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Certificate of Insurance - Roman Catholic Bishop of San JoseACoR" CERTIFICATE OF LIABILITY INSURANCE 7/D6A/2EQ(IM6M/DDIYYYY) 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 endorsements . PRODUCER CONTACT NAME: Arthur J. Gallagher & Co. PHONEIo Extl 415-546-9300 FAX Insurance Brokers of CA, Inc. LIC #0726293 E-MAIL 1255 Battery Street, Suite 450 San Francisco CA 94111 INSURER(Sl AFFORDING COVERAGE NAIC # INSURED Roman Catholic Bishop of San Jose A Corporation Sole, etal 1150 North First Street, Ste. 100 San Jose CA 95112-4966 INSURER A: National Catholic RRG , Inc 10083 INSURER B: Underwriters at Lloyd's London 15792 INSURER c: Roman Catholic Bishop of San Jose INSURER D:Safety National Casualty Corporatio 15105 INSURER E : LIOyd'S Synd 2987 rr1VGDAGCC r P70TICICATF KitinARCD• F;1235Fi4Rn DPWICI11N NIIMRFD- 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, FXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILT R LTR TYPE OF INSURANCE WVD POLICY NUMBER POLICY EFF M/DDIYYYY POLICY EXP M/DD/YYYY LIMITS A A E X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �X OCCUR Y Y RRG106110 FM1067-10 PK1010816 7/1/2016 7/1/2016 7/1/2016 7/1/2017 7/1/2017 7/1/2017 EACH OCCURRENCE $1,000,000 $50,000 PREMISEST(EaEoccurrence) MED EXP (Any one person) $5,000 X PERSONAL & ADV INJURY $1,000,000 Counselors E&O' GEN'L GENERAL AGGREGATE $2,000,000 AGGREGATE LIMIT APPLIES PER: POLICY PE� LOC X PRODUCTS - COMP/OP AGG $2,000,000 Liquor Liab $1,000,000 OTHER: E A AUTOMOBILE LIABILITY X ANY AUTO Y Y PK1010816 RRG106710 7/1/2016 7/1/2016 7/1/2017 7/1/2017 Ea accident $1,000,000 BODILY INJURY (Per person) $ ALL OWNED SUTOSULED HH AUTOS A NON -OWNED HIRED AUTOS AUTOS j BODILY INJURY (Per accident) $ PERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE. DED RETENTION $ $ C D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE y SICERT#2364 SP4054182 1/1/2016 1/1/2016 11112017 1/1/2017 X PER X OT - STATUTE ER _ $$1,000,000 E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N lA _ $$1,000,000 E.L. DISEASE - EA EMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $$1,000,000 a Property Special w/Theft Y Y B1162PWO065116 7/1/2016 7/1/2017 $500 Parish Ded $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 'Errors & Omission Coverage is Claims Made. Workers Compensation coverage include $500,000 Self -Insurance. Re: Catholic Charities of Santa Clara County, 2625 Zanker Road San Jose, CA 95134-2130. As respects agreement between City of Morgan Hill and Catholic Charities of Santa Clara County to provide a Day Break Respite and Caregiver Suport Services program and for the operation of the Long Term Care Ombudsmen program. City of Campbell and their Officers, Agents and Employees included as Additional Insureds per policy language. CERTIFICATE HOLDER CANCELLATION City of Campbell and Campbell Redevelopment Agency 70 N. 1 st Street Campbell CA 95008 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ENDORSEMENT attaching to and forming part of Policy No. ' PK1010816 NAMED ASSURED: Roman Catholic Bishop of San Jose Effective date of this endorsement: July, 1 2016 Endorsement No. 11 CERTIFICATES OF INSURANCE It is hereby understood and agreed that holders of Certificates of Insurance issued against this Policy that are shown as Additional ASSUREDS are added to this Policy pursuant to the terms of this Policy as described in GENERAL POLICY DEFINITION 1. Where Certificates of Insurance are requested for Additional ASSUREDS who do not fall within GENERAL POLICY DEFINITION 1, prior agreement of Underwriters and subsequent endorsement of this Policy is required. GENERAL POLICY DEFINITION 1, ASSURED is stated as follows - ASSURED means not only the NAMED ASSURED as stated on the Declaration Page, but also includes any past, present or future: agencies, subsidiaries, affiliates, institutions and societies owned by or operated by the NAMED ASSURED, officials, members of boards or commissions, trustees, directors, officers, partners, volunteers, student teachers, or employees of the NAMED ASSURED while acting within the scope of their duties as such, and any person, organization, trustee or estate to whom the NAMED ASSURED is obligated by virtue of a written contract or agreement to provide insurance such as is offered by this policy, but only in respect of operations by or on behalf of the NAMED ASSURED. Except as amended in this Endorsement, this insurance is subject to all coverage terms, clauses and conditions in the policy to which this Endorsement is attached. Arthur J. Gallagher & Co. Insurance Brokers of CA., Inc. 1255 Battery Street #450 San Francisco, CA 94111 4334 1 MB 0.416 CITY OF CAMPBELL AND CAMPBELL REDEVELOPMENT N CY 70 N 1ST ST UPPR CAMPBELL, CA 95008-1459 DATE (MM/DD/YYYY) AC "R" CERTIFICATE OF LIABILITY INSURANCE 7/7/2016 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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). PRODUCER Arthur J. Gallagher & Co. Insurance Brokers of CA, Inc. LIC #0726293 1255 Battery Street, Suite 450 San Francisco CA 94111 INSURED Roman Catholic Bishop of San Jose A Corporation Sole, etal 1150 North First Street, Ste. 100 San Jose CA 95112-4966 415-546-9300 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:National Catholic RRG , Inc 10083 INSURER a: Underwriters at Lloyd's London 15792 INSURER C: Safety National Casualty Corporatio 15105 INSURER o -Llovd's Svnd 2987 I I INSURER F: I I Crl1/FDAr:FC rPDTIFIr'ATF NI IMRFD• 2125980287 D1:\/ICIr1N NI IMRFD- 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. INSR ADULISUBRTYPE OF INSURANCE I POLICY EFF POLICY EXP LIMITS LTR IN D WVD POLICY NUMBER M/DD/YY MMIDD/YYYY A A D X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X� OCCUR Y Y RRG106710 FM1067-10 PK1010816 7/1/2016 7/1/2017 7/1/2016 7/1/2017 7/1/2016 7/1/2017 EACH OCCURRENCE $1,000,000 E50,000 PREMISES Ea occurrence MED EXP (Any one person) $5,000 X Counselors E&O' PERSONAL & ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 52,000,000 X POLICY PEO- LOC $2,000,000 PRODUCTS - COMP/OP AGG Liquor Liab E1,000,000 OTHER: D A AUTOMOBILE LIABILITY X ANY AUTO Y Y pK1010816 RRG106710 7/1/2016 7/1/2016 7/1/2017 7/1/2017 Ea accident S 1,000,000 BODILY INJURY (Per person) $ ALL OS NED SCHEDULED UTS BODILY INJURY (Per accident) S NON -OWNED HIRED AUTOS AUTOS $ - Per accident f UMBRELLALIAB EACH OCCURRENCE $ HOCCUR AGGREGATE EXCESS LIAR CLAIMS -MADE $ DED RETENTIONS $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y f N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F (Mandatory in NH) N / A Y SP4054182 1/1/2016 1/1/2017 X1 PER STATUTE ERH _ S1,000,000 --- $1,000,000 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE If yes, describe under DESCRIPTION OF OPERATIONS below 1 $1,000,000 E.L. DISEASE - POLICY LIMIT B Property Special w/Theft Y Y B1262PW0065216 7/1/2016 7/1/2017 $500 Parish Ded $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) "Errors & Omission Coverage is Claims Made. Re: Catholic Charities of Santa Clara County, 2625 Zanker Road San Jose, CA 95134-2130. As respects agreement between City of Morgan Hill and Catholic Charities of Santa Clara County to provide a Day Break Respite and Caregiver Support Services program and for the operation of the Long Term Care Ombudsmen program. City of Campbell and their Officers, Agents and Employees included as Additional Insureds per policy language. CERTIFICATE HOLDER CANCELLATION City of Campbell and Campbell Redevelopment Agency 70 N. 1 st Street Campbell CA 95008 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ENDORSEMENT attaching to and forming part of Policy No. ' PK1010816 NAMED ASSURED: Roman Catholic Bishop of San Jose Effective date of this endorsement: July, 1 2016 Endorsement No, 11 CERTIFICATES OF INSURANCE It is hereby understood and agreed that holders of Certificates of Insurance issued against this Policy that are shown as Additional ASSUREDS are added to this Policy pursuant to the terms of this Policy as described in GENERAL POLICY DEFINITION 1. Where Certificates of Insurance are requested for Additional ASSUREDS who do not fall within GENERAL POLICY DEFINITION 1, prior agreement of Underwriters and subsequent endorsement of this Policy is required. GENERAL POLICY DEFINITION 1. ASSURED is stated as follows - ASSURED means not only the NAMED ASSURED as stated on the Declaration Page, but also includes any past, present or future: agencies, subsidiaries, affiliates, institutions and societies owned by or operated by the NAMED ASSURED, officials, members of boards or commissions, trustees, directors, officers, partners, volunteers, student teachers, or employees of the NAMED ASSURED while acting within the scope of their duties as such, and any person, organization, trustee or estate to whom the NAMED ASSURED is obligated by virtue of a written contract or agreement to provide insurance such as is offered by this policy, but only in respect of operations by or on behalf of the NAMED ASSURED. Except as amended in this Endorsement, this insurance is subject to all coverage terms, clauses and conditions in the policy to which this Endorsement is attached. TE ,a o CERTIFICATE OF LIABILITY INSURANCE 7/1/20�5/DD/YYYY) 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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). PRODUCER CONTA CT NAME: 4rthur J. Gallagher & Co. PHONE X� (FAR- NO nsurance Brokers of CA, Inc. LIC #0726293 E-MAIL 1255 Battery Street, Suite 450 ADDRESS: San Francisco CA 94111 INSURERS AFFORDING COVERAGE NAIC0 INSURERA:Natinnal rathnlir RRG - Inr 00A3 INSURED Roman Catholic Bishop of San Jose A Corporation Sole, etal 1150 North First Street, Ste. 100 San Jose CA 95112-4966 INSURER D : INSURER E : COVERAGES CERTIFICATE NUMBER: ;tA.g9&777r, REVISION NUMBER: 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. INSR TR TYPE OF INSURANCE R POLICY NUMBER POLICY EFF POLICY EXP LIMITS A C B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY Y RRG106709 R2A3FF000004509 PK1010815 /1/2015 /1/2015 /1/2015 11/2016 /112016 /1/2016 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED— PREMISES Ea occurrence $50,000 MED EXP (An one person) $5,000 CLAIMS -MADE � OCCUR PERSONAL & ADV INJURY $1,000,000 X Counselors E&O' GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 Liquor Liab $1,000,000 X POLICY PRO-JECT LOC B A AUTOMOBILE LIABILITY ANY AUTO PK1010815 RRG106709 7/1/2015 7/1/2015 /1/2016 /1/2016 0 'INED SINGLE LIMIT Ea accident $1,000,000 X BODILY INJURY (Per person) f ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) f PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS F I E I UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE f EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ D WORKERS COMPENSATION 71725924 1/1/2015 /1/2016 X WCSTATU• ILIMITS ER AND EMPLOYERS' LIABILITY y / N ANY PROPRIETOR/PARTNER/EXECUTIVE FN-1 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE f1,000,000 If Yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 B Property Special w/Theft B1262PWO065215 7/1/2015 /1/2016 $500 Parish Ded 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 'Errors & Omission Coverage is Claims Made. Re: Catholic Charities of Santa Clara County, 2625 Zanker Road San Jose, CA 95134-2130, As respects agreement between City of Morgan Hill and Catholic Charities of Santa Clara County to provide a Day Break Respite and Caregiver Support Services program and for the operation of the Long Term Care Ombudsmen program. City of Campbell and their Officers, Agents and Employees included as Additional Insureds per policy language. CERTIFICATE HOLDER CANCELLATION City of Campbell and Campbell Redevelopment Agency 70 N. 1 st Street Campbell CA 95008 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2010 ACORD CORPORATION. All rights reservec ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD ENDORSEMENT attaching to and forming part of Policy No. PK1010815 NAMED ASSURED: Roman Catholic Bishop of San Jose Effective date of this endorsement: July 1, 2015 Endorsement No. 1 NAMED ASSURED ENDORSMENT It is here by noted and agreed that the NAMED ASSURED is The Roman Catholic Bishop of San Jose, a Corporation Sole; and Most Reverend Patrick J McGrath, DID, JDD, Incumbent, The Roman Catholic Welfare Corporation of San Jose, The Roman Catholic Seminary Corporation of San Jose, The Roman Catholic Seminary Housing Corporation of San Jose, Society for the Propagation of the Faith, Roman Catholic Communication Corporation of The Bay Area, The Center For Human Concerns of Santa Clara County, Inc., San Jose Cathedral Foundation a Corporation, DSJ Investments A DBA, Catholic Youth Organization of San Jose, Catholic Charities of San Jose a Corporation, Catholic Charities of Santa Clara County, Giovanni Center, a Non -Profit Public Benefit Corporation, Jeanne D'Arc Manor, a Non -Profit Public Benefit Corporation, South County Catholic High School and all other Corporations, Companies, Organizations and/or Entities under the Direct Control and Jurisdiction of the Roman Catholic Bishop of San Jose, a Corporation Sole, and all Jointly and/or Severally and all as was, is now, or may hereafter be constituted. It is further agreed the above NAMED ASSURED is amended to include , as an additional ASSURED any owned, controlled subsidiary, and/or affiliated company as their interests may appear, and all corporations, partnerships, joint ventures, limited liability corporations, organizations, and other entities, as have existed or as now or may hereafter exist, be acquired, merged, or constituted, and in which the specifically NAMED ASSURED did or does have 50% or more ownership interest, or has effective or managerial control, or for which it is required to or has agreed prior to loss, to maintain insurance, including any affiliated, associated, allied and subsidiary entities. Except as amended in this Endorsement, this insurance is subject to all coverage terms, clauses and conditions in the policy to which this Endorsement is attached.