (i.e., shorts, t-shirt)

Type of Shoes Was Claimant carrying anything? (if yes, what) No Yes ---
Describe claimant’s demeanor when making the report (i.e., agitated, in obvious or no obvious pain, able to move around while describing what happened, etc.)

(use the back of the form or attach an additional sheet of paper if needed)

PRINT NAME OF INDIVIDUAL COMPLETING THE FORM SIGNATURE DATE DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

Including ALLIANCE OF NONPROFITS FOR INSURANCE (ANI) &

NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC)
www.insurancefornonprofits.org

Rev. 10/2014 Page 1 of 3

Driver’s Collision Report Form

IN THE EVENT OF A COLLISION:

NONPROFIT / INSURED

Driver -- - Complete all items to the best of your ability, sign and date page 3, and immediately give it to your supervisor.

Supervisor -- - Fax this Driver’s Collision Report form to your insurance broker immediately.

BROKER Refer to our website for instructions on claim reporting.

If a claim needs to be reported after business hours or on the weekend, call (866) 718-1947.

This number is reserved for true claims emergencies after business hours and weekends.

Driver/Vehicle Information
Name of Driver (first and last) Driver’s Age Driver License No. State Driver’s Address --- Street City State Zip Telephone No. ( )
Name of Nonprofit / Employer ANI/NIAC Policy Number
Nonprofit/Employer Contact Name Contact Email Address
Nonprofit / Employer Address --- Street City State Zip Telephone No.

Make of Nonprofit’s Vehicle Body Type Year License Plate # V.I.N. (last four digits) Damage to Nonprofit’s Vehicle:

Collision Information
Date of Collision

Day of Week (circle one)
Mon Tue Wed Thurs Fri Sat Sun
Time of Collision

AM / PM
Location - Street or Highway & City
On what street were you driving?

Direction (circle one)

N S E W
Speed (approximate)
On what street was other vehicle driving?

Direction (circle one)

N S E W
Speed (approximate)
Police Report?
Yes No
If yes, name of reporting officer Agency Citation/Report # Witness #1 Name (first and last)

Telephone No.
( )
Email Address
Witness #2 Name (first and last)

Telephone No.
( )
Email Address
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

Rev. 10/2014 Page 2 of 3

Description of Collision (include weather and road conditions):
(Use the back of this sheet if additional space is needed; please use the diagrams on page 3 to draw the collision) Passenger(s) in Your Vehicle (attached additional pages if needed) Name (first and last)

Telephone No.
( )
Email Address Age Injuries?
Yes No
Name

Telephone No.
( )
Email Address Age Injuries?
Yes No
Name

Telephone No.
( )
Email Address Age Injuries?
Yes No
Ambulance called to scene?
Yes No
Name of doctor or hospital
Other Vehicle Involved
Name of Driver (first and last)

Driver License No. State
Address - Street City/State/Zip Telephone No.
( )
Email Address
Name of Vehicle Owner (if different than above) Telephone No. ( )
Email Address
Name of Insurance Company Policy # Telephone No.
( )
Year/Make of Vehicle Body Type License Plate No. State Damage to Vehicle:

Passenger’s Name (first and last)

Telephone No.
( )
Email Address Age Injuries?
Yes No
Passenger’s Name (first and last)

Telephone No.
( )
Email Address Age Injuries?
Yes No
Other Vehicle Involved (if any)
Name of Driver (first and last)

Driver License No. State
Address - Street City/State/Zip Telephone No.
( )
Email Address
Name of Vehicle Owner (if different than above) Telephone No. ( )
Email Address
Name of Insurance Company Policy # Telephone No.
( )
Year/Make of Vehicle Body Type License Plate No. State Damage to Vehicle:

Passenger’s Name (first and last)

Telephone No.
( )
Email Address Age Injuries?
Yes No
Passenger’s Name (first and last)

Telephone No.
( )
Email Address Age Injuries?
Yes No

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

Rev. 10/2014 Page 3 of 3

On the diagrams below, please draw the collision. Legend: N (Be sure to include any stop signs or traffic signals.) V 1  Your Vehicle 

V 2  Other Vehicle W   E

V 3  Other Vehicle (if any) 

S

▌ ▐
▌ ▐
▌ ▐
▌ ▐
▌ ▐

▌ ▌
▌ ▌
▌ ▌
▌ ▌
▌ ▌

On the overhead diagrams below, please indicate the location of damage to your vehicle, if any.

back ------------ VAN ------------ front back ------------ AUTO ----------- front

SIGNATURE OF DRIVER DATE

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

IL N 119 09 15

IL N 119 09 15 © Insurance Services Office, Inc., 2015 Page 1 of 1

CALIFORNIA AUTO BODY REPAIR CONSUMER BILL OF
RIGHTS

(This form was developed by the California Department of Insurance)

A CONSUMER IS ENTITLED TO:

1. SELECT THE AUTO BODY REPAIR SHOP TO REPAIR AUTO BODY DAMAGE COVERED BY THE INSURANCE COMPANY. AN INSURANCE COMPANY SHALL NOT REQUIRE THE REPAIRS TO BE DONE AT A SPECIFIC AUTO BODY REPAIR SHOP.

2. AN ITEMIZED WRITTEN ESTIMATE FOR AUTO BODY REPAIRS AND, UPON COMPLETION OF REPAIRS, A DETAILED INVOICE. THE ESTIMATE AND THE INVOICE MUST INCLUDE AN ITEMIZED LIST OF PARTS AND LABOR ALONG WITH THE TOTAL PRICE FOR THE WORK PERFORMED. THE

ESTIMATE AND INVOICE MUST ALSO IDENTIFY ALL PARTS AS NEW, USED, AFTERMARKET, RECONDITIONED, OR REBUILT.

3. BE INFORMED ABOUT COVERAGE FOR TOWING AND STORAGE SERVICES.

4. BE INFORMED ABOUT THE EXTENT OF COVERAGE, IF ANY, FOR A REPLACEMENT RENTAL VEHICLE WHILE A DAMAGED VEHICLE IS BEING REPAIRED.

5. BE INFORMED OF WHERE TO REPORT SUSPECTED FRAUD OR OTHER COMPLAINTS AND CONCERNS ABOUT AUTO BODY REPAIRS.

6. SEEK AND OBTAIN AN INDEPENDENT REPAIR ESTIMATE DIRECTLY FROM A REGISTERED AUTO

BODY REPAIR SHOP FOR REPAIR OF A DAMAGED VEHICLE, EVEN WHEN PURSUING AN INSURANCE CLAIM FOR REPAIR OF THE VEHICLE.

COMPLAINTS WITHIN THE JURISDICTION OF THE BUREAU OF AUTOMOTIVE REPAIR Complaints concerning the repair of a vehicle by an auto body repair shop should be directed to:

Toll Free (866) 799-3811

California Department of Consumer Affairs
Bureau of Automotive Repair
10949 North Mather Blvd.

Rancho Cordova, CA 95670
The Bureau of Automotive Repair can also accept complaints over its web site at: www.autorepair.ca.gov

COMPLAINTS WITHIN THE JURISDICTION OF THE CALIFORNIA INSURANCE COMMISSIONER Any concerns regarding how an auto insurance claim is being handled should be submitted to the Californ ia Department of Insurance at:
(800) 927-HELP or (213) 897-8921

California Department of Insurance
Consumer Services Division
300 South Spring Street
Los Angeles, CA 90013
The California Department of Insurance can also accept complaints over its web site at: www.insurance.ca.gov

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

Developing Organizing Visions for Everyone
NAME OF INSURED AND MAILING ADDRESS:

Anixter & Oser, Inc.
205 San Marin Drive
Novato, CA 94945-1227
POLICY NUMBER:
2022-76673 PRODUCER:

COMMERCIAL LINES COMMON POLICY DECLARATIONS
2635 Napa St.

Vallejo, CA 94590
POLICY PERIOD: FROM TO 11/24/2023 11/24/2022
AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION: Resource, referral, education for formerly incarcerated

IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE A S STATED IN THIS POLICY.

THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THESE PREMIUMS MAY BE SUBJECT TO ADJUSTMENT.

PREMIUM
.............................. $1,077 COMMERCIAL GENERAL LIABILITY COVERAGE PART - OCCURRENCE ................................................... ............. $250 COMMERCIAL AUTO LIABILITY COVERAGE PART .............................................. Not Covered COMMERCIAL AUTO PHYSICAL DAMAGE COVERAGE PART $739 .......................... IMPROPER SEXUAL CONDUCT AND PHYSICAL ABUSE COVERAGE PART SOCIAL SERVICE PROFESSIONAL COVERAGE PART Not Covered ................................................... .......

COMMERCIAL LIQUOR LIABILITY COVERAGE PART
TERRORISM COVERAGE (Certified Acts)
TOTAL: $2,066
Not Covered

INCLUDED
................................................... ........................... ................................................... .......

FORM(S) AND ENDORSEMENT(S) MADE A PART OF THIS POLICY AT TIME OF ISSUE:* CG 00 01 04 13, CG 00 33 04 13, CG 20 10 12 19, CG 20 11 12 19, CG 20 12 04 13, CG 20 18 04 13, CG 20 20 11 85, CG 20 21 07 98, CG 20 26 12 19, CG 20 34 12 19, CG 20 37 12 19, CG 21 09 06 15, CG 21 47 12 07, CG 21 73 01 15, CG 21 96 03 05, CG 22 44 04 13, CG 24 07 01 96, IL 00 17 11 98, IL 00 21 09 08, IL 02 70 12 19, NIAC-A L 01 80, NIAC-E003 GL 08 20, NIAC-E069 GL 02 19, NIAC-E078 1 1 20, NIAC-E11 GL 09 19, NIAC-E120 09 19, NIAC-E123 09 19, NIAC-E15 09 20, NIAC-E180 GL 01 21, NIAC-E180 LL 01 21, NIAC-E195 G L 05 21, NIAC-E22 09 19, NIAC-E25 12 15, NIAC-E26 1 1 17, NIAC-E28 01 99, NIAC-E282 GL 12 21, NIAC-E29 12 09, NIAC-E33 GL 09 19, NIAC-E34 09 18, NIAC-E342 GL 08 22, NIAC-E42 GL 09 19, NIAC-E5 07 15, NIAC-E56 01 17, NIAC-E59 02 12, NIAC-E60 07 12, NIA C-E61 02 19, NIAC-E70 03 19, NIAC-E72 01 17, NIAC-E 74 03 14, NIAC-GL 01 80, NIAC-LL 01 80, NIAC-NPO-001 05 20, N IAC-SC 01 80, NIAC-X1 06 18, SCHEDULE BA 01 80, SCH EDULE G 01 80, SCHEDULE L 01 80
*OMITS APPLICABLE FORMS AND ENDORSEMENTS IF SHOWN IN
SPECIFIC COVERAGE PART / COVERAGE FORM DECLARATIONS.

COUNTERSIGNED: BY
(AUTHORIZED REPRESENTATIVE)

THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY.

NIAC-CO
11/28/2022
Notice: This risk pooling contract is issued by a pooling arrangement authorized by California Corporations Code Section 5005.1. The pooling arrangement is not subject to all of the insurance laws of the State of California and is not subject to regulation by the Insurance Commissioner. Insurance guaranty funds are not available to pay claims in the event the risk pool becomes insolvent.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

Anixter & Oser, Inc.
205 San Marin Drive
Novato, CA 94945-1227
2022-76673 POLICY NUMBER: PRODUCER:

COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS NAME OF INSURED AND MAILING ADDRESS:

Developing Organizing Visions for Everyone
................................................... .... DAMAGE TO PREMISES RENTED TO YOU any one premises 2635 Napa St.

Vallejo, CA 94590
POLICY PERIOD: 11/24/2023 TO 11/24/2022 FROM
AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE Resource, referral, education for formerly incarcerated BUSINESS DESCRIPTION:

IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE A S STATED IN THIS POLICY.

LIMITS OF COVERAGE:
$2,000,000 GENERAL AGGREGATE LIMIT (OTHER THAN PRODUCTS - COMPLETED OPERATIONS) $2,000,000 .......................... PRODUCTS - COMPLETED OPERATIONS AGGREGATE LIMIT $1,000,000 ................................................. PERSONAL AND ADVERTISING INJURY LIMIT $1,000,000 ................................................... ............................. EACH OCCURRENCE LIMIT $500,000
any one person
ADDITIONAL COVERAGES:

MEDICAL EXPENSE LIMIT $20,000 ................................................... ...................................

CLASSIFICATION(S) SEE ATTACHED SUPPLEMENTAL DECLARATIONS SCHEDULE G

PREMIUM

FORMS AND ENDORSEMENTS APPLICABLE TO THIS POLICY ARE INCLUDED IN COMMERCIAL LINES COMMMON POLICY DECLARATIONS COUNTERSIGNED: BY
(AUTHORIZED REPRESENTATIVE)

THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY.

NIAC-GL
$1,077
11/28/2022
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

COMMERCIAL GENERAL LIABILITY

EXTENSION OF DECLARATIONS
POLICY NUMBER:

NAME OF INSURED:
2022-76673-NPO
Schedule G
1Page
Developing Organizing Visions for Everyone

PREMISES

CODE/CLASS
*LOC PREMIUM
BASIS
RATE *ADVANCED

PREMIUM
$921 47366/Sales, Service or Consulting Organizations - NOC - includes products and/or completed operations

5.414 170,000 1
$47 41670/Clubs - civic, service or social - no bldgs or prem owned or leased except for office purposes - NFP

1.583 30 1

ADDITIONAL COVERAGES
Event # # of people Description
Activities/Field Trips:
40 $50 Annual fundraiser 1
Increased Aggregate $59
*See Common Declarations for Total Advanced Premium and Schedule 'L' for locations.

COUNTERSIGNED: BY
(AUTHORIZED REPRESENTATIVE)

NIAC - SCHEDULE G - NPO
11/28/2022
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

COMMERCIAL GENERAL LIABILITY

EXTENSION OF DECLARATIONS
POLICY NUMBER:

NAME OF INSURED:
2022-76673-NPO
Schedule L

PREMISES

LOC/BLDG

DESIGNATED PREMISES

ADDRESS, CITY, STATE, ZIP

ADDITIONAL INSUREDS

AND OTHER INTERESTS
Developing Organizing Visions for Everyone
No Physical Location
Vallejo, CA 94589
1 COUNTERSIGNED: BY
(AUTHORIZED REPRESENTATIVE)

NIAC - SCHEDULE L
11/28/2022
- NPO
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

IMPROPER SEXUAL CONDUCT AND PHYSICAL ABUSE LIABILITY

COVERAGE PART DECLARATIONS
Developing Organizing Visions for Everyone
NAME OF INSURED AND MAILING ADDRESS:
2022-76673 POLICY NUMBER:

Anixter & Oser, Inc.
205 San Marin Drive
Novato, CA 94945-1227
PRODUCER:
2635 Napa St.

Vallejo, CA 94590
POLICY PERIOD: FROM 11/24/2022 11/24/2023 TO
AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION: Resource, referral, education for formerly incarcerated

IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE A S STATED IN THIS POLICY.

LIMITS OF COVERAGE:

GENERAL AGGREGATE $1,000,000
$1,000,000 EACH CLAIM LIMIT

PREMIUM
$739 ................................................... .......................... ................................................... ..................................

NOTE: The limit of liability available to pay judge ments or settlements shall be reduced by amounts in curred for Defense Costs.

FORMS AND ENDORSEMENTS APPLICABLE TO THIS COVERAGE PART AND MADE PART OF THIS POLICY AT THE TIME OF IS SUANCE:

TOTAL PREMIUM: $739
NIAC-E069 ISC 02 19, NIAC-E131 ISC 05 20, NIAC-E180 ISC 01 21, NIAC-E342 ISC 08 22, NIAC-E57 02 12, NI AC-ISCET 05 20 COUNTERSIGNED: BY
(AUTHORIZED REPRESENTATIVE)
Notice: This risk pooling contract is issued by a pooling arrangement authorized by California Corporations Code Section 5005.1. The pooling arrangement is not subject to all of the insurance laws of the State of California and is not subject to regulation by the Insurance Commissioner. Insurance guaranty funds are not available to pay claims in the event the risk pool becomes insolvent.

NIAC-ISC
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

COMMERCIAL LIQUOR LIABILITY COVERAGE PART DECLARATIONS
PRODUCER:

NAME OF INSURED AND MAILING ADDRESS:

POLICY NUMBER:

Anixter & Oser, Inc.
205 San Marin Drive
Novato, CA 94945-1227
2022-76673
Developing Organizing Visions for Everyone
2635 Napa St.

Vallejo, CA 94590
EACH COMMON CAUSE LIMIT..............................................................

CG 00 33 04 13
1,000,000
1,000,000
POLICY PERIOD: FROM TO
AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION:

IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE A S STATED IN THIS POLICY.

LIMITS OF COVERAGE:

GENERAL AGGREGATE LIMIT............................ .................................. $ $
Included PREMIUM:

FORMS AND ENDORSEMENTS APPLICABLE TO THIS COVERAGE PART AND MADE PART OF THIS POLICY AT THE TIME OF IS SUANCE:
11/24/2022 11/24/2023
Resource, referral, education for formerly incarcerated

THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY.

COUNTERSIGNED: BY
(AUTHORIZED REPRESENTATIVE)
Notice: This risk pooling contract is issued by a pooling arrangement authorized by California Corporations Code Section 5005.1. The pooling arrangement is not subject to all of the insurance laws of the State of California and is not subject to regulation by the Insurance Commissioner. Insurance guaranty funds are not available to pay claims in the event the risk pool becomes insolvent.

NIAC - LL
11/28/2022
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

INDEX OF FORMS ATTACHED TO THE POLICY
POLICY NUMBER: 2022-76673
Developing Organizing Visions for Everyone NAME OF INSURED: Page: 1

LIABILITY FORMS AND ENDORSEMENTS FORM NUMBER/EDITION DATE Commercial General Liability Coverage Form CG 00 01 04 13 Liquor Liability Coverage Form CG 00 33 04 13
Additional Insured - Owners, Lessees or Contractors CG 20 10 12 19 Additional Insured - Managers or Lessors of Premises CG 20 11 12 19 Additional Insured - State or Political Subdivisions - Permits CG 20 12 04 13 Additional Insured - Mortgagee, Assignee or Receiver CG 20 18 04 13 Additional Insured - Charitable Institutions CG 20 20 11 85 Additional Insured - Volunteers CG 20 21 07 98
Additional Insured - Designated Person or Organization CG 20 26 12 19 Additional Insured - Lessor of Leased Equipment - Automatic Status - Lease CG 20 34 12 19 Additional Insured - Owners, Lessees or Contractors - Completed Operations CG 20 37 12 19 Exclusion - Unmanned Aircraft CG 21 09 06 15
Employment-Related Practices Exclusion CG 21 47 12 07
Exclusion of Certified Acts of Terrorism CG 21 73 01 15 Silica - Exclusion CG 21 96 03 05
Health or Cosmetic Services Exclusion CG 22 44 04 13
Products/Completed Operations Hazard Redefined CG 24 07 01 96 Common Policy Conditions IL 00 17 11 98
Nuclear Energy Liability Exclusion Endorsement (Broad Form) IL 00 21 09 08 California Changes - Cancellation and Nonrenewal IL 02 70 12 19 Business Auto Coverage Part Declarations NIAC-AL-NPO
Member Criteria NIAC-E003 GL 08 20
Fiscal Sponsor Limitation NIAC-E069 GL 02 19
Fiscal Sponsor Limitation NIAC-E069 ISC 02 19
Professional Services - Exclusion NIAC-E078 11 20
Fireworks Exclusion NIAC-E11 GL 09 19
Lead Liability - Exclusion NIAC-E120 09 19
Firearms Sublimit Endorsement NIAC-E123 09 19
AI - Designated Person or Organization (ET) NIAC-E131 ISC 05 20 Blood Testing Exclusion NIAC-E15 09 20
Communicable Disease - Exclusion NIAC-E180 GL 01 21
Communicable Disease - Exclusion NIAC-E180 ISC 01 21
Communicable Disease - Exclusion NIAC-E180 LL 01 21
Discrimination Exclusion NIAC-E195 GL 05 21
Asbestos Exclusion NIAC-E22 09 19
Additional Insured - Designated Person or Organization NIAC-E25 12 15 Waiver of Transfer of Rights of Recovery Against Others NIAC-E26 11 17 Property Damage to Personal Property in the Care, Custody or Control of the Insured NIAC-E28 01 99 Cyber Incident - Exclusion NIAC-E282 GL 12 21
This list of forms is not part of the actual policy, but is for your information only.

Please refer to the policy(s) for actual limits, coverages and exclusions.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

INDEX OF FORMS ATTACHED TO THE POLICY
POLICY NUMBER: 2022-76673
Developing Organizing Visions for Everyone NAME OF INSURED: Page: 2

LIABILITY FORMS AND ENDORSEMENTS FORM NUMBER/EDITION DATE Employee Personal Auto Reimbursement NIAC-E29 12 09
Mold, Fungus Exclusion NIAC-E33 GL 09 19
Construction and Conversion Exclusion NIAC-E34 09 18
Anti-Stacking Condition NIAC-E342 GL 08 22
Anti-Stacking Condition NIAC-E342 ISC 08 22
Nuclear, Chemical and Biological Hazard Exclusion NIAC-E42 GL 09 19 Trampoline Bounce House Exclusion NIAC-E5 07 15
Liberalization - GL, SSP, EBL NIAC-E56 01 17
Liberalization - ISC NIAC-E57 02 12
Liberalization - LL NIAC-E59 02 12
Volunteer Medical Payments NIAC-E60 07 12
Additional Insured - Primary and Non-Contributory Endorsement for Public Entities NIAC-E61 02 19 Fundraiser and Event Endorsement NIAC-E70 03 19
Other Insurance - Coverage C NIAC-E72 01 17
Mental Anguish Endorsement NIAC-E74 03 14
Commercial General Liability Coverage Part Declarations NIAC-GL-NPO Improper Sexual Conduct and Physical Abuse Liability Coverage Form NIAC-ISCET 05 20 Commercial Liquor Liability Coverage Part Declarations NIAC-LL 01 80 Nonprofits' OWN Enhancement Endorsement NIAC-NPO-001 05 20 Improper Sexual Conduct Liability Coverage Part Declarations NIAC-SC-NPO Improper Sexual Conduct and Physical Abuse Exclusion NIAC-X1 06 18 Business Auto Coverage Schedule SCHEDULE BA 01 80
Commercial General Liability Class Code Schedule SCHEDULE G 01 80 Commercial General Liability Location Schedule SCHEDULE L 01 80 This list of forms is not part of the actual policy, but is for your information only.

Please refer to the policy(s) for actual limits, coverages and exclusions.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

POLICY NUMBER: 2022-76673
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED

PRIMARY AND NON-CONTRIBUTORY

ENDORSEMENT FOR PUBLIC ENTITIES
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE
Name of Person or Organization:

A.

C. With respect to the insurance provided to the additional insured(s), Condition 4. Other Insurance of SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following:

Section II – WHO IS AN INSURED is amended to include:

4. Any public entity as an additional insured, and the officers, officials, employees, agents and/or volunteers of that public entity, as applicable, who may be named in the Schedule above, when you have agreed in a written contract or written agreement presently in effect or becoming effective during the term of this policy, that such public entity and/or its officers, officials, employees, agents and/or volunteers be added as an additional insured(s) on your policy, but only with respect to liability for “bodily injury”, “property damage” or “personal and advertising injury” caused, in whole or in part, by:
a. Your negligent acts or omissions; or
b. The negligent acts or omissions of those acting on your behalf; in the performance of your ongoing operations.

No such public entity or individual is an additional insured for liability arising out of the sole negligence by that public entity or its designated individuals. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization.

B. Section III – LIMITS OF INSURANCE is amended to include:

8. The limits of insurance applicable to the public entity and applicable individuals identified as an additional insured(s) pursuant to Provision A.4. above, are those specified in the written contract between you and that public entity, or the limits available under this policy, whichever are less. These limits are part of and not in addition to the limits of insurance under this policy.

4. Other Insurance
a. Primary Insurance
This insurance is primary if you have agreed in a written contract or written agreement:
(1) That this insurance be primary. If other insuran ce is also primary, we will share with all that other insurance as described in c. below; or

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

POLICY NUMBER: 2022-76673
Paragraphs (1) and (2) do not apply to other insurance to which the additional insured(s) has been added as an additional insured or to other insurance described in paragraph b. below. b. Excess Insurance
This insurance is excess over:

1. Any of the other insurance, whether primary, exce ss, contingent or on any other basis:
(a) That is Fire, Extended Coverage, Builder’s Risk, Installation Risk or similar coverage for "your work";
(b) That is fire, lightning, or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner;
(c) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises temporarily occupied by you with permission of the owner; or (d)
If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION I – COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE .
(e)
(1) When this insurance is excess, we will have no duty under Coverages A or B to defend the additional insured(s) against any "suit" if any other insurer has a duty to defend the additional insured(s) against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured(s)’ rights against all those other insurers. (2) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of:
(3) We will share the remaining loss, if any, with a ny other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. (a) The total amount that all such other insurance w ould pay for the loss in the absence of this insurance; and
(b) The total of all deductible and self-insured amo unts under all that other insurance. c. Methods of Sharing
If all of the other insurance available to the additional insured(s) permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first.

If any other the other insurance available to the additional insured(s) does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer’s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers.

Any other insurance available to an additional insured(s) under this Endorsement covering liability for damages which are subject to this endorsement and for which the additional insured(s) has been added as an additional insured by that other insurance. (2) The coverage afforded by this insurance is prima ry and non-contributory with the additional insured(s)’ own insurance.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NAMED INSURED:

POLICY NUMBER: 2022-76673
Developing Organizing Visions for Everyone
FORM: NIAC-E25 12 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED - DESIGNATED PERSON

OR ORGANIZATION -

FOOD CONTRIBUTIONS OR CLIENT REFERRALS
Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy, in consideration of food contributions or client referrals you receive from them.

Name of Person or Organization:

SCHEDULE

COMMERCIAL GENERAL LIABILITY COVERAGE PART
This endorsement modifies insurance provided under the following:

Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf:

1. In the performance of your ongoing operations; or

2. In connection with your premises owned by or rente d to you.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be br oader than that which you are required by the contract or agreement to provide for such additional insured.

A.

With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limi ts of Insurance shown in the Declarations.

B. Page 1 of 1 NIAC-E25 12 15
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED – DESIGNATED

PERSON OR ORGANIZATION
CG 20 26 12 19
2022-76673
Named Insured: Developing Organizing Visions for Eve ryone Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization.

Name Of Additional Insured Person(s) Or Organization(s):

SCHEDULE

COMMERCIAL GENERAL LIABILITY COVERAGE PART
This endorsement modifies insurance provided under the following:

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Section II – Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury", "property damage" or "personal and advertising injury"
caused, in whole or in part, by your acts or
omissions or the acts or omissions of those acting
on your behalf:

1. In the performance of your ongoing operations;
or

2. In connection with your premises owned by or
rented to you.

However:

1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and

2. If coverage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.

A. B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III – Limits Of Insurance:

If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.

This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
© Insurance Services Office, Inc., 2012

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

ADDITIONAL INSURED - LESSOR OF LEASED

EQUIPMENT - AUTOMATIC STATUS WHEN

REQUIRED IN LEASE AGREEMENT WITH YOU
Developing Organizing Visions for Everyone Named Insured:
2022-76673
CG 20 34 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

COMMERCIAL GENERAL LIABILITY POLICY NUMBER:

With respect to the insurance afforded to these
additional insureds, the following is added to
Section III – Limits Of Insurance:

The most we will pay on behalf of the additional
insured is the amount of insurance:

1. Required by the contract or agreement you
have entered into with the additional insured;
or

2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.

This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.

C.

With respect to the insurance afforded to these
additional insureds, this insurance does not apply
to any "occurrence" which takes place after the
equipment lease expires.

B.

A. A person's or organization's status as an
additional insured under this endorsement ends
when their contract or agreement with you for such
leased equipment ends.

Section II – Who Is An Insured is amended to
include as an additional insured any person(s) or
organization(s) from whom you lease equipment
when you and such person(s) or organization(s)
have agreed in writing in a contract or agreement
that such person(s) or organization(s) be added as
an additional insured on your policy. Such
person(s) or organization(s) is an insured only with
respect to liability for "bodily injury", "property
damage" or "personal and advertising injury"
caused, in whole or in part, by your maintenance,
operation or use of equipment leased to you by
such person(s) or organization(s).

However, the insurance afforded to such additional
insured:

1. Only applies to the extent permitted by law;
and

2. Will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.

COMMERCIAL GENERAL LIABILITY COVERAGE PART
This endorsement modifies insurance provided under the following:
© Insurance Services Office, Inc., 2012

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED – MANAGERS OR

LESSORS OF PREMISES
CG 20 11 12 19
2022-76673
Named Insured: Developing Organizing Visions for Eve ryone Any person or organization acting as a manager or lessor of a covered premises that you are required to name as an additional insured on this policy, under a written contract, lease or agreement currently in effect, or becoming effective during the term of this policy.

Name Of Person(s) Or Organization(s) (Additional Insured):

Designation Of Premises (Part Leased To You):

SCHEDULE

COMMERCIAL GENERAL LIABILITY COVERAGE PART
This endorsement modifies insurance provided under the following:

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Section II – Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability arising out of the
ownership, maintenance or use of that part of the
premises leased to you and shown in the
Schedule and subject to the following additional
exclusions:

This insurance does not apply to:

1. Any "occurrence" which takes place after you
cease to be a tenant in that premises.

2. Structural alterations, new construction or
demolition operations performed by or on
behalf of the person(s) or organization(s)
shown in the Schedule.

However:

1. The insurance afforded to such additional
insured only applies to the extent permitted
by law; and

2. If coverage provided to the additional insured
is required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.

A.

B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III – Limits Of Insurance :

If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.

This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.

Additional Premium: Included
© Insurance Services Office, Inc., 2012

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED – OWNERS, LESSEES OR
CONTRACTORS – COMPLETED OPERATIONS
CG 20 37 12 19
2022-76673
Named Insured: Developing Organizing Visions for Eve ryone Any person or organization that you are required to
add as an additional insured on this policy, under a
written contract or agreement currently in effect, or
becoming effective during the term of this policy.

The additional insured status will not be afforded
with respect to liability arising out of or related to
your activities as a real estate manager for that
person or organization.

All insured premises and operations.

Location And Description Of Completed Operations
Name Of Additional Insured Person(s)
Or Organization(s)

SCHEDULE

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
This endorsement modifies insurance provided under the following:

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Section II – Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury" or
"property damage" caused, in whole or in part, by
"your work" at the location designated and
described in the Schedule of this endorsement
performed for that additional insured and
included in the "products-completed operations
hazard".

However:

1. The insurance afforded to such additional
insured only applies to the extent permitted
by law; and
A. B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III – Limits Of Insurance:

If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:

2. If coverage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to such additional insured will
not be broader than that which you are required
by the contract or agreement to provide for such
additional insured.

1. Required by the contract or agreement; or

2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.

This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
© Insurance Services Office, Inc., 2012

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED – OWNERS, LESSEES OR
CONTRACTORS – SCHEDULED PERSON OR

ORGANIZATION
CG 20 10 12 19
2022-76673
Named Insured: Developing Organizing Visions for Eve ryone Any person or organization that you are required to
add as an additional insured on this policy, under a
written contract or agreement currently in effect, or
becoming effective during the term of this policy. The
additional insured status will not be afforded with
respect to liability arising out of or related to your
activities as a real estate manager for that person or
organization.

All insured premises and operations.

Location(s) Of Covered Operations
Name Of Additional Insured Person(s)
Or Organization(s)

SCHEDULE

COMMERCIAL GENERAL LIABILITY COVERAGE PART
This endorsement modifies insurance provided under the following:

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Section II – Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury", "property damage" or "personal and advertising injury"
caused, in whole or in part, by:

1. Your acts or omissions; or

2. The acts or omissions of those acting on your
behalf;
in the performance of your ongoing operations for
the additional insured(s) at the location(s)
designated above.

However:

1. The insurance afforded to such additional
insured only applies to the extent permitted
by law; and
A.

B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusions apply:

This insurance does not apply to "bodily injury" or
"property damage" occurring after:

1. All work, including materials, parts or
equipment furnished in connection with such
work, on the project (other than service,
maintenance or repairs) to be performed by
or on behalf of the additional insured(s) at the
location of the covered operations has been
completed; or

2. If coverage provided to the additional insured
is required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
© Insurance Services Office, Inc., 2012

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

2. That portion of "your work" out of which the
injury or damage arises has been put to its
intended use by any person or organization
other than another contractor or subcontractor
engaged in performing operations for a
principal as a part of the same project.

C. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III – Limits Of Insurance :

If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.

This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
© Insurance Services Office, Inc., 2012

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E342 GL 08 22 Nonprofits Insurance Alli ance™ and NONPROFITS OWN® are brands of Alliance Member Services™ (AMS ). © AMS. All rights reserved.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ANTI-STACKING CONDITION

This endorsement modifies insurance provided under the following

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

Section IV – COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the following:

10. a. No coverage shall be afforded by this policy to an “Insured”, other than the First Named Insured identified in the policy Declarations to which this endorsement is attached, if coverage for the claim or “suit” is afforded under any other policy issued by us to that other “Insured”.

b. Subject to a. above, if coverage is afforded by this policy, which damages are also covered under any other coverage form within a policy issued by us, the aggregate maximum limit of insurance under all coverages within all policies issued by us applicable to the claim or “suit”, shall not exceed the highest applicable Limit of Insurance under any one coverage within any one policy. We shall, at our discretion identify the policy to which coverage for the submitted claim applies, and such policy shall be the sole and only policy written by us applicable to all such damages, regardless of the number of “Insureds”, claimants, claims or “suits”.

Condition 10. a. above does not apply:

1. To any “Insured”, with whom the First Named Insured has agreed to indemnify under a contract or agreement for damages arising out of “bodily injury”, “property damage”, and/or “personal and advertising injury” for the claim or “suit”.

2. To any coverage afforded within a policy issued by us to an “Insured” which specifically applies as excess insurance over the coverage included within the policy to which this endorsement is attached.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E22 09 19 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ASBESTOS EXCLUSION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

This insurance does not apply to any claim, “suit” or cause of action for damages due to:

1. “Bodily injury”, “property damage”, or “personal and advertising injury” arising or contributed, in whole or in part, by the actual, alleged, threatened or suspected inhalation of, contact with, exposure to, existence of or presence of asbestos or asbestos containing materials.

2. Any loss, cost or expense arising out of any:
a. Request, demand or order that any “insured” or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to or assess the effects of asbestos or asbestos-containing materials; or
b. Claim or suit by or on behalf of a governmental agency or entity for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to or assessing the effects of asbestos or assesses containing materials.

We shall have no duty or obligation to provide or pay for the investigation or defense of any loss, cost, expense, claim or “suit” excluded under any provision set forth above.

Defense and Supplementary Payments shall not apply to any loss, cost, expense, claim or “suit” excluded under any provision set forth above.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E15 09 20 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

BLOOD TESTING - EXCLUSION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

SOCIAL SERVICES PROFESSIONAL LIABILITY COVERAGE FORM

This insurance does not apply to any claim for damages arising out of:

1. Services in connection with the donating, drawing, or testing of blood, except for any evaluation, consultation or advice given by or on behalf of any insured in connection with such services;

2. Any error, omission, defect or deficiency in any such test performed;

3. The handling, transportation, distribution or storage of any blood product by any insured; or

4. The liability of any insured for the negligent hiri ng or supervision of any employee, volunteer, independent contractor, or agent of the insured with respect to any activities listed in 1. through 3. above.

If coverage is extended under the Coverage Form to which this endorsement is attached for liability arising out of the acts, errors or omissions of a phlebotomist, this exclusion will not apply to the damages arising out of that liability.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

IL 02 70 12 19

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

IL 02 70 12 19 © Insurance Services Office, Inc., 2019 Page 1 of 4

CALIFORNIA CHANGES – CANCELLATION

AND NONRENEWAL

This endorsement modifies insurance provided under the following:

CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART

COMMERCIAL AUTOMOBILE COVERAGE PART

COMMERCIAL GENERAL LIABILITY COVERAGE PART

COMMERCIAL INLAND MARINE COVERAGE PART

COMMERCIAL PROPERTY COVERAGE PART

CRIME AND FIDELITY COVERAGE PART

EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART

EQUIPMENT BREAKDOWN COVERAGE PART

FARM COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

MEDICAL PROFESSIONAL LIABILITY COVERAGE PART

POLLUTION LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

A. Paragraphs 2 . and 3 . of the Cancellation
Common Policy Condition are replaced by the
following:

2. All Policies In Effect For 60 Days Or Less
If this policy has been in effect for 60 days or
less, and is not a renewal of a policy we have
previously issued, we may cancel this policy by
mailing or delivering to the first Named Insured,
at the mailing address shown in the policy, and
to the producer of record, advance written
notice of cancellation, stating the reason for
cancellation, at least:
a . 10 days before the effective date of
cancellation if we cancel for:
( 1 ) Nonpayment of premium; or
( 2 ) Discovery of fraud by:
( a ) Any insured or his or her
representative in obtaining this
insurance; or
(b) You or your representative in
pursuing a claim under this policy.
b . 30 days before the effective date of
cancellation if we cancel for any other
reason.

3. All Policies In Effect For More Than 60 Days
a . If this policy has been in effect for more
than 60 days, or is a renewal of a policy we
issued, we may cancel this policy only upon
the occurrence, after the effective date of
the policy, of one or more of the following:
( 1 ) Nonpayment of premium, including
payment due on a prior policy we issued
and due during the current policy term
covering the same risks.
( 2 ) Discovery of fraud or material
misrepresentation by:
( a ) Any insured or his or her
representative in obtaining this
insurance; or
( b ) You or your representative in
pursuing a claim under this policy.
(3) A judgment by a court or an
administrative tribunal that you have
violated a California or Federal law,
having as one of its necessary elements
an act which materially increases any of
the risks insured against.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

( 4 ) Discovery of willful o r grossly negligent
acts or omissions, or of any violations of
state laws or regulations establishing
safety standards, by you or your
representative, which materially
increase any of the risks insured
against.
( 5 ) Failure by you or your representative to
implement reasonable loss control
requirements, agreed to by you as a
condition of policy issuance, or which
were conditions precedent to our use of
a particular rate or rating plan, if that
failure materially increases any of the
risks insured against.
( 6 ) A determination by the Commissioner of
Insurance that the:
( a ) Loss of, or changes in, our
reinsurance covering all or part of
the risk would threaten our financial
integrity or solvency; or
( b ) Continuation of the policy coverage
would:
( i ) Place us in violation of California
law or the laws of the state where
we are domiciled; or
(ii) Threaten our solvency.
( 7 ) A change by you or your representative
in the activities or property of the
commercial or industrial enterprise,
which results in a materially added,
increased or changed risk, unless the
added, increased or changed risk is
included in the policy.
b . We will mail or deliver advance written
notice of cancellation, stating the reason for
cancellation, to the first Named Insured, at
the mailing address shown in the policy,
and to the producer of record, at least:
( 1 ) 10 days before the effective date of
cancellation if we cancel for
nonpayment of premium or discovery of
fraud; or
( 2 ) 30 days before the effective date of
cancellation if we cancel for any other
reason listed in Paragraph 3.a.

B. The following provision is added to the
Cancellation Common Policy Condition:

7. Residential Property
This provision applies to coverage on real
property which is used predominantly for
residential purposes and consisting of not more
than four dwelling units, and to coverage on
tenants' household personal property in a
residential unit, if such coverage is written
under one of the following:

Commercial Property Coverage Part
Farm Coverage Part – Farm Property – Farm
Dwellings, Appurtenant Structures And
Household Personal Property Coverage Form
a . If such coverage has been in effect for 60
days or less, and is not a renewal of
coverage we previously issued, we may
cancel this coverage for any reason, except
as provided in b. and c. below.
b . We may not cancel this policy solely
because the first Named Insured has:
( 1 ) Accepted an offer of earthquake
coverage; or
(2) Cancelled or did not renew a policy
issued by the California Earthquake
Authority (CEA) that included an
earthquake policy premium surcharge.

However, we shall cancel this policy if the
first Named Insured has accepted a new or
renewal policy issued by the CEA that
includes an earthquake policy premium
surcharge but fails to pay the earthquake
policy premium surcharge authorized by the
CEA.
c . We may not cancel such coverage solely
because corrosive soil conditions exist on
the premises. This restriction (c.) applies
only if coverage is subject to one of the
following, which exclude loss or damage
caused by or resulting from corrosive soil
conditions:
( 1 ) Commercial Property Coverage Part –
Causes Of Loss – Special Form; or
( 2 ) Farm Coverage Part – Causes Of Loss
Form – Farm Property, Paragraph D .

Covered Causes Of Loss – Special.

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IL 02 70 12 19 © Insurance Services Office, Inc., 2019 Page 3 of 4

d. If a state of emergency under California
Law is declared and the residential property
is located in any ZIP Code within or
adjacent to the fire perimeter, as
determined by California Law, we may not
cancel this policy for one year, beginning
from the date the state of emergency is
declared, solely because the dwelling or
other structure is located in an area in
which a wildfire has occurred.However, we
may cancel:
(1) When you have not paid the premium,
at any time by letting you know at least
10 days before the date cancellation
takes effect;
(2) If willful or grossly negligent acts or
omissions by the Named Insured, or his
or her representatives, are discovered
that materially increase any of the risks
insured against; or
(3) If there are physical changes in the
property insured against, beyond the
catastrophe-damaged condition of the
structures and surface landscape, which
result in the property becoming
uninsurable.

C. The following is added and supersedes any
provisions to the contrary:

Nonrenewal
1 . Subject to the provisions of Paragraphs C.2.
and C.3. below, if we elect not to renew this
policy, we will mail or deliver written notice,
stating the reason for nonrenewal, to the first
Named Insured shown in the Declarations, and
to the producer of record, at least 60 days, but
not more than 120 days, before the expiration
or anniversary date.

We will mail or deliver our notice to the first
Named Insured, and to the producer of record,
at the mailing address shown in the policy.

2. Residential Property
This provision applies to coverage on real
property used predominantly for residential
purposes and consisting of not more than four
dwelling units, and to coverage on tenants'
household property contained in a residential
unit, if such coverage is written under one of
the following:

Commercial Property Coverage Part
Farm Coverage Part – Farm Property – Farm
Dwellings, Appurtenant Structures And
Household Personal Property Coverage Form
a . We may elect not to renew such coverage
for any reason, except as provided in b., c.
and d. below.
b . We will not refuse to renew such coverage
solely because the first Named Insured has
accepted an offer of earthquake coverage.

However, the following applies only to
i n s u r e r s w h o a r e a s s o c i a t e p a r t i c i p a t i n g insurers as established by Cal. Ins. Code
Section 10089.16. We may elect not to
renew such coverage after the first Named
Insured has accepted an offer of
earthquake coverage, if one or more of the
following reasons applies:
( 1 ) The nonrenewal is based on sound
underwriting principles that relate to the
coverages provided by this policy and
that are consistent with the approved
rating plan and related documents filed
with the Department of Insurance as
required by existing law;
( 2 ) The Commissioner of Insurance finds
that the exposure to potential losses will
threaten our solvency or place us in a
hazardous condition. A hazardous
condition includes, but is not limited to, a
condition in which we make claims
payments for losses resulting from an
earthquake that occurred within the
preceding two years and that required a
reduction in policyholder surplus of at
least 25% for payment of those claims;
or
( 3 )
We have:
( a ) Lost or experienced a substantial
reduction in the availability or scope
of reinsurance coverage; or
(b) Experienced a substantial increase
in the premium charged for
reinsurance coverage of our
residential property insurance
policies; and
the Commissioner has approved a plan
for the nonrenewals that is fair and
equitable, and that is responsive to the
changes in our reinsurance position.
c . We will not refuse to renew such coverage
solely because the first Named Insured has
cancelled or did not renew a policy, issued
by the California Earthquake Authority, that
included an earthquake policy premium
surcharge.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

d . We will not refuse to renew such coverage
solely because corrosive soil conditions
exist on the premises. This restriction ( d . )
applies only if coverage is subject to one of
the following, which exclude loss or
damage caused by or resulting from
corrosive soil conditions:
( 1 ) Commercial Property Coverage Part –
Causes Of Loss – Special Form; or
( 2 ) Farm Coverage Part – Causes Of Loss
Form – Farm Property, Paragraph D .

Covered Causes Of Loss – Special.
e . If a state of emergency under California
Law is declared and the residential property
is located in any ZIP Code within or
adjacent to the fire perimeter, as
determined by California Law, we may not
nonrenew this policy for one year,
beginning from the date the state of
emergency is declared, solely because the
dwelling or other struc ture is located in an
area in which a wildfire has occurred.

However, we may nonrenew:
( 1 ) If willful or grossly negligent acts or
omissions by the Named Insured, or his
or her representatives, are discovered
that materially increase any of the risks
insured against;
( 2 ) If losses unrelated to the postdisaster
loss condition of the property have
occurred that would collectively render
the risk ineligible for renewal; or
( 3 ) If there are physical changes in the
property insured against, beyond the
catastrophe-damaged condition of the
structures and surface landscape, which
result in the property becoming
uninsurable.
3 . We are not required to send notice of
nonrenewal in the following situations:
a . If the transfer or renewal of a policy, without
any changes in terms, conditions or rates,
is between us and a member of our
insurance group.
b . If the policy has been extended for 90 days
or less, provided that notice has been given
in accordance with Paragraph C.1.
c . If you have obtained replacement coverage,
or if the first Named Insured has agreed, in
writing, within 60 days of the termination of
the policy, to obtain that coverage.
d. If the policy is for a period of no more than
60 days and you are notified at the time of
issuance that it will not be renewed.
e . If the first Named Insured requests a
change in the terms or conditions or risks
covered by the policy within 60 days of the
end of the policy period.
f . If we have made a written offer to the first
Named Insured, in accordance with the
timeframes shown in Paragraph C.1., t o
renew the policy under changed terms or
conditions or at an increased premium rate,
when the increase exceeds 25%.

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NIAC E28 01 99 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY

PROPERTY DAMAGE TO PERSONAL PROPERTY IN THE CARE,

CUSTODY OR CONTROL OF THE INSURED

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART.
___________________________________________________________________________________________

It is agreed that the following is added to COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Number 2. Exclusions., Letter j. “Property damage” to: Item (4):

(a) This exclusion applies to “property damage” to personal property in the care, custody or control of the insured when the personal property is valued greater than $25,000. This is excess over any other valid collectible insurance.
(b) Defense costs arising from “property damage” to personal property in the care, custody or control of the insured are limited to $25,000 per claim or suit.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 20 20 11 85 Copyright, Insurance Services Office, Inc., 1984 P a g e1o f1 /box3 ADDITIONAL INSURED – CHARITABLE INSTITUTIONS
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART.

WHO IS AN INSURED (Section II) is amended to include as an insured:

1. Your members but only with respect to their liability for your activities or activities they perform on your behalf; and

2. Your trustees or members of the board of governors while acting within the scope of their duties as such on your behalf.

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COMMERCIAL GENERAL LIABILITY
CG 00 01 04 13

CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 16

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

Various provisions in this policy restrict coverage.

Read the entire policy carefully to determine rights,
duties and what is and is not covered.

Throughout this policy the words "you" and "your"
refer to the Named Insured shown in the Declarations,
and any other person or organization qualifying as a
Named Insured under this policy. The words "we",
"us" and "our" refer to the company providing this
insurance.

The word "insured" means any person or organization
qualifying as such under Section II – Who Is An
Insured.

Other words and phrases that appear in quotation
marks have special meaning. Refer to Section V –
Definitions.

SECTION I – COVERAGES
COVERAGE A – BODILY INJURY AND PROPERTY

DAMAGE LIABILITY

1. Insuring Agreement
a. We will pay those sums that the insured
becomes legally obligated to pay as damages
because of "bodily injury" or "property damage"
to which this insurance applies. We will have
the right and duty to defend the insured against
any "suit" seeking those damages. However,
we will have no duty to defend the insured
against any "suit" seeking damages for "bodily
injury" or "property damage" to which this
insurance does not apply. We may, at our
discretion, investigate any "occurrence" and
settle any claim or "suit" that may result. But:
(1) The amount we will pay for damages is
limited as described in Section III – Limits
Of Insurance; and
(2) Our right and duty to defend ends when we
have used up the applicable limit of
insurance in the payment of judgments or
settlements under Coverages A or B or
medical expenses under Coverage C.

No other obligation or liability to pay sums or
perform acts or services is covered unless
explicitly provided for under Supplementary
Payments – Coverages A and B.
b. This insurance applies to "bodily injury" and
"property damage" only if:
(1) The "bodily injury" or "property damage" is
caused by an "occurrence" that takes place
in the "coverage territory";
(2) The "bodily injury" or "property damage"
occurs during the policy period; and
(3) Prior to the policy period, no insured listed
under Paragraph 1. of Section II – Who Is
An Insured and no "employee" authorized
by you to give or receive notice of an
"occurrence" or claim, knew that the "bodily
injury" or "property damage" had occurred,
in whole or in part. If such a listed insured
or authorized "employee" knew, prior to the
policy period, that the "bodily injury" or
"property damage" occurred, then any
continuation, change or resumption of such
"bodily injury" or "property damage" during
or after the policy period will be deemed to
have been known prior to the policy period.
c. "Bodily injury" or "property damage" which
occurs during the policy period and was not,
prior to the policy period, known to have
occurred by any insured listed under
Paragraph 1. of Section II – Who Is An Insured
or any "employee" authorized by you to give or
receive notice of an "occ urrence" or claim,
includes any continuation, change or
resumption of that "bodily injury" or "property
damage" after the end of the policy period.
d. "Bodily injury" or "property damage" will be
deemed to have been known to have occurred
at the earliest time when any insured listed
under Paragraph 1. of Section II – Who Is An
Insured or any "employee" authorized by you to
give or receive notice of an "occurrence" or
claim:
(1) Reports all, or any part, of the "bodily injury"
or "property damage" to us or any other
insurer;
(2) Receives a written or verbal demand or
claim for damages because of the "bodily
injury" or "property damage"; or
(3) Becomes aware by any other means that
"bodily injury" or "property damage" has
occurred or has begun to occur.
e. Damages because of "bodily injury" include
damages claimed by any person or
organization for care, loss of services or death
resulting at any time from the "bodily injury".

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

2. Exclusions
This insurance does not apply to:
a. Expected Or Intended Injury
"Bodily injury" or "property damage" expected
or intended from the standpoint of the insured.

This exclusion does not apply to "bodily injury"
resulting from the use of reasonable force to
protect persons or property.
b. Contractual Liability
"Bodily injury" or "property damage" for which
the insured is obligated to pay damages by
reason of the assumption of liability in a
contract or agreement. This exclusion does not
apply to liability for damages:
(1) That the insured would have in the absence
of the contract or agreement; or
(2) Assumed in a contract or agreement that is
an "insured contract", provided the "bodily
injury" or "property damage" occurs
subsequent to the execution of the contract
or agreement. Solely for the purposes of
liability assumed in an "insured contract",
reasonable attorneys' fees and necessary
litigation expenses incurred by or for a party
other than an insured are deemed to be
damages because of "bodily injury" or
"property damage", provided:
(a) Liability to such party for, or for the cost
of, that party's defense has also been
assumed in the same "insured contract";
and
(b) Such attorneys' fees and litigation
expenses are for defense of that party
against a civil or alternative dispute
resolution proceeding in which damages
to which this insurance applies are
alleged.
c. Liquor Liability
"Bodily injury" or "property damage" for which
any insured may be held liable by reason of:
(1) Causing or contributing to the intoxication of
any person;
(2) The furnishing of alcoholic beverages to a
person under the legal drinking age or
under the influence of alcohol; or
(3) Any statute, ordinance or regulation relating
to the sale, gift, distribution or use of
alcoholic beverages.

This exclusion applies even if the claims
against any insured allege negligence or other
wrongdoing in:
(a) The supervision, hiring, employment,
training or monitoring of others by that
insured; or
(b) Providing or failing to provide
transportation with respect to any
person that may be under the influence
of alcohol;
if the "occurrence" which caused the "bodily
injury" or "property damage", involved that
which is described in Paragraph (1), (2) or (3)
above.

However, this exclusion applies only if you are
in the business of manufa cturing, distributing,
selling, serving or furnishing alcoholic
beverages. For the purposes of this exclusion,
permitting a person to bring alcoholic
beverages on your premises, for consumption
on your premises, whether or not a fee is
charged or a license is required for such
activity, is not by itself considered the business
of selling, serving or furnishing alcoholic
beverages.
d. Workers' Compensation And Similar Laws
Any obligation of the insured under a workers'
compensation, disability benefits or
unemployment compensation law or any
similar law.
e. Employer's Liability
"Bodily injury" to:
(1) An "employee" of the insured arising out of
and in the course of:
(a) Employment by the insured; or
(b) Performing duties related to the conduct
of the insured's business; or
(2) The spouse, child, parent, brother or sister
of that "employee" as a consequence of
Paragraph (1)
above.

This exclusion applies whether the insured
may be liable as an employer or in any other
capacity and to any obligation to share
damages with or repay someone else who
must pay damages because of the injury.

This exclusion does not apply to liability
assumed by the insured under an "insured
contract".

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f. Pollution
(1) "Bodily injury" or "property damage" arising
out of the actual, alleged or threatened
discharge, dispersal, seepage, migration,
release or escape of "pollutants":
(a) At or from any premises, site or location
which is or was at any time owned or
occupied by, or rented or loaned to, any
insured. However, this subparagraph
does not apply to:
(i) "Bodily injury" if sustained within a
building and caused by smoke,
fumes, vapor or soot produced by or
originating from equipment that is
used to heat, cool or dehumidify the
building, or equipment that is used to
heat water for personal use, by the
building's occupants or their guests;
(ii) "Bodily injury" or "property damage"
for which you may be held liable, if
you are a contractor and the owner
or lessee of such premises, site or
location has been added to your
policy as an additional insured with
respect to your ongoing operations
performed for that additional insured
at that premises, site or location and
such premises, site or location is not
and never was owned or occupied
by, or rented or loaned to, any
insured, other than that additional
insured; or
(iii) "Bodily injury" or "property damage"
arising out of heat, smoke or fumes
from a "hostile fire";
(b) At or from any premises, site or location
which is or was at any time used by or
for any insured or others for the
handling, storage, disposal, processing
or treatment of waste;
(c) Which are or were at any time
transported, handled, stored, treated,
disposed of, or processed as waste by
or for:
(i) Any insured; or
(ii) Any person or organization for whom
you may be legally responsible; or
(d) At or from any premises, site or location
on which any insured or any contractors
or subcontractors working directly or
indirectly on any insured's behalf are
performing operations if the "pollutants"
are brought on or to the premises, site
or location in connection with such
operations by such insured, contractor
or subcontractor. However, this
subparagraph does not apply to:
(i) "Bodily injury" or "property damage"
arising out of the escape of fuels,
lubricants or other operating fluids
which are needed to perform the
normal electrical, hydraulic or
mechanical functions necessary for
the operation of "mobile equipment"
or its parts, if such fuels, lubricants
or other operating fluids escape from
a vehicle part designed to hold, store
or receive them. This exception does
not apply if the "bodily injury" or
"property damage" arises out of the
intentional discharge, dispersal or
release of the fuels, lubricants or
other operating fluids, or if such
fuels, lubricants or other operating
fluids are brought on or to the
premises, site or location with the
intent that they be discharged,
dispersed or released as part of the
operations being performed by such
insured, contractor or subcontractor;
(ii) "Bodily injury" or "property damage"
sustained within a building and
caused by the release of gases,
fumes or vapors from materials
brought into that building in
connection with operations being
performed by you or on your behalf
by a contractor or subcontractor; or
(iii) "Bodily injury" or "property damage"
arising out of heat, smoke or fumes
from a "hostile fire".
(e) At or from any premises, site or location
on which any insured or any contractors
or subcontractors working directly or
indirectly on any insured's behalf are
performing operations if the operations
are to test for, monitor, clean up,
remove, contain, treat, detoxify or
neutralize, or in any way respond to, or
assess the effects of, "pollutants".

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

(2) Any loss, cost or expense arising out of
any:
(a) Request, demand, order or statutory or
regulatory requirement that any insured
or others test for, monitor, clean up,
remove, contain, treat, detoxify or
neutralize, or in any way respond to, or
assess the effects of, "pollutants"; or
(b) Claim or suit by or on behalf of a
governmental authority for damages
because of testing for, monitoring,
cleaning up, removing, containing,
treating, detoxifying or neutralizing, or in
any way responding to, or assessing the
effects of, "pollutants".

However, this paragraph does not apply to
liability for damages be cause of "property
damage" that the insured would have in the
absence of such request, demand, order or
statutory or regulatory requirement, or such
claim or "suit" by or on behalf of a
governmental authority.
g. Aircraft, Auto Or Watercraft
"Bodily injury" or "property damage" arising out
of the ownership, maintenance, use or
entrustment to others of any aircraft, "auto" or
watercraft owned or operated by or rented or
loaned to any insured. Use includes operation
and "loading or unloading".

This exclusion applies even if the claims
against any insured allege negligence or other
wrongdoing in the supervision, hiring,
employment, training or monitoring of others by
that insured, if the "o ccurrence" which caused
the "bodily injury" or "property damage"
involved the ownership, maintenance, use or
entrustment to others of any aircraft, "auto" or
watercraft that is owned or operated by or
rented or loaned to any insured.

This exclusion does not apply to:
(1) A watercraft while ashore on premises you
own or rent;
(2) A watercraft you do not own that is:
(a) Less than 26 feet long; and
(b) Not being used to carry persons or
property for a charge;
(3) Parking an "auto" on, or on the ways next
to, premises you own or rent, provided the
"auto" is not owned by or rented or loaned
to you or the insured;
(4) Liability assumed under any "insured
contract" for the ownership, maintenance or
use of aircraft or watercraft; or
(5) "Bodily injury" or "property damage" arising
out of:
(a) The operation of machinery or
equipment that is attached to, or part of,
a land vehicle that would qualify under
the definition of "mobile equipment" if it
were not subject to a compulsory or
financial responsibility law or other
motor vehicle insurance law where it is
licensed or principally garaged; or
(b) The operation of any of the machinery
or equipment listed in Paragraph f.(2) or
f.(3) of the definition of "mobile
equipment".
h. Mobile Equipment
"Bodily injury" or "property damage" arising out
of:
(1) The transportation of "mobile equipment" by
an "auto" owned or operated by or rented or
loaned to any insured; or
(2) The use of "mobile equipment" in, or while
in practice for, or while being prepared for,
any prearranged racing, speed, demolition,
or stunting activity.
i. War
"Bodily injury" or "property damage", however
caused, arising, directly or indirectly, out of:
(1) War, including undeclared or civil war;
(2) Warlike action by a m ilitary force, including
action in hindering or defending against an
actual or expected attack, by any
government, sovereign or other authority
using military personnel or other agents; or
(3) Insurrection, rebellion, revolution, usurped
power, or action taken by governmental
authority in hindering or defending against
any of these.
j. Damage To Property
"Property damage" to:
(1) Property you own, rent, or occupy, including
any costs or expenses incurred by you, or
any other person, organization or entity, for
repair, replacement, enhancement,
restoration or maintenance of such property
for any reason, including prevention of
injury to a person or damage to another's
property;
(2) Premises you sell, give away or abandon, if
the "property damage" arises out of any
part of those premises;
(3) Property loaned to you;
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(4) Personal property in the care, custody or
control of the insured;
(5) That particular part of real property on
which you or any contractors or
subcontractors working directly or indirectly
on your behalf are performing operations, if
the "property damage" arises out of those
operations; or
(6) That particular part of any property that
must be restored, repaired or replaced
because "your work" was incorrectly
performed on it.

Paragraphs (1), (3) and (4) of this exclusion do
not apply to "property damage" (other than
damage by fire) to premises, including the
contents of such premises, rented to you for a
period of seven or fewer consecutive days. A
separate limit of insurance applies to Damage
To Premises Rented To You as described in
Section III – Limits Of Insurance.

Paragraph (2) of this exclusion does not apply
if the premises are "your work" and were never
occupied, rented or held for rental by you.

Paragraphs (3), (4), (5) and (6) of this
exclusion do not apply to liability assumed
under a sidetrack agreement.

Paragraph (6) of this exclusion does not apply
to "property damage" included in the "products-
completed operations hazard".
k. Damage To Your Product
"Property damage" to "your product" arising out
of it or any part of it.
l. Damage To Your Work
"Property damage" to "your work" arising out of
it or any part of it and included in the "products-
completed operations hazard".

This exclusion does not apply if the damaged
work or the work out of which the damage
arises was performed on your behalf by a
subcontractor.
m. Damage To Impaired Property Or Property
Not Physically Injured
"Property damage" to "impaired property" or
property that has not been physically injured,
arising out of:
(1) A defect, deficiency, inadequacy or
dangerous condition in "your product" or
"your work"; or
(2) A delay or failure by you or anyone acting
on your behalf to perform a contract or
agreement in accordance with its terms.

This exclusion does not apply to the loss of use
of other property arising out of sudden and
accidental physical injury to "your product" or
"your work" after it has been put to its intended
use.
n. Recall Of Products, Work Or Impaired
Property
Damages claimed for any loss, cost or
expense incurred by you or others for the loss
of use, withdrawal, recall, inspection, repair,
replacement, adjustment, removal or disposal
of:
(1) "Your product";
(2) "Your work"; or
(3) "Impaired property";
if such product, work, or property is withdrawn
or recalled from the market or from use by any
person or organization because of a known or
suspected defect, deficiency, inadequacy or
dangerous condition in it.
o. Personal And Advertising Injury
"Bodily injury" arising out of "personal and
advertising injury".
p. Electronic Data
Damages arising out of the loss of, loss of use
of, damage to, corruption of, inability to access,
or inability to manipulate electronic data.

However, this exclusion does not apply to
liability for damages because of "bodily injury".

As used in this exclusion, electronic data
means information, facts or programs stored as
or on, created or used on, or transmitted to or
from computer software, including systems and
applications software, hard or floppy disks, CD-
ROMs, tapes, drives, cells, data processing
devices or any other media which are used
with electronically controlled equipment.
q. Recording And Distribution Of Material Or
Information In Violation Of Law
"Bodily injury" or "property damage" arising
directly or indirectly out of any action or
omission that violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or
addition to such law;
(2) The CAN-SPAM Act of 2003, including any
amendment of or addition to such law;
(3) The Fair Credit Reporting Act (FCRA), and
any amendment of or addition to such law,
including the Fair and Accurate Credit
Transactions Act (FACTA); or
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

(4) Any federal, state or local statute,
ordinance or regulation, other than the
TCPA, CAN-SPAM Act of 2003 or FCRA
and their amendments and additions, that
addresses, prohibits, or limits the printing,
dissemination, disposal, collecting,
recording, sending, transmitting,
communicating or distribution of material or
information.

Exclusions c. through n. do not apply to damage
by fire to premises while rented to you or
temporarily occupied by you with permission of the
owner. A separate limit of insurance applies to this
coverage as described in Section III – Limits Of
Insurance.

COVERAGE B – PERSONAL AND ADVERTISING

INJURY LIABILITY

1. Insuring Agreement
a. We will pay those sums that the insured
becomes legally obligated to pay as damages
because of "personal and advertising injury" to
which this insurance applies. We will have the
right and duty to defend the insured against
any "suit" seeking those damages. However,
we will have no duty to defend the insured
against any "suit" seeking damages for
"personal and advertising injury" to which this
insurance does not apply. We may, at our
discretion, investigate any offense and settle
any claim or "suit" that may result. But:
(1) The amount we will pay for damages is
limited as described in Section III – Limits
Of Insurance; and
(2) Our right and duty to defend end when we
have used up the applicable limit of
insurance in the payment of judgments or
settlements under Coverages A or B or
medical expenses under Coverage C.

No other obligation or liability to pay sums or
perform acts or services is covered unless
explicitly provided for under Supplementary
Payments – Coverages A and B.
b. This insurance applies to "personal and
advertising injury" caused by an offense arising
out of your business but only if the offense was
committed in the "coverage territory" during the
policy period.

2. Exclusions
This insurance does not apply to:
a. Knowing Violation Of Rights Of Another
"Personal and advertising injury" caused by or
at the direction of the insured with the
knowledge that the act would violate the rights
of another and would inflict "personal and
advertising injury".
b. Material Published With Knowledge Of
Falsity
"Personal and advertising injury" arising out of
oral or written publication, in any manner, of
material, if done by or at the direction of the
insured with knowledge of its falsity.
c. Material Published Prior To Policy Period
"Personal and advertising injury" arising out of
oral or written publication, in any manner, of
material whose first publication took place
before the beginning of the policy period.
d. Criminal Acts
"Personal and advertising injury" arising out of
a criminal act committed by or at the direction
of the insured.
e. Contractual Liability
"Personal and advertising injury" for which the
insured has assumed liab ility in a contract or
agreement. This exclusion does not apply to
liability for damages th at the insured would
have in the absence of the contract or
agreement.
f. Breach Of Contract
"Personal and advertising injury" arising out of
a breach of contract, except an implied
contract to use another's advertising idea in
your "advertisement".
g. Quality Or Performance Of Goods – Failure
To Conform To Statements
"Personal and advertising injury" arising out of
the failure of goods, products or services to
conform with any statement of quality or
performance made in your "advertisement".
h. Wrong Description Of Prices
"Personal and advertising injury" arising out of
the wrong description of the price of goods,
products or services stated in your
"advertisement".

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i. Infringement Of Copyright, Patent,
Trademark Or Trade Secret
"Personal and advertising injury" arising out of
the infringement of copyright, patent,
trademark, trade secret or other intellectual
property rights. Under this exclusion, such
other intellectual property rights do not include
the use of another's advertising idea in your
"advertisement".

However, this exclusion does not apply to
infringement, in your "advertisement", of
copyright, trade dress or slogan.
j. Insureds In Media And Internet Type
Businesses
"Personal and advertising injury" committed by
an insured whose business is:
(1) Advertising, broadcasting, publishing or
telecasting;
(2) Designing or determining content of web
sites for others; or
(3) An Internet search, access, content or
service provider.

However, this exclusion does not apply to
Paragraphs 14.a., b. and c. of "personal and
advertising injury" under the Definitions
section.

For the purposes of this exclusion, the placing
of frames, borders or links, or advertising, for
you or others anywhere on the Internet, is not
by itself, considered the business of
advertising, broadcasting, publishing or
telecasting.
k. Electronic Chatrooms Or Bulletin Boards
"Personal and advertising injury" arising out of
an electronic chatroom or bulletin board the
insured hosts, owns, or over which the insured
exercises control.
l. Unauthorized Use Of Another's Name Or
Product
"Personal and advertising injury" arising out of
the unauthorized use of another's name or
product in your e-mail address, domain name
or metatag, or any other similar tactics to
mislead another's potential customers.
m. Pollution
"Personal and advertising injury" arising out of
the actual, alleged or threatened discharge,
dispersal, seepage, migration, release or
escape of "pollutants" at any time.
n. Pollution-related
Any loss, cost or expense arising out of any:
(1) Request, demand, order or statutory or
regulatory requirement that any insured or
others test for, monitor, clean up, remove,
contain, treat, detoxify or neutralize, or in
any way respond to, or assess the effects
of, "pollutants"; or
(2) Claim or suit by or on behalf of a
governmental authority for damages
because of testing for, monitoring, cleaning
up, removing, containing, treating,
detoxifying or neutralizing, or in any way
responding to, or assessing the effects of,
"pollutants".
o. War
"Personal and advertisi ng injury", however
caused, arising, directly or indirectly, out of:
(1) War, including undeclared or civil war;
(2) Warlike action by a m ilitary force, including
action in hindering or defending against an
actual or expected attack, by any
government, sovereign or other authority
using military personnel or other agents; or
(3) Insurrection, rebellion, revolution, usurped
power, or action taken by governmental
authority in hindering or defending against
any of these.
p. Recording And Distribution Of Material Or
Information In Violation Of Law
"Personal and advertising injury" arising
directly or indirectly out of any action or
omission that violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or
addition to such law;

(2) The CAN-SPAM Act of 2003, including any
amendment of or addition to such law;
(3) The Fair Credit Reporting Act (FCRA), and
any amendment of or addition to such law,
including the Fair and Accurate Credit
Transactions Act (FACTA); or
(4) Any federal, state or local statute,
ordinance or regulation, other than the
TCPA, CAN-SPAM Act of 2003 or FCRA
and their amendments and additions, that
addresses, prohibits, or limits the printing,
dissemination, disposal, collecting,
recording, sending, transmitting,
communicating or distribution of material or
information.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

COVERAGE C – MEDICAL PAYMENTS

1. Insuring Agreement
a. We will pay medical expenses as described
below for "bodily injury" caused by an accident:
(1) On premises you own or rent;
(2) On ways next to premises you own or rent;
or
(3) Because of your operations;
provided that:
(a) The accident takes place in the
"coverage territory" and during the policy
period;
(b) The expenses are incurred and reported
to us within one year of the date of the
accident; and
(c) The injured person submits to
examination, at our expense, by
physicians of our choice as often as we
reasonably require.
b. We will make these payments regardless of
fault. These payments will not exceed the
applicable limit of insurance. We will pay
reasonable expenses for:
(1) First aid administered at the time of an
accident;
(2) Necessary medical, surgical, X-ray and
dental services, including prosthetic
devices; and
(3) Necessary ambulance, hospital,
professional nursing and funeral services.

2. Exclusions
We will not pay expenses for "bodily injury":
a. Any Insured
To any insured, except "volunteer workers".
b. Hired Person
To a person hired to do work for or on behalf of
any insured or a tenant of any insured.
c. Injury On Normally Occupied Premises
To a person injured on that part of premises
you own or rent that the person normally
occupies.
d. Workers' Compensation And Similar Laws
To a person, whether or not an "employee" of
any insured, if benefits for the "bodily injury"
are payable or must be provided under a
workers' compensation or disability benefits
law or a similar law.
e. Athletics Activities
To a person injured while practicing, instructing
or participating in any physical exercises or
games, sports, or athletic contests.
f. Products-Completed Operations Hazard
Included within the "products-completed
operations hazard".
g. Coverage A Exclusions
Excluded under Coverage A.

SUPPLEMENTARY PAYMENTS – COVERAGES A
AND B

1. We will pay, with respect to any claim we
investigate or settle, or any "suit" against an
insured we defend:
a. All expenses we incur.
b. Up to $250 for cost of bail bonds required
because of accidents or traffic law violations
arising out of the use of any vehicle to which
the Bodily Injury Liability Coverage applies. We
do not have to furnish these bonds.
c. The cost of bonds to release attachments, but
only for bond amounts within the applicable
limit of insurance. We do not have to furnish
these bonds.
d. All reasonable expenses incurred by the
insured at our request to assist us in the
investigation or defense of the claim or "suit",
including actual loss of earnings up to $250 a
day because of time off from work.
e. All court costs taxed against the insured in the
"suit". However, these payments do not include
attorneys' fees or attorneys' expenses taxed
against the insured.
f. Prejudgment interest awarded against the
insured on that part of the judgment we pay. If
we make an offer to pay the applicable limit of
insurance, we will not pay any prejudgment
interest based on that period of time after the
offer.

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g. All interest on the full amount of any judgment
that accrues after entry of the judgment and
before we have paid, offered to pay, or
deposited in court the part of the judgment that
is within the applicable limit of insurance.

These payments will not reduce the limits of
insurance.

2. If we defend an insured against a "suit" and an
indemnitee of the insured is also named as a party
to the "suit", we will defend that indemnitee if all of the following conditions are met:
a. The "suit" against the indemnitee seeks
damages for which the insured has assumed
the liability of the indemnitee in a contract or
agreement that is an "insured contract";
b. This insurance applies to such liability
assumed by the insured;
c. The obligation to defend, or the cost of the
defense of, that indemnitee, has also been
assumed by the insured in the same "insured
contract";
d. The allegations in the "suit" and the information
we know about the "occurrence" are such that
no conflict appears to exist between the
interests of the insured and the interests of the
indemnitee;
e. The indemnitee and the insured ask us to
conduct and control the defense of that
indemnitee against such "suit" and agree that
we can assign the same counsel to defend the
insured and the indemnitee; and
f. The indemnitee:
(1) Agrees in writing to:
(a) Cooperate with us in the investigation,
settlement or defense of the "suit";
(b) Immediately send us copies of any
demands, notices, summonses or legal
papers received in connection with the
"suit";
(c) Notify any other insurer whose coverage
is available to the indemnitee; and
(d) Cooperate with us with respect to
coordinating other applicable insurance
available to the indemnitee; and
(2) Provides us with written authorization to:
(a) Obtain records and other information
related to the "suit"; and
(b) Conduct and control the defense of the
indemnitee in such "suit".

So long as the above conditions are met,
attorneys' fees incurred by us in the defense of
that indemnitee, necessa ry litigation expenses
incurred by us and necessary litigation expenses
incurred by the indemnitee at our request will be
paid as Supplementary Payments.

Notwithstanding the provisions of Paragraph

2.b.(2) of Section I – Coverage A – Bodily Injury
And Property Damage Liability, such payments will
not be deemed to be damages for "bodily injury"
and "property damage" and will not reduce the
limits of insurance.

Our obligation to defend an insured's indemnitee
and to pay for attorneys' fees and necessary
litigation expenses as Supplementary Payments
ends when we have used up the applicable limit of
insurance in the payment of judgments or
settlements or the conditions set forth above, or
the terms of the agreement described in
Paragraph f. above, are no longer met.

SECTION II – WHO IS AN INSURED

1. If you are designated in the Declarations as:
a. An individual, you and your spouse are
insureds, but only with respect to the conduct
of a business of which you are the sole owner.
b. A partnership or joint venture, you are an
insured. Your members, your partners, and
their spouses are also insureds, but only with
respect to the conduct of your business.
c. A limited liability company, you are an insured.

Your members are also insureds, but only with
respect to the conduct of your business. Your
managers are insureds, but only with respect
to their duties as your managers.
d. An organization other than a partnership, joint
venture or limited liab ility company, you are an
insured. Your "executive officers" and directors
are insureds, but only with respect to their
duties as your officers or directors. Your
stockholders are also insureds, but only with
respect to their liability as stockholders.
e. A trust, you are an insured. Your trustees are
also insureds, but only with respect to their
duties as trustees.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

2. Each of the following is also an insured:
a. Your "volunteer workers" only while performing
duties related to the conduct of your business,
or your "employees", other than either your
"executive officers" (if you are an organization
other than a partnership, joint venture or limited
liability company) or your managers (if you are
a limited liability company), but only for acts
within the scope of their employment by you or
while performing duties related to the conduct
of your business. Ho wever, none of these
"employees" or "volunteer workers" are
insureds for:
(1) "Bodily injury" or "personal and advertising
injury":
(a) To you, to your partners or members (if
you are a partnership or joint venture),
to your members (if you are a limited
liability company), to a co-"employee"
while in the course of his or her
employment or performing duties related
to the conduct of your business, or to
your other "volunteer workers" while
performing duties related to the conduct
of your business;
(b) To the spouse, child, parent, brother or
sister of that co-"employee" or
"volunteer worker" as a consequence of
Paragraph (1)(a) above;
(c) For which there is any obligation to
share damages with or repay someone
else who must pay damages because of
the injury described in Paragraph (1)(a)
or (b) above; or
(d) Arising out of his or her providing or
failing to provide professional health
care services.
(2) "Property damage" to property:
(a) Owned, occupied or used by;
(b) Rented to, in the care, custody or
control of, or over which physical control
is being exercised for any purpose by;
you, any of your "employees", "volunteer
workers", any partner or member (if you are
a partnership or joint venture), or any
member (if you are a limited liability
company).
b. Any person (other than your "employee" or
"volunteer worker"), or any organization while
acting as your real estate manager.
c. Any person or organization having proper
temporary custody of your property if you die,
but only:
(1) With respect to liabilit y arising out of the
maintenance or use of that property; and
(2) Until your legal representative has been
appointed.
d. Your legal representative if you die, but only
with respect to duties as such. That
representative will have all your rights and
duties under this Coverage Part.

3. Any organization you newly acquire or form, other
than a partnership, joint venture or limited liability
company, and over which you maintain ownership
or majority interest, will qualify as a Named
Insured if there is no other similar insurance
available to that organization. However:
a. Coverage under this provision is afforded only
until the 90th day after you acquire or form the
organization or the end of the policy period,
whichever is earlier;
b. Coverage A does not apply to "bodily injury" or
"property damage" that occurred before you
acquired or formed the organization; and
c. Coverage B does not apply to "personal and
advertising injury" arising out of an offense
committed before you acquired or formed the
organization.

No person or organization is an insured with respect
to the conduct of any curren t or past partnership, joint venture or limited liability company that is not shown
as a Named Insured in the Declarations.

SECTION III – LIMITS OF INSURANCE

1. The Limits of Insurance shown in the Declarations
and the rules below fix the most we will pay
regardless of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits".

2. The General Aggregate Limit is the most we will
pay for the sum of:
a. Medical expenses under Coverage C;
b. Damages under Coverage A, except damages
because of "bodily injury" or "property damage"
included in the "products-completed operations
hazard"; and
c. Damages under Coverage B.

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3. The Products-Completed Operations Aggregate
Limit is the most we will pay under Coverage A for
damages because of "bodily injury" and "property
damage" included in the "products-completed
operations hazard".

4. Subject to Paragraph 2. above, the Personal And
Advertising Injury Limit is the most we will pay
under Coverage B for the sum of all damages
because of all "personal and advertising injury"
sustained by any one person or organization.

5. Subject to Paragraph 2. or 3. above, whichever
applies, the Each Occurrence Limit is the most we
will pay for the sum of:
a. Damages under Coverage A; and
b. Medical expenses under Coverage C
because of all "bodily injury" and "property
damage" arising out of any one "occurrence".

6. Subject to Paragraph 5. above, the Damage To
Premises Rented To You Limit is the most we will
pay under Coverage A for damages because of
"property damage" to any one premises, while
rented to you, or in the case of damage by fire,
while rented to you or temporarily occupied by you
with permission of the owner.

7. Subject to Paragraph 5. above, the Medical
Expense Limit is the most we will pay under
Coverage C for all medical expenses because of
"bodily injury" sustained by any one person.

The Limits of Insurance of this Coverage Part apply
separately to each consecutive annual period and to
any remaining period of less than 12 months, starting
with the beginning of the policy period shown in the
Declarations, unless the policy period is extended
after issuance for an additional period of less than 12 months. In that case, the additional period will be
deemed part of the last preceding period for purposes
of determining the Limits of Insurance.

SECTION IV – COMMERCIAL GENERAL LIABILITY

CONDITIONS

1. Bankruptcy
Bankruptcy or insolvency of the insured or of the
insured's estate will not relieve us of our
obligations under this Coverage Part.

2. Duties In The Event Of Occurrence, Offense,
Claim Or Suit
a. You must see to it that we are notified as soon
as practicable of an "occurrence" or an offense
which may result in a claim. To the extent
possible, notice should include:
(1) How, when and where the "occurrence" or
offense took place;
(2) The names and addresses of any injured
persons and witnesses; and
(3) The nature and location of any injury or
damage arising out of the "occurrence" or
offense.
b. If a claim is made or "suit" is brought against
any insured, you must:
(1) Immediately record the specifics of the
claim or "suit" and the date received; and
(2) Notify us as soon as practicable.

You must see to it that we receive written
notice of the claim or "suit" as soon as
practicable.
c. You and any other involved insured must:
(1) Immediately send us copies of any
demands, notices, summonses or legal
papers received in connection with the
claim or "suit";
(2) Authorize us to obtain records and other
information;
(3) Cooperate with us in the investigation or
settlement of the claim or defense against
the "suit"; and
(4) Assist us, upon our request, in the
enforcement of any right against any
person or organization which may be liable
to the insured because of injury or damage
to which this insurance may also apply.
d. No insured will, except at that insured's own
cost, voluntarily make a payment, assume any
obligation, or incur any expense, other than for
first aid, without our consent.

3. Legal Action Against Us
No person or organization has a right under this
Coverage Part:
a. To join us as a party or otherwise bring us into
a "suit" asking for damages from an insured; or
b. To sue us on this Coverage Part unless all of
its terms have been fully complied with.

A person or organization may sue us to recover on
an agreed settlement or on a final judgment
against an insured; but we will not be liable for
damages that are not payable under the terms of
this Coverage Part or that are in excess of the
applicable limit of insurance. An agreed settlement
means a settlement and release of liability signed
by us, the insured and the claimant or the
claimant's legal representative.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

4. Other Insurance
If other valid and collectible insurance is available
to the insured for a loss we cover under
Coverages A or B of this Coverage Part, our
obligations are limited as follows:
a. Primary Insurance
This insurance is primary except when
Paragraph b. below applies. If this insurance is
primary, our obligations are not affected unless
any of the other insurance is also primary.

Then, we will share with all that other
insurance by the method described in
Paragraph c. below.
b. Excess Insurance
(1) This insurance is excess over:
(a) Any of the other insurance, whether
primary, excess, contingent or on any
other basis:
(i) That is Fire, Extended Coverage,
Builder's Risk, Installation Risk or
similar coverage for "your work";
(ii) That is Fire insurance for premises
rented to you or temporarily
occupied by you with permission of
the owner;
(iii) That is insurance purchased by you
to cover your liability as a tenant for
"property damage" to premises
rented to you or temporarily
occupied by you with permission of
the owner; or
(iv) If the loss arises out of the
maintenance or use of aircraft,
"autos" or watercraft to the extent not
subject to Exclusion g. of Section I –
Coverage A – Bodily Injury And
Property Damage Liability.
(b) Any other primary insurance available to
you covering liability for damages
arising out of the premises or
operations, or the products and
completed operations, for which you
have been added as an additional
insured.
(2) When this insurance is excess, we will have
no duty under Coverages A or B to defend
the insured against any "suit" if any other
insurer has a duty to defend the insured
against that "suit". If no other insurer
defends, we will undertake to do so, but we
will be entitled to the insured's rights
against all those other insurers.
(3) When this insurance is excess over other
insurance, we will pay only our share of the
amount of the loss, if any, that exceeds the
sum of:
(a) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(b) The total of all deductible and self-
insured amounts under all that other
insurance.
(4) We will share the remaining loss, if any,
with any other insurance that is not
described in this Excess Insurance
provision and was not bought specifically to
apply in excess of the Limits of Insurance
shown in the Declarations of this Coverage
Part.
c. Method Of Sharing
If all of the other insurance permits contribution
by equal shares, we will follow this method
also. Under this approach each insurer
contributes equal amounts until it has paid its
applicable limit of insurance or none of the loss
remains, whichever comes first.

If any of the other insurance does not permit
contribution by equal shares, we will contribute
by limits. Under this method, each insurer's
share is based on the ratio of its applicable
limit of insurance to the total applicable limits of
insurance of all insurers.

5. Premium Audit
a. We will compute all premiums for this
Coverage Part in accordance with our rules
and rates.
b. Premium shown in this Coverage Part as
advance premium is a deposit premium only.

At the close of each audit period we will
compute the earned premium for that period
and send notice to the first Named Insured.

The due date for audit and retrospective
premiums is the date shown as the due date
on the bill. If the sum of the advance and audit
premiums paid for the policy period is greater
than the earned premium, we will return the
excess to the first Named Insured.
c. The first Named Insured must keep records of
the information we need for premium
computation, and send us copies at such times
as we may request.

6. Representations
By accepting this policy, you agree:
a. The statements in the Declarations are
accurate and complete;
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b. Those statements are based upon
representations you made to us; and
c. We have issued this policy in reliance upon
your representations.

7. Separation Of Insureds
Except with respect to the Limits of Insurance, and
any rights or duties specifically assigned in this
Coverage Part to the first Named Insured, this
insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom claim
is made or "suit" is brought.

8. Transfer Of Rights Of Recovery Against Others
To Us
If the insured has rights to recover all or part of
any payment we have made under this Coverage
Part, those rights are transferred to us. The
insured must do nothing after loss to impair them.

At our request, the insur ed will bring "suit" or
transfer those rights to us and help us enforce
them.

9. When We Do Not Renew
If we decide not to renew this Coverage Part, we
will mail or deliver to the first Named Insured
shown in the Declarations written notice of the
nonrenewal not less than 30 days before the
expiration date.

If notice is mailed, proof of mailing will be sufficient proof of notice.

SECTION V – DEFINITIONS

1. "Advertisement" means a not ice that is broadcast
or published to the general public or specific
market segments about your goods, products or
services for the purpose of attracting customers or
supporters. For the purposes of this definition:
a. Notices that are published include material
placed on the Internet or on similar electronic
means of communication; and
b. Regarding web sites, only that part of a web
site that is about your goods, products or
services for the purposes of attracting
customers or supporters is considered an
advertisement.

2. "Auto" means:
a. A land motor vehicle, trailer or semitrailer
designed for travel on public roads, including
any attached machinery or equipment; or
b. Any other land vehicle that is subject to a
compulsory or financial responsibility law or
other motor vehicle insurance law where it is
licensed or principally garaged.

However, "auto" does not include "mobile
equipment".

3. "Bodily injury" means bod ily injury, sickness or
disease sustained by a per son, including death
resulting from any of these at any time.

4. "Coverage territory" means:
a. The United States of America (including its
territories and possessions), Puerto Rico and
Canada;
b. International waters or airspace, but only if the
injury or damage occurs in the course of travel
or transportation between any places included
in Paragraph a. above; or
c. All other parts of the world if the injury or
damage arises out of:
(1) Goods or products made or sold by you in
the territory described in Paragraph a.
above;
(2) The activities of a person whose home is in
the territory described in Paragraph a.
above, but is away for a short time on your
business; or
(3) "Personal and advertising injury" offenses
that take place through the Internet or
similar electronic means of communication;
provided the insured's responsibility to pay
damages is determined in a "suit" on the merits, in
the territory described in Paragraph a. above or in
a settlement we agree to.

5. "Employee" includes a "leased worker".
"Employee" does not include a "temporary
worker".

6. "Executive officer" means a person holding any of
the officer positions created by your charter,
constitution, bylaws or any other similar governing
document.

7. "Hostile fire" means one which becomes
uncontrollable or breaks out from where it was
intended to be.

8. "Impaired property" means tangible property, other
than "your product" or "your work", that cannot be
used or is less useful because:
a. It incorporates "your product" or "your work"
that is known or thought to be defective,
deficient, inadequate or dangerous; or
b. You have failed to fulfill the terms of a contract
or agreement;
if such property can be restored to use by the
repair, replacement, adjustment or removal of
"your product" or "your wo rk" or your fulfilling the
terms of the contract or agreement.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

9. "Insured contract" means:
a. A contract for a lease of premises. However,
that portion of the contract for a lease of
premises that indemnifies any person or
organization for damage by fire to premises
while rented to you or temporarily occupied by
you with permission of the owner is not an
"insured contract";
b. A sidetrack agreement;
c. Any easement or license agreement, except in
connection with construction or demolition
operations on or within 50 feet of a railroad;
d. An obligation, as required by ordinance, to
indemnify a municipality, except in connection
with work for a municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement
pertaining to your business (including an
indemnification of a municipality in connection
with work performed for a municipality) under
which you assume the tort liability of another
party to pay for "bodily injury" or "property
damage" to a third person or organization. Tort
liability means a liability that would be imposed
by law in the absence of any contract or
agreement.

Paragraph f. does not include that part of any
contract or agreement:
(1) That indemnifies a railroad for "bodily injury"
or "property damage" arising out of
construction or demolition operations, within
50 feet of any railroad property and
affecting any railroad bridge or trestle,
tracks, road-beds, tunnel, underpass or
crossing;
(2) That indemnifies an architect, engineer or
surveyor for injury or damage arising out of:
(a) Preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or drawings
and specifications; or
(b) Giving directions or instructions, or
failing to give them, if that is the primary
cause of the injury or damage; or
(3) Under which the insured, if an architect,
engineer or surveyor, assumes liability for
an injury or damage arising out of the
insured's rendering or failure to render
professional services, including those listed
in (2) above and supervisory, inspection,
architectural or engineering activities.

10. "Leased worker" means a person leased to you by
a labor leasing firm under an agreement between
you and the labor leasing firm, to perform duties
related to the conduct of your business. "Leased
worker" does not include a "temporary worker".

11. "Loading or unloading" means the handling of
property:
a. After it is moved from the place where it is
accepted for movement into or onto an aircraft,
watercraft or "auto";
b. While it is in or on an aircraft, watercraft or
"auto"; or
c. While it is being moved from an aircraft,
watercraft or "auto" to the place where it is
finally delivered;
but "loading or unloading" does not include the
movement of property by means of a mechanical
device, other than a hand truck, that is not
attached to the aircraft, watercraft or "auto".

12. "Mobile equipment" means any of the following
types of land vehicles, including any attached
machinery or equipment:
a. Bulldozers, farm machinery, forklifts and other
vehicles designed for use principally off public
roads;
b. Vehicles maintained for use solely on or next to
premises you own or rent;
c. Vehicles that travel on crawler treads;
d. Vehicles, whether self-propelled or not,
maintained primarily to provide mobility to
permanently mounted:
(1) Power cranes, shovels, loaders, diggers or
drills; or
(2) Road construction or resurfacing equipment
such as graders, scrapers or rollers;
e. Vehicles not described in Paragraph a., b., c.
or d. above that are not self-propelled and are
maintained primarily to provide mobility to
permanently attached equipment of the
following types:
(1) Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting
and well servicing equipment; or
(2) Cherry pickers and similar devices used to
raise or lower workers;
f. Vehicles not described in Paragraph a., b., c.
or d. above maintained primarily for purposes
other than the transportation of persons or
cargo.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 15 of 16

However, self-propelled vehicles with the
following types of permanently attached
equipment are not "mobile equipment" but will
be considered "autos":
(1) Equipment designed primarily for:
(a) Snow removal;
(b) Road maintenance, but not construction
or resurfacing; or
(c) Street cleaning;
(2) Cherry pickers and similar devices mounted
on automobile or truck chassis and used to
raise or lower workers; and
(3) Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting
and well servicing equipment.

However, "mobile equipment" does not include
any land vehicles that are subject to a compulsory
or financial responsibility law or other motor
vehicle insurance law where it is licensed or
principally garaged. Land vehicles subject to a
compulsory or financial re sponsibility law or other
motor vehicle insurance law are considered
"autos".

13. "Occurrence" means an accident, including
continuous or repeated exposure to substantially
the same general harmful conditions.

14. "Personal and advertising injury" means injury,
including consequential "bodily injury", arising out
of one or more of the following offenses:
a. False arrest, detention or imprisonment;
b. Malicious prosecution;
c. The wrongful eviction from, wrongful entry into,
or invasion of the right of private occupancy of
a room, dwelling or premises that a person
occupies, committed by or on behalf of its
owner, landlord or lessor;
d. Oral or written publication, in any manner, of
material that slanders or libels a person or
organization or disparages a person's or
organization's goods, products or services;
e. Oral or written publication, in any manner, of
material that violates a person's right of
privacy;
f. The use of another's advertising idea in your
"advertisement"; or
g. Infringing upon another's copyright, trade dress
or slogan in your "advertisement".

15. "Pollutants" mean any solid, liquid, gaseous or
thermal irritant or contaminant, including smoke,
vapor, soot, fumes, acids, alkalis, chemicals and
waste. Waste includes materials to be recycled,
reconditioned or reclaimed.

16. "Products-completed operations hazard":
a. Includes all "bodily injury" and "property
damage" occurring away from premises you
own or rent and arising out of "your product" or
"your work" except:
(1) Products that are still in your physical
possession; or
(2) Work that has not yet been completed or
abandoned. However, "your work" will be
deemed completed at the earliest of the
following times:
(a) When all of the work called for in your
contract has been completed.
(b) When all of the work to be done at the
job site has been completed if your
contract calls for work at more than one
job site.
(c) When that part of the work done at a job
site has been put to its intended use by
any person or organization other than
another contractor or subcontractor
working on the same project.

Work that may need service, maintenance,
correction, repair or replacement, but which
is otherwise complete, will be treated as
completed.
b. Does not include "bodily injury" or "property
damage" arising out of:
(1) The transportation of property, unless the
injury or damage arises out of a condition in
or on a vehicle not owned or operated by
you, and that condition was created by the
"loading or unloading" of that vehicle by any
insured;
(2) The existence of tools, uninstalled
equipment or abandoned or unused
materials; or
(3) Products or operations for which the
classification, listed in the Declarations or in
a policy Schedule, states that products-
completed operations are subject to the
General Aggregate Limit.

17. "Property damage" means:
a. Physical injury to tang ible property, including
all resulting loss of use of that property. All
such loss of use shall be deemed to occur at
the time of the physical injury that caused it; or
b. Loss of use of tangible property that is not
physically injured. All such loss of use shall be
deemed to occur at the time of the
"occurrence" that caused it.

For the purposes of this insurance, electronic data
is not tangible property.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

As used in this definition, electronic data means
information, facts or programs stored as or on,
created or used on, or transmitted to or from
computer software, including systems and
applications software, hard or floppy disks, CD-
ROMs, tapes, drives, cells, data processing
devices or any other media which are used with
electronically controlled equipment.

18. "Suit" means a civil proceeding in which damages
because of "bodily injury ", "property damage" or
"personal and advertising injury" to which this
insurance applies are alleged. "Suit" includes:
a. An arbitration proceeding in which such
damages are claimed and to which the insured
must submit or does submit with our consent;
or
b. Any other alternative dispute resolution
proceeding in which such damages are
claimed and to which the insured submits with
our consent.

19. "Temporary worker" means a person who is
furnished to you to subs titute for a permanent
"employee" on leave or to meet seasonal or short-
term workload conditions.

20. "Volunteer worker" means a person who is not
your "employee", and who donates his or her work
and acts at the direction of and within the scope of
duties determined by you, and is not paid a fee,
salary or other compensation by you or anyone
else for their work performed for you.

21. "Your product":
a. Means:
(1) Any goods or products, other than real
property, manufactured, sold, handled,
distributed or disposed of by:
(a) You;
(b) Others trading under your name; or
(c) A person or organization whose
business or assets you have acquired;
and
(2) Containers (other than vehicles), materials,
parts or equipment furnished in connection
with such goods or products.
b. Includes:
(1) Warranties or representations made at any
time with respect to the fitness, quality,
durability, performance or use of "your
product"; and
(2) The providing of or failure to provide
warnings or instructions.
c. Does not include vending machines or other
property rented to or located for the use of
others but not sold.

22. "Your work":
a. Means:
(1) Work or operations pe rformed by you or on
your behalf; and
(2) Materials, parts or equipment furnished in
connection with such work or operations.
b. Includes:
(1) Warranties or representations made at any
time with respect to the fitness, quality,
durability, performance or use of "your
work"; and
(2) The providing of or failure to provide
warnings or instructions.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

IL 00 17 11 98

IL 00 17 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 /box3

COMMON POLICY CONDITIONS
All Coverage Parts included in this policy are subject to the following conditions.

A. Cancellation

1. The first Named Insured shown in the Declara-
tions may cancel this policy by mailing or deliv-
ering to us advance written notice of cancella-
tion.

2. We may cancel this policy by mailing or deliver-
ing to the first Named Insured written notice of
cancellation at least:
a. 10 days before the effective date of cancel-
lation if we cancel for nonpayment of pre-
mium; or
b. 30 days before the effective date of cancel-
lation if we cancel for any other reason.

3. We will mail or deliver our notice to the first
Named Insured's last mailing address known to
us.

4. Notice of cancellation will state the effective
date of cancellation. The policy period will end
on that date.

5. If this policy is cancelled, we will send the first
Named Insured any premium refund due. If we
cancel, the refund will be pro rata. If the first
Named Insured cancels, the refund may be
less than pro rata. The cancellation will be ef-
fective even if we have not made or offered a
refund.

6. If notice is mailed, proof of mailing will be suffi- cient proof of notice.

B. Changes
This policy contains all the agreements between
you and us concerning the insurance afforded.

The first Named Insured shown in the Declarations
is authorized to make changes in the terms of this
policy with our consent. This policy's terms can be
amended or waived only by endorsement issued
by us and made a part of this policy.

C. Examination Of Your Books And Records
We may examine and audit your books and re-
cords as they relate to this policy at any time dur-
ing the policy period and up to three years after-
ward.

D. Inspections And Surveys

1. We have the right to:
a. Make inspections and surveys at any time;
b. Give you reports on the conditions we find;
and
c. Recommend changes.

2. We are not obligated to make any inspections,
surveys, reports or recommendations and any
such actions we do undertake relate only to in-
surability and the premiums to be charged. We
do not make safety inspections. We do not un-
dertake to perform the duty of any person or
organization to provide for the health or safety
of workers or the public. And we do not warrant
that conditions:
a. Are safe or healthful; or
b. Comply with laws, regulations, codes or
standards.

3. Paragraphs 1. and 2. of this condition apply not
only to us, but also to any rating, advisory, rate
service or similar organization which makes in-
surance inspections, surveys, reports or rec-
ommendations.

4. Paragraph 2. of this condition does not apply to
any inspections, surveys, reports or recom-
mendations we may make relative to certifica-
tion, under state or municipal statutes, ordi-
nances or regulations, of boilers, pressure ves-
sels or elevators.

E. Premiums
The first Named Insured shown in the Declara-
tions:

1. Is responsible for the payment of all premiums;
and

2. Will be the payee for any return premiums we
pay.

F. Transfer Of Your Rights And Duties Under This
Policy
Your rights and duties under this policy may not be
transferred without our written consent except in
the case of death of an individual named insured.

If you die, your rights and duties will be transferred
to your legal representative but only while acting
within the scope of duties as your legal representa-
tive. Until your legal representative is appointed,
anyone having proper temporary custody of your
property will have your rights and duties but only
with respect to that property.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E180 GL 01 21 Includes copyrighted material of Insurance Services Office, Inc. with its permission.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

COMMUNICABLE DISEASE - EXCLUSION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

This insurance does not apply to, and we shall have no duty to defend, any claim or “suit” for "bodily injury", “property damage” or “personal and advertising injury” arising out of:

1. The actual or alleged transmission of a “communicable disease”; and/or

2. An act, error or omission by or on behalf of any “insured” in:

a. The supervision, hiring, employment, training or monitoring of any person who transmits, is infected with, and/or alleged to be infected with a “communicable disease”; and/or b. Testing for a “communicable disease”; and/or
c. The actual or alleged failure to prevent the spread of a “communicable disease”; and/or d. The actual or alleged failure to report a “communicable disease” to the authorities, including but not limited to the reporting or failure to report any person who is infected with or is alleged to be infected with a “communicable disease”, and/or any place where there is or is alleged to be a presence or spread of a “communicable disease”.

"Communicable Disease" as used in this endorsement shall mean any contagious disease, illness or syndrome which is or has been transmitted to a person or place by bacteria, virus, fungi, protozoa, a toxic agent or any combination of these.

All other terms and conditions of the Coverage Form to which this endorsement is attached remain unchanged.

Optional Coverage Available
Liability coverage for damages for “bodily injury”, “property damage” or “personal and advertising injury” arising out of a “communicable disease” may be purchased as an optional coverage. This optional coverage is provided only if an additional premium has been paid and the Communicable Disease Liability Coverage endorsement has been attached to the Commercial General Liability Coverage Form.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E180 LL 01 21 Includes copyrighted material of Insurance Services Office, Inc. with its permission.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

COMMUNICABLE DISEASE - EXCLUSION

This endorsement modifies insurance provided under the following:

LIQUOR LIABILITY COVERAGE FORM

This insurance does not apply to, and we shall have no duty to defend, any claim or “suit” for damages because of “injury” arising out of:

1. The actual or alleged transmission of a “communicable disease”; and/or

2. An act, error or omission by or on behalf of any “insured” in:

a. The supervision, hiring, employment, training or monitoring of any person who transmits, is infected with, and/or alleged to be infected with a “communicable disease”; and/or b. Testing for a “communicable disease”; and/or
c. The actual or alleged failure to prevent the spread of a “communicable disease”; and/or d. The actual or alleged failure to report a “communicable disease” to the authorities, including but not limited to the reporting or failure to report any person who is infected with or is alleged to be infected with a “communicable disease”, and/or any place where there is or is alleged to be a presence or spread of a “communicable disease”.

"Communicable Disease" as used in this endorsement shall mean any contagious disease, illness or syndrome which is or has been transmitted to a person or place by bacteria, virus, fungi, protozoa, a toxic agent or any combination of these.

All other terms and conditions of the Coverage Form to which this endorsement is attached remain unchanged.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E34 09 18 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CONSTRUCTION AND CONVERSION EXCLUSION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM

This insurance does not apply to “bodily injury”, “property damage”, “personal and advertising injury” or any claim for “damages” caused by or arising out of or in any way related to the following:

1. Any “construction” conducted by you or on your behalf; or,

2. “Your work” on any building or other structure wh ich is deemed completed for which a claim relating to “construction” has been presented; or,

3. “Your work” which is completed and may need correction, replacement or repair.

For purposes of this endorsement, “your work” will be deemed completed at the earliest of the following times:

1. When all of the work called for in your contract has been completed.

2. When all of the work to be done at each specific j ob site has been completed if your contract calls for work at more than one job site.

3. When that part of the work done at the job si te has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project.

For the purpose of this endorsement, “construction” is defined as all operations, including “your work” caused by, arising out of or in any way related to original construction, development, conversion, demolition, remodeling and all other changes, structural and non-structural, to any building or structure.

For purposes of this endorsement, “your work” is defined to mean work or operations performed by you or on your behalf and materials, parts or equipment furnished in connec tion with such work or operations. “Your work” is defined to include warranties or represent ation made at any time with respec t to the fitness, quality, durability, performance or use of “your work”; and the providing of or failure to provide warnings or instructions.

This exclusion does not apply to:

1. Service or maintenance of a building or struct ure which is owned by or leased to you; or,

2. “Construction”, including “your work”, that has not yet been completed or has not otherwise been abandoned.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E282 GL 12 21 Includes copyrighted material of Insurance Services Office, Inc. with its permission.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CYBER INCIDENT - EXCLUSION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

This insurance does not apply to, and we shall have no duty to defend, any claim or “suit” for "bodily injury", “property damage” or “personal and advertising injury” arising out of the:

1. Unauthorized access to or use of any “computer or computer system”;

2. Malicious code, virus or any other harmful code that is directed at, enacted upon or introduced into any “computer or computer system” and is designed to access, alter, corrupt, da mage, delete, destroy, disrupt, encrypt, exploit, use or prevent or restrict access to or the use of any part of any “computer or computer system” or otherwise disrupt its normal functioning or operation;

3. Denial of service attack which disrupts, prevents or restricts access to or use of any “computer or computer system”, or otherwise disrupts the normal functioning or operation of a “computer or computer system”; or

4. Publication, in any manner, of material which is caused, directly or indirectly, by the unauthorized access to or use of any “computer or computer system”.

For purposes of this endorsement “computer or computer system” is defined to mean: “an individual device or set of integrated devices that input, output, process and store data and information utilizing programmable electronic products designed to accept data, perform prescribed operations and display the results of those operations, including but not limited to mainframes, desktop and laptop computers, tablets and smart phones.”

All other terms and conditions of the Coverage Form to which this endorsement is attached remain unchanged.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E195 GL 05 21 Nonprofits Insurance Alliance™ and NONPROFITS OWN® are brands of Alliance Member Services™ (AMS). © AMS. All rights reserved.

THIS ENDORSEM
ENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

DISCRIMINATION EXCLUSION
This endo
rsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM
This insurance does not apply to any liability for “bodily injury”, “property damage” or “personal and advertising injury” arising out of actual or alleged discrimination, whether intentional or unintentional, including but not limited to discrimination based upon a person’s race, color, national origin, ancestry, religion, sex and/or age, or any other protected class or characteristic under the law of the state or jurisdiction pursuant to which this policy shall be construed.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC E29 12 09 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

EMPLOYEE PERSONAL AUTO REIMBURSEMENT

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART
____________________________________________________________________________________________

We agree to pay the lesser of the personal auto insurance comprehensive deductible, or the actual cost of repair in the absence of personal auto insurance comprehensive coverage, up to $1,000 to an employee or volunteer of the Insured if the personal auto of the employee or volunteer is damaged by a client of the Insured. The most we will pay during a policy term is limited to $3,000.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

COMMERCIAL GENERAL LIABILITY
CG 21 47 12 07

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 21 47 12 07 © ISO Properties, Inc., 2006 Page 1 of 1 

EMPLOYMENT-RELATED PRACTICES EXCLUSION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

A. The following exclusion is added to Paragraph 2.,
Exclusions of Section I – C o v e r a g e A – B o d i ly Injury And Property Damage Liability:

This insurance does not apply to:
"Bodily injury" to:
( 1 ) A person arising out of any:
( a ) Refusal to employ that person;
( b ) Termination of that person's employment;
or
( c ) Employment-related practices, policies,
acts or omissions, such as coercion, demo-
tion, evaluation, reassignment, discipline,
defamation, harassment, humiliation, dis-
crimination or malicious prosecution di-
rected at that person; or
( 2 ) The spouse, child, parent, brother or sister of
that person as a consequence of "bodily injury"
to that person at whom any of the employment-
related practices described in Paragraphs (a),
(b), or (c) above is directed.

This exclusion applies:
( 1 ) Whether the injury-causing event described in
Paragraphs (a), (b) or (c) above occurs before
employment, during employment or after em-
ployment of that person;
( 2 ) Whether the insured may be liable as an em-
ployer or in any other capacity; and
( 3 ) To any obligation to share damages with or
repay someone else who must pay damages
because of the injury.

B. The following exclusion is added to Paragraph 2.,
Exclusions of Section I – Coverage B – Person-
al And Advertising Injury Liability:

This insurance does not apply to:
"Personal and advertising injury" to:
( 1 ) A person arising out of any:
(a) Refusal to employ that person;
(b) Termination of that person's employment;
or
(c) Employment-related practices, policies,
acts or omissions, such as coercion, demo-
tion, evaluation, reassignment, discipline,
defamation, harassment, humiliation, dis-
crimination or malicious prosecution di-
rected at that person; or
( 2 ) The spouse, child, parent, brother or sister of
that person as a consequence of "personal and
advertising injury" to that person at whom any
of the employment-related practices described
in Paragraphs (a), (b), or (c) above is directed.

This exclusion applies:
( 1 ) Whether the injury-causing event described in
Paragraphs (a), (b) or (c) above occurs before
employment, during employment or after em-
ployment of that person;
( 2 ) Whether the insured may be liable as an em-
ployer or in any other capacity; and
( 3 ) To any obligation to share damages with or
repay someone else who must pay damages
because of the injury.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

COMMERCIAL GENERAL LIABILITY
CG 21 09 06 15

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 21 09 06 15 © Insurance Services Office, Inc., 2014 Page 1 of 2

EXCLUSION – UNMANNED AIRCRAFT

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

A. Exclusion 2.g. Aircraft, Auto Or Watercraft under
Section I – Coverage A – Bodily Injury And
Property Damage Liability is replaced by the
following:

2. Exclusions
This insurance does not apply to:
g. Aircraft, Auto Or Watercraft
(1) Unmanned Aircraft
"Bodily injury" or "property damage"
arising out of the ownership,
maintenance, use or entrustment to
others of any aircraft that is an
"unmanned aircraft". Use includes
operation and "loading or unloading".

This Paragraph g.(1) applies even if the
claims against any insured allege
negligence or other wrongdoing in the
supervision, hiring, employment, training
or monitoring of others by that insured, if
the "occurrence" which caused the
"bodily injury" or "property damage"
involved the ownership, maintenance,
use or entrustment to others of any
aircraft that is an "unmanned aircraft".
(2) Aircraft (Other Than Unmanned
Aircraft), Auto Or Watercraft
"Bodily injury" or "property damage"
arising out of the ownership,
maintenance, use or entrustment to
others of any aircraft (other than
"unmanned aircraft"), "auto" or
watercraft owned or operated by or
rented or loaned to any insured. Use
includes operation and "loading or
unloading".

This Paragraph g.(2) applies even if the
claims against any insured allege
negligence or other wrongdoing in the
supervision, hiring, employment, training
or monitoring of others by that insured, if
the "occurrence" which caused the
"bodily injury" or "property damage"
involved the ownership, maintenance,
use or entrustment to others of any
aircraft (other than "unmanned aircraft"),
"auto" or watercraft that is owned or
operated by or rented or loaned to any
insured.

This Paragraph g.(2) does not apply to:
(a) A watercraft while ashore on
premises you own or rent;
(b) A watercraft you do not own that is:
(i) Less than 26 feet long; and
(ii) Not being used to carry persons
or property for a charge;
(c) Parking an "auto" on, or on the ways
next to, premises you own or rent,
provided the "auto" is not owned by
or rented or loaned to you or the
insured;
(d) Liability assumed und er any "insured
contract" for the ownership,
maintenance or use of aircraft or
watercraft; or
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

(e) "Bodily injury" or "property damage"
arising out of:
(i) The operation of machinery or
equipment that is attached to, or
part of, a land vehicle that would
qualify under the definition of
"mobile equipment" if it were not
subject to a compulsory or
financial responsibility law or
other motor vehicle insurance law
where it is licensed or principally
garaged; or
(ii) The operation of any of the
machinery or equipment listed in
Paragraph f.(2) or f.(3) of the
definition of "mobile equipment".

B. The following exclusion is added to Paragraph 2.

Exclusions of Coverage B – Personal And
Advertising Injury Liability:

2. Exclusions
This insurance does not apply to:

Unmanned Aircraft
"Personal and advertising injury" arising out of
the ownership, maintenance, use or
entrustment to others of any aircraft that is an
"unmanned aircraft". Use includes operation
and "loading or unloading".

This exclusion applies even if the claims
against any insured allege negligence or other
wrongdoing in the supervision, hiring,
employment, training or monitoring of others by
that insured, if the offense which caused the
"personal and advertising injury" involved the
ownership, maintenance, use or entrustment to
others of any aircraft that is an "unmanned
aircraft".

This exclusion does not apply to:
a. The use of another's advertising idea in
your "advertisement"; or
b. Infringing upon another's copyright, trade
dress or slogan in your "advertisement".

C. The following definition is added to the Definitions section:
"Unmanned aircraft" means an aircraft that is not:

1. Designed;

2. Manufactured; or

3. Modified after manufacture;
to be controlled directly by a person from within or
on the aircraft.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

COMMERCIAL GENERAL LIABILITY
CG 21 73 01 15

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 21 73 01 15 © Insurance Services Office, Inc., 2014 Page 1 of 1

EXCLUSION OF CERTIFIED ACTS OF TERRORISM

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

EMPLOYEE BENEFITS LIABILITY COVERAGE

IMPROPER SEXUAL CONDUCT AND PHYSICAL ABUSE LIABILITY COVERAGE PART

DIRECTORS AND OFFICERS LIABILITY POLICY

A. The following exclusion is added:

This insurance does not apply to:

TERRORISM
"Any injury or damage" arising, directly or
indirectly, out of a "certified act of terrorism".

B. The following definitions are added:

1. For the purposes of this endorsement, "any
injury or damage" means any injury or damage
covered under any Coverage Part to which this
endorsement is applicable, and includes but is
not limited to "bodily injury", "property
damage", "personal and advertising injury",
"injury" or "environmental damage" as may be
defined in any applicable Coverage Part.

2. "Certified act of terrorism" means an act that is
certified by the Secretary of the Treasury, in
accordance with the provisions of the federal
Terrorism Risk Insurance Act, to be an act of
terrorism pursuant to such Act. The criteria
contained in the Terrorism Risk Insurance Act
for a "certified act of terrorism" include the
following:
a. The act resulted in insured losses in excess
of $5 million in the aggregate, attributable to
all types of insurance subject to the
Terrorism Risk Insurance Act; and
b. The act is a violent act or an act that is
dangerous to human life, property or
infrastructure and is committed by an
individual or individuals as part of an effort
to coerce the civilian population of the
United States or to influence the policy or
affect the conduct of the United States
Government by coercion.

C. The terms and limitations of any terrorism
exclusion, or the inapplicability or omission of a
terrorism exclusion, do not serve to create
coverage for injury or damage that is otherwise
excluded under this Coverage Part.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E123 09 19 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

FIREARMS SUBLIMIT ENDORSEMENT
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

SECTION I - COVERAGES

COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY

2. Exclusions, is amended to include:

r. Firearms

“Bodily injury” or “property damage” for damages in excess of $1,000,000, which are caused by, arises out of, or in any way related to:

(a) The use of or failure to use any “firearm” by, at the instruction of, at the direction of, or arising out of any act or omission by you, any insured, or contractor, subcontractor or independent contractor for whom you or any insured is legally responsible;
(b) The negligent employment, investigation, hiring, supervision, training or retention by you, any insured, or any contractor, subcontractor or independent contractor for whom you or any insured is legally responsible, with respect to the use of or failure to use any “firearm”; or (c) The rendering of, or failure to render care necessitated by anyone injured by the use of or failure to use any “firearm” by you, any insured or by any contractor, subcontractor or independent contractor for whom you or any insured is legally responsible.

This exclusion applies to any liability for payment for damages, defense costs and fees including any payments made pursuant to SUPPLEMENTARY
PAYMENTS COVERAGES A AND B within this Coverage Form. Any payment made pursuant to this FIREARMS SUBLIMIT ENDORSEMENT will decrease the General Aggregate Limit included within the Commercial General Liability Coverage Form to which this endorsement is attached.

(1) For the purpose of this endorsement, “firearm” means any gun including but not limited to handguns, rifles, shotguns, tasers, stun guns or projectile weapons which use bullets or shoot projectiles.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E11 GL 09 19 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

FIREWORKS EXCLUSION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

This insurance does not apply to “bodily injury,” “property damage,” or “personal and advertising injury” arising out of the use, handling, distribution or sale of fireworks or any similar explosive device or material, including but not limited to a cherry bomb, firecracker, flare, rocket, skyrocket, sparklers and/or squib.

We shall not be obligated to investigate on behalf of an "insured" or to defend or indemnify an "insured" or any person or entity claiming any right under the policy for the matters excluded in this endorsement. Defense and Supplementary Payments shall not apply to any loss, cost, expense, claim or "suit" excluded under any provision set forth above.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E069 GL 02 19 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

FISCAL SPONSOR LIMITATION OF COVERAGE

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

BUSINESS AUTO COVERAGE FORM

This insurance does not apply to “bodily injury,” “property damage,” or “personal and advertising injury” arising out of an Insured’s status as a “fiscal sponsor” until:

a. The first Named Insured enters into a “fiscal sponsor agreem ent” arising out of or in connection with the First Named Insured’s status as a “fiscal sponsor” for that person, entity or organization; and b. The first Named Insured provides any underwriting informatio n and pays any additional premium required by us.

This insurance does not apply to “bodily injury” or “property d amage” that occurs before the first Named Insured enters into the “fiscal sponsor agreement” which is subject of the claim, loss, damage or expense or because of an offense that constitutes “personal and advertising injury” that is committed before the first Named Insured enters into the “fiscal sponsor agreement” which is the subject of the claim, loss, damage or expense.

If there is other insurance available to any party pursuant to a “fiscal sponsor agreement“ for “bodily injury,” “property damage,” or “personal and advertising injury” which are covered by this endorsement, including but not limited to a duty to defend the first Named Insured by that other insurance, the coverage provided by this endorsement is excess to that other insurance.

“Fiscal sponsor” is defined to mean the first Named Insured’s s tatus as the entity or organization which offers its legal and tax-exempt status to another person, entity or organization pursuant to a “fiscal sponsor agreement”; who participates in the operations of that person, entity or organization by receiving assets and incurring liabilities for the mutual benefit of pursuing charitable goals; and in consideration for the benefit of that person, entity or organization has assumed responsibility to manage programs, events, revenue, grants, contributions, contracts and/or insurance programs.

“Fiscal sponsor agreement” is defined as a written contract or agreement by the first Named Insured with a person, entity and/or organization in which the first Named Insured agr ees to serve as a “fiscal sponsor” for such person, entity or organization.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E70 03 19 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

FUNDRAISER AND EVENT

ENDORSEMENT

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

This insurance applies to those sums that an insured becomes legally obligated to pay as damages because of "bodily injury”, "property damage”, or "personal and advertising injury" arising out of a "fundraiser” or “event”.

Except for a "fundraiser" or “event” that is specifically scheduled on the policy, this insurance does not apply to liability arising out of a "fundraiser" or “event” which involves, directly or indirectly, any of the following:

 Any "fundraiser" or “event” with more than 500 people present at any one time  Animals (including, but not limited to, animals involved in rodeos, petting zoos, animal exhibitions)  Athletic activities or contests, not including golf or bowling  Carnivals, circuses, fairs, festivals, parades
 Powered Rides or Amusement attractions (including, but not limited to, climbing walls, slides, mechanical bulls, bungee jumps)
 Firearms or weapons
 Water events (including, but not limited to, activities involving swimming pools, lakes, rivers or other bodies of water)
 Trampolines, bounce houses, rebounding equipment, inflatable amusement or sports devices, moon walks, or inflatable wrestling or combatant suits.

“Fundraiser" is any event sponsored or co-sponsored by "you" with the primary purpose of raising monetary contributions.

“Event” is any activity sponsored or co-sponsored by “you” apart from your regular scope of operations

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
CG 22 44 04 13

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 22 44 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1

EXCLUSION – SERVICES FURNISHED BY

HEALTH CARE PROVIDERS

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Description Of Operations:

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

The following exclusion is added to Paragraph 2.

Exclusions of Section I – Coverage A – Bodily
Injury And Property Damage Liability and
Paragraph 2. Exclusions of Section I – Coverage B
– Personal And Advertising Injury Liability:

With respect to any operation shown in the Schedule,
this insurance does not apply to "bodily injury",
"property damage" or "personal and advertising injury"
arising out of:

1. The rendering of or failure to render:
a. Medical, surgical, dental, X-ray or nursing
service, treatment, advice or instruction, or the
related furnishing of food or beverages;
b. Any health or therapeutic service, treatment,
advice or instruction; or
c. Any service, treatment, advice or instruction for
the purpose of appearance or skin
enhancement, hair removal or replacement or
personal grooming;

2. The furnishing or dispensing of drugs or medical,
dental or surgical supplies or appliances; or

3. The handling or treatment of dead bodies,
including autopsies, organ donation or other
procedures.

This exclusion applies even if the claims against any
insured allege negligence or other wrongdoing in the
supervision, hiring, employment, training or
monitoring of others by that insured, if the
"occurrence" which caused the "bodily injury" or
"property damage", or the offense which caused the
"personal and advertising in jury", involved that which is described in Paragraph 1., 2. or 3.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-X1 06 18 Page 1 of 2

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

IMPROPER SEXUAL CONDUCT AND

PHYSICAL ABUSE EXCLUSION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

The insurance provided by this policy affords NO COVERAGE with respect to any claim, suit or cause of action which arises from, or is in any way related to liability arising out of:

A. Any form of improper sexual conduct, including but not limited to any actual, alleged, attempted, proposed or threatened sexual abuse, sexual molestation, sexual harassment, sexual assault, sexual battery, sexual exploitation, erotic physical contact or sexual injury by anyone to any person;
B. Any form of physical abuse, including but not limited to assault, including assault with a deadly weapon or with force likely to produce bodily harm, battery or unreasonable physical restraint or constraint by anyone to any person. This exclusion does not apply to “bodily injury” resulting from the use of reasonable force to protect persons or property;
C. The employment, investigation, supervis ion or retention of a person for whom any insured is or ever was legally responsible and whose conduct would be excluded by (A) or (B) above;
D. The failure to report an incident of any form of improper sexual conduct or physical abuse to the proper authorities, or the withholding of pertinent information concerning the same from such authorities; or
E. The failure to provide professional serv ices to any person or the neglect of the therapeutic needs of any person because of improper sexual conduct or physical abuse following any form of improper sexual conduct or physical abuse for which an insured could be legally liable.

This exclusion shall apply regardless of the legal form ANY claim or complaint may take, and shall apply to each and every cause of action and allegation contained in a claim or complaint, if ANY cause of action or allegation in that claim or complaint, in ANY manner, sets forth an allegation of ANY form of improper sexual conduct or physical abuse. For example, if a claim is made or a complaint is filed against an individual or entity referred to in paragraph A or B above, there is NO COVERAGE for ANY individual or entity under the policy, regardless of ANY other coverage provisions that might otherwise apply.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-X1 06 18 Page 2 of 2

BINDING ARBITRATION CLAUSE
Notwithstanding any other term set forth herein, the parties hereby agree that any dispute which arises from the application of this exclusion shall be resolved through binding arbitration.

The parties acknowledge that by agreeing to binding arbitration they are waiving the right to a jury trial. Binding arbitration shall take place in San Francisco, unless otherwise agreed upon and shall be conducted by a single neutral arbitrator selected by the American Arbitration Association, pursuant to its rules. The arbitrator shall apply the law of the state or the District where the policy to which this exclusion is attached, and is issued. The cost of the arbitration shall be shared equally by the participants.

COVERAGE AVAILABLE (OPTIONAL)

IMPROPER SEXUAL CONDUCT AND PHYSICAL ABUSE LIABILITY COVERAGE Coverage for improper sexual conduct and physical abuse liability may be purchased as an optional coverage. This optional improper sexual conduct and physical abuse liability coverage is provided only by the Improper Sexual Conduct and Physical Abuse Liability Coverage Form. Such coverage is provided only if it is shown in the Declarations page to this policy, the additional premium indicated has been paid, and the Improper Sexual Conduct and Physical Abuse Liability Coverage Form has been issued by us.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E120 09 19 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

EXCLUSION - LIABILITY ARISING OUT OF LEAD

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

This insurance does not apply to:

1. "bodily injury", "property damage" or "personal and advertising injury" arising out of, resulting from, or in any way caused by or related to the actual, alleged or threatened ingestion, inhalation, absorption, or exposure to lead in any form from any source; or

2. any loss, expense, liability or other type of obligation arising out of or resulting from, or in any way related to any:

a. claim, suit, request, demand, directive, or order by or on behalf of any person, entity, or governmental authority that any "insured" or others test for, monitor, clean up, remove, contain, treat, detoxify, neutralize, or in any way respond to, or assess the effects of lead in any form from any source, or to any

b. claim or suit by or on behalf of any person, entity, or governmental authority for damages or any other relief or remedy because of testing for, monitoring, cleaning up, removing, containing, treating or detoxifying or neutralizing, or in any way responding to, or assessing the effects of lead in any form.

We shall not be obligated to investigate on behalf of an "insured" or to defend or indemnify an "insured" or any person or entity claiming any right under the policy for the matters excluded in this endorsement. Defense and Supplementary Payments shall not apply to any loss, cost, expense, claim or "suit" excluded under any provision set forth above.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC E 56 01 17 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

LIBERALIZATION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM

EMPLOYEE BENEFITS LIABILITY ENDORSEMENT

The following is added to the conditions section:

If we revise this coverage form or its endorsements during this policy period to provide more coverage without an additional premium charge, your policy will automatically provide the additional coverage as of the day the revision is effective.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC E59 02 12 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

LIBERALIZATION

This endorsement modifies insurance provided under the following:

LIQUOR LIABILITY COVERAGE FORM
____________________________________________________________________________________________

The following is added to the conditions section:

If we revise this coverage form or its endorsements during this policy period to provide more coverage without an additional premium charge, your policy will automatically provide the additional coverage as of the day the revision is effective.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

COMMERCIAL GENERAL LIABILITY
CG 00 33 04 13

CG 00 33 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 6

LIQUOR LIABILITY COVERAGE FORM

Various provisions in this policy restrict coverage.

Read the entire policy carefully to determine rights,
duties and what is and is not covered.

Throughout this policy the words "you" and "your"
refer to the Named Insured shown in the Declarations,
and any other person or organization qualifying as a
Named Insured under this policy. The words "we",
"us" and "our" refer to the company providing this
insurance.

The word "insured" means any person or organization
qualifying as such under Section II – Who Is An
Insured.

Other words and phrases that appear in quotation
marks have special meaning. Refer to Section V –
Definitions.

SECTION I – LIQUOR LIABILITY COVERAGE

1. Insuring Agreement
a. We will pay those sums that the insured
becomes legally obligated to pay as damages
because of "injury" to which this insurance
applies if liability for such "injury" is imposed on
the insured by reason of the selling, serving or
furnishing of any alcoholic beverage. We will
have the right and duty to defend the insured
against any "suit" seeking those damages.

However, we will have no duty to defend the
insured against any "suit" seeking damages for
"injury" to which this insurance does not apply.

We may, at our discretion, investigate any
"injury" and settle any claim or "suit" that may
result. But:
(1) The amount we will pay for damages is
limited as described in Section III – Limits
Of Insurance; and
(2) Our right and duty to defend ends when we
have used up the applicable limit of
insurance in the payment of judgments or
settlements.

No other obligation or liability to pay sums or
perform acts or services is covered unless
explicitly provided for under Supplementary
Payments.
b. This insurance applies to "injury" only if:
(1) The "injury" occurs during the policy period
in the "coverage territory"; and
(2) Prior to the policy period, no insured listed
under Paragraph 1. of Section II – Who Is
An Insured and no "employee" authorized
by you to give or receive notice of an
"injury" or claim, knew that the "injury" had
occurred, in whole or in part. If such a listed
insured or authorized "employee" knew,
prior to the policy period, that the "injury"
occurred, then any continuation, change or
resumption of such "injury" during or after
the policy period will be deemed to have
been known prior to the policy period.
c. "Injury" which occurs during the policy period
and was not, prior to the policy period, known
to have occurred by any insured listed under
Paragraph 1. of Section II – Who Is An Insured
or any "employee" authorized by you to give or
receive notice of an "injury" or claim, includes
any continuation, change or resumption of that
"injury" after the end of the policy period.
d. "Injury" will be deem ed to have been known to
have occurred at the earliest time when any
insured listed under Paragraph 1. of Section II
– Who Is An Insured or any "employee"
authorized by you to give or receive notice of
an "injury" or claim:
(1) Reports all, or any part, of the "injury" to us
or any other insurer;
(2) Receives a written or verbal demand or
claim for damages because of the "injury";
or
(3) Becomes aware by any other means that
"injury" has occurred or has begun to occur.

2. Exclusions
This insurance does not apply to:
a. Expected Or Intended Injury
"Injury" expected or intended from the
standpoint of the insured. This exclusion does
not apply to "bodily injury" resulting from the
use of reasonable force to protect persons or
property.
b. Workers' Compensation And Similar Laws
Any obligation of the insured under a workers'
compensation, disability benefits or
unemployment compensation law or any
similar law.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

c. Employer's Liability
"Bodily injury" to:
(1) An "employee" of the insured arising out of
and in the course of:
(a) Employment by the insured; or
(b) Performing duties related to the conduct
of the insured's business; or
(2) The spouse, child, parent, brother or sister
of that "employee" as a consequence of
Paragraph (1) above.

This exclusion applies whether the insured
may be liable as an employer or in any other
capacity and to any obligation to share
damages with or repay someone else who
must pay damages because of the "injury".
d. Liquor License Not In Effect
"Injury" arising out of any alcoholic beverage
sold, served or furnished while any required
license is not in effect.
e. Your Product
"Injury" arising out of "your product". This
exclusion does not apply to "injury" for which
the insured or the insured's indemnitees may
be held liable by reason of:
(1) Causing or contributing to the intoxication of
any person;
(2) The furnishing of alcoholic beverages to a
person under the legal drinking age or
under the influence of alcohol; or
(3) Any statute, ordinance or regulation relating
to the sale, gift, distribution or use of
alcoholic beverages.
f. Other Insurance
Any "injury" with respect to which other
insurance is afforded, or would be afforded but
for the exhaustion of the limits of insurance.

This exclusion does not apply if the other
insurance responds to liability for "injury"
imposed on the insured by reason of the
selling, serving or furnishing of any alcoholic
beverage.
g. War
"Injury", however caused, arising, directly or
indirectly, out of:
(1) War, including undeclared or civil war;
(2) Warlike action by a m ilitary force, including
action in hindering or defending against an
actual or expected attack, by any
government, sovereign or other authority
using military personnel or other agents; or
(3) Insurrection, rebellion, revolution, usurped
power, or action taken by governmental
authority in hindering or defending against
any of these.

SUPPLEMENTARY PAYMENTS
We will pay, with respect to any claim we investigate
or settle, or any "suit" against an insured we defend:

1. All expenses we incur.

2. The cost of bonds to release attachments, but only
for bond amounts within the applicable limit of
insurance. We do not have to furnish these bonds.

3. All reasonable expenses incurred by the insured at
our request to assist us in the investigation or
defense of the claim or "suit", including actual loss
of earnings up to $250 a day because of time off
from work.

4. All court costs taxed against the insured in the
"suit". However, these payments do not include
attorneys' fees or attorneys' expenses taxed
against the insured.

5. Prejudgment interest awarded against the insured
on that part of the judgment we pay. If we make an
offer to pay the applicable limit of insurance, we
will not pay any prejudgment interest based on
that period of time after the offer.

6. All interest on the full amount of any judgment that accrues after entry of the judgment and before we
have paid, offered to pay, or deposited in court the
part of the judgment that is within the applicable
limit of insurance.

7. Expenses incurred by the insured for first aid
administered to others at the time of an event to
which this insurance applies.

These payments will not reduce the limits of
insurance.

SECTION II – WHO IS AN INSURED

1. If you are designated in the Declarations as:
a. An individual, you and your spouse are
insureds.
b. A partnership or joint venture, you are an
insured. Your members, your partners, and
their spouses are also insureds, but only with
respect to the conduct of your business.
c. A limited liability company, you are an insured.

Your members are also insureds, but only with
respect to the conduct of your business. Your
managers are insureds, but only with respect
to their duties as your managers.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

CG 00 33 04 13 © Insurance Services Office, Inc., 2012 Page 3 of 6

d. An organization other than a partnership, joint
venture or limited liab ility company, you are an
insured. Your "executive officers" and directors
are insureds, but only with respect to their
duties as your officers or directors. Your
stockholders are also insureds, but only with
respect to their liability as stockholders.
e. A trust, you are an insured. Your trustees are
also insureds, but only with respect to their
duties as trustees.

2. Each of the following is also an insured:
a. Your "employees", other than either your
"executive officers" (if you are an organization
other than a partnership, joint venture or limited
liability company) or your managers (if you are
a limited liability company), but only for acts
within the scope of their employment by you or
while performing duties related to the conduct
of your business. Ho wever, none of these
"employees" is an insured for:
(1) "Injury":
(a) To you, to your partners or members (if
you are a partnership or joint venture),
to your members (if you are a limited
liability company), or to a co-"employee"
while that co-"employee" is either in the
course of his or her employment or
performing duties related to the conduct
of your business;
(b) To the spouse, child, parent, brother or
sister of that co-"employee" as a
consequence of Paragraph (a) above; or
(c) For which there is any obligation to
share damages with or repay someone
else who must pay damages because of
the injury described in Paragraph (a) or
(b) above.
(2) "Property damage" to property:
(a) Owned or occupied by; or
(b) Rented or loaned;
to that "employee", any of your other
"employees", by any of your partners or
members (if you are a partnership or joint
venture), or by any of your members (if you
are a limited liability company).
b. Any person or organization having proper
temporary custody of your property if you die,
but only:
(1) With respect to liabilit y arising out of the
maintenance or use of that property; and
(2) Until your legal representative has been
appointed.
c. Your legal representative if you die, but only
with respect to duties as such. That
representative will have all your rights and
duties under this Coverage Part.

3. Any organization you newly acquire or form, other
than a partnership, joint venture or limited liability
company, and over which you maintain ownership
or majority interest, will qualify as a Named
Insured if there is no other similar insurance
available to that organization. However:
a. Coverage under this provision is afforded only
until the 90th day after you acquire or form the
organization or the end of the policy period,
whichever is earlier; and
b. Coverage does not apply to "injury" that
occurred before you acquired or formed the
organization.

No person or organization is an insured with respect
to the conduct of any curren t or past partnership, joint venture or limited liability company that is not shown
as a Named Insured in the Declarations.

SECTION III – LIMITS OF INSURANCE

1. The Limits of Insurance shown in the Declarations
and the rules below fix the most we will pay
regardless of the number of:
a.

Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits".

2. The Aggregate Limit is the most we will pay for all
"injury" as the result of the selling, serving or
furnishing of alcoholic beverages.

3. Subject to the Aggregate Limit, the Each Common
Cause Limit is the most we will pay for all "injury"
sustained by one or more persons or
organizations as the result of the selling, serving
or furnishing of any alcoholic beverage to any one
person.

The Limits of Insurance of this Coverage Part apply
separately to each consecutive annual period and to
any remaining period of less than 12 months, starting
with the beginning of the policy period shown in the
Declarations, unless the policy period is extended
after issuance for an additional period of less than 12 months. In that case, the additional period will be
deemed part of the last preceding period for purposes
of determining the Limits of Insurance.

SECTION IV – LIQUOR LIABILITY CONDITIONS

1. Bankruptcy
Bankruptcy or insolvency of the insured or of the
insured's estate will not relieve us of our
obligations under this Coverage Part.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

2. Duties In The Event Of Injury, Claim Or Suit
a. You must see to it that we are notified as soon
as practicable of an "injury" which may result in
a claim. To the extent possible, notice should
include:
(1) How, when and where the "injury" took
place;
(2) The names and addresses of any injured
persons and witnesses; and
(3) The nature and location of any "injury".
b. If a claim is made or "suit" is brought against
any insured, you must:
(1) Immediately record the specifics of the
claim or "suit" and the date received; and
(2) Notify us as soon as practicable.

You must see to it that we receive written
notice of the claim or "suit" as soon as
practicable.
c. You and any other involved insured must:
(1) Immediately send us copies of any
demands, notices, summonses or legal
papers received in connection with the
claim or "suit";
(2) Authorize us to obtain records and other
information;
(3) Cooperate with us in the investigation or
settlement of the claim or defense against
the "suit"; and
(4) Assist us, upon our request, in the
enforcement of any right against any
person or organization which may be liable
to the insured because of "injury" to which
this insurance may also apply.
d. No insured will, except at that insured's own
cost, voluntarily make a payment, assume any
obligation, or incur any expense, other than for
first aid, without our consent.

3. Legal Action Against Us
No person or organization has a right under this
Coverage Part:
a. To join us as a party or otherwise bring us into
a "suit" asking for damages from an insured; or
b. To sue us on this Coverage Part unless all of
its terms have been fully complied with.

A person or organization may sue us to recover on
an agreed settlement or on a final judgment
against an insured; but we will not be liable for
damages that are not payable under the terms of
this Coverage Part or that are in excess of the
applicable limit of insurance. An agreed settlement
means a settlement and release of liability signed
by us, the insured and the claimant or the
claimant's legal representative.

4. Other Insurance
If other valid and collectible insurance is available
to the insured for a loss we cover under this
Coverage Part, our obligations are limited as
follows:
a. Primary Insurance
This insurance is primary. Our obligations are
not affected unless any of the other insurance
is also primary. Then, we will share with all that
other insurance by the method described in b.
below.
b. Method Of Sharing
If all of the other insurance permits contribution
by equal shares, we will follow this method
also. Under this approach each insurer
contributes equal amounts until it has paid its
applicable limit of insurance or none of the loss
remains, whichever comes first.

If any of the other insurance does not permit
contribution by equal shares, we will contribute
by limits. Under this method, each insurer's
share is based on the ratio of its applicable
limit of insurance to the total applicable limits of
insurance of all insurers.

5. Premium Audit
a. We will compute all premiums for this
Coverage Part in accordance with our rules
and rates.
b. Premium shown in this Coverage Part as
advance premium is a deposit premium only.

At the close of each audit period we will
compute the earned premium for that period
and send notice to the first Named Insured.

The due date for audit and retrospective
premiums is the date shown as the due date
on the bill. If the sum of the advance and audit
premiums paid for the policy period is greater
than the earned premium, we will return the
excess to the first Named Insured.

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CG 00 33 04 13 © Insurance Services Office, Inc., 2012 Page 5 of 6

c. The first Named Insured must keep records of
the information we need for premium
computation, and send us copies at such times
as we may request.

6. Representations
By accepting this policy, you agree:
a. The statements in the Declarations are
accurate and complete;
b. Those statements are based upon
representations you made to us; and
c. We have issued this policy in reliance upon
your representations.

7. Separation Of Insureds
Except with respect to the Limits of Insurance, and
any rights or duties specifically assigned in this
Coverage Part to the first Named Insured, this
insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom claim
is made or "suit" is brought.

8. Transfer Of Rights Of Recovery Against Others
To Us
If the insured has rights to recover all or part of
any payment we have made under this Coverage
Part, those rights are transferred to us. The
insured must do nothing after loss to impair them.

At our request, the insur ed will bring "suit" or
transfer those rights to us and help us enforce
them.

9. When We Do Not Renew
If we decide not to renew this Coverage Part, we
will mail or deliver to the first Named Insured
shown in the Declarations written notice of the
nonrenewal not less than 30 days before the
expiration date.

If notice is mailed, proof of mailing will be sufficient proof of notice.

SECTION V – DEFINITIONS

1. "Bodily injury" means bod ily injury, sickness or
disease sustained by a per son, including death
resulting from any of these at any time.

2. "Coverage territory" means:
a. The United States of America (including its
territories and possessions), Puerto Rico and
Canada;
b. International waters or airspace, but only if the
"injury" occurs in the course of travel or
transportation between any places included in
Paragraph a. above; or
c. All other parts of the worl d if the "injury" arises out of:
(1) Goods or products made or sold by you in
the territory described in Paragraph a.
above; or
(2) The activities of a person whose home is in
the territory described in Paragraph a.
above, but is away for a short time on your
business;
provided the insured's responsibility to pay
damages is determined in a "suit" on the
merits, in the territory described in Paragraph
a. above or in a settlement we agree to.

3. "Employee" includes a "leased worker".
"Employee" does not include a "temporary
worker".

4. "Executive officer" means a person holding any of
the officer positions created by your charter,
constitution, bylaws or any other similar governing
document.

5. "Injury" means damages because of "bodily injury"
and "property damage", including damages for
care, loss of services or loss of support.

6. "Leased worker" means a person leased to you by
a labor leasing firm under an agreement between
you and the labor leasing firm, to perform duties
related to the conduct of your business. "Leased
worker" does not include a "temporary worker".

7. "Property damage" means:
a. Physical injury to tang ible property, including
all resulting loss of use of that property. All
such loss of use shall be deemed to occur at
the time of the physical injury that caused it; or
b. Loss of use of tangible property that is not
physically injured. All such loss of use shall be
deemed to occur at the time of the occurrence
that caused it.

8. "Suit" means a civil proceeding in which damages
because of "injury" to which this insurance applies
are alleged. "Suit" includes:
a. An arbitration proceeding in which such
damages are claimed and to which the insured
must submit or does submit with our consent;
or
b. Any other alternative dispute resolution
proceeding in which such damages are
claimed and to which the insured submits with
our consent.

9. "Temporary worker" means a person who is
furnished to you to subs titute for a permanent
"employee" on leave or to meet seasonal or short-
term workload conditions.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

10. "Your product":
a. Means:
(1) Any goods or products, other than real
property, manufactured, sold, handled,
distributed or disposed of by:
(a) You;
(b) Others trading under your name; or
(c) A person or organization whose
business or assets you have acquired;
and
(2) Containers (other than vehicles), materials,
parts or equipment furnished in connection
with such goods or products.
b. Includes:
(1) Warranties or representations made at any
time with respect to the fitness, quality,
durability, performance or use of "your
product"; and
(2) The providing of or failure to provide
warnings or instructions.
c. Does not include vending machines or other
property rented to or located for the use of
others but not sold.

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NIAC-E003 GL 08 20 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

MEMBER CRITERIA

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

LIQUOR LIABILITY COVERAGE FORM

BUSINESS AUTO COVERAGE FORM

SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM

IMPROPER SEXUAL CONDUCT AND PHYSICAL ABUSE LIABILITY COVERAGE FORM

A named insured of the Nonprofits Insurance Alliance of California (NIAC) must meet at least the following criteria:

1. is organized chiefly to provide or fund health or human serv ices, but does not include a hospital;

2. is incorporated in California or qualified to do business in California and is an organization described in section 501(c)(3) of the Internal Revenue Code and exempt from tax under section 501(a), or any corresponding sections of any future federal tax code. Any member which receives a final determination that it no longer qualifies as an organization described in section 501(c)(3) of the Internal Revenue Code, or corresponding section of any future tax code, shall immediately notify the corporation of such determination and the effective date of such determination.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC E74 03 14 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

MENTAL ANGUISH ENDORSEMENT

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SECTION V – DEFINITIONS, Paragraph 3 is replaced with the following:

3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death or mental anguish resulting from any of these.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E33 GL 09 19 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

MOLD, FUNGUS OR MICROBIAL

CONTAMINATION EXCLUSION
This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

COMMERCIAL GENERAL LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

EMPLOYEE BENEFITS LIABILITY ENDORSEMENT

IMPROPER SEXUAL CONDUCT AND PHYSICAL ABUSE LIABILITY COVERAGE PART

It is agreed that this policy does not apply to any claim, suit or cause of action for “damages” due to:

1. "Bodily injury," "property damage," or "personal and advertising injury" arising out of or contributed to by mold, fungus or "microbial contamination";

2. Any loss, cost or expense arising out of any:

a. Request, demand or order that any "insured" or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to or assess the effects of mold, fungus or "microbial contamination"; or

b. Claim or suit by or on behalf of a governmental agency or entity for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to or assessing the effects of mold, fungus or "microbial contamination." We shall have no duty or obligation to provide or pay for the investigation or defense of any loss, cost, expense, claim, or suit excluded under any provision set forth above.

Defense and Supplementary Payments shall not apply to any loss, cost, expense, claim or suit excluded under any provisions set forth above.

"Microbial contamination" means any contamination, either airborne or surface, which arises out of or is related to the presence of mold, fungus, or spores, including, without limitation, Penicillium, Aspergillus, or Stachybotrys chartarum.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED –

MORTGAGEE, ASSIGNEE OR RECEIVER
2022-76673
CG 20 18 04 13 Named Insured: Developing Organizing Visions for Eve ryone Any person or organization acting as mortgagee,
assignee, or receiver with respect to locations scheduled on the policy.

Designation Of Premises Name Of Person(s) Or Organization(s)

SCHEDULE

COMMERCIAL GENERAL LIABILITY COVERAGE PART
This endorsement modifies insurance provided under the following:

Section II – Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to their liability as mortgagee,
assignee, or receiver and arising out of the
ownership, maintenance, or use of the premises by
you and shown in the Schedule.

However:

1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and

2. If coverage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.

A.

B.

With respect to the insurance afforded to these
additional insureds, the following is added to
Section III – Limits Of Insurance:

If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.

This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

C.

This insurance does not apply to structural
alterations, new construction and demolition
operations performed by or for that person or
organization.
© Insurance Services Office, Inc., 2012

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-E42 GL 09 19 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

NUCLEAR, CHEMICAL AND BIOLOGICAL HAZARD EXCLUSION
This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

LIQUOR LIABILITY COVERAGE FORM

EMPLOYEE BENEFITS LIABILITY COVERAGE

IMPROPER SEXUAL CONDUCT AND PHYSICAL ABUSE LIABILITY COVERAGE FORM

This insurance does not apply to any liability, loss, cost or expense of whatsoever nature directly or indirectly caused by, contributed to by, resulting from, arising out of or in connection with the use or release, or threat thereof, of any nuclear weapon or device or chemical or biological a gent, regardless of any other cause or event contributing concurrently or in any other sequence to the loss.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-NPO-001 05 20 Page 1 of 8

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

NONPROFITS’ OWN ENHANCEMENT ENDORSEMENT

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

I. SCHEDULE OF ADDITIONAL COVERAGES, BENEFITS AND LIMITS The following is a summary of additional coverages and limits provided by this endorsement. If two or more Additional Coverages identified within this endorsement apply to a claim, loss and/or suit, the Additional Coverage with the greatest limit shall be the sole and only Additional Coverage provided by us applicable to the claim, loss and/or suit.

C o v e r a g e L i m i t P a g e

Abuse of Process Included 2
Cyber Breach Management and Reward Expense $25,000 2 Cyber Extortion $50,000 2
Damage to Property of Others $5,000 Occurrence / 2 $25,000 Aggregate
Electronic Data and Protected Health Information $50,000 2 Executive Recruitment Expense $50,000 3
Identity Theft Expense $30,000 3
Kidnap Expense $50,000 3
Network Security Reimbursement $10,000 3
Newly Formed Entities - until end of policy period N/A 4 Non-owned Watercraft (up to 75 feet) N/A 4
Security Event Costs and Expenses $50,000 4
Subpoena Response Expense $10,000 4
Terrorism Travel Reimbursement $30,000 4
Unsatisfied Contributions $25,000 4
Workplace Violence / Crisis Incident / Outside Aggressor $100,000 5 B e n e f i t L i m i t P a g e
Supplementary Payments – Bail Bonds $5,000 5
Supplementary Payments – Investigation or Defense $1,000 / per day 5

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NIAC-NPO-001 05 20

II. ADDITIONAL COVERAGES

Abuse of Process

Section V – Definitions, Paragraph 14.b. is replaced by the following:

b. Malicious prosecution or abuse of process;
Cyber Breach Management and Reward Expenses
We will reimburse you for all reasonable costs and expenses you incur, with our prior written consent, for "Cyber breach management" due to a "Cyber security event", if that "Cyber security event" takes place during the policy period.

We will reimburse you for all reasonable costs and expenses you incur, with our prior written consent, for payment of a "reward".

Our maximum aggregate limit of liability for all "Cyber breach management" and "reward" costs and expenses covered by this policy shall be $25,000.

Cyber Extortion
We will reimburse you for reasonable costs and expenses you incur, with our prior written consent, because of a threat or threats, during the policy period, that include an actual extortion demand related to your computer system.

Our maximum aggregate limit of liability for all costs and expenses due to extortion covered by this policy shall be $50,000.

Damage to Property of Others

1. We will pay:

a. For damage to property of others when such damage is the result of an act committed by your “client” and the property damaged is owned by someone other than you or any of your “clients”, employees or volunteers; or

b. Those sums for which you are legally obligated to pay for damage to property which is rented or occupied by you, including any costs or expenses incurred by you or any other person, organization or entity for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another’s property, which is not the result of an act committed by your “client”.

2. Our maximum limit for all damage to property of others and/or damage to property which is rented or occupied by you is $5,000 for any one act, error or omission, or a series of related acts, errors or omissions, subject to an annual aggregate limit of $25,000.

3. If two or more coverage parts, forms or policies written by us apply to a property damage claim, the coverage part, form, or policy provided by us with the highest limit applicable to that property damage shall be the sole coverage provided by us applicable to that property damage.

4. If other coverage not written by us applies to a claim for damage to property to which this endorsement applies, you agree:

a. to transfer to the extent of payment made pursuant to the coverage provided by this endorsement, any rights to that other coverage to us;
DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-NPO-001 05 20

b. to do nothing to impair those rights or the transfer of those rights to us; and

c. to cooperate with us in the pursuit and enforcement of those rights.

Any claim for property damage which arises out of an act, error or omission, or a series of related acts, errors or omissions which commences in one policy year and continues and/or results in additional property damage in a subsequent policy year, will be construed as though the property damage was sustained or incurred solely in the policy year in which the damage first commenced.

Electronic Data and Protected Health Information

We will pay those sums that the insured becomes legally obligated to pay as damages because of the loss of “Electronic data” or disclosure of “Protected health information”. The loss of “Electronic data” must be caused by a negligent act, error or omission or a series of causally related negligent acts or errors or omissions which take place during the time that this policy is in effect.

All damages which arise out of an offense which constitutes a disclosure, loss or use of “Protected health information” or a series of continuous or interrelated disclosures, losses or uses of “Protected health information” will be considered as arising out of one disclosure, loss or use of “Protected health information” which shall be deemed to be an offense committed on the date of the first such disclosure, loss or use of “Protected health information” or violation of privacy rights through the disclosure, loss or use of “Protected health information”, which disclosure, loss, use or violation must take place during the time that this policy is in effect.

The most we will pay for the sum of all damages and expenses under this policy because of “Loss of electronic data” and/or the disclosure, loss or use of “Protected health information” shall be an annual aggregate limit of $50,000.

Executive Recruitment Expense

We will reimburse necessary and reasonable extra expense incurred to recruit a person to replace the Chief Executive Officer or Executive Director of the ”Organization” if the Chief Executive Officer or the Executive Director dies by accident during the policy period. Such extra expense includes amounts paid by the “Organization” for advertising, travel reimbursement, legal costs and executive search firm consulting fees. This additional coverage is subject to an annual aggregate of $50,000, which is the most we will pay for the sum of all recruitment expense claims under this policy.

Identity Theft Expense

We will reimburse any natural person who qualifies as a current “Member”, for necessary and reasonable “Identity theft expense” due to an “Identity theft” first discovered by the “Member” during the policy period, reported to us within 60 days after discovery, and if the “Identity theft” occurred while the “Member” was acting within the scope of employment for the “Organization”. This additional coverage is subject to an annual aggregate of $30,000, which is the most we will pay for the sum of all “Identity theft expense” claims under this policy.

Kidnap Expense

We will reimburse necessary and reasonable expenses incurred by the “Organization” resulting directly from the kidnapping of a “Member” or a “Relative” during the policy period. This additional coverage is subject to an annual aggregate of $50,000, which is the most we will pay for the sum of all kidnap expense claims under this policy.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57

NIAC-NPO-001 05 20

Necessary and reasonable kidnap expenses include:

1. Fees and costs of independent negotiators;

2. Travel costs and accommodations incurred by a “Member” or a “Relative”;

3. Salary paid by the “Organization” to a “Member” who is kidnapped, from the date of abduction to the earliest of:

a. Up to 30 days after release if the kidnapped “Member” has not yet returned to work; b. Discovery of the kidnapped “Member’s” death;
c. 120 days after the last credible evidence following abduction that the kidnapped “Member” is still alive; or
d. 60 months after the Member’s” abduction.

4. Interest costs for any loan from a financial institution taken by the “Organization” to pay a ransom demand;

5. Reward money paid by the “Organization” to an informant, other than a “Member” or a “Relative,” that leads to the arrest and conviction of parties responsible for loss under this additional coverage.

Network Security Reimbursement

We will reimburse you up to $10,000 for reasonable costs and expenses you have incurred, with our prior written consent and subject to verification, for payment of an insurance deductible and/or self-insured retention for insurance issued to you as the named insured by an entity other than us, which insurance has been paid to you or on your behalf for a loss sustained during the time that this endorsement is in effect or a claim for damage sustained during the time that this endorsement is in effect, which loss or damage results from the unauthorized access to, disclosure from or interference with your computer system, including the failure by you to prevent such unauthorized access, disclosure or interference.

Newly Formed Entities
Section II – Who is an Insured, Paragraph 3. a. is replaced by the following:
a. Coverage under this provision is afforded until the end of the policy period.

Non-owned Watercraft
COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2.g. Exclusions, Aircraft, Auto, or Watercraft Subparagraph (2) (a) is replaced by the following:
(a) Less than 75 feet long; and
Security Event Costs and Expenses
We will reimburse you for reasonable costs and expenses you incur, with our prior written consent, for notification of a "Security event" to third parties in compliance with governmental or judicial requirements, or for credit protection services furnished to third parties whose private information may have been disclosed.

DocuSign Envelope ID: 9FEE570B-5861-4449-AA0C-7DE5113BFA57